A Proposal for Psychiatric Hospitals in Mental Health Hospitals - Research Paper Example

Governor Andrew Cuomo

Office of Mental Health

44 Holland Avenue

Albany, NY 12229

December 15, 2017

RE: Need for exercise skills in psychiatric hospitals in New York State

To the honorable Governor Cuomo,

I hereby write to express my deep feeling on the above mentioned subject. The mental hospitals in the society are under desperate condition, which ultimately affects their patients. The situation also touches the cancer patients and the diabetic patients. As such, the need to include perspectives and vital skills in such institutions in order to give the patients a chance to live like other individuals in the society is stringent. Through implementing these aspects a favorable environment can be created, allowing the patients to express their joy in the society. Furthermore, it can also help in discharge of the patients, as more will heal in the process. The proposal will highly appreciate the involvement of your services in the proposed solution. Thus, the following represents a proposal on the perspectives and skills designed for the program.

Thank you in advance.

Abstract

Recently, a stringent need to add exercise skills and trainings in the psychiatric hospitals in New York State became evident. These vital skills can help calm patients down in the psychiatric hospitals, considering that they feel lonely and alienated from the outside world. The introduction of the PAVES program can also help the patients develop passion in their situation. Currently, patients are often misjudged and overdosed in hospitals. However, the doses can be replaced with an enriching program, which is not currently in existence for this vulnerable population. Exercises help keep the body in good functionality system. When one’s body is not in the excellent functionality, their mind cannot function properly, as exercise helps boost the mental activities (Jung & Hull, 2006). These youngsters should be taught life’s necessary skills such as to know the meaning of life and prepare them for the future. Equally, the number of parents at the psychiatric health institutions supersedes the children. When a parent is a mental health, this can affect the parenting role in the family. In this light, the present proposal approaches the situation of psychiatric patients with serious illnesses, such as Schizophrenia, OCD depression, and bipolar disorder, implying physical training in relevant fields in which the patients seem comfortable. Some of the areas include carpentry, masonry, tailoring, mechanic, and plumbing. The job coaching mentoring program and teaching of activities are designed such as to be easy to understand, being a form of apprenticeship. This paper will cover the perspectives and vital training skills in hospitals with special patients such as mentally ill patients.

Keywords: mental illness, psychiatry, training, vital skills.

Introduction

Statement of need

The present research seeks to determine the situation of the patients in the psychiatric hospitals and some other patients who need special care. The aim of the proposed policy is to equip patients in psychiatric hospitals with structure, routine, and skills for the benefit of their families and society.

Mitrushina, Abara, and Blumenfeld (1994) performed a research in psychiatric hospitals seeking to determine how the patients can be helped to improve their lives. Although the patients were mentally ill, they could perform physical tasks and help build the society (Carter, N. 2015). Their work highlights the importance of providing the mentally ill the opportunity to engage in health physical activities and job coaching (Morgan, 1982). Currently, psychiatric hospitals do not offer enough time for the patients to spend with their loved ones, as they have limited visiting hours. Furthermore, the patients are not sufficiently involved in vital exercises. Thus, there is a need to implement new physical activities for the patients in order to accelerate their healing rate. The program uses local available materials in preparing them. In this regard, Mitrushina, Abara, and Blumenfeld’s research discusses the types of physical activities which should be incorporated and the jobs to be trained on, the type of services, the research design and methodology, along with detailed ethical considerations. Lastly, the authors’ report concludes by addressing the importance of physical activity and job training programs in the mental health hospitals, while revealing methods of disseminating and evaluating the functions.

Mission

To help the mentally ill patients achieve their mission in life and incorporate them in the society and equip them with the necessary life skills.

Vision

To set up a society which values the mentally challenged patients and enlighten them in new areas of duty.

The Proposal

Proposed situation

The current situation in the county psychiatric hospitals is worsening, as the patients are neglected, being deprived of their freedom. They are not given sufficient time for exercise skills and for their loved ones (Jung, C. 2006). Moreover, there are no proper channels to stimulate these patients and help them understand the real life situation outside the hospital. Therefore, trainings should be implemented, such as to prepare them for the better part of life, considering that these patients also suffer from anxiety, as they were neglected by their family members and friends. Ultimately, their loneliness worsens their illness. Patients suffering from Schizophrenia and bipolar disorder were also entangled in the triangle (Galena, 2014).

