Addressing the Mental Health and Psychological Issues of Nursing Home Residents
Expound on Mental Health and Psychological issues
Mental health and psychological issues are a significant concern to public health (Abbasi, 2020). Over the decades, many organizations concerned with mental health have come up, among them, the American Psychiatric Association, whose goal is to cater to mental health issues. Most of the nursing home residents, as seen earlier, are geriatrics. These patients are at greater risk of developing a broad spectrum of mental health and psychological issues. Some disorders are related to aging, while others, such as anxiety, are related to admission into these nursing home facilities. According to Abbasi (2020), 4 out of twenty nursing home residents have a mental health issue. In addition, 2-3 percent have severe mental health conditions (Abbasi, 2020). These issues include depression, anxiety, schizophrenia, bipolar disorder, and other mental health issues (Abbasi, 2020). As seen from the statistics, mental health issues are of public significance, hence the need for effective mitigation strategies. Interventions to prevent, recognize early, and manage this public health concern should be promptly done.
Reasons why I chose the topic and its relevance to the nursing profession.
Mental health and psychological issues are easily neglected in nursing homes. Mental issues are often acute, and care in nursing homes is often long-term (Arango et al., 2019). They are thus easily negligible. Cancer Care, reproductive health, endocrine disorders, cardiovascular disorders, and respiratory illnesses make up the significant concerns in nursing homes. Funding and other resources such as professionals are directed towards the care of these patients. In comparison, mental health issues rarely get attention, and if they do, they are not adequately managed. Thus, cases of mental health and psychological issues has been on the rise over the last few decades. Coupled with the fact that mentally ill patients are poorly managed in health institutions, mental health and psychological issues are an area of significant concern.
Leadership and change management in mental health and psychological issues
Leaders bear the role of initiating and managing change in any institution. For change to be effective, leaders must be actively involved in it. Management and leadership are integral in initiating change interventions. Leaders find opportunities to change. They also educate the other hospital members on the importance of the change. They create a sense of urgency by showing the other healthcare providers the deficits in current healthcare practice and the importance of embracing the change (Barrow, Annamaraju & Toney-Butler, 2017). Leaders provide incentives and facilitate adjustments during the change process. When change has the potential to produce positive effects on the mental health issue, leaders must institute it and include root it in the organizational traditions. Barrow et al. (2017) states that once a change is incorporated into an institutional culture, it gains stability and becomes a new normal.
In nursing homes, Kurt Lewin’s theory of change, is promptly applicable. Unfreezing shall occur when the leaders influence the people to accept mental health triaging into nursing homes routine care (Barrow et al., 2017). In moving, the leaders should facilitate change and ensure that required sources are available. Lastly, the leaders should ensure that mental health triaging is incorporated into the hospital culture and hospital policies. When management fails to back up any change, its likelihood of failure is remarkably high.
Propose strategies for communicating and collaborating with the patient, family, or group to improve associated with the mental health issue.
In this assignment, I met Florence, a 95-year-old who was recently diagnosed with Major depression. During the session, her family was in attendance. They were all in shock to hear of her diagnosis. I explained to them the importance of care collaboration and the effects that it has on healthcare outcomes. Major depressive disorder develops over time and recognizing depression in early stages would have been integral in its management. The patient is an integral part of their care. Informing the patient and family is thus important. As Park et al. (2018) notes. nurses and other healthcare providers should ensure that they educate the patient on their care. Patients have a right to know what is ailing them and what management they are undergoing.
Patients who are informed collaborate in care. Informing the patients of every detail concerning their care is thus imperative. According to Park et al. (2018), the teach-back method is one of the most effective methods of ensuring patients understand and retain what they are taught. Individuals should be taught how to recognize when their mental health and that of their loved ones begin to derail. They are then requested to reproduce the information to check if they have understood. Planning and organizing care is another effective strategy in ensuring collaboration during care. Assigning a task to an individual and ensuring they are responsible for it ensures care coordination and accountability care (Reeves et al., 2017).
