The Delivery Of Psychiatric Nursing Care Social Work Essay

Traditionally, people sing mental wellness jobs were removed from society and placed in refuges across the state, indefinitely ( Thornicroft and Tansella, 2002, pp. 84-90 ) . Patients within the mental wellness system were expected to take a compliant function in the direction of their attention and go forth the determination devising to the professionals. In today ‘s society that is non the instance. In this assignment the author will get down by researching the publication ‘Vision for Change ‘ while discoursing the chief subject of this publication which is ‘the importance of service user engagement and the importance of authorising the service user in the mental wellness system of Ireland ‘ ( Ireland, Dept of Health & A ; Children, 2006 ) . To authorise the service user requires the control of power to be transferred from the professionals to the now known “ Service User ” . The author will discourse the consequence of this alteration and the importance of this alteration within the mental wellness system. The Mental Health Act 2001 requested the closing of many refuges and the move towards a community based theoretical account of attention. The deinstitutionalisation of many patients and resettlement back into the community required alterations in the manner the psychiatric nurse and service user operate.

Evidence has shown the importance of service user ‘s engagement in research, instruction and in pattern through out the mental wellness attention system. The author in this assignment will discourse the importance of service user engagement in the bringing of psychiatric nursing attention, concentrating on the nursing appraisal utilizing a holistic attack.

Finally, the author will discourse the importance of service user engagement in the staying phases of the nursing procedure ; the nursing diagnosing, outcomes, planning, execution and rating while researching the demand for a curative relationship between service user and psychiatric nurse to finish the nursing procedure successfully.

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With people sing mental wellness troubles, who now reside in the community, it is critical that service users become involved in the development and bringing of mental wellness services, such as self-help services, drop-in Centres, and in supplying aid with activities of day-to-day life. The purpose of this is to sensitize society to the demand of incorporating people with mental wellness troubles back into community life.

As quoted in a Vision for Change ;

“ Service users must be at the Centre of determination devising at an single degree in footings of the services available to them, through to the strategic development of local services and national policy. To utilize a motto of the disablement rights motion: ‘nothing about us, without us ‘ .

To cut down the stigma attached to people with mental wellness troubles the term ‘patient ‘ was changed to serve user, as most of the attention they receive is provided in the community. The Mental Health Act, 2001 suggests ‘the term ‘patient ‘ is used to depict person who is involuntarily admitted. Patient does non therefore refer to all persons in an sanctioned Centre ‘ . In the Vision for Change it states that ‘the right manner to depict person with a mental wellness unwellness was to see the individual before the unwellness, for illustration person with anorexia nervosa was non to be described as ‘an anorectic ‘ instead than as a individual with anorexia nervosa. Pigeonholing in mental wellness is every bit detrimental as any other stereotype ( Ireland, Dept of Health & A ; Children, 2006 ) ‘ . Peoples, who experience mental wellness troubles, can be the experts through their ain experience ( Bee et al, 2008, pp. 442-447 ) .

Psychiatric nurses remain the largest staff group involved in the proviso of mental wellness attention, ( Bee et al, 2008, pp. 442-447 ) . Therefore, to guarantee the mental wellness attention service abides by statute law, it is critical for psychiatric nurses to re-evaluate their function to guarantee precedence is given to including the service user. An Bord Altranais recommend that a holistic attack is adopted and it is listed as one of the demands in nurse enrollment instruction programmes ( An Bord Altranais, 2005 ) . It is cardinal that the service user participates in the nursing appraisal particularly where the holistic theoretical account of appraisal is used. The biopsychosocial theoretical account uses a holistic position, turn toing the biological, psychological and societal factors lending to a individual ‘s mental wellness jobs. Harmonizing to Boyd ( 2004, p.190 ) it proposes a person-centred intervention attack which addresses each of these elements through an integrated attention program agreed with service users and their carers and involves engagement of the service user throughout the appraisal. This appraisal requires the service user to reply a series of inquiries, some being of intimate nature about themselves. This enables the assessor to obtain relevant information required in doing a nursing diagnosing. To guarantee accurate nursing diagnosing it is critical that the services user listens carefully to the inquiries asked and is wholly honorable when replying the inquiries. This procedure besides requires the service user to be patient while the assessor records the informations received. However, it is of import to retrieve that an initial appraisal can happen when a service user is foremost admitted into psychiatric attention. Harmonizing to Boyd ( 2004, p.194 ) the assessor must hold empathy and an apprehension of how hard it is for a individual to discourse confidant inside informations of 1s life ‘s to a complete alien, even if it is in the individual ‘s best involvement.

Although the nursing appraisal is the get downing point of the nursing procedure, the author feels that service user ‘s engagement remains of equal importance throughout the nursing procedure. The freedom of information act 1997 requires that all services users can bespeak entree to any information stored about them. While, it is now a legal demand for service users to be involved at all phases of the nursing procedure, the author suggests that it is imperative that the service user is informed of the nursing diagnosing. This will authorise the service user, by promoting the service user to happen relevant information sing their diagnosing which can help in them going experts of their ain mental unwellness.