Proposed solution

The present paper proposes the inclusion of physical activities in the hospitals and job trainings, which seek to train patients on various jobs that they find comfortable. The vital exercise skills and job coaching will be launched every two days of a week. The activity is scheduled to take place for 5 months. However, it should be noted that the patients are drugged on a daily basis and are idle, which worsens the condition.

Benefits of the proposal

The proposed solution will help ease the current situation in the New York Health Institution. As such, it intends to reduce the overcrowding situation, as, at the end of the process, many patients will improve their health and will be discharged. The trainees will operate in different parts of the country, hence, building the economy of the country (Gibeau, 2016).

Background of the Study

Sui Genies research

The proposal can be classified as Sui Genies, implying that it is a unique approach, not performed before. The project aims at giving society opportunity to provide the patients with an emotional disability the opportunity to use their time productively and work towards a common goal. Its uniqueness mentioned above is brought by the transcendent approaches employed throughout it. The step by step methods used seek to better ease the research work, while the psychiatric patients are susceptible to critics and stigma. The study further requires monitoring the patients’ psychology and emotional health, as the psychologies of certain patients need to be treated with special care. The primary challenge implies keeping the patients calm. Furthermore, similar characteristics will be treated the same, while those with different traits receive specialized attention. The study also considers psychological studies, in order to deal with patient’s psychology. As such, inconveniences in psychiatric hospitals can be reduced by creating a more natural environment. Equally, the regular training helps in achieving the primary aim, with the primary objective being to equip the patients with the necessary knowledge required in the areas of practice. The study also involves the education of their behaviors, while the methods of behavior study help in monitoring change over time (Naguib et al., 2017).

The mission and vision of this study was to set free the special patients who were able to work for themselves.

Program Design

The sessions are scheduled to take place at different times, encompassing different programs according to the state of the patients. These programs will be based on the acute, serious and mild conditions of the patients. When considering the training in the mentioned areas of work, the study requires specialists from these fields. As such, carpentry trainees are to examine the skills learned in class to a real-life situation. Equally, masonry and computer trainers will be sourced from the surrounding institutions. It is believed that at the end of the training this program will have saved at least, if not more, 80% of the patients. Upon research, many of the inpatients seem to be capable of physical training, possessing suitable characteristics for training in the physical jobs. Moreover, instruction on proper and successive medication represents another positive aspect. Patients have a medicinal routine and, therefore, should be taught consistently in all hospitals how to take their medicine in time, without skipping doses. In the same light, the training enhances knowledge, attitudes, and skills in clinicians, which make them more competent in the clinic (Carter, 2015).

Aims of the Proposal/ Objectives of the proposal

This research was carried out with the interest of the society and that of the special case hospitals. The society was not fit with less labor and a lot of work. The labor supply was considered as well as the skilled labor. The following are the main objectives of the proposal

• Increase pool of candidates for physical jobs: Several factors were considered in developing the plan. Among these factors are included the low turnouts in the physical job sectors. Currently, the country is running on a low turnout in the blue collar jobs. Many people studied professional careers and pretentious jobs. Research indicates that the blue collar jobs have very few people (Sani, 2006).
• Empowering patients for employment post discharge: Job coaching is aimed at helping the patients start a new life and support their families. Many of the patients are parents and some have families (Britton, 2014).
• Patient training for life skills and acclimating to society: The patients in psychiatric hospitals are not permanently hospitalized. There comes a time when they are discharged and reunite with their families and friends. By the time they are released, they should have proper training from the psychiatric hospitals, possessing the skills required in interacting with the public (Jung & Hull, 2006).
• Evidence based data reveals that exercise helps the body and the mind: The physical activities are also found to be significant, helping the patients recover quickly. When one's mind is involved in physical activity, they tend to cooperate more in the business. (Carter, 2015).

Research Methodology

Research Design

Perquisite visits were made in Agha-Khan hospital, California Psychiatric Hospital, and the Kareem hospital. Some of the hospitals are located in thick forests, which made them difficult to find. The other challenge may result from poor weather conditions, such as mist, which hinders the visibility. The presence of friendly staffs in the institutions makes it possible and easier for the researchers to collect data, while they were all willing to cooperate (Morgan, 1982).

