Understanding Care Management of Social Work in Community Mental - Report Example

Understanding Care Management of Social Work in Community Mental Health al Affiliation Areas of Care Management Mental care management has several aspects that need to be considered for the best care to be given to those who seek mental health services. According to NHS (2012), it requires the working together of various practitioners so that they can provide the best patient centered care. This involves the prevention, diagnosis, treatment and management of these cases. Typically, the management entails designing, evaluating and implementing the needed interventions to handle both acute and chronic mental health conditions. The national Quality Protects objectives are normally adapted to improve care management and service delivery for both children and adults. In the diagnosis, evaluation, treatment and management of such conditions, it is normally imperative to ensure that the patients are attached to the carers who have the capability of providing them with not only safe but also effective care for the duration of the service. As such every aspect of the management should always be designed in a way that ensures the patient always gets services from practitioners who are capable of giving effective services. This at times requires the formation of a multi-disciplinary team to help out in giving the best possible care. During the various management stages, the patient must always be protected from physical and emotional abuse. This is in addition to minimizing chances of sexual abuse and neglect. According to NHS (2015) it is usually the duty of the care giver and the mental health facility to ensure that patients gain maximum benefit from the services offered. This is made possible when the social, physical and emotional needs of those benefitting from the plan are identified. When this is effectively done, it will be possible to provide the appropriate conditions and settings both in the facility where care is being provided and in the community (Enable 2014). Such needs should always be regularly and adequately reviewed. The review helps in identifying emergent issues and problems and effectively tackling them so that the best outcome can be realized. The users and the carers need to be involved in identifying the needs of the patients. By doing this, the planning and tailoring of the services will occur in a manner which ensures individualized care that is appropriate in dealing with mental health problems. Emerson & Hatton (2009) state that it is common to find care givers coming up with diagnosis and treatment plans without the involvement of the patients. In some extreme circumstances, the plans used are standardized for all cases. In such scenarios, the individual needs and issues affecting a patient or a community will not be captured. The outcome is that the best services will not be provided. When doing referrals as well as in the assessment process, it is also imperative to discriminate between the dissimilar types and levels of needs. It helps in coming up with a more timely and effective response and intervention. Mental Health Act Application and Assessment Process The assessment process is a very important aspect of mental health care. This process is normally guided by the Mental Health Act (Simons 2006). This Act redefines the circumstances and the conditions under which an individual can be subjected to compulsory assessment and treatment (Mental Health Act 1983; Mental Health Act 2007). Moreover, it gives out the rights of such people and ways through which these rights can be protected by those who are involved in the process. Health care professionals are expected to follow and abide by these provisions that consolidate the various laws related to mental health care treatment. The Act has four sections that address mental assessment and treatment (NHS Management Executive 2010). Section 2 of the Act gives Approved Mental Health Professionals the ability to detain an individual in hospital so that assessment of his mental health can be done and any kind of treatment needed administered (Centre for Residential Child Care 2010). The assessment will look at whether the person is suffering from a mental disorder, the type of disorder in question and whether treatment is needed or the particular case. This section applies to the people who had not been assessed before or those who have not undergone examination in a hospital for a significant duration of time. Section 3 of the Act provides guidelines for detaining individuals for his own safety and for the protection of other persons. One can be detained under this provision if he has a well-known mental health condition and thus does not need the assessment required in Section 2 of the Act. Section 4 on the other hand relates to cases of emergency (Mental Health Act 2007). This focusses on the detainment for a shorter duration of time. It is done for four major reasons. They include; evaluation for medical treatment, when section 2 is not applicable as it brings delays, and when it is done for the best interest of the patient. It is also used if there is urgent need for admission and