Community Mental Health Nurses Research Articles

Göçmenlerde Oluşabilecek Riskler Ve Buna Yönelik Toplum Ruh Sağlığı Hemşiresinin Görevleri

Giriş: Bireylerin, kendi ülkelerinde yaşadıkları ekonomik sıkıntılar, savaş, yoksulluk, siyasi baskılar, hastalıklar, eğitim olanakları gibi çeşitli etmenler onları göçe sevk etmektedir. Göç olgusu ruh sağlığı açısından çok önemlidir. Yeni bir ülkeye alışma, kültür çatışması, sağlık sorunlarıyla ilgilenememe, çocukların eğitim ile ilgili sorunları, beslenme ve barınma gibi sorunlar göçmenlerde çeşitli ruhsal sorunlara yol açmaktadır. Travma sonrası stres bozukluğu yaşayan bazı göçmenlerde buna ek olarak majör depresyon ve anksiyete bozukluğu yaşadıkları görülmüştür. Amaç: Göç eden bireylerin yaşadıkları ruhsal sorunlar ve buna yönelik baş etme yöntemleri araştırıldıktan sonra, oluşan veya oluşabilecek riskler bağlamına ruh sağlığı hemşiresinin göçmenlere yönelik toplumsal hizmetlerini tanımlamaktır. Gelişme: Göçmenlerde oluşabilecek riskler incelendiğinde; kadın ve çocuk göçmenlerin göç sebepleri, savaş, kıtlık vb. gibi durumlar olarak görülmekteyken, erkek göçmenlerin göç sebepleri arasında daha çok, iş imkanı, barınma ve beslenme olanaklarının yetersizliği gibi durumlar sayılabilmektedir. Göçmenlerde göç edilen ülkede uyum sağlamada zorluk, damgalanma korkusu, depresyon, kültür farklılıkları, dil problemlerinden ortaya çıkan iletişim sıkıntıları ve buna bağlı olarak kadın ve çocuk göçmenlerin sağlık hizmetlerine ulaşımında zorluklar görülmüştür. Son zamanların ortak sorunu olan pandeminin etkisi ile göçmenlerde olan veya oluşabilecek sorunların artmakta olduğu gözlenmiştir. Bu bağlamda toplum ruh sağlığı hemşirelerinin göçmenlere yönelik hizmetlerinde önemli rolleri bulunmaktadır. Sonuç: Araştırmalar sonucunda göçmenlere yardım edilememesinin en büyük etmeninin iletişim, çevirmenlerin azlığı ve kültür farklılıkları olduğu görülmüştür. Bu derleme makalede göçmenlere yönelik toplum ruh sağlığı hemşireliği hizmetleri okuyucuya aktarılacaktır.

Effectiveness of community mental health nurses in an integrated primary care service: An observational cohort study

BackgroundThe movement of community mental health nurses into primary care is important for the delivery of primary care integrated teams. There is little evidence or guidance on how integration should be implemented, or on the effectiveness of mental health nurses in primary care. Objectives1. Examine one method of integrating community mental health nurses in a primary care mental health service to identify factors that both facilitated and hindered integration. 2. Report on the outcomes of community mental health nurses in delivering problem-specific evidence-based psychological interventions in primary care. DesignA naturalistic observational cohort study SettingAn integrated primary care mental health service in the UK North Midlands Participants1,582 referrals from 1st April 2019 – 31st March 2022. MethodAnonymised patient records from routine treatment with community mental health nurses in an integrated primary care service were extracted and analysed to identify patient characteristics, content of treatment and outcomes. Features of service design were also examined to report on aids and barriers to primary care integration. ResultsLarge and clinically significant pre to post treatment effect sizes of between 0.5 and 0.8 were observed in symptom reduction and functional improvement for patients treated by community mental health nurses for a range of mental health problems. Aids to integration were: A single line of clinical management and governance; shared training across all roles; a shared IT system/electronic appointment diary. Barriers to integration were: Different contract management structures, and different clinical IT systems across primary and secondary care. ConclusionsIntegrating community mental health nurses into one primary care mental health service comprising different mental health professionals provided a single point of access to different mental health treatments. Primary care community mental health nurses delivered effective evidence-based psychological interventions in a stepped-care model that reduced demands on secondary care services.

