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Team work is significant in any setting more so in a mental health setting. The milieu needed to care for patient depends up on the qualification,experience,skillful handling of the situation by all members of the team with similar approach. For promotion of a therapeutic environment members of the various discipline coordinate their activity. The multidisciplinary mental health team is no longer viewed as solely limited to professionals. A grooving conviction exist that if treatment is to be effective , the team must include the client and the family as integral members. This position reflect the fact that effective treatment of a person with mental illness , especially one who has serious , persistent illness must include the insight and experiences of those who know him or her best – the client and those who have known him or her over a period of time and who help the client’s care on a daily basis , most often the family. Four health care professionals constitute the core mental health disciplines : psychiatric nursing, psychiatry, clinical psychology, and psychiatric social work. They all emerged as specialties with in their respective professions during the last half of the nineteenth century at the time when the behaviorally disturbed persons are viewed as being ill rather than as being posses by demons or morally corrupt. PSYCHIATRIC NURSING The first school of nursing in a psychiatric setting was established at Mc Lean hospital in 1882. This schools purpose was to improve the care of the psychiatric patients by upgrading the skills of attendants. Nurses are professionals whose initial educational preparations is through an associated degree, baccalaureate degree or diploma programme. An increasing number of nurses with baccalaureate degree have continued their education to attain masters degree in a particular clinical specialty. The nurses prepared as clinical specialists in clinical psychiatry or mental health nursing at have advanced preparation in promoting the mental health of the individuals , groups , families and communities as well as in assisting those persons in increasing the effectiveness of their adaptation. She provides individual , group and family therapy in a hospital and community setting. Participates actively in primary, secondary
These clinical psychologist concerned with the diagnosis of mental illness have developed expertise in the use of inferential tools designed to assist in the diagnostic process and assessment of treatment process. administration and research besides publishing work in a mental health setting. • Registered nurse in psychiatric unit or hospitals-registered nurse goes through a general nursing and midwifery programme or BSc nursing or post basic BSc nursing programme or diploma in nursing education and administration. psychology has become such a broad discipline that most psychologist specialize . Works as a leader and can practice independently. Such tools are projective techniques. PSYCHIATRY Psychiatrists are the physicians who had several years of supervised residency training in the medical specialty of psychiatry. 2 . He serves as the leader of the mental health team. Mary C Jarrett believed to be the first psychiatric social worker . Those who are most directly involved in the treatment of those with mental disorders are called as clinical psychologists. The psychiatrist’s unique function is prescribing medications and administering other somatic treatments such as electroconvulsive therapy. In addition he is the only person equipped to make a medical diagnosis and is particularly skilled in identifying and treating persons whose problems have highly inter related emotional and psychological components. personality inventories etc. he or she is a graduate in social work and a post graduate in psychiatric social work. but the specialty of psychiatric social work began in the 1900s. PSYCHIATRIC SOCIAL WORK Social work began as an organized profession in1880s . only clinical psychologist are trained in the interpretation of these highly complex instruments.and tertiary prevention of mental disorders. They should have post graduation in Psychiatry and two to three years of residence training. preferably with post graduate research work. CLINICAL PSYCHOLOGY Clinical psychology began with the university as an academic research oriented discipline devoted to the scholarly study of human behavior. As in the field of nursing and medicine . • Psychiatric nurse clinical specialist-should have a masters degree in nursing. Takes up responsibility for teaching. Psychologists are the professionals who have advanced education in the study of mental process and the treatment of mental disorders.
educational therapy and patient library services(bibliotherapy). The therapist focused on the vocational skill and activities of daily living to raise the self concept of the patient. Occupational therapist. ACTIVITY THERAPY Although activity therapies are not considered a core mental health discipline . the types of the toys and his reaction towards the calling. Recreational therapist-recreational therapist plans activities to stimulates muscle coordination. interpersonal relationship and socialization.Social workers are health professionals and are prepared to work with individuals and families who have wide variety of physical. emotional and social problems.makes observation of the client or child during his play. they share the principle that it is helpful to the emotionally disturbed persons to be engaged in the activity that focus on the object outside the self. The concept of object relation is fundamental in activity therapy. horticulture therapy and manual art therapy. music therapy. art therapy. Psychiatric social workers are particularly skilled in assessing familial . such as dance therapy. They are aware about the state laws and legal rights of patients and protect these rights. Although each form of activity therapy has specific focus . the mental health care team will not be complete without them. He has a pivotal role by using manual and creative techniques to asses the interpersonal process of the patient. They are also contributors to the planning and implementation of follow up care. The discipline that make the activity therapies include occupational therapy. Recreational and occupational therapies are always need based Diversion play therapist. Patients are help to develop skill in the area of their choice and become independent economically. it is very significant in the treatment and recovery of the patient. rehabilitation counseling .environmental and social factors that contribute to the dysfunctional behaviors of the individual and family. beating or throwing are the 3 . recreational therapy. The behaviors of the child while playing.occupational therapists goes through specialized training. A masters degree is required to enter in to art therapy. The activity therapist are required to have at least a bachelor degree in their field. the therapist and the other participants. If occupational therapy is planned well. They are skillful in interview techniques and group dynamics. With in these specialties other therapies may also provided . This concept not only the materials used in the therapy but also the setting . drama therapy.
