Challenges caregivers face when caring for individuals with mental illness

Respond to at least two different colleagues’ postings in one or more of the following ways:

Expand on your colleague’s posting by explaining additional challenges caregivers might face when caring for individuals with mental illness.

Offer a different intervention that might also address caregivers’ challenges.

Explain how the local resources your colleague described are similar to or different from the resources in your local area.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of your colleagues’ comments.

Use Reference

DB 1

Lorie—

Post a brief explanation of how the deinstitutionalization policy has affected inpatient psychiatric care.

Since the 1950s, the creation of policies in the United States has been gradually decreasing inpatient psychiatric hospital beds and there has been a shift to deinstitutionalize those who are mentally ill and release them to be cared for in community mental health services (Hudson, 2016).The costs of this shift have been attributed to homelessness, nursing home care, and criminalization of the mentally ill (Hudson, 2016), but it also impacts inpatient psychiatric care with more individuals in the community needing specialized inpatient care.Hospitals with specialized psychiatric units are critical for the treatment of mental health dis s that may not be provided by community outpatient services, such as crisis care, short-term detoxification, complex drug therapy, and stabilization of patients (Stensland et al., 2012). Hospitals had to create inpatient psychiatric units to manage the population that was no longer living in institutions.

Then, explain how the policy affects the roles of psychiatric social workers in providing care for patients with mental illness.

Psychiatric social workers care for individuals who are mostly “suicidal, homicidal, or decompensating (experiencing the rapid return of severe or psychotic symptoms) to such a degree that they cannot care for themselves nor respond to community-based interventions” (Beder, 2013, p. 158). This requires specialized training and working with a multidisciplinary team.Johns Hopkins Medicine reports social workers in the psychiatric unit of the hospital are involved in educating patients and their families on how to best manage their illness and where to get the support they will need in the community. This role would be essential due to the deinstitutionalization policies that shift care to the community.

Considering the policy, explain the challenges and issues caregivers face when caring for individuals with mental illness.

The move to deinstitutionalize mental health has brought challenges to not just the community, but also the family members who are caregivers.Their responsibilities have increased where they are now dealing with more caregiving, frequently experiencing stigma, shame, and they may be blamed for the illness, treatment non-adherence, and other harmful effects (Beder, 2013).In the institution, their loved one was cared for by professionals who were trained and had specialized skills.

Identify three resources (provide name and web address) available in your local area (county or state) to support patients with mental illness and caregivers. Explain whether these resources are adequate to meet the needs of mental illness patients and caregivers. Justify your response.

The following are three local resources that support those with mental illness and their caregivers:

The National Alliance of Mental Illness (NAMI)– Tri-Cities https://namitricities.org/

Lourdes Counseling https://www.yourlourdes.com/mental-health

Comprehensive Healthcare https://comphc.org/locations/pasco-2/

NAMI can help individuals and families feel less stigmatized by connecting them with others in the community.Lourdes and Comprehensive Healthcare use professionals that are experienced in mental health and they provide comprehensive specialized inpatient and outpatient treatment.They can also link families to other resources and referrals in the community that can help improve their quality of life.

References

Beder, J. (2006). Hospital social work: The interface of medicine and caring. Routledge.

Hudson, C.G. (2016). A model of deinstitutionalization of psychiatric care across 161 nations: 2001-2014. International Journal of Mental Health, 45(2), 135-153.

Johns Hopkins Medicine. (n.d.). The history of psychiatry social work. Retrieved from http://www.hopkinsmedicine.org/psychiatry/expert_t…

Stensland, M., Watson, P. R., & Grazier, K. L. (2012). An examination of costs, charges, and payments for inpatient psychiatric treatment in community hospitals. Psychiatric Services, 63(7), 666-671.

DB 2

Erika—

A brief explanation of how the deinstitutionalization policy has affected inpatient psychiatric care:

According to Hudson, deinstitutionalization is associated with income inequality, racial and ethnic diversity, low population density, a high Human Development Index, psychiatric commitment laws, high incarceration rates, among other conditions. The deinstitutionalization movement, which shifted patients to the community for care, took off in the 1950’s shift to the community (Beder, 2006). The purpose of this shift occurred because of the growing need for mental health services, and it cost taxpayers too much to fund these services.The policy freed up space to help sick patients and lighten inpatient mental health workers’ workload.The policy created more jobs for mental health workers in the community.With the passage of the Community Mental Health Act in the 1960s, the federal government assumed most of the financial burden for a huge portion of the mental health services provided.

How the policy affects the roles of psychiatric social workers in providing care for patients with mental illness:

The demand for psychiatric social workers grew, and they could provide longer in and outpatient services.According to Beder, with the person-in-environment perspective, it seems natural that social workers would have become central players in developing and implementing psychiatric services.

Explain the challenges and issues caregivers face when caring for individuals with mental illness.

The caregivers are not trained properly to handle the actions of their family members with mental illness. Depending on the patient’s age, it is hard to seek help because they still have rights even in their unstable condition. If the person is a danger to themselves or others, there are some legal options for the family member to have them admitted to the psychiatric facility—involuntary evaluation and treatment (302) to a psychiatric unit in a community hospital. Voluntary Commitment (“201”) A voluntary commitment may be appropriate for anyone 14 years of age or older who is experiencing a mental health crisis and feels that an in-patient stay is necessary for his/her safety. Emergency evaluation (aka “a 302”): This is typically the first step of involuntary treatment. When a person is believed to be a danger to themselves or others due to mental illness, they can be taken to a hospital and evaluated by a physician.

Identify three resources (provide name and web address) in your local area (county or state) to support patients with mental illness and caregivers.

1. MHMR of Tarrant County- www.mhmrtarrant.org

2. NAMI Tarrant County- http://www.namitarrant.org

3. Trinity Springs –https://www.jpshealthnet.org/locations/trinity-spr…

Explain whether these resources are adequate to meet the needs of mental illness patients and caregivers. Justify your response.

MHMR provides help to children, adolescents, and adults with severe mental illness and other serious emotional disturbances.MHMR of Tarrant County is an income-based outpatient clinic. Some individuals with health insurance may be served if MHMR accepts that type of insurance. The resource is not adequate because they can only service a specific number of patients per day. If you have insurance, you are only allowed one initial visit, and then you are referred to (JPS). John Peter Smith hospital is mainly for the uninsured population; however, insured patients are welcomed.Trinity Springs is located on the grounds of JPS. They provide in-patient mental health care to a select number of patients. Overall, there is a shortage of funds, workers, and space to service a large population of mentally ill individuals. According to the government website, The State of Texas has only 10 state mental hospitals. From personal experience, It seems you are penalized for having health insurance through your employer or retirement. Most of the free or reduced services such as crisis line to get a patient admitted is for the uninsured. When a person is having a crisis, it shouldn’t matter if there have insurance or not.

References:

Beder, J (2006) Hospital Social Work: The Interface of Medicine and Caring. Routledge: New York, NY.

Chapter 14, “Social Work on the Psychiatric Unit” (pp. 151-161).

Hudson, Christopher J.(2016)A Model of Deinstitutionalization of Psychiatric Care across 161 Nations: 2001–2014,International Journal of Mental Health,45:2,135-153,DOI: 10.1080/00207411.2016.1167489