Caregiving and receiving experiences in UK community mental health services during COVID-19 pandemic restrictions: A qualitative, co-produced study.

WHAT IS KNOWN ON THE SUBJECT?: At the outset of the COVID-19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic. Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID-19 on people with existing health needs or remote working more specifically. Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This co-produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID-19 pandemic. The study questions whether recovery-based approaches are possible in a hybrid way of working. The findings identify challenges for nurses' well-being and work-life boundaries when working from home. The study adds to historical professional narratives of mental health nursing. WHAT ARE THE IMPLICATIONS FOR PRACTICE: While hybrid approaches developed in response to COVID-19 restrictions may offer more choice these approaches need further co-produced evaluation on the impact of recovery-focused care and therapeutic relationships. Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety. Nurses and service users need to raise awareness within society and policy on the impact that COVID-19 had on people with existing mental health conditions. ABSTRACT: Introduction Community Mental Health Team responses to COVID-19 included fundamental service delivery adaptations. Aim/Question Our co-produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method Qualitative semi-structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co-produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings Care radically changed from in-person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery-focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion Changes to care delivery challenged the fundamentals of recovery-focused interventions and therapeutic relationships. Service users and nurses well-being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice Recovery-focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well-being of nurses engaged in complex service-user interactions from home.

Giving evidence before the First-tier Tribunal (Mental Health): the role of inpatient mental health nurses

The First-tier Tribunal (Mental Health) is a legal body that reviews the rights of detained patients in hospital and whether continued detention under the Mental Health Act 1983 remains in the best interests of the patient. To undertake this work, the Tribunal examines evidence presented in clinical reports and oral evidence by mental health staff, including psychiatrists, community mental health nurses and/or social workers, and inpatient mental health nurses. This article discusses best practice concerning preparation required by inpatient mental health nurses attending the Mental Health Tribunal as expert witnesses to give evidence.

A Qualitative Study of the Psychosocial, Physical and Spiritual Benefits and Challenges Experienced by Psychiatric Patients Engaging Community Mental Health Services

Background Mental illness generates feelings of shame, low self-esteem, isolation, and hopelessness which affect wellbeing and quality of life. Mental health care practitioners, therefore, need to support their clients to improve their quality of life. Despite an increasing awareness of the importance of spirituality in mental health contexts, a religiosity gap exists in the difference in the value placed on spirituality and religion. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts and can result in people's spiritual needs being neglected or dismissed within clinical practice (K. Milner et al., 2020). Additionally, mental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient and their family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons (Kakuma R et al., 2010). Objective: The aim of this study was to explore the contribution of community mental healthcare services to the wellbeing of persons with a history of mental illness using the Betty Ferrell’s Quality of Life (QoL) model. Methods A qualitative research approach was adopted, using exploratory descriptive design to describe the experiences of psychiatric patients engaging community mental health services. An in-depth interview was conducted using Betty Ferrell’s Model as a guiding framework. Each interview lasted about an hour. All interviews were audiotaped, transcribed, and the content analyzed thematically. A purposive sampling method was used to select 11 participants who participated in a face-to-face in-depth interview. Responses from the interviews were transcribed verbatim and analysed using the thematic content analysis approach. Results The findings from the study revealed the important and valuable contribution of community mental health nursing services to the quality of life and wellbeing of persons with mental illness in all spheres of their functioning. The main themes and sub-themes on how community mental healthcare services impact the wellbeing of persons with history of mental illness were Spiritual wellbeing (‘hope’, ‘transcendence’, ‘positive changes’), Social wellbeing (‘good social interaction’, ‘good relationship with family’, ‘good relationship with community members’, ‘good relationship with church members’), Psychological wellbeing (‘perception of overall quality of life’, ‘anxiety/depression’, cognition/attention’, assertiveness’), and Physical wellbeing (‘adherence to medication regimen’, overall physical health’, functional ability’, appetite’). Community mental health nurses have also been instrumental in promoting the social wellbeing of people with history of mental illness. Improvement in the spiritual lives and religious activities of the clients through the intervention of the nurses helped them to find some purpose and meaning in life. Counselling, reassurance, encouragement, and education of clients by the nurses provided some relief from their anxieties and depression and promoted client compliance with prescribed treatment regimen. Conclusion Both theoretical and empirical literature reviewed show that social and emotional support for persons living with mental illness, or with a history of mental illness, are important to their quality of life. The support given within the community is invaluable. Thus, community mental health care services span the well-being in the domains of physical, social, spiritual, and psychological functioning.

