RESUMO
Individuals with serious mental illnesses (SMI) who are incarcerated pose major treatment challenges for both correctional personnel and healthcare providers, yet deserve the same high standards of care as those in traditional mental health facilities. The literature references these challenges as types of mental health treatment disparities, and calls for improvement measures from clinicians, researchers, policy-makers, and advocates. From the standpoint of psychiatric-mental health (PMH) nursing, this paper explores, examines, and offers some contemporary clinical and practice perspectives for providing best-practice psychiatric care for SMI individuals who are in jails. The diverse roles of PMH nursing can contribute meaningfully to tackling quality improvement initiatives on mental health treatment agendas for SMI inmates.
Assuntos
Transtornos Mentais/psicologia , Pessoas Mentalmente Doentes/psicologia , Prisões , Enfermagem Psiquiátrica/normas , Acessibilidade aos Serviços de Saúde , Humanos , Serviços de Saúde Mental , Prisioneiros/psicologia , Qualidade da Assistência à SaúdeRESUMO
There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in the development of innovative, revolutionary, and transformative paradigmatic models aimed at eradicating treatment barriers, promoting well-being, and reducing preventable mortalities and morbidities among SMI persons.
Assuntos
Prestação Integrada de Cuidados de Saúde/métodos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Enfermagem Psiquiátrica/métodos , Comportamento Cooperativo , Enfermagem Baseada em Evidências , Acessibilidade aos Serviços de Saúde , Humanos , Transtornos Mentais/psicologia , Índice de Gravidade de DoençaRESUMO
The literature consistently shows that medical-surgical nurses frequently lack the knowledge, skills, and attitudes necessary to render holistic nursing care to patients with severe mental illness (SMI). The negative perceptions often portrayed by medical-surgical nurses towards SMI patients with comorbid medical-surgical disorders must be addressed in order to ameliorate treatment gaps. Current concepts, issues, and challenges associated with the perceptions of nurses who care for patients with (SMI) in medical-surgical settings can prove overwhelming to both nurses and patients, and can result in concerning practice gaps. In accordance with a contemporary model of patient-centered care, it is imperative that medical-surgical nurses acquire the knowledge, skills, and attitudes necessary to work with this high-risk population. Cultivating an environment that promotes apposite attitudes along with effective training programs for medical-surgical nurses, may shift negative perceptions and ultimately meet best practice standards and improve outcomes for patients with SMI.
Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Enfermagem Médico-Cirúrgica , Transtornos Mentais/enfermagem , Recursos Humanos de Enfermagem Hospitalar/psicologia , Humanos , Índice de Gravidade de Doença , Estigma SocialRESUMO
In order to provide culturally authentic healthcare, psychiatric-mental health nurses and other professionals must familiarize themselves with the culture-specific syndromes, idioms of distress, beliefs and practices that may present among the diverse patient groups with whom they work. Psychiatric conditions relating to the Jamaican belief in "Obeah" are specific, culturally-interpreted phenomena that psychiatric nurses may encounter among Jamaican patients. This paper describes the phenomenon of Obeah and its influences on the worldview of life, health, illness; psychiatric conditions in the form of culture-bound syndromes; and help-seeking behaviors throughout Jamaican cultural communities. Inability to understand the obeah-illness concept from a culturally-interpreted perspective may be constrictive and result in less-than-optimal care. Armed with the knowledge of the concept of Obeah from a core belief perspective, how it influences psychiatric presentations, and embracing its significance to the Jamaican health belief model will assist in building a workable, caring, best-practice framework aimed toward a clinical and practice paradigm for this unique folk-health belief system.
Assuntos
Emigrantes e Imigrantes/psicologia , Magia , Medicina Tradicional , Religião e Psicologia , Xamanismo , Assistência à Saúde Culturalmente Competente , Humanos , Jamaica/etnologia , Estados UnidosRESUMO
In communities across the United States and internationally, police officers frequently come into contact with individuals experiencing mental health crisis despite not having the skills to safely intervene. This often results in officers resorting to excessive or even deadly force. The Crisis Intervention Team (CIT) is heralded as a revolutionary and transformative intervention to correct this gap in practice. Several previous interdisciplinary national and international studies, including criminology and sociology, have examined these concepts using quantitative and qualitative methodological designs, however, no prior nursing studies have been done on this topic. The purpose of this study was to determine the effect of CIT training on police officers' knowledge, perception, and attitude toward persons with mental illness. Twenty five police officers participated. An explorative, quasi experimental, descriptive design was used to collect the data on the three major concepts. Results on knowledge about mental illness improved at p<.0125 (p<.05 after Bonferroni correction). Perception scores improved at p<.0125 (p<.05 after Bonferroni correction), and attitudes were more favorable at p<.0125 (p<.05 after Bonferroni correction). The results of this study validated the CIT program as an innovative community health program that benefits law enforcement, consumers, mental health professionals, and stakeholders.
Assuntos
Intervenção em Crise/educação , Capacitação em Serviço , Polícia/educação , Enfermagem Psiquiátrica/educação , Adulto , Atitude do Pessoal de Saúde , Comportamento Cooperativo , Currículo , Feminino , Florida , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Comunicação Interdisciplinar , Masculino , Pessoas Mentalmente Doentes/psicologia , Avaliação de Programas e Projetos de Saúde , Apoio Social , Inquéritos e QuestionáriosRESUMO
Cultural characteristics play an important role in the lives of many older Afro-Caribbean as they continue to migrate, acculturate, and assimilate in the United States. Many among this unique cultural subgroup will develop mental illness; however, despite the availability of effective treatment, seeking appropriate care within the formal mental health system continues to be a challenge for this group as a consequence of their cultural heritage. This review describes how these cultural determinants often lead to mental health disparities among older Afro-Caribbean living in the United States. Suggestions are also included for how mental health nurses and other professionals can incorporate research and practice into the caring model of cultural humility as they continue to come in contact with this population in various clinical settings.
Assuntos
População Negra/etnologia , População Negra/psicologia , Características Culturais , Emigrantes e Imigrantes/psicologia , Disparidades em Assistência à Saúde/etnologia , Transtornos Mentais/etnologia , Transtornos Mentais/enfermagem , Serviços de Saúde Mental/provisão & distribuição , Idoso , Etarismo , Região do Caribe/etnologia , Comportamento Cooperativo , Competência Cultural , Humanos , Comunicação Interdisciplinar , Medicina Tradicional , Transtornos Mentais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estigma Social , Valores Sociais , Estados UnidosRESUMO
Effective management of people who are in mental health crisis in the community has gained national concern from the standpoint of law enforcement. This article addresses a revolutionary concept known as the Crisis Intervention Team, which teaches law enforcement personnel how to safely approach and de-escalate people who are experiencing a mental health crisis and get them safely to treatment.