An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness

2017 ◽  
Vol 24 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jeannemarie Baker ◽  
Jasmine L. Travers ◽  
Penelope Buschman ◽  
Jacqueline A. Merrill
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Quality Care ◽  
Coordinated Care ◽  
Community Based ◽  
Provide Quality Care

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.

Nurse Practitioner Led Emergency Clinic for Nosocomial Tuberculosis Exposure in a Level 3 NICU

2020 ◽  
Vol 39 (4) ◽  
pp. 222-226
Author(s):  
Vidya Catherine Persad
Keyword(s):  
At Risk ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Quality Care ◽  
Relationship Building ◽  
Therapeutic Management ◽  
Initial Assessment ◽  
Outbreak Management ◽  
Level 3 ◽  
Set Up

This article describes the nurse practitioner (NP) led management of a possible nosocomial exposure of tuberculosis (TB) in a level 3 NICU in Toronto, Canada. 26 babies, premature and term, were identified as being at risk and multiple emergency clinics were set up to diagnose possible infection, prescribe window prophylaxis, and monitor for adverse effects to the medication. The NICU NPs were chosen to organize, co-ordinate, and manage these emergency clinics because of their skills in leadership, diagnosing, therapeutic management, and client relationship building. The clinic was able to achieve 100 percent follow up with each at risk baby, from initial assessment through to completion of window prophylaxis with negative tuberculin skin test. Some insight in to the decision making surrounding possible TB outbreak management is provided, and special considerations around therapeutic management specific to this population are discussed. This incident demonstrates how nurse practitioners can be utilized to provide high quality care, across multiple clinical situations, to meet the needs of the health care system.

scholarly journals Mental health in Sierra Leone

2019 ◽  
Vol 17 (1) ◽  
pp. 14-16 ◽  
Author(s):  
Dawn Harris ◽  
Tarik Endale ◽  
Unn Hege Lind ◽  
Stephen Sevalie ◽  
Abdulai Jawo Bah ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Sierra Leone ◽  
Quality Care ◽  
Mental Health Policy ◽  
Sub Saharan Africa ◽  
National Budget ◽  
People With Mental Illness ◽  
Provide Quality Care ◽  
Sub Saharan

Sierra Leone is a West African country with a population of just over 7 million. Many Sierra Leoneans lived through the psychologically distressing events of the civil war (1991–2002), the 2014 Ebola outbreak and frequent floods. Traditionally, mental health services have been delivered at the oldest mental health hospital in sub-Saharan Africa, with no services available anywhere else in the country. Mental illness remains highly stigmatised. Recent advances include revision of the Mental Health Policy and Strategic Plan and the strengthening of mental health governance and district services. Many challenges lie ahead, with the crucial next steps including securing a national budget line for mental health, reviewing mental health legislation, systematising training of mental health specialists and prioritising the procurement of psychotropic medications. National and international commitment must be made to reduce the treatment gap and provide quality care for people with mental illness in Sierra Leone.

Homelessness Among Persons With Serious Mental Illness in an Enhanced Community-Based Mental Health System

2000 ◽  
Vol 51 (8) ◽  
pp. 1012-1016 ◽  
Author(s):  
Eri Kuno ◽  
Aileen B. Rothbard ◽  
June Averyt ◽  
Dennis Culhane
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health System ◽  
Serious Mental Illness ◽  
Mental Health System ◽  
Community Based

Utilization of an Innovative Psychoeducational Group for Veterans With Severe Mental Illness: A Program Evaluation of a Quality Improvement Initiative

2020 ◽  
pp. 107839032097063
Author(s):  
Wendi L. Koonce Morse ◽  
Sasha Mankowski ◽  
S. Akeya Harrold
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Quality Improvement ◽  
Health Care Providers ◽  
Serious Mental Illness ◽  
Nurse Practitioner ◽  
Quality Improvement Initiative ◽  
Treatment Team ◽  
Care Providers ◽  
Collaborative Interactions

INTRODUCTION Cognitive impairments—episodes of mania or psychosis, paranoia, and substance use—are common effects of serious mental illness, which can lead to stigmatization, social isolation, and a decrease in interaction with health care providers. These consequences can obstruct a person with serious mental illness ability to comprehend diagnosed mental disorders and to fully participate in treatment. Consistent with the Substance Abuse and Mental Health Services Administration Recovery Model for Disease Management, nurse practitioner residents in a mental health nurse practitioner residency program developed an interactive psychoeducation series to improve veteran health self-efficacy and self-management. OBJECTIVE The overall purpose of this sequential quality improvement initiative was to develop and deliver a psychoeducational series, which is both veteran centric and recovery oriented. METHODS Series I of the project produced psychoeducational sessions based on collaborative interactions among veterans and members of the treatment team, with a focus on neurobiology, pharmacology, and evidence-based treatment recommendations. Through an innovative and interactive framework, Plan–Do–Study–Act cycles were utilized to bring about foundational themes and inherent changes in the psychoeducation delivery. With veterans’ feedback and collaboration, Series II of the project was developed within the continuous improvement evaluations from Series I. RESULTS Treatment collaboration between veterans and providers was fostered as veterans experienced learning, symptom recognition, and empowerment. CONCLUSION This project is unique in that it is the first known review of a quality improvement initiative to incorporate concurrent changes in psychoeducational session delivery, involving veterans and their providers to foster collaboration.

scholarly journals MyCare study: protocol for a controlled trial evaluating the effect of a community-based intervention on psychosocial, clinical outcomes and hospital admission rates for adults with severe mental illness

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040610
Author(s):  
Renée O'Donnell ◽  
Melissa Savaglio ◽  
Debra Fast ◽  
Ash Vincent ◽  
Dave Vicary ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Controlled Trial ◽  
Community Based ◽  
Admission Rates ◽  
Mental Health Support ◽  
Health Support

IntroductionPeople with serious mental illness (SMI) often fail to receive adequate treatment. To provide a higher level of support, mental health systems have been reformed substantially to integrate mental healthcare into the community. MyCare is one such community-based mental health model of care. This paper describes the study protocol of a controlled trial examining the effect of MyCare on psychosocial and clinical outcomes and hospital admission and duration rates for adults with SMI.Methods and analysisThis is a multisite non-randomised controlled trial with a 3, 6 and 12-month follow-up period. The study participants will be adults (18–64 years of age) with SMI recruited from Hobart, Launceston and the North-West of Tasmania. The treatment group will include adults who receive both the MyCare intervention and standard mental health support; the control group will include adults who receive only standard mental health support. The primary outcome includes psychosocial and clinical functioning and the secondary outcome will examine hospital admission rates and duration of stay. Mixed-effects models will be used to examine outcome improvements between intake and follow-up. This trial will generate the evidence needed to evaluate the effect of a community mental health support programme delivered in Tasmania, Australia. If MyCare results in sustained positive outcomes for adults with SMI, it could potentially be scaled up more broadly across Australia, addressing the inequity and lack of comprehensive treatment that many individuals with SMI experience.Ethics and disseminationThis study has been approved by the Tasmanian Health and Medical Human Research Ethics Committee. The findings will be disseminated to participants and staff who delivered the intervention, submitted for publication in a peer-reviewed journal and shared at academic conferences.Trial registration numberACTRN12620000673943.

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