Evaluating the efficacy of the Thai Health Improvement Profile intervention for preventing weight gain in people with early stage psychosis: A randomized controlled trial

ObjectivesTo investigate the efficacy of the Thai Health Improvement Profile intervention for preventing clinically significant weight gain in people with early stage psychosis. MethodsWe undertook a randomised controlled trial from 10/2018 to 05/2021. Participants with early stage psychosis (<5 year duration) were recruited using convenience sampling from the caseloads of community psychiatric nurses in Thailand and randomly allocated to either the Thai Health Improvement Profile intervention or treatment as usual group following baseline assessment. Outcome assessors were blind to group allocation, whereas participants were not. Participants in the intervention group received three monthly (five in total) systematic health checks using the Thai Health Improvement Profile tool, which was used to develop a personal health plan in collaboration with a family member/carer. Nurses supported participants to implement the health plan using behaviour change techniques derived from motivational interviewing. The treatment as usual group consisted of medication and psychosocial support, and no additional intervention was provided. The primary outcome was weight gain (defined as a greater or equal to 7 % increase in weight against baseline) within 1 year. ResultsFifty-three participants were allocated to the intervention and an equal number to the treatment as usual group. Primary outcome data were available for 30 participants in each group at the 12 month follow-up. We undertook an intention to treat analysis with multiple imputation (to handle the missing data) for the primary outcome. The treatment as usual group was found to have higher odds than the Thai Health Improvement Profile intervention group of gaining ≥7 % of baseline body weight (OR = 6.52; 95 % CI: 1.88–22.65, p = 0.004). ConclusionsThe Thai Health Improvement Profile intervention was effective at preventing weight gain in people with early stage psychosis at one year, though attrition was relatively high. The results highlight the need for community mental health nurses to adopt a holistic approach, the potential benefits of conducting regular comprehensive health checks and the importance of involving family members when aiming to improve the physical health of people diagnosed with early stage psychosis. A large definitive multi-site randomised controlled trial of the Thai Health Improvement Profile with a longer follow-up is now justified. Trial registrationProspectively registered with the Thai Clinical Trials Registry (reference: TCTR20180305002).

Factors contributing to depressive symptoms among undergraduate nursing students: A cross-sectional study.

To investigate predictive factors of student's academic year, interest in the field of nursing, stress, self-efficacy, and problem-focused and emotion-focused coping on the depressive symptoms among undergraduate nursing students. As the burden of depression among students has increased worldwide, depressive symptoms have become a standard part of mental health problems in college and university students. Among the various fields of medical sciences, nursing students face more stressors during their study period and are more at risk of suffering depressive symptoms than other students. A cross-sectional design. A total of 230 undergraduate nursing students from a university in Myanmar were recruited from August to September 2021. The data were collected using standard research instruments, including a Demographic Questionnaire, Student Nurse Stress Index Questionnaire, General Self-efficacy Scale, Brief COPE Inventory, and Center for Epidemiology Studies Depression Scale (CES-D). Descriptive statistics were used to describe the sociodemographic characteristics of the participants. Inferential statistics were used to identify the predictive effect of academic year, interest in the field of nursing, stress, self-efficacy, problem-focused coping, and emotion-focused coping on depressive symptoms, using multiple linear regression analysis. Academic year, interest in the field of nursing, stress, self-efficacy, and problem-focused and emotion-focused coping accounted for 31.5% of the variance of depressive symptoms (F(8, 221) =12.704, p<.001) with an R2 =.315. Stress was the factor that most influenced student's depressive symptoms (β =.407, p<.001). Self-efficacy (β =-.244, p<.001) and emotion-focused coping (β =.199, p<.05) were also critical factors contributing to depressive symptoms among undergraduate nursing students. The results of this study provide insight and knowledge about depressive symptoms and factors that can contribute to depressive symptoms among undergraduate nursing students. Results suggest that nurse educators and community mental health nurses should focus on reducing stress, increasing self-efficacy, and enhancing proper coping strategies among students to prevent depressive symptoms.

