Report on Community Health Care Mental Health Service Delivery

This report provides a comprehensive overview of community mental health care services, emphasizing ethical and legal considerations for mental health professionals. It delves into the code of practice, discrimination, dignity of risk, practice standards, privacy, confidentiality, policy frameworks, and records management. The report also explores the rights and responsibilities of workers, individuals accessing services, and employers, along with specific mental health legislation and its impact. Furthermore, it examines the values and principles of the mental health sector, including recovery-oriented practice, health promotion, holistic approaches, empowerment, access, equity, and social justice. The report also covers evidence-based recovery, types of mental illnesses, best-practice frameworks, strategies for supporting individuals in distress, and communication techniques. Finally, it discusses reflective practice and its role in continuous learning and improvement within the mental health field.

COMMUNITY HEALTH
CARE MENTAL HEALTH
SERVICE

TABLE OF CONTENTS
Question 1- Ethical and legal considerations for mental health work and applied in individual
practice and organisations................................................................................................................1
Code of practice...........................................................................................................................1
Discrimination..............................................................................................................................1
Dignity of risk..............................................................................................................................1
Practice standards.........................................................................................................................2
Privacy, confidentiality and disclosure........................................................................................2
Policy frameworks.......................................................................................................................2
Records management...................................................................................................................2
Rights and responsibilities of workers, individuals accessing the service and employers .........2
Specific mental health legislation and its impact on individual workers.....................................3
Work role boundaries— limitations and responsibilities.............................................................3
Work health and safety................................................................................................................3
Question 2- Values and principles of the mental health sector-1000..............................................3
Recovery......................................................................................................................................3
Recovery oriented practice..........................................................................................................3
Health promotion and prevention................................................................................................4
Holistic approach.........................................................................................................................4
Empowerment/ dis-empowerment...............................................................................................4
Access and equity........................................................................................................................5
Early intervention.........................................................................................................................5
Rights...........................................................................................................................................5
Social justice and inclusion..........................................................................................................5
Citizenship...................................................................................................................................5
Question 3- Evidence base for recovery.........................................................................................6
Research.......................................................................................................................................6
Personal recovery.........................................................................................................................6
Question 4- Types of mental illnesses.............................................................................................6
Question 5- Local and international best-practice frameworks.......................................................7
Planning.......................................................................................................................................7

Assessment...................................................................................................................................7
Implementing plan.......................................................................................................................7
Review.........................................................................................................................................7
Question 6- Strategies......................................................................................................................7
Support a person in distress or crises...........................................................................................7
De-escalate incidents of risk........................................................................................................8
Question 7- Comparison between historical model of mental illness and national framework for
recovery-oriented mental health services.........................................................................................8
Question 8- Techniques for communication and motivational interviewing/ counselling..............9
Active listening............................................................................................................................9
Attending skills, use of body language, non-verbal communication...........................................9
Paraphrasing...............................................................................................................................10
Reflecting feelings.....................................................................................................................10
Open and closed questioning or probing...................................................................................10
Summarising..............................................................................................................................10
Re-framing.................................................................................................................................10
Exploring options.......................................................................................................................11
Question 9- Normalising statements?............................................................................................11
Question 10- Reflective practice and its role in underpinning ongoing learning, growth and good
practice...........................................................................................................................................11
REFERENCES..............................................................................................................................12

Question 1
Community mental health care services refers to the program of care in which patients
community, not a particular facility such as hospital is primary provider of care for individual
with the mental illness. The purpose of these facilities often includes more than simply offering
out patient psychiatric and other heath related treatment.
Code of practice
Mental health service provider and workers must follow the ethical norm and have ethical
obligation to assure that patients should understand supports and services to be provided.
Discrimination
Prejudicial or unjust treatment of various categories of people, usually on the grounds of
age, race or sex is discrimination. Health care’s professional within organisation do not identify
or treat people based on their gender or religious they must provide equal health care treatments.
They should behave ethically and cannot make any differences between peoples based on their
age or sex.
Dignity of risk
Health care Professional always consider the amount of risk while they operating or
providing treatment to people with mental disability or dementia (Le Boutillier and et.al., 2015).
It is the concept that outlines how professional must have freedom to make decision, they must
know the amount of risk as failure which is essential before treating any patients.
