Personal Reflection On Community Psychiatry And Mental Healthcare Nursing Essay

Personal Reflection On Community Psychiatry And Mental Healthcare Nursing Essay As a part of my clinical SSC, I had to do visits to a variety of mental health care settings: 1 visit to River House at Bethlem Royal Hospital 1 visit to Scutari Clinic at St Thomas Hospital 1 visit Cheyne Ward at Kings College Hospital 4 visits to 190 Kennington Lane Clinic These visits broadened my knowledge about mental health care and the services provided. In each placement, I observed at least one consultation and had an opportunity of talking to a variety of health care professions about mental health care services and patient care. This reflective account discusses my experiences in the mental health care and the things that I observed. A Brief History on Psychiatry Psychiatry can be defined as the study of mental illnesses, their diagnoses, management and prevention (Oxford Medical Dictionary) and when this is carried out in the community, it is called community psychiatry. Here is a brief timeline of transformation from mental asylums to community based care: In 1601 the Poor Law was established which stated that individuals who were unable to care for themselves should be supported (History of Mental Health and Community Care- Key Dates, Mind.org.uk). In 1800s, introduction of the County Asylums 1808 allowed the asylums and psychiatric hospitals to be established, treating mentally ill patients (History of Mental Health and Community Care- Key Dates, Mind.org.uk). The number of bed allocated to patients with mental health problems was at its peak in 1954 (152,000 beds). However, with the introduction of new treatment plans, such new anti psychotic medication, rehabilitation in community, the numbers of people being admitted to psychiatric hospital reduced (ABC of Mental Health, 2nd Edition and History of Mental Health and Community Care- Key Dates, Mind.org.uk). Mental health care centres were the one of the steps taken in terms of the implementation of mental health care policies in 1980s (Sayce et al. 1990). 1990s, mental health care in the community was reformed and implemented a form of community mental health team which is a team of professions including a psychiatric, psychologist, social worker, occupational therapist and care coordinator, manage people with mental illnesses in the community settings (ABC of Mental Health,2nd Edition). Community Mental Health Team and Other Services Mental health problems are normally managed by primary health care, e.g. GPs, and referrals can be made to either community mental health teams or secondary health care if needed (ABC of Mental Health Care, 2nd Edition and Mental Health Policy Implementation Guide: Community Mental Health Teams, 2002). The majority of the patients who use the services provided by community mental health care teams have time limited problems and will be referred back to their general practices once they have made the necessary recovery (Mental Health Policy Implementation Guide: Community Mental Health Teams, 2002). Reflecting back upon a consultation that I observed at Kennington Lane Clinic, a patient was discharged from the clinic after having used the services as there was a significant improvement in her condition. One of the reasons for the referral to community mental health care team is that primary health care may not be able to offer services such as cognitive behavioural therapy or rehabilitation, required for patients with certain mental disorders, for example obsessive compulsive disorder (Mental Health Policy Implementation Guide: Community Mental Health Teams, 2002). Once the referral is done, patient is risk assessed and assigned a care coordinator, who would support, advice and have a regular contact with the patient. At Kennington Lane Clinic, the care coordinator whom I spoke with stated that when one of his patients do not attend a scheduled appointment, then he would go to visit this patient at his/her home so in other words, providing a continuity of care and support. During my time at River House, a medium secure hospital, one of the doctors that I have met articulated the fact that medium secure hospitals fill the gaps that are created by both the psychiatric units of general hospitals and the high secure hospitals. Since the patients admitted to medium secure hospital are not suitable for both: high secure hospitals may not accept these patients because they are not dangerous or insane enough and psychiatric units of general hospital may find these patients dangerous enough to refuse the admission. Therefore, medium secure hospitals are solely developed to accommodate such patients. The same principle can be applied to community mental health teams as they are thought to form a bridge between primary and secondary health care (ABC of Mental Health Care, 2nd Edition). During the transformation to community based psychiatry, it was thought that the prevalence of homicide carried out by psychiatric patients after deinstitutionalisation was going up but in fact these claims were not accurate (Fakhoury and Priebe, 2007). Deinstitutionalisation and allowing patients with psychiatric problems to be managed and cared for in the community settings intended to lessen and curtail social stigma related to patients with mental health problems, to integrate these patients into the community, and importantly to reduce and prevent long term hospital stays (Fakhoury and Priebe, 2007). So, one can conclude the fact that Community health care teams allow patients with mental disorder to stay in the community and have a life that as normal as possible. However, Fakhoury and Priebe, 2007 stated that community psychiatry has not quite achieved its goal in terms of social integration as most of the psychiatric patients in the community are unemployed, live in a sheltered accommodation or even homeless. During my time at Kennington Lane Clinic, I met a patient whom I will be naming as Mr. A due to confidentiality code. This patient looked depressed and was complaining about having nightmares, unpleasant thoughts and phobia of using public transport. He also mentioned having thoughts of self harming and suicide. On further questioning, he revealed that he did think about committing suicide by overdosing himself with his antidepressants but could not do it as he could not find a place to do it: he is unemployed, homeless and lives with his elderly parents and occasionally with his daughters both of whom are married. In terms of what observed and felt at Kennington Lane Clinic, patients whose files that read or met were either using street drugs or having housing problems compared to the patients that I saw at Scutari Clinic in St Thomas Hospital, however this may not be the case in general since I cannot generalise what I observed during my time at both places to the rest of the country. One of the main difficulties experienced by the community mental health team is that the DNA (Did Not Attend) rates are very high in comparison to out-patient clinics at hospitals. I visited Kennington Lane Clinic four times in total but managed to observe only two consultations so I had to read the patient files and talk to their care coordinator instead. At the Scutari Clinic, I noticed that almost all the patients did attend their scheduled appointment with the doctor. I could not help but ask the duty doctors about the rate of DNAs both at the community based clinics and hospital based outpatient clinic levels and the answer that I received did confirm what I observed. I believe that one of good things about community mental health teams is that they facilitate home visits which are not normally offered for the patients attending out-patient clinics. I agree with William R. Breakey, the author of Integrated mental health services: modern community psychiatry, that home visits allow clinicians to see patients in their own surroundings and to allow them plan an appropriate care plan for a particular patient. Of course, there is a variety of services dedicated to patients with mental health problems: an appropriate choice of service would be chosen for the patients best interest. Reflecting back on my time at Kennington Lane Clinic, I came across Mr Bs file from which I read his past medical history and discussed this patient with a social worker who was involved with this particular case. On discussion, I found out that he was originally referred to the clinic by his GP and treated by this clinic quite a long time but unfortunately was relapsing and not compliant with his medication. When something like this is the case, patients can be detained at hospital against their own will under the Mental Act legislation (Rethink, Factsheet, 2010). This particular patient was going to be detained under Section 2 for 28 days. In order to carry this out, the patient had to be seen by 3 professions (2 psychiatrics and 1 social worker) in the presence of police. These three professions are specialise d in mental health care that would assess the patients mental state and make a decision. In addition, during my time at Cheyne ward, I shadowed a senior registrar who was on call in AE. I managed to observe a consultation which lasted about 30 minutes. Mr C was complaining about low mood and was self-harming. Having learnt that his father had a history of long term depression and his relationship with his father is not good, he was suggested to stay in hospital in order to carry out a full mental assessment. End the end of the consultation; he was happy to go ahead with this decision. As can be seen, the main difference between these two cases (Mr B and Mr C) is the way of the admission process: one is being admitted to hospital by force and the other one is giving consent. Mr C is an example of informal patient who is admitted to hospital with his own will and not detained under the Mental Health Act legislation, whereas Mr B is sectioned under the Mental Health Act legislation and cannot have the right refuse treatment. All in all, this revolution of change from hospital based treatment to community based treatment played an important role modernising the mental health services in the UK. Community mental health care provides help and support to those with mental illnesses at the community settings and appropriate patients are referred to this service. From what I observed and read, I can confidently say that community mental health services provide a care that is continuous and offer advice.