As noted, there is limited international research on the manner of exploring physical and job coaching program in mental hospitals. Many people find it difficult to interact with the psychiatric patients, which hindered research in the hospitals. Equally, certain laws block people from accessing the hospitals, as the patients are considered hostile. According to the federal laws act, there are constraints in sharing substances with the inpatients, such as meals, and mingling, as well as the privacy of an inpatient. In addition, section 264 (privacy regulations) under HIPAA states that the info of any patient should not be disclosed to strangers (Blessing & Chakrabarti, 2014).

Challenges associated with the research design

There are also some challenges in using questionnaire where the data collected cannot be actual. Some people do not give the actual data as they do not feel safe in giving their data to be used. Interviews may also appear to be tiresome and sometimes the interview can fail in the event the persons to be interviewed miss. Some individuals are not comfortable with the interview questions and will answer rudely. The change in environment was also a challenge as the environment was not familiar. The bureaucracy in government offices and some policies posed challenges as this delayed data collection. The letter for authorization to data access and collection took some time to be approved.

Research Methodology

When considering methodology, the proposal employed a mixture of methods in approaching the research. The data collection method used in the first phase of this study is the questionnaire method. Questionnaires were made available to the psychiatric staff based on the strengths and limits of the patients. The reason for choosing the survey focuses on its efficiency on fetching data over along an area of research within a given time (Morgan, 1982). Another reason implies its ability to be used in collecting information based on behavior and attitude, while polls are efficient in comparing data. In this case, the questionnaire offers the possibility to classify the patients into groups with the same characteristics. As such, patients will be able to learn quickly, sharing knowledge with their fellow patients. The questionnaires are also useful in comparing information of the broad population, in this case, the inpatients. Furthermore, considering the limited time for reviewing the survey, the research is also backed up by an interview. Thus, interviews are staged in the hospitals between the staffs and the researchers, with the meetings seeking to expound on the information in the questionnaires. These discussions can help in opening up to the psychiatrists, while highlighting the researcher’s expectations from the training (Mawson, 1982).

A sample of questionnaires was distributed to the staffs and cross interviews were made to the patients. The interviews were best in collecting data as they gave authentic information.

Mixed Research Method

According to Creswell (2005), when one method of research appears to be inadequate, a mixed method research becomes appropriate. In this sense, the researcher developed a follow up, consisting of two phases. The quantitative and the qualitative aspects were used in the first and second follow up stages respectively.

Data Collection and Analyzing

Data collected from the variety of hospitals indicates that most of the patients are in mild condition. Thus, they can respond positively to the proposed research method, with 100 patients out of 150 agreeing to participate in the training. The area of survey implies three psychiatric hospitals, the Agha-Khan hospital, California Psychiatric Hospital, and the Kareem hospital.

After collecting and analyzing the quantitative data, the researcher turns his focus towards the qualitative data. The qualitative data is analyzed, explained, and expounded upon from the quantitative results obtained in the first phase. It should also be noted that, as the methodologies stand alone, they can potentially complement each other while addressing the questions entirely regarding the research. The quantitative component was used to determine the actual population in the psychiatric hospitals and the duration of their hospitalization. It also helped to base the number of acute admissions, as well as the recovering cases. Notably, the quantitative analysis builds up the first phase of the study. Furthermore, the qualitative research elaborates on the manner in which physical and job training can help the inpatients. The mixed research helps in removing ambiguity and doubtless in the research method (Kammen, S-K 1995).

Strategic decision Making Process

This proposal outlines certain perspectives related to vital exercises, while considering the financial, customer, internal process and learning and growth perspectives. These four categories of perspectives should be carried out at a certain time and within the scheduled duration. Nevertheless, the initiative project of vital skills can only be incorporated within the above mentioned perspectives, with a strong focus on the decision making process. Thus, the main aim of the proposal is to bring awareness in the psychiatric hospital towards the training of vital skills (Kds.sagliknet.saglik.gov.tr, 2017).

The internal factors arising from the project are analyzed through SWOT analysis, discussing strengths, weaknesses, opportunities, and threats. According to Sani (2006), the following sections present critical factors in achieving the proposed project.

Strengths of the proposed project

Vital exercise skills help inpatients gain knowledge towards the meaning of life and their future, as the life outside depends on these vital skills. Furthermore, vital skills help the inpatients become aware of the emerging issues in the society. These trainings can create a robust economy, as the inpatients are able to work in different industries and firms. The creation of the perspective can enhance a good relationship between the inpatients and the hospital staff, understanding their condition in a more positive way (Mawson, 1982). The health training are in place with skilled professional and provide clientele.