using Section 2 may introduce delays. The Mental Health Act also allows the nurse or doctor to stop a person from leaving a hospital or health care facility (Shaw & Amos, 2014). This is given in Section 5 of the act. It is used when it is deemed possible that section 2, 3 and 4 cannot be effective. Section 5(2) gives the doctor who is in charge the powers to detain the patient (Heller, Miller & Factor 2009). However, he must give a report indicating why it was necessary to do this. Section (4) gives the nurse the powers to immediately stop the patient from leaving the facility to protect him or other people. In all the four sections, application for admission to the hospital must always be made by an Approved Mental Health Professional (UKCC 2010). A close relative can also carry out the application. These requests should be seen within fourteen days and reviewed by two separate doctors who are specialists in mental health care. After studying the requests, the doctors have to see the patient within five days and admission done within 14 days after the final examination is done. It is imperative to remember that throughout the process the interest of the patient in question should always be put in the fore front. The Mental Capacity Act The Mental Capacity Act plays a very vital role in metal health care management. It is designed to protect and also empower persons who do not have the mental capacity to make sound resolutions regarding the care and treatment which they may require. According to Bersani (2010) this law applies only to persons who are aged 16 years and above. These people may lack the mental capacity as a result of several reasons including mental disorder and memory loss. In applying the provisions of the act, it is normally assumed than an individual has mental capacity until it has been proven that he does not through an assessment (UKCC 2011). All the decisions made prior, during and after the evaluation and treatments are always to be in the greatest concern of the individual seeking the services. The Act goes further to states that the liberty of the person can only be taken away under specific conditions in given situations. This should be the least restrictive way of keeping the person safe. Every individual working with or caring for a person who is lacking some mental capacity is expected to conform to the Mental Capacity Act as well as its codes of practice. It directly affects the lives of several individuals who suffer from such conditions and their carers. It influences how these people are supported in whatever area they live in. Registered persons and professionals are encouraged to comply with the act and promote its awareness. To do this, they need to always know that the patients must be helped in making decisions. Individuals must not be treated as being unable to make decisions until the right kind of steps have been made to help him do so without success. Moreover, the Act makes it clear that making unwise choices should not be taken to mean that the person lacks mental capacity (Jones 2013). When it has been determined that an individual lacks mental capacity, the doctor or the nurse is tasked with the responsibility of making some decisions regarding treatment on behalf of the patient. It may include the interventions needed as well as the treatment plan that will benefit them. In doing this, the acts done and choices opted for must be ones that will benefit the patient without necessarily having to compromise their interests. One way of doing this is by taking their various needs into account in all the processes. Moreover, such acts and decisions must always be applied in ways that are less restrictive to the person’s rights of action. Overview of appointee-ship Due to the inability of some persons having mental health disorders to make certain decisions on their own, the law allows for the appointment of a different individual to act on their behalf. The person may be an officer or a relative to the individual having mental disorder. According to Munro & Rumgay (2010) this only happens when the person is totally unable to manage his or her affairs. This practice is normally referred to as an appointment to act while the individual accorded the new responsibilities is called an appointee. An appointment should never be made just because it is convenient to either the care giver or the prospective appointee. On the contrary, it should be done if it is deemed that such a move will have positive impact on the wellbeing of the individual in question. It applies to an individual who is eighteen years and above and at any particular time, there should only be a single appointee acting on behalf of the patient or the individual seeking mental health treatment. Prospective people who can be allowed to do these include an individual, organization or its representative or a limited company (Freeman 2009). There are several benefits associated with appointee-ship. The first one is that through the practice, a patient may be able to receive the care that could have otherwise been difficult to get due to their inability to make decisions. The appointees makes crucial decisions on behalf of the patient including