Nursing Research: Impact of Community Services on Patient Care

This nursing research report delves into the crucial relationship between community-based services and the inpatient time of individuals suffering from mental illness. The report examines the effectiveness of clinical practice change interventions, focusing on factors like smoking, substance abuse, and the importance of equal treatment. It explores the impact of improving mental health services, compulsory community treatment (CCT), and long-term care considerations, emphasizing the significance of practitioner-patient relationships and the need for equitable attention. The report also highlights the importance of adequate community-based services, suggesting that they can lead to reduced inpatient stays. Key findings include the effectiveness of CCT, the need for sufficient nursing staff to ensure equal attention for all patients, and the importance of addressing stigma. Recommendations focus on ensuring sufficient nurse-to-patient ratios and the implementation of CCT to improve patient outcomes and reduce inpatient time. The report concludes by emphasizing the need for equal and adequate care for all patients, irrespective of their background, in compliance with equality laws.

Nursing research

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
Research Question...........................................................................................................................1
Research Topic :..............................................................................................................................1
Literature Review ............................................................................................................................1
Effectiveness of clinical practice change interventions..........................................................1
Improving mental health services...........................................................................................2
Compulsory community and involuntary outpatient treatment..............................................3
Long term care for people with mental illness.......................................................................3
Relationship between practitioners and community based services.......................................4
RECOMMENDATIONS................................................................................................................5
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................7

INTRODUCTION
In any health care and community centre, there are enormous number of patients involved
but what actually matters is the rate of community based services that are being provided to them
(Jorm, 2012). There can be various factors because of which practitioners may pay more
attention to a few as compared to the others and the ones who are being paid more attention and
are given adequate community based services require less inpatient time as compared to those
who are not been provided with the same.
Research Question
“Do clients with a mental illness that are given adequate community-based services, compare to
those that haven't and does this decrease there inpatient time?”
The question has been chosen as there are various people that are affected by the
phenomenon of getting neglected because of a few reasons. It may be because of some reasons
such as practitioner carer ratio, cultural factors etc. But it does not have a good impact on the
patients because all the people in a community home should be given equal attention and the
ones who does not have been given adequate community based services, their inpatient time
increases (McGorry, Bates and Birchwood, 2013) .
Research Topic :
To understand whether the fact that people with mental illness, who are given more
adequate community services have less inpatient time as compared to those who are not been
provided with the same.
The national strategic framework for chronic condition focuses on setting the way and
directions along with the results so that the vision can be achieved. Also, it focuses on the fact
that all people should live a healthy and happier life and be able to manage these chronic
conditions. The topic specifies the same that it is not good to be partial with the patient because
of a few factors because it can lead to increased inpatient time for someone. So, it is better to
treat everyone equal as according tot heir condition.
Literature Review
Effectiveness of clinical practice change interventions
As per Kate and et.al., 2013, the people who suffer from mental illness face issues in
various places. There are various factors that are related to the lifestyle changes such as smoking,
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drinking, substance abuse can be considered as factors which can also be considered as reasons
for developing such mental and abnormal behaviour. Proper effectiveness should be taken in
order to stay prevented from such measures that lead to mental behaviour. As smoking, drinking
and specially doing substance abuse can actually affect the mental stability of the person because
these products contain narcotics and other related stuff which gives a sort of relaxation to mind
for a smaller period, so it can be assumed that how much it would be affecting the mental health
of the person. So, for such persons as well whoa re suffering from mental illness, proper and
equal treatment should be given to such individuals. In this, a two group baseline design was
being implemented in which two groups of the community mental health services took place and
it was meant to maximize the allocation of the assessment of the clients. In this, four risk factors
were involved as smoking, consumption of vegetable and inadequate amount of fruit. These four
factors were considered as those that are most responsible for increasing the rate of chronic
diseases. So, the practitioners and nurses in the community care centres and hospitals should
ensure to provide these in equal amount so that the patients can cope early with their issues of
health and mental illness. So, if practitioners focus on providing such care adequately and
equally to every patient dealing with mental illness, then they all can get better fast and have a
lesser inpatient time as well.
Improving mental health services
As per improving mental health services (2018), it has been observed that for about 20%
of the people in Australia are suffering from mental illness and it may be because of any reason.