Duty of care
The duty of health care professionals it to focuses on people safety and health and always
act in the appropriate interest of patients. They cannot act or fail to act in the way that outcomes
in harm, professional must focuses on people safety and consistently show their care towards
mental disable person.
Human rights
Patients in health care organisations have the rights to know about what type of
healthcare treatment they get. As they have the rights to take decision and take part in decision
making procedure in context of their health care treatments. The most essential right of patients
is to get the copy of their medical records and rights to take the best medical treatments in health
care institutes. Ethical code of professionals states that people have the rights to know truth about
its medical status.

Mandatory reporting
Health care professionals must reporting to this higher management within health care
organisations in context of medical treatments and about patient’s health recovery. Mandatory
reporting is very essential in practices of individual as it helps to consider people demands and
needs of health care treatments. With the help of reporting professional can be able to determine
the effectiveness of current treatment in context of health care and wellbeing of people.
Practice standards
Healthcare professional must maintain safe and cleanness around working practices
which is essential for people as well as their health. They must follow clinical practice protocols
and also used clean equipment during patient treatment.
Privacy, confidentiality and disclosure
Professionals must protect patients’ privacy which is important in according with health
insurance accountability and portability Act (Kidd, Kenny and McKinstry, 2015). They only
allow to disclose treatment information in front of patients and its family members. They should
follow and know HIPPA laws and cannot disclose people data. Ethically and legally health care
professional cannot violate people trust because it is very important component of treatment.
Policy frameworks
Health care professional must work under the government health and social care policies
which is important for people while they are taking treatments as well as also important for
professionals. They must take appropriate decision less amount of risk as failure which impact
on people health.
Records management
Health care professionals must gather all the relevant records about their patients’ health
and treatment which they getting from. They should managed records in which all the
information about people has been mentioned that is essential for them and help during providing
health care treatments.
Rights and responsibilities of workers, individuals accessing the service and employers
Health care employees have the rights to respectful and considerate behaviour from its
superiors and to be free from abuse, harassment and metal abuse (Hungerford and Fox, 2014).
Their responsibilities to take care about their patients. Individual accessing the health care
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services also have few rights and responsibilities such as accountable for getting information
about symptoms, hospitalization and other pertinent information.
Specific mental health legislation and its impact on individual workers
Mental Health Act 2014 is related to workers practices in which they need to consider all
the rules under this legislation as they can provide mental health treatments. It impacts on health
care centre employees and its performance effectively. Workers need to follow all the principles
within mental health Act 2014 and make privacy about its patients.
Work role boundaries— limitations and responsibilities
Healthcare professional and staff members must maintain proper boundaries. Patients is
vulnerable and they need to be respected and acknowledge at all times. Professional always play
their role under limitations and boundaries which is essential for them as well as patients. They
must act professionally and do not make any interfere in personal life of their patients.
Work health and safety
Work health and safety is the best and most important ethical consideration which effect
individual practices as well as health care firms. Professional must focus on employees as well as
patient safety, they need to provide better health treatment to mental disable person (Bird and
et.al., 2014). Assure them that people are getting the best treatment and organisation prioritise
their safety as well.
Question 2- Values and principles of the mental health sector
Recovery
Values and principles for recovery in health practises are:
 Uniqueness of an individual: Helps the patients to realise that they are centre of care that
they receive.
 Patients should realise that all the recovery outcomes are different and unique for each
and every individual so that their satisfaction level can be increased in terms of quality of
life and social inclusion (Gillard and et.al., 2017).
 Making patients realise that recovery is not always about cure but it is also about
improving quality of life, living a meaningful or purposeful life.
 Hopes and expectations of patients should be let down as it leads to healing and helps
them to recover.
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Recovery oriented practice
Values and principles for recovery oriented mental health practises are:
 Real Choices: Support individuals so that they make their own choice of the way they
want to live their own life. Healthcare professionals should acknowledge their choice so
that they are meaningful and creatively explored. Individuals should be supported in such
a way that they can build strength and take responsibilities for their lives.
 Attitude and rights: An individual's legal rights, citizenship should be protected. Increase
hope within an individual so that they can think about their future and live a meaningful
life.