Weaknesses of the proposed project

Many organizations are not willing to cooperate, as they believe working with the psychiatric inpatients can deliver no positive fruits. Generally, the society and the government have a notion of keeping the inpatients under boundary, considering them critically ill. As such, the participation of the considered stakeholders and hospital personnel becomes a challenge in achieving the established plan.

Opportunities

The training on vital skills can help in creating a more social place for the inpatients, as well as the hospital staff. In addition, the trainees are able to work in different companies, under less supervision, hence, creating a robust economy growth. Equally, young children can substantially improve their future, as they are equipped with the necessary skills. Opportunity for more stakeholder involvement. It also provides staff development opportunities.

Threats

As some of the patients are at a higher risk than others, they can fail to understand the perspectives and the vital skills, ending end up being demotivated which can lead to unsuccessful outcomes or desperate situations. Additionally, some patients are weak and can easily harm themselves in the case they feel pressure to learn new aspects. This can bring staff constraints, staff resistance to change and organizational bias.

Sampling and Participants

Sampling Technique

In the case of the present proposal, the sampling used a specific population, according to acute, severe, and mild admissions in the hospitals. The selected sample for this study implies individuals from the hospitals visited by the researcher. The researcher employed the probability sampling technique, as the samples were random (Cochran, 2006).

California Psychiatric Hospital

In the case of the California psychiatric hospital, a clustered random sampling was employed to select 15 of the psychiatric hospitals. With the director’s approval, mental health nursing access was granted to 700 mental health patients, with 60 questionnaires being distributed within each mental health hospital. According to the sample, 70% of all the hospitals were legible for the service (Gibeau, 2016).

Dissemination of the results

Outcome and Report Accessibility

The present information is available and dedicated to the society and to all non-governmental organizations intending to use it for future studies (Lucas, 1980). Numerous patients receive their treatment at home and they are highly encouraged to contact the researcher for further clarifications. The report is also available to all the authority headquarters and the district health quarters. However, one should note that when assessing mentally ill patients at home care is primordial.

The ways of dissemination should also be discussed, as different media, such as newspaper and televised press can be involved. As noted earlier, the priority of any research is delivering results to the authorities concerned (Dax, 1953). However, this proposal intends to seek funding from the government specifically the Office of Mental Health and any other willing institution on its way towards achieving its completion. As such, the proper communication channels include sending letters to the involved institutions, such as the offices of the health department and the legal measures. Equally, the private sponsors will be invited to the launch meetings to be held weekly in preparation of the plan. Moreover, the national environmental management authorities should be contacted, as vital exercises involve environmental care as well.

Discussions and Findings

Findings

The research found that many mental ill patients were neglected in the hospitals, while some dwell in the society. In addition, some patients suffering from cancer and diabetes are stigmatized and need immediate action. As such, the research highly recommends physical activities, as the situation in the hospitals is worsening day by day. In this light, the training is aimed at giving hope and showing them life beyond mental illness, with the activities involved incorporating psychological training. The research aims to positively transform the lives of mentally ill patients. The research can also be improved, welcoming any further research that can enhance its results.

Discussion

Exercise helps the patients and accelerates their healing. Statutory offerings, which include grownup intellectual health offerings, have the capacity to help mentally ill parents in their parenting function. These services provide them with mental fitness, considering that they are likely to encounter difficulties in parenting, such as throughout an acute exacerbation in their mental illness (Gopfert et al., 2004). Consequently, considering the increasing worries regarding the properly-being of mentally ill parents and their youngsters/households, the need for coverage and exercise among intellectual health professionals becomes stringent, consisting of RPNs (Registered Practical Nurse), training within standard adult mental health services, to interact in FFP. The research showed that the patients need special health care.

Table 1: Staffing plan Sample Description

The managerial department of the involved three hospitals agreed to co-operate in the proposed situation. All the staff congratulated the move and recognized that it can have a positive impact on the institutions. This step was followed by coursing the donors in order to fund the raised plan. As some of the hospitals were overcrowded, the managerial discussion involved the inclusion of the county government under the health department such as to facilitate the implementation of the proposed plan. The social workers have cooperate in maintaining a favorable environment for training, while, during the training, the patient’s behavior is monitored by a psychiatrists. As such, the study has a multidimensional nature, as it is centered on both physical and psychological training ( Rawnsley K, 1977).