Suicidal Behavior and Difficulty of Patients, as Perceived by Community Mental Health Nurses

Mental health professionals who work in community mental health services play an important role in treating patients after attempted suicide or deliberate self-injury. When such behaviors are interpreted negatively, patients may be seen as difficult, which may lead to ineffective treatment and mutual misunderstanding. The goal of this study was to assess the association between the grading of suicidality and perceived difficulty. We hypothesized that a higher grading of suicidality is associated with increased perceived difficulty. We analyzed cross-sectional data from 176 patients who participated in 2 cohort studies: 92 patients in the MATCH-cohort study and 84 patients in the Interpersonal Community Psychiatric Treatment (ICPT) study. The dependent variable was perceived difficulty, as measured by the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ) and the Difficulty Single-item (DSI), a single item measuring the difficulty of the patient as perceived by the professional. Grading of suicidality was considered as the independent variable. Multiple linear and logistic regression was performed. We found a significant association between perceived difficulty (DDPRQ) and high gradings of suicidality (B: 3.96; SE: 1.44; β: 0.21; P=0.006), increasing age (B: 0.09; SE: 0.03; β: 0.22; P<0.003), sex (female) (B: 2.33; SE: 0.83; β: 0.20; P=0.006), and marital status (being unmarried) (B: 1.92; SE: 0.85; β: 0.17; P=0.025). A significant association was also found between the DSI and moderate (odds ratio: 3.04; 95% CI: 1.355-6.854; P=0.007) and high (odds ratio: 7.11; 95% CI: 1.8.43-24.435; P=0.005) gradings of suicidality. In this study, we found that perceived difficulty was significantly associated with moderate and high gradings of suicidality, increasing age, female sex, and being unmarried.

Edukasi Keluarga dalam Mengatasi Stres Perawatan Orang Skizofrenia di Desa Penyengat Olak Jambi Luar Kota Muaro Jambi

Caring for people with schizophrenia is one of the stressfull. Families do not get information on how to cope the stress experienced. This can affect the recurrence of schizophrenic patients. Families have never received education how to deal with stress. The purpose of community service activities is to increase family knowledge in dealing with stress in the care of people with schizophrenia. The method is carried out through classical learning such as lectures, discussions, and simulations and followed by mentoring through whatsup groups and direct supervision. This service activity has been carried out from the period August to September 2022 in Penyengat Olak Village. A total of 40 participants consisting of 26 family caregivers of people with Skizofrenia, 9 mental health cadres, 5 people from the leadership and staff of the puskesmas and the village have participated in the entire series of activities. The results showed an increase in capabilty to cope stress in caring for people with schizophrenia (Pv 0.000). Handbooks are useful for families in dealing with the daily stress of caring. Family caregivers have used stress coping techniques and created activity schedules as a way of applying stress coping techniques. Family caregivers are expected to implement the stress coping technics using the guidelines provided. The Community mental health Nurse and village health cadres are expected to monitor and report on families stress and provide consulting services on how to deal with stress and make referrals to families experiencing severe stress.