Following the diagnosing it is required by jurisprudence that the psychiatric nurses discuss all inside informations of the result with the service user. The psychiatric nurse demands to guarantee that the service user ‘s values and beliefs are precedence when be aftering the result. If any intervention is deemed necessary for the route to recovery, so it is mandatory that the service user is capable of understanding the effects of the intervention proposed, this demand is stated Under the Mental Health Act, 2001:

“ the service user must be capable of understanding the nature, intent and likely effects of the proposed intervention and the adviser head-shrinker has given the patient equal information in a signifier and linguistic communication that the patient can understand, on the nature, intent and likely effects of the proposed interventions ( Section 56 ) . Factors for consideration include the capacity to grok and make up one’s mind, hazards involved, patient ‘s wants to be informed, the nature of the process and the effects of information on the service user. ”

The service user must be informed of the benefits of taking the medicine prescribed, for what continuance the medicine is to be taken and what side affects may happen when taking the prescribed medicine. Coercing an unwilling inmate to have medicine has been considered an unnecessarily coercive, traumatic, and even punitory assault on a individual ‘s privateness. It has been stated that the patients ‘ refusal of medicine is declarative of a spread between their experience and apprehension of the medicine and the purpose of the prescribing doctor. ( Kaltiala-Heino et Al, pp. 290-295 ) In today ‘s mental wellness attention system, many service users receive intervention in the community ; hence, it is critical that services users listen to information sing their prescribed medicine while raising any concerns they may hold.

Planning and the execution phases of the nursing procedure are non possible without the engagement of the service user. Communication and understanding between the service user and the psychiatric nurse is necessary. Potential obstructions need to be pointed out, and methods of get the better ofing these obstructions, discussed. Potential hazard countries for the service user needs to be discussed and a curative hazard appraisal carried out by the psychiatric nurse to guarantee the service user is non at hazard or danger of harming themselves or others. Awareness of patients perceptual experiences of their impaired quality of life gives psychiatric nurses of import information for be aftering separately tailored intercessions ( Pitkanen, A. et Al, 2008, pp. 1598-1606 ) .

Finally, the rating phase evaluates client advancement and reappraisals programs in conformity with evaluated informations in audience with the client. Evidence shows that the rating of a services users experience is of critical importance in determining the hereafter of service user ‘s results within the mental wellness service. It besides enables the psychiatric nurse to take the necessary stairss required to guarantee that the single service user is satisfied with the service received. The Department of Mental Health, UK stated that the experience of service users, including those from black and minority cultural groups, is a recognized national marker in the public presentation of the UK mental wellness services. In 2006, the UK National Service Framework ( NSF ) in line with the Mental Health Unit of the Regional Office for Europe carried out a systematic reappraisal of empirical service user positions and outlooks of UK-registered mental wellness nurses. Feedback from this reappraisal was both positive and negative, with service users keeping mental wellness nurses in high respect. However ; feedback besides reveals that there was a strong demand for nurses to be more effectual in interpersonal communicating and relationship edifice, whilst disbursement more clip with the service user ( Bee et al, 2008, pp. 442-447 ) .

Throughout the nursing procedure it is necessary for a curative relationship to be between the service user and the psychiatric nurse to. Relationships are cardinal in furthering and keeping hope ( Byrne et al 1994 ) . Psychiatric nurses are required to hold a echt involvement in services users, listening in a non judgemental manner to what is being said. In a user-led survey grounds has shown service users identified the importance of curative relationships and how they inform patient experiences. Communication was highlighted by all participants as necessary. One participant in the study quoted ; “ Equally shortly as you come they can see that you are angry. Then person will state, sit down, allow ‘s speak about it, do a cup of tea. ” Failure to set up a curative relationship between the service user and the psychiatric nurse can ensue in negative patient experiences. Participants identified coercion as the chief ground for failure to set up a curative relationship ( Gilburt, H. et Al, 2008 ) .


The author in this assignment briefly exposed the intervention of patients within the mental wellness attention prior to the debut of the Mental Health Act 2001 and the publication of ‘Vision for Change ‘ . Then, the author discussed the major alterations within the Mental Health Services as a consequence of this act and publication. The Mental Health Act 2001, focused on the closing of many refuges and a community based theoretical account of attention to be adopted, nevertheless, both the Mental Health Act and the Vision for Change besides focus on the importance of service user engagement and authorising the service user. The author demonstrates how a new psychiatric and service user function was required to accommodate to policy alterations within the Mental Health Service and to guarantee all parties were accommodating to policy demands that aims at service user engagement at all phases, therefore ; authorising the service user. The author reports how the publication ‘Vision for Change ‘ besides hoped at cut downing stigma by taking to affect services users in developing and presenting mental wellness services. The author mentioned the importance of service user engagement in research, instruction and pattern, while concentrating on the pattern country by researching the nursing procedure, get downing with the appraisal. Evidence is clear that it is non possible for a psychiatric nurse, even with the necessary accomplishments required to continue with the nursing procedure without the engagement of the service user at all phases. The author concluded this assignment by researching grounds which reveals that service users regard a curative relationship and good communicating between the service user and the psychiatric nurse of high importance.


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