Management and Employees plan

The California Psychiatric hospitals scheduled a calendar for the proposed project, along with a plan of setting up the rooms for the training, and budget set aside for the whole project. During the launching of the events, the staff plan also included the family visiting day. Other hospitals to participate include the Agha Khan Hospital, Nazareth Hospital, and the Kareem Psychiatric Hospital. In this light, the NYS DOH can help in sourcing potential sponsors via the three mentioned hospitals (Gibeau, 2016).

Table 2: Proposed Involved parties and the roles in the special skills training

Institution

Management plan

California Psychiatric Hospital

Hold the training venue

The Agha Khan Hospital

Facilitate the provision of Health Services in the training

Nazareth Hospital

Sponsor the computer training skills

Kareem Psychiatric Hospital

Sponsor the sports activities

World Health Organization WHO

Sponsor and oversee the whole program

The Ministry of Health Us

Sponsor of the perspectives and vital skills

(Mental health careers, (2017)

Ethical Considerations

Throughout the research process, the researcher for the above studies followed ethical considerations, as required by the law. All researchers are expected to adhere to ethical principles in their research, while ethics are central to all aspects of a research study, from commencement to completion (Goodwin et al., 2003). This section discusses the ethical considerations underpinning this study. This proposed policy will adhere to strict ethical standards. This proposed policy will adhere to strict ethical standards. This proposal follows the utilitarian ethical philosophy “in a systematic approach toward the benefit of society and the greater good” (Mandal, Ponnambath, and Parija).

The researcher obtained a full ethical review for various reasons. Firstly, the researcher perceived that the support and approval of UCD HREC, including the use of UCD letter head, was highly important in the case of this project (Sani, 2006). Equally, patient confidentiality is part of the code of ethics and it should be maintained at all times. Since according to the ethics, names of the patients should not be revealed, the patients are marked by numbers, which seeks to respect their privacy. The patients will not be allowed to leave the premises after the training, as their conditions can decrease again. The trainees will work in different departments of the government under the ministry of health (MOH), while the staffs in the mentioned hospitals will be trained on how to handle the patients.

Budget Sample (Proposed to request from NYS DOH office Of Mental Health)

The New York society department of health is involved in the funding and sourcing of other financial sponsors, such as the UNHCR and the federal government. The budget for the present proposal needed covers the following: games toolkit, carpentry equipment, tailoring equipment, masonry equipment, trained personnel, transport and communication channels, first aid kits, accommodation.

Figure 1: Budget

Table 3: budget for physical activity and job training in mental hospital

Item

Amount required($)

Games toolkit and aid kits

30,000

Carpentry equipment’s

25,000

Masonry equipment’s

23,000

Tailoring equipment’s

21,000

Transport and communication channels

20,000

Accommodation

35,000

Trained personnel (6)

50,000

Total $104,000

Decision Making Process

The board of directors identified the problems made in the proposal and were able to come up with various decision making. This proposal outlines certain perspectives related to vital exercises, while considering the financial, customer, internal process and learning and growth perspectives. These four categories of perspectives should be carried out at a certain time and within the scheduled duration. Nevertheless, the initiative project of vital skills can only be incorporated within the above mentioned perspectives, with a strong focus on the decision making process. Thus, the main aim of the proposal is to bring awareness in the psychiatric hospital towards the training of vital skills (Kds.sagliknet.saglik.gov.tr, 2017).

Conclusion and summary

As revealed throughout the present research, there is a stringent need to include perspectives and skills training in mental hospitals. As such, they can regain the meaning of life and benefit from a comfortable environment in which they can prosper. Through introducing the perspectives and the special skills training can enhance the relationship of the inpatients and the hospital’s staff. The introduction can be successful through skills search, such as computer training and other perspectives. In order to reach the concerned parties and source donors, the researcher employed proper channels of communication, such as letters. The present proposal has a high potential of helping young patients in the hospitals to gain their future and focus on their lives. Thus, the training programs are centered on delivering the best results, which can bring growth in the country’s economy. This robust economy can ultimately help the country achieve future strategic plans, which represents a general benefit. This program will help the patients gain back the value of life. The essential life skills will help them in economic empowerment as they can work in different parts.