“Helping Mentally Ill, a Reward Both in this Life and After”: A Qualitative Study Among Community Health Professionals in Somaliland

This study aimed to describe the experiences of community mental health workers, predominantly female, nurses and doctors providing community-based mental health services in Borama, Somaliland. A qualitative explorative study using focus group discussions was conducted. Data were collected from three focus group discussions with 22 female community health workers, two medical doctors, and two registered nurses and analyzed using content analysis with an inductive approach. Three main categories were identified from the analysis: (1) bridging the mental health gap in the community; (2) working in a constrained situation; and (3) being altruistic. Overall, the community mental health workers felt that their role was to bridge the mental health gap in the community. They described their work as a rewarding and motivated them to continue despite challenges and improving community healthcare workers’ work conditions and providing resources in mental health services will contribute to strengthening mental health services in Somaliland.

Anxiety and Aggressive Behavior in Adolescents: A Correlational Study

Background: Aggressive behavior has become a severe behavioral problem in adolescents recently. Some cases have even been deemed an emergency for mental health behavior in adolescents. Many factors are suspected to be associated with aggressive behavior, one of which is anxiety. Anxiety and aggressive behavior remain widely studied in children, but the number of studies is limited to middle and late adolescents. In addition, there is no clear description of the psychosocial aspects between anxiety and aggressive behavior in adolescents based on the psychosocial development tasks. Objective: The study aims to identify the association between adolescents’ anxiety and aggressive behavior.Methods: The research used an analytical correlation design with a cross-sectional approach. The research was conducted in senior high schools in Surakarta in July 2021. Subjects were taken using convenience sampling, in which 626 students filled out the online questionnaire, while 32 students did not complete some items resulting in a total sample of 594 respondents. Then, the research instruments employed DASS 21 for anxiety and Buss Perry Questionnaire for aggressive behavior. The statistical analysis then utilized the Pearson product-moment test.Results: The research revealed that most respondents were female (67,8%). The respondents had a bullying victim history (44.8%), a violence victim history (13.3%), and parental divorce history (10.3%). The statistical test also uncovered a significant correlation between anxiety and aggressive behavior (p-value 0.0001, r: 0.649, OR:7.86, CI 95%).Conclusion: The finding demonstrates the association between adolescents’ anxiety and aggressive behavior. Consequently, the community mental health nurses should organize a partnership mental health program with the senior high schools to manage adolescent anxiety and aggressive behavior

Coping with COVID-19: Strategies of Frontline Nurses

Nurses are the largest workforce within healthcare systems. They are integral to managing pandemics, but due to pandemics, Nurses encounter various traumatic situations, mainly due to distressing and stressful work life. Therefore, nurses must strengthen their resilience in coping with difficulties, adapting to new strategies, and protecting their work and daily life. If nurses have sufficient resilience strategies, burnout and the rate of leaving a job or resigning decrease, posttraumatic growth develops, and work satisfaction increases. The results showed that psychological resilience is an essential predictor of perceived stress in nurses. Protecting the mental health of nursing staff is essential for nurses to combat COVID-19 effectively. Community mental health and psychiatric nurses should develop, implement, and evaluate interventions designed to enhance psychological resilience in clinical nurses.

Optimalisasi Kemampuan Perawat Community Mental Health Nursing dalam Manajemen Asuhan Keperawatan Psikososial pada Masa Pandemi COVID-19 di Kabupaten Sumedang

The COVID-19 pandemic has a significant impact on mental health conditions, such as experiencing psychosocial problems marked by emotional reaction’s changes, e.g. anxiety, fear of transmission, depression, stigma and social discrimination against people who are confirmed positive for COVID-19. The results of a survey in one village in Sumedang Regency show us that they have mental-emotional disorders with an average Self Reporting Questionnaire score of 14, so efforts are needed to overcome them by CMHN nurses as mental health service providers in the community. Therefore, further efforts are needed to optimize the ability of CMHN nurses in the management of psychosocial nursing care. This community service activity aims to increase the knowledge and ability of CMHN nurses in providing psychosocial nursing care to overcome psychosocial problems in the community during the COVID-19 pandemic. The methodology used is training and mentoring with an Intermediate Course Community Mental Health Nursing (IC-CMHN) model approach. Evaluation of this activity was carried by pretest and posttest also using the Behavioral Health Care Competency Survey instrument. The results obtained in the CMHN training and mentoring activities for nurses in primary health service are an increase in nurse’s knowledge which was originally worth 71 to 95 and shows changes in the level of nurse readiness mostly from low to moderate levels.