How to work on complex tasks in a team Essay -- Management

Every day in our life we come across challenges. It becomes imperative that we find solutions to them. Some problems we need to face alone and some we need to encounter as a team. I worked in several teams all my professional life and I believe that any task can be easily completed when there is coordination between the members of the team. In this reflection paper I would like to present my views on the importance of defining roles, advantages of being with the same team, challenges in a diversified group and the significance of trusting team members. Defining Roles â€Å"Roles are positions in a group that have a set of expected behaviours attached to themâ€Å"(John and Saks, 2011: Page 225 of quote). I feel that most of the problems in a team occur because roles are not clearly defined. Roles provide sense of direction to the team members and drive them towards the common goal. I would like to quote my experience when I joined as a trainee to depict the importance of roles in a team. Our team had two tasks, supporting the existing applications and developing new applications. Even though there were 6 members in our team, there used to be issues every day. There used to be slippages in deadlines and we used to miss support tickets too. This went on for about 3 months and our lead arranged a meeting to find out the reason behind our poor performance. The first and foremost thing that popped up was that none of the members of sure of their roles. Everyone concentrated on just one task and as a result we always defaulted. Drastic improvement in our team’s performance after each member was assigned a specific role proved the importance of team roles. My practical experience combined with the theoretical proof that â€Å"Role ambiguity causes... ...hin few months she started working efficiently and the outcome was that we won best team award within our entire account. To conclude, there might be several reasons behind exceptional or poor performance of a team but I regard the points mentioned above highly and I feel that if the above issues are taken care then the team would perform to their potential, providing exceptional results. References 1. Organizational Behaviour, Sixth Edition by Gary Johns & Alan M. Saks 2. Why teams don’t work – Interview by Diane Coutu 3. Building the Emotional Intelligence of Groups by Vanessa Urch Druskat and Stephen B.Wolff 4. http://en.wikibooks.org/wiki/Managing_Groups_and_Teams/Diversity#How_Are_Diverse_Teams_Different_From_Homogenous_Ones.3F 5. http://jmo.e-contentmanagement.com/archives/vol/10/issue/1/article/382/trust-a-neglected-variable-in-team-effectiveness

