Consumers and Carers as Colleagues - Report Example

Consumers and Carers as Colleagues Name: University: Course: Tutor: Date: Word Count: 2638 Paper 1: Expanded Practice Roles for Community Mental Health Nurses: What do Consumers and Carers have to say? Introduction There has been an extension of autonomous roles of the mental health nurses recently. This has subsequently led to the expansion of community mental health nursing profession. These dynamics have affected consumers and carers the most. However, limited research has been carried out to find out what consumers and carers feel about these new developments in mental health nursing. The paper to be analyzed tries to feel this gap by conducting a qualitative study of the opinions of Australian carers and consumers by conducting interviews. The findings of the study show that consumers and carers perceive the extended responsibilities in a positive way. The dynamics in the nursing practices now places the community first in provision of mental health care. The study further hypothesizes that these changing roles have improved healthcare by reducing inpatient care. (Elsom, et al, 2007). Synopsis There is literature gap that this paper seeks to fill. Although the changing roles in the nursing practice have affected carers and consumers the most, limited literature is available to explain their views on this phenomenon. The paper seeks to establish what the participants feel concerning the extended responsibilities of community mental health nurses. The study is carried out by conducting in-depth interviews on consumers in Australian (n=4) and carers (n=6). Literature Review According to Whiteford, Buckingham and Manderschied (2002), the changes to mental health care have seen positive influence since the community is given priority. This has reduced the inpatient care and improved mental health generally. Mental health care is now provided without much focus on the traditional roles of the medical staff thus creating autonomy and independence. (Clearly, 2004). Furthermore, limited medical resources coupled with the autonomous nursing practices have led to tremendous expansion of the nursing roles. (Dunphy, et al 2004). The growth of the society mental wellbeing care has necessitated the involvement of informal carers. Informal carers dedicate about 104 hours a week in providing health care to mental health patients. Method The study employed a qualitative exploratory approach in which six informal carers and four consumers participated. Participants were selected and interviews were arranged. Among the consumers, two of them had earlier obtained therapy for mental health problems. The carers were all parents of persons who were receiving mental health treatments. Approval from the relevant institutions was sought and participants were given an in-depth explanation of the interview procedure. The researchers also obtained written consent from the participants. An interview guide was developed and the interview questions clearly articulated. Interviews were conducted for a period of between 30 minutes and one hour and the responses captured. Special codes were given to the participants in order to maintain their autonomy. Data Analysis The responses were audio taped and transcribed into a verbatim. Data analysis included the following steps: “getting used to information obtained; recognizing a thematic structure, cataloging ideas; tabling them; and, the recording and analysis of themes.” (Elsom, et al, 2007). Findings Four main themes emerged from the study. First, participants felt that the expansion of the nursing roles would increase the accessibility and convenience of society mental health workers. This accessibility would facilitate treatment in a suitable way. The second theme involved relationship with clinicians. Participants felt that interactions between themselves and the clinicians would improve. Thirdly, the perception of the participants about the benefit to clinicians came out strongly. Finally, there was concern over whether nurses had the relevant training and experience to prescribe medication to mental health patients. (Elsom, et al 2007). Discussion In this paper, a significant literature gap is addressed concerning the perception of carers and consumers on the extended duties of the workers. It was perceived that this expansion positively and felt that it would improve provision of mental health care. The participants felt that the expanded roles of the nurses would increase accessibility to doctors and hence convenience. Earlier studies draw parallels with this study even though they were limited by the fact that they were conducted in primary care settings. (Elsom, et al 2007). Participants also felt that the expanded roles would improve the closeness and interactions with the clinicians. Consumers and carers also acknowledged that nurses would personally benefit from the expanded roles through increased responsibility and efficiency. However, they were concerned about whether the nurses were appropriately qualified to handle the challenges. Generally the program was successful since most participants responded well and found it interesting. The program faced several limitations, which is expected of any study. First, the participants may have provided biased positive responses since they were already interested in the study. Thus, they may not have been a representative of the general population (Happel & Roper, 2006). Conclusion The aim of the study was to investigate the perception of the carers and consumers about the extended duties of the mental health care workers. The significance of the study is that it gives further implications of clinical research. It will also help the medical professionals to have a better understanding of what the participants feel about extended duties. This understanding will improve the value of health care given to mental healthiness patients and by extension the quality of life of consumers and carers. (Cleary et al., 2005) Nurses will therefore be obliged to consider the findings of this study in order to keep abreast of the nursing profession. This will be significant in view of increasing expectation by the carers and customers that they be adequately qualified to face the new challenges. Paper 2: Demystifying research and Evidence-based practice for consumers and carers: Development and