Efektivitas Terapi Hipnotis 5 Jari dalam Penurunan Tingkat Kecemasan Akibat Hipertensi

Community Mental Health Nursing (CMHN) is one of the efforts used to help the community solve mental health problems (psychosocial) with promotive and preventive efforts that involve families. Many psychosocial problems occur in the community, namely anxiety, the global prevalence of anxiety is 11.6% of the total population of Indonesia or around 24,708,000 people. Efforts to reduce anxiety are by giving generalist therapy to control five-finger hypnosis anxiety. The purpose of its implementation is to provide inner peace for individuals, reduce anxiety, worry and anxiety, reduce tension, reduce blood pressure, lower heart rate, and sleep soundly. The implementation of 5 finger hypnosis was carried out in 4 meetings. This activity was carried out on 27 June 2022 with 20 elderly participants. The results of the evaluation showed that there was a decrease in the level of anxiety in the elderly at the pretest and posttest. A suggestion for the Public Health Center (Puskesmas) is to monitor the results of this education.

Uncertainty in illness among individuals with schizophrenia: a phenomenology study in Indonesia

PurposeIndividuals with schizophrenia experience uncertainty due to the unpredictable symptoms, the course of the illness and poor knowledge about the disease, treatment and prognosis. Uncertainty in illness is linked with poor treatment outcomes, coping strategies, check-up decisions and psychological distress. This study aims to explore the uncertainty in illness among individuals with schizophrenia.Design/methodology/approachEight individuals with schizophrenia living in the community were interviewed regarding their illness. The phenomenology approach was used to collect and analyze the data.FindingsThree themes emerged from the findings of the study; the unpredictable course of the illness, compliance amid uncertainty and uncertainty of information about their illness. This study provides an essential overview of how patients with schizophrenia live in uncertain conditions.Originality/valueIt should be considered by various parties, particularly the community mental health nurses working with individuals with schizophrenia. Considering the uncertainty of illness while looking after or interacting with patients and their family is significant in improving adequate mental health-care delivery.

Nursing Care Offered to A Teenager at Risk of Gender Dysphoria and Suicide: A Community Mental Health and Public Health Nursing Approach

Young people who are gender dysphoria are often at risk for certain psychosocial problems as well as being victims of discrimination and stigmatization. Such problems include issues such as social isolation, social withdrawal, loneliness, dropping out of school, tendency to crime, substance abuse, and being subject to violence. It is thought that all these problems are especially important in personal and social lives of young people living in societies where traditional gender roles have been conserved. In this study, it was aimed to offer holistic nursing care interventions to a 17-year-old male person who stated that he had wanted to commit suicide and been subject to homophobic attitudes because of the confusion about his gender.

Aplicación del modelo comunitario de enfermería de salud mental entre las personas con esquizofrenia

ObjectiveThis study aimed to evaluate the application of community mental health nursing (CMHN) model using an intervention of nursing standard care and cognitive behavioral therapy on life skills and work productivity for the adult population with schizophrenia. MethodThis study was an experimental study with an equivalent control group using randomly allocated 193 participants to either the intervention or control group at community health center in Cipayung, Jakarta. The intervention comprised in a 4-month cognitive behavioral therapy that was implemented by 33 community psychiatric nurse staff to improve the life skills and work productivity of people with schizophrenia. The instruments used to evaluate the intervention were the Indonesian version of the life skill profile (LSP) questionnaire and the work productivity and activity impairment scale (WPAI). The data analysis used a paired t-test. ResultsThe findings show that there was a significant difference in scores on the LSP before and after the implementation in the intervention group (19.94 ± 1.27 and 38.83 ± 9.32) with p < .001 and the control group (26.93 ± 12.50 and 30.89 ± 12.41) with p = .002. The findings also show that there was a significant difference of WPAI before and after the implementation for the intervention group (2.21 ± 1.12 and 3.82 ± 1.28) with p < .05 compared with the control group (1.91 ± 1.42 and 2.19 ± 1.58) with p = .188. ConclusionsCMHN models using basic community mental health nursing interventions can be used to improve life skills and work productivity of people with schizophrenia so this could be a skill to strengthen the ability to live in the community in this type of patients.