Patients easily collaborate in care provision when they feel respected. Patients have unmet needs, and under whatever circumstances, healthcare providers should respect them. Patients often experience anxiety due to their conditions and may behave inappropriately. Healthcare providers should respect the patients’ and their families’ decisions at all times to enhance care collaboration (Park et al., 2018). Healthcare policies should be such that they promote and upholding patient respect.
Explain how your proposed intervention shall improve the quality of care, enhance patient safety, and reduce the cost to the system and individual.
Mental health triaging is a vital intervention. As mentioned earlier, most mental health issues in nursing home residents go unrecognized until later, when the mental health issues cause complications. Mental health issues interfere with a patient’s recuperation process, leading to further complications. Studies, for example, that of Teixeira et al. (2017), contend that mentally ill patients pose significant challenges in care collaboration. Most often, the care providers in nursing homes lack the necessary expertise to handle severe mental issues.
With mental health triaging, caretakers will be able to recognize mental health problems early, and complications shall be avoided with immediate and effective interventions. This minimizes the cost incurred by the individual and the systems in managing complications of mental health conditions (Arango et al., 2018). Patients who have severe mental issues are given special psychiatric care or referred to mental hospitals where they receive specialized care, thus improving the quality of care.
Improved care quality leads to improved healthcare outcomes and patients’ healthcare experience. Arguably, mental health triaging shall increase mental health awareness in the hospitals (Arango et al., 2018). It also ensures patients are correctly diagnosed. Poorly diagnosed patients are often mismanaged hence poor patient health outcomes. Medication errors are common with misdiagnosis. With mental health triaging and the right staff, the proper mental diagnoses are made, ensuring patient safety and treatment effectiveness. Individuals and systems are saved from costs incurred in trying one therapy to another with failure and complications that arise in the process.
Among mental health triage tools is assessing the risk of harm to self and others as exhibited by patients suffering from mental illnesses. The clinicians and nurses assess the patients for signs such as paranoia, suicidal ideations, and suicidal attempts and ascertain their safety and other patients’ safety. When a patient has such symptoms, they are isolated and given special care hence promoting their safety and the safety of others.
Mental health triaging categorizes patients according to the severity of symptoms and urgency of their needs. This gives a clear overview of mental health issues in a hospital at any given time. Classification of the patients informs their management. It makes it easy for the healthcare providers to determine those patients requiring urgent interventions and act swiftly. Thus, quality and effective care interventions are relayed to the patient. At another step, mental health triage determines the patients at risk for developing mental health conditions and necessary steps.
Mental health statistics from triaging help give insight into the nursing home’s mental health burden. Such information, according to Lesser (2021), is integral in helping the government to plan care healthcare funding. Government can allocate more resources directed towards mental healthcare funding depending on available data. Adequate government funding enhances quality care delivery to the patient and helps minimize care costs to the system and individuals. Mental health triaging has myriad benefits that accrue to it, hence the need for healthcare leaders to embrace it in nursing homes.
State/board/nursing practice standards and organizational/governmental policies
The national mental health act of 1946, through developments over time, informs and prioritizes mental health care (Lesser, 2021). The act regulates psychiatric and mental health education, research, diagnosis, and treatment of psychiatric conditions. The government has been on the frontline in developing policies that favor mental health service delivery. Provisions of the NMHA protect the rights of a mentally ill patient. It also ensures the implementation of the stated laws in respective institutions. A significant government input lies in funding.
Government funding determines the success of mental health care initiatives (Lesser, 2021). The government is also the primary source of funding for the development of community mental health resources. Thus, the government plays an integral role in managing the mental health of patients in the country. The state and federal governments play a significant role in funding research to improve mental healthcare delivery (Lesser, 2021). As seen above, a lack of government policies would lead to marked negative effects on public mental health delivery. For the government to intervene, much information on the current state of public health mental state must be available. Information from mental health triaging can influence government funding which shall enhance care delivery in the nursing homes.
Explain how technology, care coordination, and utilization of community resources can be used in addressing mental health and psychological issues.
