CURRENT ISSUES AND TRENDS IN MHC

CURRENT ISSUES AND TRENDS IN MENTAL HEALTH CARE

UPDATED 2024

A
Psychiatric nurse faces various challenges because of changes in the inpatient
care approach. Some of these changes that affect her role are as follows:

Trends in Health Care

• Increased mental health problems
• Provision for quality and
  comprehensive services
• Multidisciplinary team approach
• Providing continuity of care
• Care provided in alternative settings

Economic
Issues

• Industrialization
• Urbanization
• Raised standard of living

Changes in Illness Orientation

• Shift from illness to prevention
  (modification of style), specific to holistic, quantity of care to quality of
  care

Changes in Care Delivery

• Care delivery is shifted from
  institutional services to community services, genetic services to counseling
  services, nurse patient relationship to nurse-patient partnership.

Information Technology

• Telenursing
• Telemedicine
• Mass media
• Electronic systems
• Nursing informatics

Consumer Empowerment

• Increased consumer awareness
• Awareness of the community in early detection
  and treatment of mental illness as well as proper utilization of available
  psychiatric hospitals
• Patients are health care consumers
  demanding quality health care services at affordable cost with less restrictive
  and more humane rates.

Deinstitutionalization

• Bringing mental health patients out
  of the hospital and shifting care to community.

Physician Shortage and Gaps in Service

• Physician shortage can provide the
  opportunity for new roles, for example, nurse practitioner. In respect to gaps
  in services, nurses always meet the needs of people for whom services are not
  available, for example, home visiting nurse.

Demographic Changes

• Increasing number of the elderly
  group
• Type of family (Increased number of
  nuclear families).

Change in Patient Needs

• Wanting a more holistic orientation
  in health care.

Challenges in Psychiatric Nursing

• Knowledge development, dissemination
  and application
• Overcoming stigma
• Health care delivery system issues
• Impact of technology

Educational Programs for the Psychiatric Nurse

• Diploma in Psychiatric Nursing (The
  first program was offered in 1956 at NIMHANS, Bengaluru)
• MSc in Psychiatric Nursing (The first
  program was offered in 1976 at Rajkumari Amrit Kaur College of Nursing, New
  Delhi)
• Mphil in Psychiatric Nursing (1990,
  MG University, Kottayam)
• Doctorate in Psychiatric Nursing
  (offered at MAHE, Manipal; RAK College of Nursing, Delhi; NIMHANS, Bengaluru,
  National Consortium for PhD in Nursing under RGUHS, Karnataka, etc)
• Short term training programs for both
  the degree and diploma holders in nursing

Standards of Mental Health Nursing

The
development of standards for nursing practice is a beginning step towards the
attainment of quality nursing care. The adoption of standards helps to clarify
nurses areas of accountability, since the standards provide the nurse, the
health agency, other professionals, patients, and the public, with a basis for
evaluating practice. Standards also define the nursing profession’s
accountability to the public. These standards are therefore a means for
improving the quality of care for mentally ill people.

Development of Code of Ethics

This is very
important for a psychiatric nurse as she takes up independent roles in
Psychotherapy, behavior therapy, cognitive therapy, individual therapy, group therapy,
maintains patient’s confidentiality, protects his rights and acts as patient’s
advocate.

Legal Aspects in Psychiatric Nursing

Knowledge of
the legal boundaries governing psychiatric nursing practice is necessary to
protect the public, the patient, and the nurse. The practice of psychiatric
nursing is influenced by law, particularly in its concern for the rights of
patients and the quality of care they receive.

The
patient’s right to refuse a particular treatment, protection from confinement,
intentional torts, informed consent, confidentiality, and record keeping are a
few legal issues in which the nurse has to participate and gain quality
knowledge.

Promotion of Research in Mental Health Nursing

The nurse
contributes to nursing and the mental health field through innovations in
theory and practice and participation in research.

Cost-effective Nursing Care

Studies need
to be conducted to find out the viability in terms of cost involved in training
a nurse and the quality of output in terms of nursing care rendered by her.

Focus of Care

A psychiatric nurse has to focus care on certain target groups like the elderly, children, women, youth, mentally retarded and chronic mentally ill.

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