separation or any other condition. Case manager can and do have professional preparations in any one of the four core mental health disciplines. Analysis will help in bringing the repressed feeling of the patient to a conscious mind. The therapist explore the child’s behavior and relates the conditions like phobia.focus of attention. • To provide activities for the structured normal activities of daily living. • To assist in diagnostic and personal evaluation. live figures drown by the patient . Creative art therapist. child abuse ..this can be done through the observations of the clients as they participate in activities. The case manager’s role is based on the belief that to be successful in community the client’s needs continuity of care that is accessible and comprehensive. Case management practice 4 . • To enhance psychotherapy and other psychotherapeutic measures-the activity provided for the client often provides a non verbal means for the client to express and resolve the feelings being discussed verbally in other setting. The following five goals are common to all activity therapies in a mental health setting. PSYCHIATRIC CASE MANAGEMENT Case management is both a treatment intervention and a delivery method that has become increasingly necessary for individuals whose need are complex and long term such as those with a serious persistent mental illness. The therapist analyze the use of bright colors leading to light and fading colors which have a meaning .an arts graduate encourages the patient to express his work freely with colors. • To assist the client in making transition from the sick role to becoming a contributing member of the society • To assist the client to develop skill in relating and interacting with others in a cooperative manner. Because hospital stays are becoming shorter with the discharged clients still needing varying degrees and types of care a worker is needed on whom the client can depend to get various types of care.activities are designed to help the clients deal with their basic problems. Inter personal relationship established between the client and the therapist provides another vehicle for the provision of corrective emotional experiences.
their role is to prepare the ECT machine and other article and give ECT under the supervision of a psychiatrist or anesthetist. advocacy Services delivered to the clients in a variety of formats. Auxiliary personnel Are volunteer house keepers or clerical staff who come in contact with the patient . 5 .AS A MULTIDISPLINARY TEAM MEMBER. monitoring of service delivery 5. and other needed therapies or assistance. client identification and out reach 2. OTHER PSYCHIATRIC PARA PROFESSIONALS Psychiatric nursing aids / attendants High school educational level. psych therapy . Each member brings specialize knowledge to the treatment process. and are available 24 hours a day and 7 days a week. assessment 3. In most of the settings. ECT technicians These technicians goes through a training period of six to nine months . ROLE OF NURSE. service planning 4. medication management . They are given training on the job. These team function collaboratively to provide comprehensive care that may include general medical care . the nurse is a member of an inter disciplinary team.differs widely. there by enhancing assessment and management. substance abuse services. access to entitlements. they should be given in service education to interact with the patient therapeutically. They assist in maintaining the therapeutic environment and provide care under supervision. it is generally agreed that the five core component of case management are1. Clergy manReligious persons from different religions may be asked to come to the hospital unit once a week so that the patient can have a spiritual discussion or make a confession if he or she desires.
regressed. They may be suspicious about the process of receiving mental health care . fears and impressions that may hamper their effectiveness with clients and the family. they must be believed that nurses and other mental health professionals will solve their problems for them and may expect to play a passive role while an expert cures them. The behavior of the client represent the range of human disturbances –from violent. In fact nurses role model for their clients how to cope with feelings in appositive way. Collaboration implies that members work towards a common goal and shire responsibilities for out come of care. Managing stress and burnout Nurses who enter the psychiatric field frequently are motivated by a sense of altruism . How nurse deal with these behavior reflects their personal values and experiences as well as their success in the field. Learning to acknowledge . Clients seeking mental health care are often frightened . search for effective interventions . that is they are working with a desire to contribute to something to the society. 6 . measure client outcomes and if needed design interventions. Although the work has an innately humanitarian purpose . Nurses may feel ashamed of their reactions to disturbances in clients or feel that their responses are unprofessional . it also has stressor that induce nurses to feel fear and anxious. hostile or aggressive to bizarre . Nurses new to the field of psychiatric mental health nursing are likely to discover certain feelings . or dependent. They may feel that the treatment will dehumanize them or that providers will overmedicate or not listen to them. express and deals with feelings is as important for nurses and other mental health professionals as it is for their clients. Nurses and other mental health professionals are responsible for clarifying these misconceptions and providing straight forward information about the importance of client participation. follow guide lines and standards of care . and hide or deny their feelings.Team also include the client and his or her family . The mental health care providers must explore their own thoughts and feelings . Understanding the clients view of mental health care. Learning to provide appropriate care. relieved or anxious about what will happen to them.
5. 1st edn. Essentials of psychiatric nursing. London . New York . 3rd edn. Taylor CM. Kumar publishing house.Cooperation and collaboration with the whole group As a team member nurse has the responsibility to coordinate the activities of various disciplines. New Delhi. Mohr WK. A concised text book of psychiatric nursing. Psychiatric mental health nursing. Text book of psychiatric nursing. 4. Reynolds W and Cormack D. London. Psychiatric and mental health nursing – theory and practice. CBS publishers . 1990 Kapoor B. 2006 Bhatia MS. Reference 1. 3. In some settings nurses are the team leaders and they are the responsible persons to provide a conducive environment to the patients. 2. Chapman and Hall publishers. Mosby publishers 1994. 2006 7 . 1st edn. 14th edn. She has to cooperate well with other disciplines to provide better and standardized care tom the clients. 2006. 6th edn . New Delhi . Lippincot Williams and Wilkins.
Manipal University Submitted by: Jincy Jose 070504002 MCON .MULTIDISCIPLINARY TEAM ROLE OF THE NURSE Submitted to: Mrs. Manipal University Submitted on: 29-09-2007 ● ◦ ● ◦ ● ◦ ● ◦ ● ◦ ● 8 . Blessy Prabha Valsaraj Assistant Professor Department of mental health nursing MCON.
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