Collaborative Working for Health and Well-being in Mental Health Essay Sample
Mental health nursing Collabrative Working Essay
This study is going to examine collaborative working for health and wellbeing in mental health settings with a specific focus on collaborative working between clinicians and service users with depression.
Historically, collaborative approach to health and wellbeing especially among psychiatric patients is built on the recognition that a service user should be involved in the decisions that are made about their life and needs(Davidson et al., 2008). The emphasis has further by influenced by the liquid, shrinking and ever-changing world in which we live, that is characterised by social, cultural, political and economic upheavals and transformations and the effects of a move toward the decentralization of information, knowledge and expertise (Borg & Kristiansen, 2004). This influence is also amplified by growing principles of democracy, social justice, human rights and the growing importance of the people’s voice as well as the need for collaboration (Menear et al., 2020).
In collaborative practice, the most critical outcomes is that service users’ care as well as treatment wishes ought to be sought out and complied with by services. Secondly, the other important outcome is to uphold the statutory rights of service users to advocacy, confidentiality and assistance with expressing themselves in line with the mental capacity Act, the Equality Act, as well as the Care Act (Bower et al., 2006). Additionally, the development of the NICE Guidelines on decision making and mental capacity provide or set out principles that need to be adhered to in the process of providing care for the patients who may lack the capacity to do so (NICE, 2021). NICE guidelines set out four quality principles that need to be adhered to. These include supported decision making in ways that reflect the person’s circumstances and meets their specific needs (NICE, 2021). Secondly, opportunity to discuss advance care plans at each health and social care review. Third is the assessment of capacity to implement specific decisions and a record of reasons why there is a lack of capacity and practical solutions to support them (NICE, 2021). Lastly is best interest’s decision making which means that decisions must have the service users wishes, feelings, values and beliefs (NICE, 2021).
Existing evidence suggests that there are many factors that affect the physical health of severely mentally ill patients. Research has shown that these patients with confirmed psychiatric conditions tend to have high rates of physical illness (Battersby et al., 2013). Some of the main factors causing this influence long term effects of psychotic medications, eating less well, less exercise than the general population and other social factors such as poverty, poor housing and underemployment as causal factors (Lawrence et al., 2013; Phelan et al., 2001). Additionally, studies also point to some symptoms of mentally ill patients as contributing to physical ill health such as cognitive impairment, social isolation, lack of social skill among others (Lawrence et al., 2013). Other studies have mentioned reduced access to healthcare either through delayed presentation, reduction in uptake of health screening and preventive care, difficult coping with demands of long-term care, misattribution of symptoms among others (Ashworth et al., 2017a; Thornicroft, 2011). Hence, studies point to diagnostic overshadowing which is the interpretation of symptoms of physical disease or red flags but pass them as another manifestation of the severe mental illness (Ashworth et al., 2017b). Based on this therefore, collaborative practice with service users is viewed as the best way to ensure that these issues, problems and indicators of ill health are identified and resolved earlier to prevent mortality and morbidity.
A better integration of care between primary care and mental health care provides is widely perceived as a solution for improving quality of care and patients’ experience in care. The collaborative mental health care model is now emerging as a model for integrated care (Bedwell et al., 2012). This involves health care providers sharing resources, expertise, and decision making so as to ensure that primary care populations receive more effective, coordinated and cost-effective mental health care (Banfield & Lackie, 2009; Croker et al., 2012). While this model has been used extensively in mental health settings, studies indicate that specific programs and approaches remain unclear with studies supporting the use of different strategies as effective (Ness et al., 2014). Overall, current studies have pointed to a much as 15 different strategies used by mental health care provider to engage patients or families in collaborative care with up to 2 psychosocial approaches being used in one go(Andvig et al., 2014; Brett et al., 2014). A vast majority of these strategies tend to occur at the direct care level where patients and families interact with professionals in the collaborative mental health care team. Common strategies include patient education used significantly across programmes (Andvig et al., 2014; Menear et al., 2020). Education was viewed to cover different topics such as the mental health condition, treatments and importance of adherence to treatments and prevention of relapses (Strong, 2000; Sundet, 2011). Other strategies that have also been used include self-management for strengthening patient skills; behavioural change interventions such as motivational interviewing, personalised care planning, shared decision making, use of peer supports and patient navigation. In using either of these approaches, patients were placed at the centre of the strategies and had access to their health records of patient portal for purposes of finding clinical information and communicating with their clinical teams (Anderson, 2012b; Ness et al., 2014). Other studies however indicate that such strategies are not only patient focused but also occur at the organizational level, professional level and research level. Organizational level strategies include approaches such as needs assessment while professional level approaches include simulated patients’ strategy and at the research level include patient consultations, involvement in study phases and use of research advisory groups among others (Strong, 2000). Therefore, based on these findings, multiple strategies and approaches can be applied depending on the condition, patient needs, existing resources among others. Effectiveness of these approaches will vary, although to enhance success, studies propose a combination of two or more methods with the objective of enhancing health related outcomes.