Employee Welfare Measures Questionnaire Essay

Dear Recruiter, Request you to please fill in the questionnaire and help me understand the labour laws compiled in your organisation that will help me to produce factual data to my project. Project Topic: Employee welfare measures followed in small textile units in Bhiwandi city Please be rest assured about maintaining the confidentiality of the data. Your timely help will be highly appreciated. Regards Govind R Sharma MBA (HRM) Pondicherry University Compliance of labours laws & Employee welfare measures Name: Designation: Company: Please fill the column where information sought and reply the questions asked in Yes/ No type question Questions Answers Total employee strength of your company Type of company (Proprietary/ Pvt. Ltd./ Ltd/ listed) Strength of HR team in organization Company type (Indian/ Indian MNC/ Foreign based MNC) Does your company follow Industrial Dispute Act? Does your Organization make deduction to all employees as per ESI Act? Does your Organisation Make Deduction as per PF & MIsc Act? Does your organization follow Maternity Benefit Act, Payment of Wages Act and Payment of Minimum Wages Act? Does your organization follow all the procedures laid down in Factories Act & Shops and Establishment Act? Do you pay equal remuneration to both male and female employees ? Do you think that all the rules laid down on above mentioned Act are employer and employee friendly? What is the amount of Bonus you usually pay to your employees? Do you think that there should be only 5 days working or the daily working hours should not exceed 8 hours or 48 hours in a week? Please mention the various employee welfare programme in your organization beside of those made compulsory by various labour legislation. What is the grievance handling mechanism followed in the organization? What is your view that a small organization having employee strength of 10-30 people cannot implement employee welfare measures as per the prescribed Act or beyond the purview of the Act? Please specify in brief. How many times the Factory Inspector, labour inspector, PF commissioner or officials/ ESI officers visit your organization? Are you happy with their inspection work? Are they employer and employee friendly or believe in making money only? What is the maximum duration any employee stay in your organization? Do you allow them to work in your company more than 5 years? After completing 5 years in your organization, whenever they leave your organization, do you provide them any extra monetary benefits? If yes, please specify the amount. Apart from the salary, what other benefits you provide to your employees? Do you think that providing too many benefits to employees lead to industrial unrest hence they should kept within certain limit? Justify your answer please.

