Community Mental Health Nursing - Simplified / Community Health Nursing/ Mental Health Nursing.

I. Introduction
• The Community Mental Health movement in India was started in 1960s. Later, in 1963 - Community Mental Health Centers (CMHC) act was passed
• In 1970s, Community clinics at primary health centres (PHCs) and the training of medical officers and multipurpose health workers were started in India.
• Thus, the methods of treating mental illness have changed dramatically in the past century.
II. Definition
“ Community Mental Health Nursing is the application of knowledge of psychiatric nursing in promoting and maintaining mental health of people, to help in early diagnosis and care and to rehabilitate the clients after mental illness.
(Bimla Kapoor)
III. Aims / Goals / Purpose of C M H Nursing
1. Provide prevention activities
2. Anticipate emotional problems
3. Provide prompt interventions
4. Develop innovative approach to primary preventive activities.
5. Provide mental health education.
IV. Objectives- CMHN
1. Promotion and Maintenance of mental health.
2. Prevention of Mental illnesses and stigma
3. Promote community participation
4. Early detection and treatment
5. Provide basic community mental health facilities
6. Encourage IEC in mental health Nursing.
V. Importance of CMHN
1. To promot and Maintain the mental health of family
2. To enhance the potentials of community people
3. To educate the family members
4. To help family members to recognize that the social, cultural and situational aspects
5. To teach the community people to monitor their mental health and that of the community.
VI. Scope of CMHN
Community Mental Health care includes:
1. Mental health promotion- Preventive services.
2. Stigma / Misconception removal
3. Psychosocial support and counseling
4. Provision of Rehabilitation services / Rehabilitatory services
5. Prevention of harm from alcohol and substance use
6. Treatment of mentally ill by using primary health care system
7. Others
VII. Models of preventive psychiatry: Levels of prevention in CMHN
A. Primordial Prevention
- (Behavioural modification & Sound Habit formation)
The specific interventions
i. Special attention / preventive services
ii. Health education
iii. Provision of Community services availability
iv. School health program/ services
v. Elimination of causative agents / risk factors
B. Primary Prevention:
a. Promotion and maintenance mental health and
b. specific protection
The specific interventions are:
i. Identification of people at risk.
ii. Identification of stressors i.e. actual or potential.
iii. Development of community based program
iv. Providing awareness classes for caregivers.
C. Secondary Prevention:
a. Early diagnosis and
b. Prompt treatment
Specific Interventions
i. Early diagnosis
ii. Continuous monitoring of clients or cases,
iii. Crisis interventions through hotlines, walk - in - clinics etc.
iv. Prompt treatment
D. Tertiary Prevention:
a. Disability limitation, Counseling and
b. Rehabilitation.
The specific interventions are:
i. Main focus on disability limitation and
ii. Rehabilitation
includes:
- Daycare centers/ hospitals,
- Foster homes,
- Self - help groups and
- liaison workers
VIII. Community Mental Health Facilities Available
1. Hospital Services
2. Partial Hospital
3. Quarter way homes
4. Half way homes
5. Self- Help Groups
6. Others
- Suicide Prevention Centers
- Helping hands
- Other agencies
IX. Issues in CMHS / Problems in CMHN
1. Limited manpower
2. Uneven distribution of resources.
3. Low priority in national budget for mental health
4. Others
X. Community Mental Health Programmes
a. National Mental Health programme (NMHP) - 1982
b. District Mental Health Programme (DMHP) - 1996
c. Others
XI. Role and Functions of C H Nurse in Community Mental Health Nursing
1. Health monitor and Promotor.
2. Preventer (Preventive role)
3. Care Provider
4. Manager
5. Planner
6. Organizer & Co-ordinator
7. Facilitator
8. Supervisor
9. Trainer
10. Evaluator
11. Health Educator
12. Counselor
13. Researcher
14. Others
Functions of CHN in CMHN
1. Domiciliary care
2. Mental health education
3. Conduct and assist in therapies
4. Training
5. Supervise.
6. Research
7. Others.
Other Functions of CHN in CMHN.
a. Social skill training
b. Anxiety management and relaxation
c. Assertive training
d. Bereavement Counseling.
e. Group meeting
f. Community outreach work services
g. Child care services
h. Adult care and elderly services.
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