The Role of Nurses in Integrated Mental Health Care in the UK - Essay Example

?The Role of Nurses in Integrated Mental Health Care in the UK Introduction Integrated healthcare is an emerging issue in mental health clinical practice in the UK. Essentially, integrated care makes access easy in a way that underserved primary care patients can obtain treatment (Blount 2003). Contemporary approaches towards integrated care are explained, and methods for the involvement of nurses within primary care situations are examined. Dependence upon primary care physicians (PCPs) for mental health problems persists in spite of increasing empirical evidence indicating that those who obtain mental health services encounter mental health and physical gains. For instance, children who obtained psychological treatments for psychosomatic and behavioural problems experienced hardly any primary care visits and received less healthcare services after treatment (Finney, Riley, & Cataldo 1991). There are also indications that group counselling enhances the functioning of the immune system, pregnancy rates, and the quality of life of cancer patients. This fact is known to a large number of mental health nurses (Aldridge 2004). Even though the significance of the emotional health of patients and its connection to physical well being has been supported for several years, practitioners have been disappointed in determining how to enhance access to mental health (Hemmings 2000). Mental health equality, which needs insurance companies to offer reasonable coverage for mental health and physical care, has currently been the major goal for enhancing such success. Integrated Care in Mental Health Contexts Inopportunely, mental health equality may not be a universal remedy, as several professionals think. Insurance companies, for example, if obliged by government policy to give equitable coverage, will transfer the extra costs to the public through co-payments and higher premiums, which will also restrict mental healthcare access, although indirectly (Kent & Hersen 2000). Per se, the main objective of this essay is to draw the attention of mental health nurses to a materialising development, integrated care, and recommend techniques for taking part in an integrated care process. Integrated care, a new development, gives much assurance to patients and all healthcare employees. Integrated care is the enhanced cooperation of mental health practitioners within primary care contexts (Lesser 2000). More particularly, integrated care is quite successful when services are given through co-location, specifically, when mental health nurses work collaboratively with primary care physicians in the same office (McCulloch, Friedli & Parker 2002). In this form of integrated set up, mental health nurses and PCPs discuss frequently the needs and demands of patients, in several cases, visit a patient together to identify the most suitable treatment process (Keady, Clarke & Page 2007). Research on integrated care has shown major positive outcomes, such as: reduced despair and improved quality of life of adults in relation to a ‘treated’ control group, and anxiety-free periods for individuals with panic disorder, reduced in-patient admissions, and reduced patient depression levels (Knapp, McDaid, Mossialos & Thornicroft 2007). Furthermore, evidence indicates that patients choose to receive mental health care within their primary care environment, reveal fewer stigmas about obtaining psychiatric help, and feel comforted by the thought that their nurses are involved in therapy (Knapp et al. 2007). Ultimately, in a current analysis of more than 60 integrated care investigations, Blount (2003) discovered that, generally, integrated care generated enhanced medical outcomes, enhanced provider and patient satisfaction, and enhanced cost effectiveness. Grounds for the effective outcomes involve the ease of mental healthcare access within a common context, but also involve the involvement of nurses in the mental healthcare needs of patients as well as the reprieve of nurses by the thought that they have in-house assistance to address their patients’ psychiatric requirement (Blount 2003). These findings are significant in view of the stress being placed upon improving psychiatric access while at the same time trying to regulate costs of health care. Recommendations Concerning integrated care, the kinds of activities carried out will differ relying upon the ideology of the agency, the personnel and their requirements, the kind of agency, and the qualifications and competencies of the mental health practitioner (Rose & Black 1985). For instance, a mental health nurse employed in a self-determining family tradition could be accountable for more ‘case management type activities’ (ibid, p. 113) than a nurse employed in a subsidised programme intended to help patients and families deal with illness and its treatment. Nevertheless, these implications appear quite reliable when employed in an integrated care context. (1) Mental health nurses who want to take part in integrated care contexts should discover means to associate with physicians. Approaches involve leasing office spaces in or next to a clinical practice compound and seeing local psychiatric physicians to provide discussion on a ‘fee-for-service bases’ (Seaburn, Lorenz, Gunn, Gawinski & Mauksch 1996). It has been discovered that numerous collaborative set ups are produced when mental health practitioners instigate or recommend integrated care to their private doctors or doctor friends (Seaburn et al. 1996). Moreover, several metropolises have health education offices committed to provide regular training for healthcare practitioners (Kates, Crustolo, Farrar & Nikolau 2001). Getting in touch with these offices can help psychiatric nurses locate like-minded practitioners concerned in realising integrated care. (2) To be appealing to PCPs, it is vital for mental health nurses to acquire licensure and get hold of a position in insurance panels (Brooker & Repper 1998). Psychiatric nurses who can obtain ‘third party insurance reimbursement’ (ibid, p. 59) will have a greater opportunity to be hired by PCPs due to the capability of generating revenue. Psychiatric nurses also require a representative to policymakers to make certified