evaluation of an educational package Introduction There is growing participation of carers and consumers in mental health care provision. Despite this increasing participation, their involvement in research has not been that prominent. In this paper, consumers and carers understanding oh how research is conducted is explored. The paper gives a study of the consumers and carers attitudes towards research and their knowledge of research practices. The aim of the study was therefore, to fill a literature gap that exists due to lack of research on this issue. The results of the study shows that the participants became more knowledgeable and were enthusiastic in participating in future research through workshops attendance. (Cleary, et al, 2008) Synopsis Provision of good mental health care requires that the consumers of the services participate ion all aspects of the care. The participation of the consumers in mental health care services has increased in the recent past. However, their participation in research has not increased significantly. The paper seeks to explore the consumers’ involvement in research. Literature review The growing participation of customer in mental health care services has been useful particularly in de-stigmatization of the mental diseases. The consumer involvement in addition raises the confidence and helps to defeat negative emotions. However, there exists a literature gap since the effects of these active participations of the consumer have not been documented. The participation of the consumer and carers in research has not been that prominent. Studies have shown that consumers and carers are more eager and interested about learning the research methodology. Since consumers and carers benefit directly from the studies results, it is necessary to inform them of the study findings. In this study, a workshop was created seeking raise participants knowledge of the study methodology. (Cleary et al 2008) Methods During the study, carer and consumer governmental and non-governmental associations were involved to distribute expression of interests that invited people to the workshops. For a period of three months, five workshops were established and a good sample of carers and consumers attended. The contents of the workshops were prepared in conjunction with the hospital staff and the government and non-government carer and consumer organizations. Various topics were covered. The topics covered include; explanation of research, its importance, how it is done, its usefulness to the society, factors that make research successful, limitations of the studies, and ways of gaining access to the results of a study. Exercises were conducted to facilitate discussion among participants. The attitudes of the participants were studied through surveys. Results Forty-five people out of whom 44 completed the survey attended the workshops. This shows a very impressive response rate of 98%. A further 84% of the survey (representing 37 people) was usable. The rest had incomplete data. The male to female ratio was eleven were men (30%) to 26 women, 70%. Furthermore, 25 were consumers, 67.6%, and 4 were carers, 10.8%, while eight were both consumers and carers. The average age of the participants was 48.7 years. (Cleary et al 2008) Most of the participants were very interested in the research workshop. They felt that the research was essential in improving their mental health. However, they identified various obstacles that hinder their involvement in studies. Significance of the study subject, lack of information, fear of being used as guinea pigs, confidentiality, need for incentives and transport problems. Discussion In the research, the attitudes and expectations of consumers and carers towards research were evaluated. Most participants demonstrated deep interest in research. The participants felt that research was critical towards improvement of mental health care. Many participants cited confidentiality, lack of communication by researchers, nature of the research, fear of being used as guinea pigs and lack of incentives among other fears as the primary reasons of not engaging in research. It is therefore clear that attending workshops could increase participation in research. The program was largely a success. However, the program major limitation of the study was the probability of bias since some of the participants may have had interests in research. (Cleary et al 2008) Paper 3: “Mental health peer support for hospital avoidance and early discharge: An Australian example of consumer driven and operated service” Introduction Consumers’ participation in mental health management is essential to the increased recovery of patients. Mental health patients as well as staff view consumers who are living well as role models. (Copeland, 2006) The paper studies how an Australian mental health peer support that provides hospital avoidance and early discharge to consumers of health care services. Consumer participation is through peer support groups. Solomon, 2002, defines peer support as “social emotional support, frequently coupled with instrumental support that is mutually offered or provided by persons having a mental health condition to others sharing a similar mental health condition”(P. 393) Synopsis The study aims at assessing how effective it is in using peers in ensuring hospital avoidance and early discharge to consumers. The paper also evaluates the role of peers in supporting carers and the acceptance of the roles by the medical staff. Literature review As articulated in the illness model, the biggest burden to the consumers is that they stress too much on what is wrong with the consumers rather than stressing on what is wrong with the situation. (Mead & McNeil, 2004). Consumers therefore tend to become passive participants rather than active parties in their care. Consequently, consumers do not become good self-managers and carers do not become good service providers. (Glover, 2005) Hospital re-admission is a common phenomenon in patients with mental health problems. This has largely been attributed to the lack of community support as opposed to the patient’s illness. (Davidson et al 2001). About 30% of all patients relapsed to the hospital after three months of discharge. This paper studies how peer support will reverse this situation. Method The Peer Service at the Southern Mental Health consists