matters to do with finances and when done as per the interest and needs of the patient, the outcome will be positive (Jones 2013). The second advantage of the practice is that it hastens the pace at which care and treatment is given to the patient. This happens when the responsibility of making choices is placed on a person with sound mind. The final major plus is that it ensures that the rights of the care seeker are maintained. There are, however, a couple of shortcomings of this intervention. The main issue is associated with the person appointed not acting on the best interest of the primary beneficiary. Since the patient might not know when the appointee is not acting in their best interest, it usually rests on the other individuals and practitioners to raise the concerns with the relevant officers and stakeholders. The other shortcoming is that appointee-ship may entail additional charges. Some of those who take up the responsibility may ask for charges so that they can give the services. The final shortcoming is that it may lead to the misappropriation of funds that were intended to help in giving the patient the best care. Despite these challenges, appointees play a crucial role in mental health care. Supervised Community Order (CTO) Supervised community Order was introduced into the Mental Health Act in November 2008 under section 17A-G. It is every so often referred to as the community Treatment Order. Those who are subject to CTO are normally called the community patients (Heller, Miller & Factor 2009). Before the introduction of this section, the nearest equivalent was the supervised discharge that was addressed in Section 25A-J of the mental Health Act. The transitional provisions required that during the first six months of receiving after-care under the supervision of the carer, the patients were to be assessed and placed on guardianship as per the requirements of section 2 and 3 of the Act. According to Health and Safety Executive (2011), the CTO is usually an option to the section 3 of the mental Health Act. It is also used when dealing with criminal patients who are not restricted. In the provision, a person may not be given a longer term leave to be away until clinicians decide whether they should be discharged from the hospital as per section 17 (2A) on a CTO. CTO further defines a longer term leave or absence as seven consecutive days or an extension that will tally up to equal days. For supervised Community Order to be used, there are five core conditions that must be met. The first one is the person in question should be having a mental disorder that is of a nature requiring a certain kind of treatment or intervention. Secondly, it should be necessary for the treatment to be given to the patient for his health and safety or for that of other individuals. The third condition is that the treatment should be one that can be given without the patient being detained further in the hospital or health care facility. However, a clinician should be able to recall the patient back to the hospital as provided for in Section 17E (1). Finally, appropriate medical treatment must be available. The detention time under the CTO is normally the same as that under Section 3 of the Mental Health Act (NHS 2014). In the first period, it takes a maximum of 6 months. This can however be reviewed to another 6 months and subsequently 12 months as per section 17C and section 20A (3). It is mandatory for the clinician to ensure that the person will make it for examination when deemed appropriate. In addition, if a certificate is to be given under Part 4A of the act, the person must make it for examination which is to be carried out. Biopsychosocial Factors of Child Development in Mental Health There are several biological, social and psychological factor which lead to developmental dysfunctional in adolescents. Most of these factors are biological. According to Jones (2013), there are some mental illnesses that are normally linked to abnormal functioning of certain nerve cells and pathways that connect certain brain sections. The nerve cells in these circuits communicate by means of neurotransmitters. When there is improper functioning, the communication is hindered and thus resulting in development of mental issues. The other biological factor is genetics. There are some disorders that run within a family. This means that an individual with a family member who is having such a condition may be at risk of developing it. The susceptibility will be passed from one individual to the other through genes. According to Taylor & Gunn (2009), despite the fact that the genes can be inherited, it is the interaction between them and the environment that results in the development of the illnesses. As such, it is likely that an individual can inherit the susceptibility but still avoid developing the illness. However, events such as sickness, abuse and stress can trigger the condition. Certain infections during childhood can also case the illnesses. These are contagions that damage the brain. An example is the pediatric autoimmune neuropsychiatric disorder. The infection is caused by a bacterium called Streptococcus and is attributed to mental disorder in