A study by Reeves et al. (2017) assert that effective interprofessional collaboration and interprofessional communication are integral in improving patient health outcomes and healthcare experiences. Healthcare providers coordinate in the provision of care to ensure the patients receive quality holistic care. Poor communication is the basis of all healthcare errors. Health information systems (HIS) are integral communication channels in ensuring the correct information is available to all healthcare providers (Harerimana, Forchuk, & O’Regan, 2019). HIS ensures communication is effective and reaches all healthcare providers. Common healthcare errors occurring due to misinformation and poor communication are thus easily mitigated.
The use of smartphone apps has been helpful in the management of patients with anxiety disorders and depression (Harerimana et al., 2019). Using smartphone apps has a positive effect on patients’ mental health status (Harerimana et al., 2019). They contain information and thus fill in gaps where patients have insufficient knowledge. The apps have also positively affected the recuperation of patients with mental health disorders such as depression and anxiety (Lustgarten & Elhai, 2018). Smartphones have also increased patient-healthcare provider linkages. This has allowed for mental health consultation over the phone. In this way, necessary information is available to the patients. As a result, they make informed decisions leading to improved quality of care and better health outcomes.
Care of the mentally ill is made less costly by utilizing community resources (Lustgarten & Elhai, 2018). Community institutions that deal with mental illness are instrumental in managing these patients. As a result, patients are given focused professional care that is holistic and at a lower cost than that provided in nursing homes leading to better care quality and better patient healthcare outcomes.
As seen above, several factors interact in the delivery of quality care that is safe and affordable to the individual and the system. Each factor has a significant role to play. For instance, we have noticed that interprofessional collaboration and care coordination are integral in managing any patient. In addition, patient input in their care process is essential. Healthcare technology and community resources are also instrumental in managing the mental health and psychological issues among nursing home residents. Implementing mental health triaging shall require a collaborative effort and dedication from all healthcare providers. Healthcare technology, care coordination, community resources, government policies, and leadership are all integral parts that determine the success of mental health triaging in mitigating the surge in mental in psychological issues among nursing home residents.
- Abbasi, J. (2020). “Abandoned” nursing homes continue to face critical supply and staff shortages as COVID-19 toll has mounted. JAMA, 324(2), 123-125. doi:10.1001/jama.2020.10419
- Arango, C., Díaz-Caneja, C. M., McGorry, P. D., Rapoport, J., Sommer, I. E., Vorstman, J. A., & Carpenter, W. (2018). Preventive strategies for mental health. The Lancet Psychiatry, 5(7), 591-604. https://doi.org/10.1016/S2215-0366(18)30057-9
- Barrow, J. M., Annamaraju P., & Toney-Butler, T. J. (2020). Change Management. In: StatPearls. StatPearls Publishing, Treasure Island (FL). https://europepmc.org/article/nbk/nbk459380
- Harerimana, B., Forchuk, C., & O’Regan, T. (2019). The use of technology for mental healthcare delivery among older adults with depressive symptoms: a systematic literature review. International Journal of Mental Health Nursing, 28(3), 657-670. https://doi.org/10.1111/inm.12571
- Lesser, B. (Mar 2021). U.S. Mental Health Legislation: Dual Diagnosis org. Retrieved from https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiKqfyFionxAhUjnVwKHesWBAUQFjAMegQIHBAE&url=https%3A%2F%2Fdualdiagnosis.org%2Fmental-health-and-addiction%2Fus- legislation%2F&usg=AOvVaw2okPCkV_vuAsISpoanhpZi
- Lustgarten, S. D., & Elhai, J. D. (2018). Technology use in mental health practice and research: Legal and ethical risks. Clinical Psychology: Science and Practice, 25(2), e12234. https://psycnet.apa.org/doi/10.1111/cpsp.12234
- Park, M., Lee, M., Jeong, H., Jeong, M., & Go, Y. (2018). Patient-and family-centered care interventions for improving the quality of health care: a review of systematic reviews. International Journal of Nursing Studies, 87, 69-83. https://doi.org/10.1016/j.ijnurstu.2018.07.006
- Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6). https://doi.org/10.1002/14651858.CD000072.pub3
- Teixeira, L., Azevedo, M. J., Alves, S., Pires, C. L., & Paúl, C. (2017). Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services. Quality in Ageing and Older Adults, 18(3), 212-220. https://doi.org/10.1108/QAOA-11-2016-0043