community mental health

1. Community mental
health
Khalda Ahmed

2. Definition
• Is the run of protective and curative
measures aimed at fitting the individual for
satisfactory and useful life within his own
social environment.
• It represents all mental health activities
carried out in the community.

3. Shifting from institutional care to
community care
• community mental health has developed in
response to the realization that much of
the effort expended in the past as
treatment for mentally ill individuals
encouraged chronicity rather than a return
of productive life.

4. • The studies conducted in the
environment and treatment of patient
in large public hospitals pointed out
many defects in the way of living in
mental hospital that led to
desocialization of the patient.

5. • And the patients are returning back to
the hospital immediately with worse
condition because they were faced by
their main problems within the
community, the problems of their
home and job environment and work
opportunity and the problems of
disturbed interact ional processes.

6. • So they believed that the correction of
mental disturbance and rehabilitation of
patients is more likely when the individual
is treated in his own cultural settings close
to the family and other social systems of
the culture.

7. • Which well reduce the large number of
admission to mental hospitals and to get
rid of the stigma of hospitalization and
prevent chronic mental illness.

8. • The tranquilizer drugs played a large role
in develop of community mental health
care by helping mentally ill patients control
their behavior and remain in the
community.

9. Community mental health settings
• In-patient services
• Out-patient services
• Day and night hospital unit
• Crisis intervention centers
(emergency)
• Half way houses
• Family therapy centers
• Rehabilitation centers

10. Diagnostic Services and Rehabilitation
Services
• Diagnostic services and rehabilitation
services including education
programs for training of professional
and Para Professional workers and
conducting research into the
prevention, cure and treatment of
mental illness.
• Evaluation of the efficiencies of the
program being carried forward.

11. Function of the mental health
centers
• Promotion of mental health.
• Prevention of mental illness.
• Care, treatment and rehabilitation of i
• Early detection of cases.
• Group and family therapy.
• Environmental and social support and
intervention.
• Community participation.

12. Community mental health
resources
• Day and night hospital
• Purpose: to provide a comprehensive
psychiatric treatment for patients who are
able to remain at home part of time.
• Day hospital: the patient come to the
hospital either voluntary or by referral
• 3 months is approximate period of
hospitalization for day hospital.

13. • Goal: psychotherapy, therapeutic
milieu and activity therapy
• Advantage: Associated with day and
night hospital
• - the patient is able to continue his
social contact with family and
community.
• Illness period is shortened. The is
fewer problem in rehabilitation.

14. 2- night hospital: the need to treat
individual who could not afford to
leave their employment due to a
financial problems.
patient come to the night hospital
following their daily work in the
community, they sleep in the center,
weekends are free for visits at home
and with friends. The client receive
medications, participate in group
discussion and counseling.

15. advantages:
They have been doing prescribed work
during the day.
Maintain their own contact in the
community.
Disadvantage: they do not enjoy
restricted social activities after
therapy.
The informal social hour just sit, smoke,
relax then sleep and in the morning
eat breakfast and leave for work.

16. Out-patient psychiatric clinic
These units is located in psychiatric and
general hospitals
These services are operated in social
centers (mosques, schools and housing).
Clients usually screened by the clinic staff
as a preliminary step in order to determine
the need or urgency for treatment.

17. The refers are made by local
physicians, social agencies schools
and patients discharged for follow up.
Interviews and group sessions with
patients regularly and full use of
psychiatric team work is essential
activity.

18. Psychiatric services in general
hospital (inpatient)
Some of general hospitals have separate
unit for treating psychiatric patients. To
give total and comprehensive care for all
patients. the average length of stay in
these services is about 3 weeks.

19. Advantages:
1-Early treatment is made available in the
community.
2-People show acceptance of psychiatric
facilities attached the general hospital.
3-The stigma associated with mental illness
is reduced.
4-admission to mental hospitals are
decreased.
5-there is consultative sharing between the
medical and psychiatric staffs which result
in understanding of emotional aspect of
illness.

20. Half way hospital
It is recognized that patients whose progress
in the mental hospital is at a stand still
continued hospitalization.
These patients occupy a position midway
between sickness and healthy.
These houses are maintained by laymen in
cooperation with psychiatrists.

21. -Patient is prepared for this experience
through counseling and group therapy
employment is obtained for them in
hospitals or community before they are
transferred.
-periodic visits are made to the home by
vocational rehabilitation counselors to
determine the patients adjustment to the
home and work.

22. Foster home care
-some persons can not maintain healthy
relationships with members of their own families,
so they inter the foster home.
-after discharge these persons are assisted in
obtaining employment before leaving the
hospital and arrangement for return to the out
patient department for follow up
-foster home has also arranged for elderly
patients.

23. Community mental health center
It is one of the in-patient community
resources who provides a
comprehensive services for
prevention, treatment and
rehabilitation.
-it provides in-patient, out-patient, day
and night care, emergency
consultation and rehabilitation.
-it is more accessible for people
especially in area of limited member
of population (rural community)

24. Community mental health
association in Egypt
1- general and private mental hospitals
2-psychiatric unit in general hospitals
3- Out- patient clinics.
4- special institutions as centers:
- institute of mentally retarded.
- drug addict center
- child psychiatry clinic

25. prevention
Primary prevention:
-
It involve decreasing the rate of new cases
of mental illness by contracting harmful
factors before they have a chance to
produce illness.

26. - a healthy population is the goal of
such programs as maternity and
family centered clinics
-Discussion groups for parents in which
free communication is encouraged
and parents can discuss their
problems and receipt support and
guidance.

27. Such as discussion groups also formed
for teacher and others who are in
contact with growing children.
- Crisis intervention
- Primary prevention maintain mental
health rather than illness prevention.

28. Secondary prevention
It reduce prevalence of mental illness by
shortening the duration of it.
Early case finding and promote effective
treatment.
Identify the high risk group within the
community.( frequently upset, changing
jobs frequently, frequent minor accidents
and significant loses)

29. Tertiary prevention
It include treatment and rehabilitation
services for those persons who diagnosed
mentally ill—follow up monthly.
Doing home visits and meetings with the
family.
Patients in the acute phase may be
treatment of drug addicts, alcoholics and
depressive patients

30. Role of the nurse by settings
• In-patient services:
- the nurse provide therapeutic milieu
and focus on early discharge for her
patients.
- take an action part in the daily living
activities of the patients
- participate in the ward meetings
- plan and carry out treatments.
- develop an understanding of the
culture of the patients.

31. • The day and night centers:
- mobile population who comes and
go according to their own individual
needs.
- engage the patients in short time
interval activities.
- teach the patients stress coping
techniques.

32. • Out- patient clinics:
- makes a visits to the patients homes for
evaluation and helping to situate in new
situations.
- work with family for better housing
condition for the patient.

33. -provides consultation and education
services
- plans and implements programs that
focus not only on individual patients but
the community of which they are a part.

34. thanks