Nurses are at the centre of providing support for patients with depression and mental illness and are driven immensely not only by the NMC code but also by other values that help support patients suffering from mental health illness (Banfield & Lackie, 2009). The NMC code in particular provides the need for nurses to act with professionalism and integrity as well as work within agreed professional, ethical and legal frameworks; practice compassion, be respectful and maintain dignity and the health and wellbeing of the patient(Andvig et al., 2014). The NMC also provides that mental health nurses must work with all individuals of all ages using values-based mental health frameworks. They must use strategies that foster the development of positive relationships built on social inclusion, human rights and recovery. Existing studies have proposed that service users prefer nursing staff that have qualities such as warmth, kindness and honesty which underpin all therapeutic relationships (Anderson, 2012a; Bower et al., 2006). Additionally, service users also have been perceived to value relationships with nursing staff that were interested in and engaged with them, who were professional but acted with compassion and humanity (Andvig et al., 2014). Overall, the elements help improve the overall ability of the service users to improve their levels of satisfaction and ensures that nurses are able to deliver the quality of care expected for the mentally ill patients in a professional manner.
In conclusion, collaborative working for health and well-being ensures that services users are in a position to benefit from the collaborative practices in a structured manner. While meeting the needs of the patients is critical in using collaborative approaches, ability of the health care practitioners to facilitate the process is even paramount. It was found that severely ill mental health patients are predisposed to factors, sometimes outside their control that have adverse effects on their physical health.
These when not taken into consideration result in diagnostic overshadowing where practitioners think that these symptoms are only but a manifestation of the illness. However, through collaborative approaches to health and wellbeing, they are able to identify and prioritize their needs more effectively. The use of approaches such as self management, patient assessments and other psychosocial approaches have been proposed as effective ways of collaborating and improving patient care. In this process however, nurses play a critical role. The NMC codes was found to spell out modes of interaction and professional practices and values as well as ethics that ought to be adhered to. In conducting this, it is assumed that they will be better placed to provide the right care required to the patient and hence improve patient health and wellbeing in future. Indeed, for collaborative care to be truly patient-centered, service users must be treated as respected and autonomous partners in care and have timely access to relevant information, support, and encouragement to participate actively in care planning, decision-making, and self-care.
Anderson, H. (2012a). Collaborative Practice: A Way of Being “With.” Psychotherapy and Politics International, 10(2), 130–145. https://doi.org/10.1002/ppi.1261
Anderson, H. (2012b). Collaborative Practice: A Way of Being “With.” Psychotherapy and Politics International, 10(2), 130–145. https://doi.org/10.1002/ppi.1261
Andvig, E., Syse, J., & Severinsson, E. (2014). Interprofessional Collaboration in the Mental Health Services in Norway. Nursing Research and Practice, 2014, 1–8. https://doi.org/10.1155/2014/849375
Ashworth, M., Schofield, P., & Das-Munshi, J. (2017a). Physical health in severe mental illness. British Journal of General Practice, 67(663).