The Issue Of Animal Cruelty - 1023 Words

All beings, â€Å"things†, and properties of life have a sole function and reason to be in existence. Everything must have an ends to itself rather than a means to another ends (Aristotle, 617-636). Aristotle examines the idea of function and purposefulness within the ten books of Nicomachean Ethics. Finding this ends to itself is how one can achieve the ultimate happiness. Aristotle discovers that if everything has an ends to itself, man too, must have an end. What does being a â€Å"person† really mean, and who is eligible to classify themselves as a â€Å"person†? How can one distinctively be told apart from an intellectual animal? Aristotle’s pinpointing the function and purpose of man, can directly relate to Mary Midgley’s article Persons and Non-Persons. Midgley’s article speaks about the issue of animal cruelty. The case of harming a dolphin and eventually becoming self-destructing is the main focus of the article. The researcher decid ed to set the dolphins free into the water, creating an even more dangerous environment for a lethargic, self-destructing dolphin. Both sources focus on the idea of the defining feature of man, and questions what is it that makes us human? Society is constantly abusing the idea of human superiority. Although humans have a distinctive feature, what gives one the right to be cruel to the other beings of the world, no matter what their function or their purpose in the world is? One must be careful not to abuse their power. One must use their practical andShow MoreRelatedAnimal Cruelty Is An Ethical And Moral Issue Essay1273 Words   |  6 Pagesan ethical and moral issue? What are the different opinions about the actual issue or how to solve the issue? Animal cruelty can be either deliberate abuse or simply the failure to take care of an animal. Either way, or whether the animal is a pet, a farm animal or wildlife, the victim can suffer terribly. Animal cruelty is an ethical and moral dilemma as there is no clear right or wrong answers that can solve all of the issues. There are numerous opinions on how this issue can be solved, theseRead MoreThe Ongoing Issue of Animal Cruelty, Abuse, and Animal Testing1078 Words   |  4 PagesAnimal cruelty is an ongoing issue in today’s society. When we listen to the news and hear about these animals being starved, beaten, and treated poorly our hearts drop and we get a lump in our throat holding back the tears. We see these animals suffer, we see the pain in their eyes begging for our help, we want to put an end to this but we fail to see the bigger picture. Animal cruelty is a more severe and extreme than we think it is. Animal cruelty just is not owners beating their pets. AnimalRead MoreAnimal Cruelty Is A Tremendous Issue Concerning The United States1663 Words   |  7 PagesAnimal Cruelty and the Link to Abuse Toward Humans Animal cruelty is a tremendous issue concerning the United States and has a large link to abuse toward humans. On DoSomething.org (n.d.), they found that â€Å"Today animal cruelty has been reported in urban, suburban, and rural settings in all regions of the country† (para. 6). But at the same time, there is animal welfare, which can protect animals when they have been mistreated. Individuals who participate in animal cruelty are more likely to engenderRead MoreAnimal Cruelty And Domestic Violence Essay1679 Words   |  7 Pages Animal Cruelty and Domestic Violence: Intersections of Abuse Animals are an important and valued part of many families and cultures. In many households, animals are considered members of the family, receive Christmas and birthday presents, and are cared for just as a human child would be. Opposition to animal cruelty has even become a sort of universal value in American culture(Kordzek 604). But animals are uniquely vulnerable to abuse, and despite this theyRead MoreDomestic Violence VS Animal Cruelty and Child Abuse1665 Words   |  7 PagesOver the centuries, animals have suffered from cruelty from humans. In the United States, animals are beaten, neglected, or forced to struggle for survival. Animals have been inflicted with pain from humans for reasons other than self-defense. They have been slaughtered for their food and fur for personal gain in profit. In a majority of cases they have even been abused for someone’s own personal amusement or out of rage filled impulses. In some cases animals are found and rescued. They are givenRe ad MoreA Brief History of Animal Abuse and Cruelty Essay1152 Words   |  5 Pagesattracted by black smoke. She managed to put out the the flames with her sweater and proceeded to rush him to a small animal hospital with severe burns over his whole body and a serious ankle infection. Although he lost 60% off of both of his ears he maintained almost complete mobility of his leg. He still has a slight limp. Judi Bunge, a senior vet technician at Buffalo Small Animal Hospital who had been looking after Phoenix, adopted him soon after he had fully recovered. He now lives with Judi andRead MoreAnimal Abuse And Cruelty1342 Words   |  6 PagesCruelty to animals can either be the unintentional and the intentional infliction by humans of suffering or harm upon any non-human animal, regardless of whether the act is against the law. So much has happened recently that the US has broken it down into four categories, simple or gross neglect; intentional abuse and torture; organized abuse, including dogfighting and cockfighting; and animal sexual abuse (Fricker). The very first group of people in U.S. history to give laws for animal cruelty wasRead MoreAnimal Cruelty Essay969 Words   |  4 PagesAnimal cruelty is any act of violence or neglect against an animal. A few things one may have seen are an animal tied up outside for all hours of the day with no food or water or maybe a person has seen an owner purposely hit their dog. Animals, like humans, have feelings and reactions to the way they are handled: abused animals could become dangerous to society. Society most often defines animal cruelty as the infliction of physical pain, suffering, or death upon an animal when not necessary forRead MorePersuasive Essay On Animal Abuse1272 Words   |  6 Pages Animal Abuse Im sure you’ve seen all of those ad T.V. commercials with all the cute, sad animals? The ones that usually make you tear up and act emotional? Well those ads are very important because animal abuse/animal cruelty is still going on. Even as youve read the past couple sentences, about 39 animals have died. Animal cruelty is a huge problem NOT just in the US but also in the whole world from circuses to science labs, horse racing, and even movies. Most of us have pets we considerRead MorePersuasive Speech Outline (Using Monroes Motivated Sequence Essay1044 Words   |  5 PagesSpeech Animal Laws Should Be More Strict Many people may not know that animal cruelty has been around for hundreds of years. . In the article Animal Cruelty Prosecution published by American Prosecution Research Institute found that, The Puritans of the Massachusetts Bay Colony established â€Å"The Body of Liberties† found by the Animal Cruelty Prosecution, in 1641. The Body of Liberties was a document written for the protection of animals from unnecessary pain and suffering. Animal cruelty happens