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COMMUNITY MENTAL HEALTH NURSING (CMHN

)
Sulastri, MKep, Sp.Jiwa Program Studi Keperawatan Mitra Lampung

OBJECTIVES
Understand concept of community mental health nursing  Describe comprehensive nursing care through three levels of prevention  Describe mental health nursing process in community mental health nursing.

OVERVIEW
PROBLEMS: • Physical • Psychological • Social • Culture • Spiritual RECOVERY

• Concept of community mental
health nursing • Comprehensive nursing Care • Mental health nursing proces
CMHN NURSE

MENTAL HEALTH
Mental health is not merely free of mental disorders, but something that is needed by everyone to perform harmonies and productive in life.

CHARACTHERISTICS OF HEALTHY MENTAL HEALTH        Be positive for him/her self Be able to grow. develop and achieve self actualization Be able to deal stress/change of himself Be responsible to take action and decision realistic perception Accept of other's feeling & behaviors Adapt to the environment. .

. muscle spasm • Headache.PSYCHOSOCIAL PROBLEMS • • • • • • • Anxiety. fear Irritability Difficult to concentrate Doubtful /low self-esteem Disappointed Angriness and aggressive Physical reaction: heart palpitation. worry overtly.

Definition of Health.illness In Mental Health Nursing .

Mental Disorders • Angry without cause • Withdrawal • Does not recognize the other people • Uncontrolled Speaking • Speak to himself • Unable to perform self-care. .

COMMUNITY MENTAL HEALTH NURSING (CMHN) Comprehensive Complete Ongoing Holistic Focus on Community  Healthy Mental  Prone to stress  Rehabilitation .

Comprehensif Nursing Care Primary Prevention Secondary Prevention Tertiary Prevention .

HOLISTIC NURSING CARE Biologics Psychological Social Cultural Spiritual .

integrative mental health care and service of mental health from community resources. .Comprehensive Nursing Care Complete service of care levels that is from specialist mental health service.

Mental Hospital General Hospital Health Center Holistic Care Individual Family Community .

Concept of Community Mental Health Nursing Applied in Nursing Care: • Healthy mental of community member • People who suffers from mental illness and still in the community. . • No need to refer to the hospital.

Maintain & Promote Mental Health Reduce the Occurrence of Mental Disorders . socialization & Relapse Prevention Reduce Disability because of mental Disorders Prevent Mental.COMPREHENSIVE NURSING CARE PREVENTION PRIMARY Health Promotion & mental Health Prevention SECONDARY Early Detection of psychosocial Problems & Mental Disorders TERTIARY Promote Function.

HE program. Drug abuse prevention program 4.Primary Prevention Target: Community member who doesn't experience disorders according to group old age of children. social support program 3. 2. stress management. Activities: 1. adult and elderly. socialization program. parenting preparation. Growth stimulation. Suicide prevention program . adolescent.

Modalities Therapy 5. . Follow up and referral cases. Activities: 1. Early Case Findings 2. Screening & Further Activities 3. Suicide Treatment 4.Secondary Prevention Target : Community member who are at risk or shows psychosocial problems & mental disorders.

2. Social support program using sources in community. Rehabilitation program by using the patient & family until independently. 3.Tertiary Prevention Target: Community member who experience mental disorders in rehabilitation processes. Stigma prevention Program . Activities: 1.

Focus Individual Family Community Groups .

2005. adapted from van Ommeren. 2005) .COMMUNITY MENTAL HEALTH SERVICE PYRAMID Low 6 High Mental Hospital 5 Requirement frequency Expense Psychiatrist. psychologist. psychologist. CMHN Nurse Unit service of mental health in Hospital 4 Health Service of society 3 Mental Health Service of Basic Health Care Informal & formal support outside CMHN Nurse 2 1 health sector Self-Support Individual & family High Required Service Amount Low (Maramis A. Mental Health Nurse Psychiatry.

very important the family to include in caring their family member.  .Self-Care of Individual & Family  Community both individual and family are expected maintain their mental health independently. At this level.