of a project manager, the peer coordinator and 8 peer support workers all of whom have prior experience and formal training. The group meets every week to discuss emerging issues in the work place. The coordinator communicates frequently to all the workers for support. Peers also provide mentorship to each other. (Lawn, et al 2008) A statewide call center handles referrals. After receiving the referrals, the Peer coordinator matches them with the consumer’s peer skills and experience. A 3-month pilot period was set as from June to August 2006. Referrals received during this period were evaluated. Feedback was obtained from participating groups such as consumers, peer support workers, mental health staff, carers, GPs, peer coordinator, and MHL staff. Data was collected following ethical approval. The data collected included the benefit to the consumers, views on the role of peers. Findings The study shows that peer support contributed to hospital avoidance with 41 patients showing early discharge while the other eight having hospital avoidance. The peer support contributed to active hospital avoidance in the patients. About 300 bed days were saved by the peer support service. This translates to a monetary value of $113,000. The feedback collected from the participants showed that they felt the peer support was important to them. (Lawn, et al, 2008, pp. 502-507) Personal Reflection to the papers The papers analyzed above addresses very important issues in the mental health care provision. It is a generally accepted fact that the active participation of the carers and consumers will have better impact on mental health care provision. The expanding roles of the community mental health care nurses have had great impact on the health care sector. The findings of the first paper will have great implications for further research and in modifying the clinical practices. It is important that health care professionals understand what the consumers and carers feel. The active participation of consumers is integral in improving recovery-oriented service as shown in the second paper (Lawn, et al p. 479, 2008) Carers and consumers benefits from early recovery, hospital avoidance, and reduced bed days due to the peer support service. Reduction in the number of bed days will not only be beneficial to the carers and consumers but also to the clinical staff as well as the country’s economy. As Lawn, Smith, and Hunter (2008) found out, about 300 bed days were saved, translating to a value of $113,000. (P. 506) It is also interesting to note that most consumers and carers have great interest in research. I personally agree with the findings of the papers. As the illness model outlines, consumers are overburdened by focusing on themselves as the problem as opposed to focusing on their circumstances. (Mead & McNeil, 2004, p. 127). This will change with active participation of the consumers and carers. Conclusion The expectation that carers and consumers should be involved more in provision of mental health care has been growing steadily. Even though their participation in care has increased in the recent past, their participation in research has been minimal. (Price, 2007) The papers explore the roles of the carers and consumers in research. In the first paper, the views of the consumers and carers regarding the changing roles of the nurses are evaluated. The participants view this positively as something that will improve the health care provision. (Elsom, et al 2007). In the second paper, the attitude of consumers and carers towards research is studied. The participants show great interest in research even though lack of communication and incentives hinder their participation. (Cleary et al 2008). The third paper shows how peer support program to Australian consumers lead to early discharge and hospital avoidance. The papers outline very important areas of study that nurses and other medical professionals should strive to pursue. The studies show that the participation of the consumers and carers in all aspects of mental health care will have a positive impact on the service. Furthermore, the importance of incorporating peer support in mental health care is shown to improve health care. It is also important to conduct further research in this area since limited literature is available on many aspects. References Cleary, M., Matheson, S., Walter, G., Malins, G. and Hunt, G. E. (2008). Demystifying research and Evidence-based practice for consumers and carers: Development and evaluation of an educational package. Issues in Mental Health Nursing, 29:131-143. ISSN: 0161-2840 print/1096-4673. Copeland, M. E. (2006). Wellness recovery action plan and peer support. Available at: http://www.mentalhealthrecovery.com Davidson, L., Stayner, D. A., Nickou, C., Styron, T. H., Rowe, M., & Chinman, M. L. (2001). Simply to be let in Inclusion as a basis for recovery. Psychiatric Rehabilitation Journal, 24, 375 – 388 Dunphy, L. M, Young, K. L. and Smith, N. K. (2004) Advanced Practice Nursing. Philadelphia: FA Davis Co. Elsom, S., Happell, B. and Manias, E. (2007). Expanded Practice Roles for Community Mental Health Nurses: What do Consumers and Carers have to say? Issues in Mental Health Nursing. 28: 1065-1079. ISSN: 0161-2840 print/ 1096-4673 Glover, H. (2005). Recovery based service delivery: Are we ready to transform the works into a paradigm shift?. Australian e-Journal for the Advancement of Mental Health, 4(3), 1 – 4. Happel, B. and Roper, C. (2006). When equality is not really equal: affirmative action and consumer participation. Journal of Public Mental Health, 5 (3) 6-11 Lawn, S., Smith, A. and Hunter, K. (2008). Mental health peer support for hospital avoidance and early discharge: An Australian example of consumer driven and operated service. Journal of mental health. 17(5): 498-508. Mead, S., & McNeil, C. (2004). Peer support: What makes it unique? Accessed 2 June 2006 from: http://www.mentalhealthpeers.com/booksarticles.html Price, K. (2007). Nurses in general practice settings: Roles and Responsibilities. Contemporary nurse. 26 (1) 7-14 Solomon, P. (2004). Peer support: Underlying processes, benefits, and critical ingredients. Psychiatric Rehabilitation, 27, 392 – 401. Whiteford, H., Buckingham, B. and Manderscheid, R. (2002Australia’s National Mental Health Strategy. The British Journal of Psychiatry. 180: 210-215 Read More