Health promotion and prevention
Values and principles for Health promotion and prevention in health practises are:
Person centred care should be provided to individuals so that a trustworthy relationship can be
build. This can only be done by working with the person and providing them with effective
treatment. Families and friends involvement should be valued as they play a vital role in
recovery process of an individual (Pincus and et.al., 2016). Understanding mental health and
education as well as understanding needs of an individual's friends and family members plays an
essential part and plays as a therapy for the patients. Not only this their involvement is a good
experience for the patients.
Holistic approach
Values and principles for Holistic approach in health practises are:
Holistic approach is one of the most powerful approach that helps an individual in healing as
everyone has their own inner healing power. All the mental patients should be treated as a person
not as a disease. This approach focuses on fixing the main root cause of the condition not just on
eliminating all symptoms. Team approach should be used where patient, doctor, family members
and all the friends are involved.
Empowerment/ dis-empowerment
Values and principles for Empowerment/ dis empowerment in health practises are:
Empowerment is one of the major principle of mental health sector as it focuses on the way
mental health workers supports and fulfil needs of mental health patients. Empowerment
supports mental patients and their families to make choices and decisions about their lives and
related to the delivery of service that is required by them. This helps in removing dis-
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empowerment within an individual (Slade, 2017). Empowered people can take their own
decisions, have assertive thinking, can access all resource and information required by them.
Access and equity
Values and principles for Access and equity in health practises are:
The main principle of Access and equity is equality, non-discrimination, participation. Needs of
all mental patients should be addressed in all ways regardless of their culture or background or
their disease.
Early intervention
Values and principles for Early intervention in health practises are:
Early interventions provide specialist support and interventions to patients suffering from metal
illness. These interventions helps in improving patients mental health and well being and reduces
their mental illness as well as increases their positive socio economic outcomes. These
interventions help in reducing long term consequences of their mental illness and risk of
developing this mental illness further is also reduced.
Rights
Values and principles for Rights in health practises are:
Each and every mental health patient has some rights related to their treatment and illness. They
should be trusted, honoured and respected. All the commitments made to them should be
fulfilled. Time to time feedbacks should be taken from them so that evidence based and high
quality treatment can be provided to them, this increases their opportunities of increased mental
health and wellness.
Social justice and inclusion
Values and principles for Social justice and inclusion in health practises are:
All the mental illness patients should be supported, prevented from crises and should not be
discriminated. They should be provided with expert advice and treatment so that they can
manage and improve their health (Williams and Doessel, 2017). Healthcare practitioners should
focus on whole person not just on their symptoms as it affects their treatment.
Citizenship
Values and principles for Citizenship in health practises are:
Concept of citizenship is basically based upon equal right for each and every individual
regardless of their access circumstances to economic or social opportunities, political or civil
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opportunities. This is one of the most important value and principle for mental health problem
people so that they can enjoy social justice and rights of a citizen that are protected from laws,
institutional services, social exclusion and many other that helps in segregation any kind of
discrimination and are treated equally and can enjoy all the rights that are provided to a citizen of
a country.
Question 3- Evidence base for recovery
Research
Evidence based approaches helps in recovery of patients. There are various strategies that
helps in promoting mental health like: awareness about mental health and its causes. This helps
in increasing awareness and reasons due to which people suffer from mental illness like: taking
too much stress is one of the main reason of mental illness (Slade and Longden, 2015). Thinking
or deeply involving oneself in a situation or a cause is another common reason for mental illness.
Personal recovery
Personal recovery in mental health can be done in various ways like: Conducting
counselling of mental patient and by understanding the main root cause of their mental illness,
increasing their engagement in their personal life in order to make them understand their purpose
of life. By increasing motivational level within them and making them see their situation from a
different perspective so that they can recover from their mental illness in a better way.
Question 4- Types of mental illnesses
There are various kinds of mental illness such as:
 Anxiety Disorder: People with this disorder reacts to certain situation or objects with
dread or fear due to which they suffer anxiety or panic.
 Mood disorder: People with this disorder have persistent feeling of frustration or sadness
or feel extremely happy or extremely sad.
 Psychotic Disorder: This awareness involves distorted thinking and awareness.
 Eating disorder: This disorder involves extreme emotions, behaviours and attitude which
involves food and weight (Underwood and Washington, 2016).
 Impulse control and addiction Disorder: people with this disorder cannot control or resist
their urge to perform an action that might be harmful for them as well as for others
 Personality Disorder: person with this disorder have inflexible and extreme personality
traits that could distress them.
