NMIH304

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  • Early Intervention in Mental Health
  • •Introduction There was strong advocacy for a great emphasis on prevention, promotion of positive mental health, early intervention and for more sustained and comprehensive service delivered in the community. According to Victorian Mental Health Reform Strategy 2009-2019, there are four core elements to be reminded for health care professionals. 1) Prevention - RECOGNISING THE POTENTIAL 2) Early Intervention - RESPONDING EARLY IN LIFE 3) Recovery - PROMOTING ACCESS & ONGOING SUPPORT 4) Social Inclusion - DESTIGMATISING •Situation/Context State-funded clinical mental health services deliver assessment, treatment and clinical case management in acute inpatient settings and in a range of services in the community. They include child and adolescent mental health services, adult mental health services and mental health services for older people (NSW Community Mental Health Strategy 2007–2012, pp. 5-6).
  • Procedure that guides or directs mental health care related to psychosis
  • P: People with first onset psychosis I: Early intervention treatment in the community reduces inpatient hospitalisation C: Receiving no early intervention treatment in the community O: Nil or few inpatient admissions/hospitalisations
  • "Is early intervention in the community designed to keep people with first onset psychosis out of hospital and supported in the community?"
  • ST. LUKE'S MENTAL HEALTH HOSPITAL
  • Jimmy Cater 23(M) 10/05/1992 DOA 1/4/2016 Aggressive behaviour
  • "I don't know why I'm here. They don't understand what's going on."
  • 'He's not getting any better...'
  • "They're lying, Jimmy..."
  • EMERGENCY BUTTON
  • "Dr.Kim, Let's refer him to the community health nurses."
  • Evidence shows that preventing and intervening through early community mental health service for young people who are developing psychosis can improve outcomes. Early intervention can lessen disability and disruption to school or work for the young person, lower the risk of relapse, and reduce family disruption and distress (Victoria's 10-Year Mental Health Plan 2015, p. 19).
  • HOSPITAL MULTIDISCIPLINARY TEAM
  • Tertiary, acute, hospital care potentially creates trauma and disability in young people with psychosis. Jimmy(23/M) has no history of mental health issues in the past. He was currently stressed out from university work.
  • The trial has some possible limitations regarding sample size and the duration of case management. Previous studies of early intervention service for patients with first episode have suggested that although EIS improved patient social functions and readmission rates, these effects did not persist. However, these results also depend on the treatment provided to the control group, and community mental health services are widely available.
  • COMMUNITY NURSING (HOME VISIT CARE)
  • HOME VISIT DAYS
  • I feel so much better and I appreciate my nurse taking care of me by visiting regularly
  • Jimmy has admitted to the mental health ward on 31/03/2016. On arrival, he was wearing beach shorts and blue shirts. He was shouting and yelling at his neighboUr. The neighboUr said, "He often acts weird but he hardly gets out of his house."
  • Comprehensive early intervention for patients with first-episode psychosis
  • "Early psychosis intervention programs have been shown to decrease duration of untreated psychosis, decrease hospitalization, decrease police involvement in admissions, lower medication use, improve functional outcome, lower relapse rates, improve treatment adherence and lead to greater patient satisfaction." (Koike et al. 2011, p.156)
  • NSW Mental Health Policy sounds reliable since it has updated with EBP researches
  • Early intervention treatment in the community is designed to keep people with first onset psychosis out of hospital and supported in the community. 80% of patients affected by a psychotic disorder experience their first episode between the ages of 16-30.
  • Jimmy needs rather on-going community care interventions as essential adjuncts to medication.
  • Patients with a first episode are best treated by specialist multidisciplinary early intervention teams that deliver psychosocial interventions (Byrne, P. 2007, Managing the acute psychotic episode, British Medical Journal, vol. 334, no. 7595, PP. 686–692). However, any residual advantages after early intervention has ended, it is necessary to consider whether Jimmy's quality of life can remain optimal once the assertive intervention has ended.
  • The core components of the early psychosis prevention and intervention centre model for Australian communities are; 1: community education and awareness. 2: easy access to service. 3: home-based assessment and care. 4: access to streamed youth-friendly inpatient care. 5: psychological interventions. 6: family programmes and family peer support based on partnership.
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