Ashworth, M., Schofield, P., & Das-Munshi, J. (2017b). Physical health in severe mental illness. In British Journal of General Practice (Vol. 67, Issue 663, pp. 436–437). Royal College of General Practitioners. https://doi.org/10.3399/bjgp17X692621
Banfield, V., & Lackie, K. (2009). Performance-based competencies for culturally responsive interprofessional collaborative practice. In Journal of Interprofessional Care (Vol. 23, Issue 6, pp. 611–620). https://doi.org/10.3109/13561820902921654
Battersby, M. W., Beattie, J., Pols, R. G., Smith, D. P., Condon, J., & Blunden, S. (2013). A randomised controlled trial of the Flinders ProgramTM of chronic condition management in Vietnam veterans with co-morbid alcohol misuse, and psychiatric and medical conditions. Australian and New Zealand Journal of Psychiatry, 47(5), 451–462. https://doi.org/10.1177/0004867412471977
Bedwell, W. L., Wildman, J. L., DiazGranados, D., Salazar, M., Kramer, W. S., & Salas, E. (2012). Collaboration at work: An integrative multilevel conceptualization. Human Resource Management Review, 22(2), 128–145. https://doi.org/10.1016/j.hrmr.2011.11.007
Borg, M., & Kristiansen, K. (2004). Recovery-oriented professionals: Helping relationships in mental health services. Journal of Mental Health, 13(5), 493–505. https://doi.org/10.1080/09638230400006809
Bower, P., Gilbody, S., Richards, D., Fletcher, J., & Sutton, A. (2006). Collaborative care for depression in primary care. Making sense of a complex intervention: Systematic review and meta-regression. In British Journal of Psychiatry (Vol. 189, Issue DEC., pp. 484–493). https://doi.org/10.1192/bjp.bp.106.023655
Brett, J., Staniszewska, S., Mockford, C., Herron-Marx, S., Hughes, J., Tysall, C., & Suleman, R. (2014). Mapping the impact of patient and public involvement on health and social care research: A systematic review. Health Expectations, 17(5), 637–650. https://doi.org/10.1111/j.1369-7625.2012.00795.x
Croker, A., Trede, F., & Higgs, J. (2012). Collaboration: What is it like? - Phenomenological interpretation of the experience of collaborating within rehabilitation teams. Journal of Interprofessional Care, 26(1), 13–20. https://doi.org/10.3109/13561820.2011.623802
Davidson, L., Andres-Hyman, R., Bedregal, L., Tondora, J., Frey, J., & Kirk, T. A. (2008). From “double trouble” to “dual recovery”: Integrating models of recovery in addiction and mental health. In Journal of Dual Diagnosis (Vol. 4, Issue 3, pp. 273–290). https://doi.org/10.1080/15504260802072396
Lawrence, D., Hancock, K. J., & Kisely, S. (2013). The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: Retrospective analysis of population based registers. BMJ (Online), 346(7909). https://doi.org/10.1136/bmj.f2539
Menear, M., Dugas, M., Careau, E., Chouinard, M. C., Dogba, M. J., Gagnon, M. P., Gervais, M., Gilbert, M., Houle, J., Kates, N., Knowles, S., Martin, N., Nease, D. E., Zomahoun, H. T. V., & Légaré, F. (2020). Strategies for engaging patients and families in collaborative care programs for depression and anxiety disorders: A systematic review. In Journal of Affective Disorders (Vol. 263, pp. 528–539). Elsevier B.V. https://doi.org/10.1016/j.jad.2019.11.008
Ness, O., Karlsson, B. E., Borg, M., Biong, S., Sundet, R., McCormack, B., & Kim, H. S. (2014). Towards a model for collaborative practice in community mental health care. Scandinavian Psychologist, 1. https://doi.org/10.15714/scandpsychol.1.e6
NICE. (2021). Quality statements | Decision making and mental capacity | Quality standards | NICE. NICE Guidelines. https://www.nice.org.uk/guidance/qs194/chapter/Quality-statements
Phelan, M., Stradins, L., & Morrison, S. (2001). Physical health of people with severe mental illness: Can be improved if primary care and mental health professionals pay attention to it. In BMJ (Vol. 322, Issue 7284, pp. 443–444). BMJ Publishing Group. https://doi.org/10.1136/bmj.322.7284.443
Strong, T. (2000). Six orienting ideas for collaborative counsellors. European Journal of Psychotherapy & Counselling, 3(1), 25–42. https://doi.org/10.1080/13642530050078547
Sundet, R. (2011). Collaboration: Family and therapist perspectives of helpful therapy. Journal of Marital and Family Therapy, 37(2), 236–249. https://doi.org/10.1111/j.1752-0606.2009.00157.x
Thornicroft, G. (2011). Physical health disparities and mental illness: The scandal of premature mortality. In British Journal of Psychiatry (Vol. 199, Issue 6, pp. 441–442). https://doi.org/10.1192/bjp.bp.111.092718