psychiatric nurses in private practice entitled to obtain Medicaid and Medicare settlement (Hafen, Karren, Frandsen & Smith 1996). Presently, aside from physicians, only certified psychologists and social workers are entitled under these schemes. Hence, it is vital for mental health nurses to keep updated of public regulations and to contact their advocates in Congress suggesting assistance for major nurse-friendly policy. (3) Mental health nurses can receive subsidies to begin admission into integrated care. Subsidies can furnish the resources needed to compensate psychiatric nurses until insurance repayments are verified (Kemp 1993). In order to develop capabilities in writing grant letters and gain more knowledge of grant opportunities, psychiatric nurses are persuaded to get in touch with their local university or colleges to ask about books, classes, and intensive courses (Burns, Wagner, Gaynes, Wells & Schulberg 2000). (4) Integrated care processes are frequently fast paced settings where therapies are commonly short (Seaburn et al. 1996). Hence, it is vital for mental health nurses to be knowledgeable in assessment to make sure that patients are properly diagnosed and the needed treatment is given. Employing concise standardised screening procedures and performing structured interviews is vital in these contexts (Seaburn et al. 1996). Special attention should be given to illnesses which are usually screened in primary care contexts, such as anxiety disorders, depression, and substance abuse (Brody, Khalig & Thompson 1997). Frequently, PCPs are lacking training or time to carry out careful diagnosis of emotional and mental disorders; hence, capabilities in this area can be especially useful to physicians, as well as to patients (Brody et al. 1997). After screening, psychiatric nurses should be trained and skilled leading structured groups, performing relaxation exercise, offering psycho-training, and providing brief treatment on a group and individual basis as required (Arean & Miranda 1996). (5) Psychiatric nurses in a primary care setting should also be eager to work with a general, inclusive population throughout various illnesses. As stated by Kates and colleagues (2001), nurses will see patients across a wide-ranging scope of ethnicity, age, and manifesting problems. Capable mental health nurses will be capable of diagnosing and identifying various mental health problems, and will be capable of relating with children and older adults from diverse cultural backgrounds. (6) A strong professional relationship among the psychiatric nurse, physician, and other practitioners is a vital part of effective integrated care. Psychiatric nurses should be resilient and eager to cooperate with individuals from different disciplines while sustaining an outlook of understanding and openness. When operating in a fast paced setting, psychiatric nurses should be capable of clearly and briefly expressing their opinion and listening to the perspectives of other professionals as well. Mental health nurses should also understand that the shift to integrated care requires significant time. Numerous healthcare practitioners are not knowledgeable of integrated care (Aldridge 2004), per se; it may require a significant time for mental health nurses to become recognised by other healthcare employees. (7) Psychiatric nurses should also be at ease operating within a bio-psycho-social framework of care, which involves treatments (Brooker & Repper 1998). They should be updated with developments in pharmacological treatments for various illnesses and be capable of identifying side-effects of these various treatments (Kates et al. 2001). Working with PCPs in diagnosing problems with treatments, such as side-effects, narrow-mindedness, and non-compliance, can be especially useful for patients and employees. (8) Psychiatric nurses may also be responsible for carrying out studies of the success of integrated care. Relevant factors to observe include: long-term recommendations, frequency of office visits, particularly spur-of-the-moment office visits (Aldridge 2004). Due to the fact that hospital admissions, emergency room visits, and long-term care are very expensive, observing these occurrences can give helpful information into integrated care’s cost effectiveness. Appointment compliance and satisfaction of nurses, physicians, and patients are other reasonable areas for research into the success of integrated care. Conclusions Due to enhance medical outcomes, cost savings, and high satisfaction evaluations of patients and healthcare practitioners in the UK may perhaps be the means to the future. The process of integrated care in the UK generates a synergy that gives advantages to all concerned: Physicians obtain the assistance they require to deal with the growing population of primary care patients having mental health problems, psychiatric nurses are provided the chance to work in distinct environments that reach numerous individuals who ordinarily would remain untreated and, essentially, patients obtain integrated care which may considerably improve the quality of their lives. In spite the numerous advantages of integrated care, a number of problems are present. Ethical concerns, for instance, may surface within the context of integrated care. Every so often, physicians and nurses may have opposing judgments about what is appropriate for and needed by patients. Per se, it is vital for physicians and psychiatric nurses to talk about their ethical norms so as to identify where problem exists and identify reasonable methods for resolving conflicts while sustaining ethical honesty. Normally, these discussions have to take place early in the joint set up to guarantee harmony between mental health nurses and physicians. Furthermore, mental health nurses may sense isolation working within a practice of integrated care because numerous processes hire only one psychiatric specialist. It is vital for mental health nurses to be capable of discussing issues and appropriate medication methods with other mental health practitioners. Hence, mental health nurses should look for external assistance, particularly peer assistance with other nurses operating within other practices of integrated care. 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