Formal & informal Services / Supports outside Health Sectors  Public figures. formal and informal groups outside health sector is target of mental health care. Public Figures • Target of Care • Partners of CMH team Traditional Healer .

 Every health care institution (e. . PHC.g.Mental Health Service of Basic Health Care Every health caregivers in the community: private practice doctor /midwife/nurse/psychologist. Clinics)  Partners of Mental Health Team.

Mental Health Care Unit in General Hospital pelayanan rawat jalan dan rawat inap bagi pasien gangguan jiwa Hospitals In Distric/Town Referral System .

Mental Health Hospital Specialist care mental health that focus at mental disorder patient who are not success cared in the family/PHC/Hospital. Referral Back Primary Health Care Continuum care at the family .

HEALTH CARE ORGANIZATION .

Caregivers in Community Mental Health Services  Psychiatrists  Clinical Psychologist  CMHN Nurse .

CMHN NURSE In PHC Psychosocial Problems & Mental disorders Included family. Formal & informal outside health sectors Conduct mental Health care in PHC area Mental Disorders Patient & Family ..

CMH Team Psychiatrist & Clinical Psychologist CMHN Nurse Consultant Perkeswa Kom di Puskesmas Bertanggung jawab atas keberhasilan perawatan pasien di keluarga Mampu merawat pasien sehingga dapat berfungsi dalam kehidupan sehari-hari .

Hospital District/Town (Psychiatrist.  Working in team. CMHN Nurse) Nurses who work in Mental hospitalization Unit:  Treat the patient in the acute phase  Help the patient. Clinical Psychologist. family and community to solve the problems.  Nurse in hospital in direct contact with the nurse in PHC in order to continuum care. .

Role and Function of CMHN Nurses .

Direct Nursing Care (Practitioner) Nurse Patient Nursing Care Problem solving abilities Function Increases Nursing Process • Management of cases • Nursing Intervention Individual & Family • Collaboration .

. Recognize the problem Make decision Care the family member Environment modification Using health care institutions.Educator Health Education • • • • • • Develop solving problem abilities • Conduct 5 tasks of the family health.

Coordinator Activities Coordination: CASE FINDINGS Referral System .

COMMUNITY ORGANIZATION .

Tsunami & Disaster Community characteristics change Response: Healthy/adaptive Psychosocial Problems Mental Disorders Community Organization .

Community Organization in CMHN CMHN NURSE Community Nurse Community Cooperation .

problems.Identify needs. CMHN Nurse Community Nurse Community Grouping The Community data Healthy People Psychosocial Problems Mental Disorders Planning and intervention of the cases: Daily activities Schedule Home visit Schedule Evaluation and Follow up Refer Case or Not . and resources in community.

and resources which are exists in the community  The ways to get the data :  Information from the community such as teachers. community members who suffer from mental disorders  Information from community nurse  Case finding by direct assessment of individual.  By formal & informal meetings. family and groups. problems.Identify needs. .

If found mental disorder case needed immediate recovery intervention and rehabilitation .Grouping the Data    If found healthy community member needed prevention and promotion program to prevent psychosocial problems and mental disorders. If found healthy community member suffers from psychosocial needed intervention program for immediate recovery.

 . include: Daily activities schedule according to daily activities.Planning and Nursing Intervention to the Cases  CMHN nurse makes schedule to provide intervention to the case by using module of nursing care.  Visiting schedule for the case to treat according to the rehabilitation program.

.Evaluation and Follow Up Record the patient progress and the family's ability in caring the patient  If condition be better continue with care plan until the patient independent the family continue the care to prevent relapse and increase the patient’s quality of life.

 If with caring and medication are not successful (condition become worse) the patient is referred to the PHC/Hospital/Mental Hospitals.If found signs and symptoms that need treatment CMHN nurse can give medicine according to standard delegation medication program monitor medication.  .

Thank You Have Nice Week .