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 Obsessive-compulsive disorder: People with this disorder are plagued by constant feat or
thoughts that cause them to perform certain routine or rituals.
Question 5- Local and international best-practice frameworks
Whenever individuals participate at different levels of collaboration as per their needs,
collaboration, circumstances, it is considered to be one of the best practise framework goal.
There are various kinds of national and international frameworks for health practises such as:
Planning
Local and national Planning framework for public health practice are:
Local Framework for health practise: National Standard for mental health services 2010
(NSMHS)
International Framework for health practise: planning framework for public health practise.
Assessment
Local and national assessment framework for public health practice are:
Local Framework for health practise: National framework for recovery oriented mental health
service
International Framework for health practise: WHO framework for Health system framework
Implementing plan
Local and national implementing plan framework for public health practice are:
Local Framework for health practise: National framework implementation plan by department of
health (Sivertsen, 2017).
International Framework for health practise: Framework for public health practise
Review
Local and national Review framework for public health practice are:
Local Framework for health practise:Mental illness assessment framework.
International Framework for health practise: International nursing review practise
Question 6- Strategies
Support a person in distress or crises
Mostly person in crises can be supported by providing them with crises counselling.
These counselling helps the person in crises and improves their personal and mental well being
(Albert and Simpson, 2015). It also helps in reducing a person mental, physical, emotional and
behavioural reactions towards crises which eventually helps them to return to a normal level
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which they were before the incident. In these counselling patients are told that these feelings or
symptoms are temporary and within a specific period they will return to their normal health.
Person in distress can be supported in various ways such as: If a person is in distress then
first of all he should be reassured that everything will be alright. They should be motivated that
everything will be back to normal any kind of disturbing situating is for short duration of time.
if someone is in distress, then one should listen to them without judging or interrupting them. By
promising them that their situation or conversation will be confidential and will be discreet
(Mehanna and et.al., 2016). Understanding their situation by keeping oneself in their shoe. By
assuring them that they are not alone and when ever they need someone they can contact. By
providing them with solution to their problem or distress.
De-escalate incidents of risk
Managing a mental patient's dissatisfaction and complains can be quite an unpleasant but
a true reality for healthcare organisations. Despite of healthcare professionals the best efforts
they need to face certain situation where patients feel uncomfortable, unhappy or unpleasant and
sometimes they might become aggressive or angry. If a patient becomes violent staff need to be
prepared in order to handle them. First of they need to ensure patient's and other staff members
safety, then they need to help the patient to manage their emotions and control their behaviour,
they should avoid using any kind of restraints and lastly they should avoid any kind of
intervention that can escalate their agitation again. For this De-escalation is one of the most
appropriate technique that can be used by professionals and other staff members of health care
organisation which can help them to control their violent behaviour (Beaudoin and Moore,
2018). For De-escalating incidents of risk healthcare professionals and other staff members
should follow certain things such as: they should maintain a safe position and respect their
personal space, they should not provoke the aggressive patient, staff members should try to
establish a verbal contact, try to identify their needs and feelings, agree to their all the demands,
listen carefully what they are saying and explain and make them understand what is correct and
right for them.
Question 7- Comparison between historical model of mental illness and
national framework for recovery-oriented mental health services
Psychological model of mental disorder is one of the most common model that is being
used. This model plays a vital role in treatment of mental disorder (Jacob, 2015). This model
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says that both social and biological factors together contribute in improving a person metal
illness and their individual experiences that are improved by conjoint efforts of all psychological
processes. Psychological model of mental illness says that dysfunction and disruption in
psychological processes is a common process or a pathway due to which mental illness or
disorder are been developed within an individual. So as per this model in order to treat a mental
illness patient it is important to consider all social, psychological and biological factors of an
individual. In simple words this model focuses on determining the main root cause of the disease
and its outcomes.
In simple words Recovery oriented practises can be defined as a team process
where all the stakeholders are involved where all the patients are aware of their responsibilities,
good lines of communication are present in patients, they feel free to accept the support provided
to them. National framework for recovery-oriented mental health services framework defines an
individual recovery to live and create a meaningful as well as contributing life without presence
of any kind of mental health issue (Popplau, Chini and Hanganu-Opatz, 2018). In simple words
this frameworks focuses and lays a great emphasis on national understanding and consistent
approach for recovery oriented mental health practise. Psychological model of mental disorder
focuses on treating a mental patient by considering all biological, social and psychological
factors whereas National framework for recovery-oriented mental health services framework
focuses on recovering a mental patient by understanding all approaches of recovery related to
mental health illness. It focuses on recovery oriented mental health practise focuses on finding a
pathway due to which mental illness is developed within an individual. Psychological model
provides new approach to mental health and patients behaviour whereas national framework
develops a strategy to reduce mental illness of an individual.