Some measures and services should be involved by the government in order to exclude some
situations that can lead to mental illness of the people because there may be various reasons such
as poverty etc. So, some measures should be taken in order to prevent such situations. So, it
ensures the urgent requirement of ways to be implemented in community based services so that
the patients suffering from mental issues and illness can be able to get a proper and standard
quality treatment. Also, it focuses on the fact that small programs that are trying to get the issue
down are not that compatible and useful and they will only continue to provide poor service to
such people and because of that, they will continue getting unhygienic as well as unsure services,
which means not being cost effective at all and also delivering poor quality services, which
cannot even provide the surety of some symptoms getting resolved. So, focus should be shifted
on programs that can actually help and also, should be given to each patient equally and
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appropriately so that no sort of discrimination will take place and proper attention and time will
be given to each patient suffering from mental illness.
Compulsory community and involuntary outpatient treatment
According to Steve and Leslie, (2014), various controversies have been brought up on the
fact that whether community based services should be provided to the people with mental illness
or they should opt for compulsory community treatment which is also referred as CCT. It
has been analysed that it helps in modifying the clinical outcomes of the people that are suffering
from mental illness. Also, CCT along with some community based services and that too in
adequate amount if provided to the patients, then they can get better in a faster amount of time.
Cochrane Collaboration's tool has been used for the assessment of the risk of bias. For the binary
outcomes, the rate of risk ratio was evaluated as 95% whereas the rate for continuous outcomes
were analysed as same as 95%. Also, it has been observed that the people who were receiving
CCT, were very less likely to become victims of any crime or other related issues (Ben-Zeev and
Drake, 2013). But CCT is being used widely for the people suffering from mental illness or any
other mental issue. Also, it helps in bringing a sort of stability in the lives of people, so the
practitioners and nurses in community service care centres also focus on providing and using
CCT for the people suffering from any mental illness. So, this treatment can be given to every
patient adequately so that they can get better as soon as possible.
Long term care for people with mental illness
As per Jose (2011), the whole concept of long term mental illness and longer durations in
the health care has been addressed as one of the bigger challenges for several reasons. When the
carer may provide efficient and appropriate services to the patient, it will automatically help the
patient to get better faster. There can be various reasons considered because of which there come
some complications due of which the patient cannot be able to get accurate treatment, thus their
inpatient time increases as well. Sometimes, because of stigma, the patient does not undergo the
specified treatment, which also affects on the duration of them in the community centre. In
contradiction to this, Henderson, Evans-Lacko and Thornicroft (2013) says that it is the
responsibility of the carers to involve some ways through which they can make the patient
comfortable enough so that they may not face any stigma because it is very important that the
patients with mental illness go under every required treatment so that it can help them in getting
better faster. The community based services are popular for providing efficient satisfaction of
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the patients and also be able enough to meet their basic needs and requirements (Corrigan and
Rüsch, 2012). Although, they focus on preventing factors such as stigma of patients etc. so that
efficient treatment can be provided to the patient. As per Jose (2011), when there are sufficient
number of nurses present in the centre, there must not be any issue of the patient carer ratio as it
neglects some patients because of which they have to spend more time in the centre than others
who have been provided with the efficient amount of services. However, it can be evaluated that
there are various factors which can help in proving that the longer term admissions of patients
leads to more complications and also, terms as quite inefficient because it somehow affects the
mental condition of the patient as well because the environment inside and outside these centres
and hospitals is completely different and also, it seems to be irritating for the patient after some
time.
Relationship between practitioners and community based services
As per Jeannemarie (2017), for the person suffering from mental health illness, it is very
difficult for them to deal with the real life situations. Quality care is very important in
community centres so that a proper and efficient treatment is given to the patients suffering from
mental illness because when a person is not mentally active, the power of understanding and
making decisions seems hard enough. So, the practitioners and nurses should ensure the fact that
it is very important for those patients to deal with patience and care so that it does not affect their
mental health any more. In contradiction to this, Munn-Giddings and Winter (2013) says it has
been observed in various cases that a huge range of people are suffering from mental sickness
and it may be because of various factors such as complications with the physical health, issues in
relationships, academic performance etc. So, it should be considered that these people do not
harm or hurt someone deliberately but it is because of their present mental condition that they are
not able to realise and understand what they are doing and what that is impacting upon others
(Henderson, Evans-Lacko and Thornicroft, 2013). So, the nurses should make sure that it is
extremely essential to treat them with proper care so that they can be manipulated easily to go
through treatments and for having specific medications. Therefore, it is equally important to give
equal attention to every patient suffering from this.