both children and adults (Becker & Vazquez-Baquero 2012). Brain defects and injury to certain brain regions are also known to result in certain mental illnesses. Other biological factors include prenatal damage and exposure to toxins like lead. These factors do not only cause the illnesses but also worsen the symptoms. Stressful life conditions and situations also increase the chance of developing the disorders. These may include financial problems, losing a loved one or being separated from parents. Other children who are abused and neglected while growing up have also suffered from such conditions. Generally, mental illness and disorder is a common phenomenon. It is reported that about one in every five adults experience such illnesses on yearly basis. It can initiate at an early age or later on in adulthood. Mental Health Assessment Due to the high prevalence of the mental illnesses and disorders, it is normally imperative to carry out an appropriate assessment that is key to giving the best intervention to the patients. Holistic assessment is normally used. Extensive training, coupled with experience in various mental health settings allow clinicians to come up with the best care plan and intervention (Bradley & Bersani, 2011). Holistic assessment entails considering all the aspects of the patient’s life as well as his needs. It goes beyond identifying the mental issue itself. In carrying out holistic examinations, several steps and procedures are usually followed. The first one is the identification of both the current as well as the past mental health problems that have been encountered by the patient. It may require the carer to give his or her informal perspective about the conditions. The clinician identifies both the past and the current interventions used for the identified mental problems. It entails looking at the outcomes and acute and adverse side effects of these interventions. The third component of holistic assessment is looking into the person’s personal, social and family situations and circumstances. This is usually done to identify the various biopsychosocial issues that in one way or the other impact on the mental status of an individual. The other issues that are considered in this evaluation approach include the physical health, life skills, service needs and drug and alcohol use (Simons 2010). Furthermore, the capacity of the individual to consent to the planned care and treatment need to be looked at. Clinicians are asked to record the target time for the completion of the assessment which they are carrying out. This way, they can easily screen and track the various components of the approach. All this is done so that the most appropriate treatment and plan of care which will benefit the patient is developed and used for the best outcome. Reference List Becker, T & Vazquez-Baquero, J. 2012, ‘The European perspective of psychiatric reform. Acta Psychiatry Scand, vol.410, no. 1, pp. 8–14. Bersani, H. 2010, Family Monitoring: Making Sure a House is Still a Home. Paul Brookes, Baltimore MD. Bradley, J & Bersani, H. 2011, Quality Assurance for Individuals with Development Disabilities: It’s Everybody’s Business. Paul Brookes, Baltimore MD. Centre for Residential Child Care 2010, Physical Restraint – Practice, Legal, Medical and Technical Considerations. Centre for Residential Child Care, Glasgow. Emerson, E & Hatton, C. 2009, Moving Out: Relocation from Hospital to Community. HMSO, London. Enable. 2014, Stop It! Bullying and Harassment of People with Learning Disabilities. Enable, Glasgow. Freeman, H. 2009, Community Psychiatry. Mosby-Wolf, London Health and Safety Executive, 2011, Health and Safety in Care Homes.[online]. Available at: < http://www.hse.gov.uk/pUbns/priced/hsg220.pdf> Heller, T, Miller, A & Factor, A. 2009, ‘Autonomy in residential facilities and community functioning of adults with mental retardation’, Mental Retardation, vol. 37, pp. 449-457. Jones, K 2013. Asylums and After. Athlone Press, London. Mental Health Act 1983. London. Mental Health Act 2007. London. Munro, E & Rumgay, J .2010, ‘Role of risk assessment in reducing homicides by people with mental illness’, Br J Psychol, vol.176, pp. 116–20. NHS 2014, A guide to Mental Health Services in England. Available from [Online] Accessed 8 march 2015. NHS 2012, All Mental Health Trusts- What is a Mental Health Trust? Available at: [Online] Accessed 8 march 2015. NHS, 2015. NHS Authorities and Trusts. Available at: [Online] Accessed 8 March 2015. NHS Management Executive 2010, A Guide to Consent for Examination of Treatment. NHS Management Executive, Leeds. Shaw, J &Amos, T 2014, ‘Mental illness in people who kill strangers: longitudinal study and national clinical survey’, BMJ, vol. 328, pp. 734–7. Simons, K 2010, Whose Home Is This? Pavilion Press, Brighton. Taylor, P & Gunn, J 2009, ‘Homicides by people with mental illness: myth and reality’, Br J Psychol, vol. 174, pp. 9–14. UKCC (2010) Guidelines for the administration of medicines. Central Council for Nursing, Midwifery and Health Visiting (UKCC) UKCC (2011) Position statement on the covert administration of medicines. Central Council for Nursing, Midwifery and Health Visiting (UKCC) Read More