Question 8- Techniques for communication and motivational interviewing/
counselling
Negotiation
It is one of the best way through which patients problem can be solved and understood in
a better manner.
Active listening
Active listening is a communication technique which is used to build trust within the
client. It helps in demonstrating concern as well as show understanding. It helps in understanding
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what the client is saying and how they feel about it (Carcone and et.al., 2016). This gives the
client an assurance that they are being listened clearly.
Attending skills, use of body language, non-verbal communication
Non verbal communion is also one of the most important type of communication
technique which helps the counsellors to make their clients feel comfortable with them as actions
speaks louder than words. For this they need to show their attending skills clearly and use their
body language appropriately. By building eye contact, body postures, facial expression
counsellors can make their client feel comfortable with them.
Paraphrasing
It is also a type of communication technique in which clients or patients statements are
rephrased and stated in one's own language which helps in gaining understanding of their clients
as well as for themselves. This helps in knowing what the client meant or what they meant to
say.
Reflecting feelings
Reflective feelings is a communication technique used by counsellors to explore and
restate clients affective feelings (Hasan and et.al., 2019). Their response might capture clients
both feelings and content but it mainly lay emphasis on their feelings. Counsellors convey clients
feelings accurately by understanding them. This helps the clients to feel relaxed and comfortable.
Open and closed questioning or probing
Closed ended questions are that can be answered in form of yes, no or ten times in past
months, and open ended questions are those questions that cannot be answered in these forms.
Most of the counselling sessions consist of both open and closed ended questions. These
questions help the client in moving forward from the incident or distress.
Summarising
Summarising is one of the most common and effective way of communicating with
others. Summarising is a form of reflective listening that is used by the counsellors in which they
listen carefully and pay attention to all kinds of central and important points and by summarising
it so that client can confirm it and give their feedback on the same. This helps the client to
understand that the counsellor is paying attention to their problem and what they are trying to
state or explain (Pollak and et.al., 2016). They can even correct the counsellor if they find any
wrong information or thing spoken by them.
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Re-framing
Re-framing helps in seeing a situation from a different perspective. This helps the
healthcare professionals to understand their patients situation and by re-framing it they try to
communicate their perspective on the same situation to their clients (Monteggia, Heimer and
Nestler, 2018). This technique is used by counsellors to make their clients understand and see
their situation from a different perspective.
Exploring options
It is a kind of counselling communication technique which helps the clients to explore
various other options that can be done or could have been done for their situations or make them
understand that, that particular situation could have been ended in another way which might not
have been fruitful for them.
Question 9- Normalising statements?
Normalising statements are used when a person wants to share their feelings or
experiences. These statements help a person in realising that their feelings or experience are
neither usual nor sign of their differences. In fact this statement helps people to understand that
all the other people share the same feeling which inspires their hopes and demonstrates support
and empathy (Choi and et.al., 2015). There are many examples that helps and supports people
who are facing challenges. Examples such as: “this is a really common experience and is mostly
linked to”, “I have experienced that too”, “having that feeling or experience is quite common”
and many more.
Question 10- Reflective practice and its role in underpinning ongoing
learning, growth and good practice
Reflective practise can be defined as an ability to reflect one's own experience or actions
for continuous learning or improving ones own work. It is one of the most important practise for
health care professionals who want to carry out their learning throughout their lives. It is one of
the great way to bring improvement in oneself, become more proactive, increase confidence and
become a qualified professional (Dimmock, 2016). This reflective practise plays a vital role
healthcare sector as in this sector there is a need for continuous learning, growth, good practises.
Healthcare professionals need to continuously to learn and improve their practise, enhance their
clinical knowledge or knowledge related to healthcare practises (Knott and Scragg, 2016). This
reflective practise also help professionals in this sector to bring improvement within themselves,
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increase their willingness to accept and adopt new knowledge as well as implement that
knowledge in their personal lives.
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