Interviews were conducted for a period of between 30 minutes and one hour and the responses captured. Special codes were given to the participants in order to maintain their autonomy. Data Analysis The responses were audio taped and transcribed into a verbatim. Data analysis included the following steps: “getting used to information obtained; recognizing a thematic structure, cataloging ideas; tabling them; and, the recording and analysis of themes.” (Elsom, et al, 2007). Findings Four main themes emerged from the study.

First, participants felt that the expansion of the nursing roles would increase the accessibility and convenience of society mental health workers. This accessibility would facilitate treatment in a suitable way. The second theme involved relationship with clinicians. Participants felt that interactions between themselves and the clinicians would improve. Thirdly, the perception of the participants about the benefit to clinicians came out strongly. Finally, there was concern over whether nurses had the relevant training and experience to prescribe medication to mental health patients.

(Elsom, et al 2007). Discussion In this paper, a significant literature gap is addressed concerning the perception of carers and consumers on the extended duties of the workers. It was perceived that this expansion positively and felt that it would improve provision of mental health care. The participants felt that the expanded roles of the nurses would increase accessibility to doctors and hence convenience. Earlier studies draw parallels with this study even though they were limited by the fact that they were conducted in primary care settings.

(Elsom, et al 2007). Participants also felt that the expanded roles would improve the closeness and interactions with the clinicians. Consumers and carers also acknowledged that nurses would personally benefit from the expanded roles through increased responsibility and efficiency. However, they were concerned about whether the nurses were appropriately qualified to handle the challenges. Generally the program was successful since most participants responded well and found it interesting. The program faced several limitations, which is expected of any study.

First, the participants may have provided biased positive responses since they were already interested in the study. Thus, they may not have been a representative of the general population (Happel & Roper, 2006). Conclusion The aim of the study was to investigate the perception of the carers and consumers about the extended duties of the mental health care workers. The significance of the study is that it gives further implications of clinical research. It will also help the medical professionals to have a better understanding of what the participants feel about extended duties.

This understanding will improve the value of health care given to mental healthiness patients and by extension the quality of life of consumers and carers. (Cleary et al., 2005) Nurses will therefore be obliged to consider the findings of this study in order to keep abreast of the nursing profession. This will be significant in view of increasing expectation by the carers and customers that they be adequately qualified to face the new challenges. Paper 2: Demystifying research and Evidence-based practice for consumers and carers: Development and evaluation of an educational package Introduction There is growing participation of carers and consumers in mental health care provision.

Despite this increasing participation, their involvement in research has not been that prominent. In this paper, consumers and carers understanding oh how research is conducted is explored. The paper gives a study of the consumers and carers attitudes towards research and their knowledge of research practices. The aim of the study was therefore, to fill a literature gap that exists due to lack of research on this issue.

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