Some patients always get neglected as because of various reasons such as culture, race
etc. But it is very important to ensure the fact that as per the equality act 2010, it says there
should be no sort of discrimination in the health and social care centres, whether it is on the base
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of colour, race, gender etc. it is not allowed at all. Therefore, the nurses and practitioners should
treat them equally by giving equal and adequate attention to them by providing efficient amount
of community based services to them. Also, the law says anyone involved in such types of acts
may have to pay huge penalties and also may get suspended of their roles and responsibilities.
RECOMMENDATIONS
The community centres and health care should ensure the fact to involve a sufficient
range of nurses so that in case of many patients, they can be able to give proper and efficient
attention to every single patient separately. This will help patients in getting adequate amount of
community based services, thus they all can have a lesser inpatient time. CCT's can be used in
order to provide a faster and efficient treatment to the people suffering from mental illness, so it
can be considered as a better option to be included in the service care centres. Four essential
factors such as no smoking, no drinking, intake of adequate amount of fruit and regular
consumption of vegetables can be used in order to prevent some sort of relief to the people
suffering from health and mental issues. Also, the centre can provide some sessions for the
nurses and practitioners on how to deal with the people with mental illness as they are quite
sensitive because they are not even able to understand and realise what they are acting and doing.
So, it is very important to treat them with proper care, attention, patience and support. For future
research, a proper methodology can help in getting better results. In the research methodology,
the researcher can make use of the primary data rather than secondary data. Primary data is
considered as the data that is being collected for the first time and involves sources like
interviews, surveys, focused groups and questionnaires. Secondary data has been already
collected by some external body. So, for further researches, the data from surveys, interviews can
actually help in conducting a better methodology that can help the research as for better
analysing the community based services and its impact on the inpatient timing of the patients
with mental illness.
CONCLUSION
It can be concluded from the report that there are various people who are suffering from
mental illness and then, there are various community based services available which can be
provided to them in order to treat them efficiently. The fact to be noticed was that some patients
are being given adequate amount of community based services while some not, so it actually
means to increase the inpatient time for those who are not been given efficient amount of
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community based services. So, the centres along with the nurses and practitioners should ensure
to provide equal and sufficient treatment to the people suffering from mental illness.
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REFERENCES
Books and Journals
Jorm, A. F. (2012). Mental health literacy: empowering the community to take action for better
mental health. American Psychologist. 67(3). 231.
McGorry, P., Bates, T. and Birchwood, M., 2013. Designing youth mental health services for the
21st century: examples from Australia, Ireland and the UK. The British Journal of
Psychiatry. 202(s54). pp.s30-s35.
Corrigan, P. W. & Rüsch, N. (2012). Challenging the public stigma of mental illness: a meta-
analysis of outcome studies. Psychiatric services. 63(10). 963-973.
Ben-Zeev, D. & Drake, R. E. (2013). Mobile technologies among people with serious mental
illness: opportunities for future services. Administration and Policy in Mental Health and
Mental Health Services Research. 40(4). 340-343.
Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013). Mental illness stigma, help seeking,
and public health programs. American journal of public health. 103(5). 777-780.
Munn-Giddings, C., & Winter, R. (2013). A handbook for action research in health and social
care. Routledge.
Drake, R. E., & Whitley, R. (2014). Recovery and severe mental illness: description and
analysis. The Canadian Journal of Psychiatry. 59(5). 236-242.
Wahlbeck, K., & McDaid, D. (2012). Actions to alleviate the mental health impact of the
economic crisis. World psychiatry. 11(3). 139-145.
Online
Kate., B. and et.al., 2013. Evaluating the effectiveness of a clinical practice change intervention
in increasing clinician provision of preventive care in a network of community-based
mental health services: a study protocol of a non-randomized, multiple baseline trial.
Available through:
<https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-8-85>.
Improving mental health services, 2018. Available through:
<https://mhaustralia.org/our-work/improving-mental-health-services>.
Steve., R. and Leslie., A. 2014. Compulsory community and involuntary outpatient treatment for
people with severe mental disorders. Avaialble through
:<http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004408.pub4/abstract>
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Jose., M. 2011. Long term mental health acre for peoplew ith severe mental disorders. Available
through: <https://ec.europa.eu/health/sites/health/files/mental_health/docs/
healthcare_mental_disorders_en.pdf>.
Jeannemarie., B. 2017. An effciient nurse practitioner-Led community based service model for
delivering coordinate care to persons with serious emntal illness at risk for homelessness.
Available through: <http://journals.sagepub.com/doi/abs/10.1177/1078390317704044>
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