Applying the community mental health nursing model among people with schizophrenia.

This study aimed to evaluate the application of community mental health nursing (CMHN) model using an intervention of nursing standard care and cognitive behavioral therapy on life skills and work productivity for the adult population with schizophrenia. This study was an experimental study with an equivalent control group using randomly allocated 193 participants to either the intervention or control group at community health center in Cipayung, Jakarta. The intervention comprised in a 4-month cognitive behavioral therapy that was implemented by 33 community psychiatric nurse staff to improve the life skills and work productivity of people with schizophrenia. The instruments used to evaluate the intervention were the Indonesian version of the life skill profile (LSP) questionnaire and the work productivity and activity impairment scale (WPAI). The data analysis used a paired t-test. The findings show that there was a significant difference in scores on the LSP before and after the implementation in the intervention group (19.94±1.27 and 38.83±9.32) with p<.001 and the control group (26.93±12.50 and 30.89±12.41) with p=.002. The findings also show that there was a significant difference of WPAI before and after the implementation for the intervention group (2.21±1.12 and 3.82±1.28) with p<.05 compared with the control group (1.91±1.42 and 2.19±1.58) with p=.188. CMHN models using basic community mental health nursing interventions can be used to improve life skills and work productivity of people with schizophrenia so this could be a skill to strengthen the ability to live in the community in this type of patients.

The Psychiatric Nurse Care Coordinator on a Multi-disciplinary, Community Mental Health Treatment Team.

Community mental health nurses sometimes join multi-disciplinary teams, but the role has not been defined and studied carefully. This article describes the psychiatric Nurse Care Coordinator (NCC)-a unique position created to support care management, facilitate systematic medication management, and coordinate medical care in the Social Security Administration's 30-site Supported Employment Demonstration. The authors reviewed the study's NCC manual, supervised and consulted with the NCCs weekly over nearly three years, and reviewed data on NCC activities. Although the 984 participants assigned to NCCs experienced numerous mental health, substance use, and chronic medical conditions, only 59% completed intake assessments and engaged over time with NCCs. For those 581 participants, NCCs spent approximately 51% of their time helping with mental health issues, 35% on medical care, and 12% on substance use conditions. The NCC was critically important for complex, high-need individuals.

Improvement Of Caregivers Ability to Care for Patients in Mentari Hati Social Institutions Tasikmalaya

Based on Riskedas data in 2013, the prevalence of mental disorders in Indonesia is about 6% of the population has emotional disorders and 1.7% of serious mental disorders. In West Java the prevalence reaches 1.6%, while in Tasikmalaya City there are 171 sufferers. Mental disorders can be caused by biological, psychological and socio-cultural factors, it can also be caused by inadequate provision of patient care, especially in small towns and villages. Patients with chronic mental disorders need care management that involves various elements in the healing process, such as family, community and caregivers. The role of care giver which is very influential in the patient's healing process, they are in charge of providing emotional support and the necessities of life. The complex problems in patient care caused many of them not to be well cared for. One of the phenomena was found at the Mentari Hati Social Institusion. The caregiver's low educational background, and lack of knowledge in care, are among the factors causing the ineffective treatment provided. For this reason, a mental nursing service management program is needed which is managed in a Community Mental Health Nursing (CMHN) program which aims to empower caregivers by providing consultation and education services, and providing information on mental health principles. The purpose of this community service activity is to improve the care giver's ability to care for mental patients.