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Psychiatric-Mental Health Nursing

7.6 Challenges to Continuity of Care

Psychiatric-Mental Health Nursing7.6 Challenges to Continuity of Care

Learning Objectives

By the end of this section, you will be able to:

  • Describe the complexity of mental health care and providing continuity of care
  • Explain how communication helps or hinders continuity of care for clients
  • Describe the nurse’s role in providing continuity of care

The nature of mental illness, as well as the variety of treatments offered, contribute to the complexity of mental health services. This makes quality care coordination a top priority when caring for clients with mental illness. Excellent communication is particularly important when dealing with multiple professions and agencies in order to prevent fragmentation of care. As always, the nurse plays an important role as care coordinator, removing boundaries and ensuring smooth communication.

Complexity of Mental Health Services

The complexity of mental health services can be seen in the types of services available, the variability of the conditions that mental health professionals treat, and the challenges in accessing these services. One of the nurse’s central roles in providing mental health services is care coordination. As previously mentioned, care coordination refers to the organization and distribution of health-care services across different providers and settings in order to ensure that clients receive the right care at the right time.

One key factor contributing to the complexity of mental health services is the wide range of conditions that fall under the category of “mental illness.” Mental health professionals may work with individuals experiencing depression, anxiety, bipolar disorder, schizophrenia, eating disorders, addiction, and many other conditions, each with its own set of symptoms and treatment approaches. Mental health services often involve a multidisciplinary team of professionals, including psychiatrists, psychologists, social workers, nurses, and other specialists, who must work together to provide the most effective care possible. This coordination can be challenging, particularly when working with clients who may have multiple health issues or complex treatment needs.

Another factor that contributes to the complexity of mental health services is the difficulty in accessing care. In most parts of the world, mental health services are not as widely available or affordable as they need to be, and individuals may face long wait times or significant physical or financial barriers to accessing care. Additionally, mental health services are often delivered in a variety of settings, including hospitals, clinics, community centers, schools, and even online. This diversity of settings means that mental health professionals must be adaptable and able to work effectively across different environments. The complexity of mental health services requires specialization of health-care services, communication, and continuity to ensure access and utilization of the care continuum.

Specialization of Health-Care Services

Specialization in mental health-care services refers to the process of focusing on specific areas of mental health practice to provide more targeted and effective care for individuals with specific mental health needs. There are many reasons why mental health-care services may become specialized, including the need to provide more individualized care, the desire to improve outcomes, and the recognition that different mental health conditions require different types of care.

Specialization is commonly seen in the treatment of specific mental health disorders. For example, there are specialized treatment programs for individuals with eating disorders, substance use disorders, and post-traumatic stress disorder (PTSD). These programs often involve a multidisciplinary team of health-care providers who have extensive training and expertise in treating the specific disorder.

Another area where specialization is increasingly common is in the delivery of telehealth services. With the increasing use of technology in mental health care, providers can now offer specialized services to individuals in remote or underserved areas. Telehealth services can include online counseling, virtual therapy sessions, and remote monitoring of mental health symptoms.

Specialization in mental health-care services can also extend to specific populations, such as children, adolescents, or older adults. For example, providers may specialize in working with children and adolescents with autism spectrum disorder or older adults with dementia. Specializing in a particular population allows providers to better understand the unique mental health needs of that group and tailor their care accordingly.

Overall, the specialization of mental health-care services can lead to more targeted and effective care for individuals with specific mental health needs. By focusing on specific areas of practice, providers can gain the expertise needed to deliver high-quality care and improve outcomes for their clients. The specialization of care can lead to clients having to see multiple providers to address all of their needs. This can lead to fragmentation of communication and care across a continuum. The nurse has a role in care coordination, ensuring continuity throughout all health services.

Communication along the Continuum of Care

The continuum of care refers to the different stages of care that a person may receive, from prevention and early intervention to treatment and recovery. Effective communication is crucial for providing high-quality mental health care across all these stages. Communication involves the exchange of information, ideas, and emotions between mental health professionals, clients, their families, and other health-care providers involved in the client’s care.

At the prevention and early intervention stage, communication involves educating the public about mental health, reducing the stigma associated with mental illness, and promoting awareness of the signs and symptoms of mental health problems. This may include providing educational materials, conducting community outreach programs, and promoting mental health screenings.

In the assessment and diagnosis stage, communication involves the exchange of information between the client and their health-care provider to gather information about the client’s mental health history, symptoms, and other relevant information. Effective communication at this stage is essential for making an accurate diagnosis and developing a treatment plan that meets the client’s needs.

In the treatment and recovery stage, communication involves ongoing collaboration between nurses, clients, other providers, and their families to meet treatment goals and monitor progress. This may involve regular check-ins with the client, medication management, therapy sessions, and support groups. Effective communication at this stage is essential for promoting client engagement, adherence to treatment, and positive outcomes.

Throughout the continuum of care, communication also involves coordination and collaboration between mental health professionals and other health-care providers involved in the client’s care. This may include primary care physicians, social workers, case managers, and other specialists. Effective communication between these providers is essential for ensuring that clients receive comprehensive and coordinated care that addresses all of their mental health needs.

Communication Hindering or Helping Continuity of Care

What contributes to more comprehensive and better health care through the coordination and quality of health-care services a client receives over time from various health-care providers or care settings is continuity of care. When employed effectively, communication is the most effective tool for providing continuity of care for clients. When incomplete or inconsistent, communication can hinder continuity of care. Missing or incorrect information can have a particularly negative effect on client outcomes.

Communication Helping with Continuity of Care

The communication skills of nurses are essential for delivering effective care and promoting positive health outcomes. By communicating effectively with clients, nurses establish a trusting relationship, which is important for promoting client engagement and involvement in the care process. Nurses can also help to identify potential barriers to treatment, such as medication side effects or lack of social support, and work to address them. Furthermore, regular communication between nurses and clients can help ensure that clients receive consistent care, even when they see different providers at different times. Good nurse communication also involves collaboration and coordination with other health-care providers, such as physicians and mental health specialists, to ensure that clients receive appropriate and timely care. By working together, health-care providers can ensure that clients receive consistent and comprehensive care.

Communication Hindering Continuity of Care

Just as good communication can ensure continuity of care for clients, communication barriers can cause significant problems with continuity of care for mental health clients. When communication is inadequate, it may lead to a lack of information, or misinformation, being exchanged between health-care professionals. If nurse-client communication is poor, clients may struggle to communicate their symptoms or concerns, leading to missed diagnoses, inadequate treatment, or medication errors. Communication barriers can contribute to misunderstandings between clients and health-care providers, leading to a lack of trust, poor client engagement, and a lack of follow-up.

The Nurse’s Role in Promoting Continuity of Care

The nurse’s role in promoting continuity of care in mental health services is central. The nurse works as a liaison between different mental health-care providers and coordinates care to ensure that clients receive comprehensive and consistent care. The nurse can also maintain open and ongoing communication with the client and their family to ensure that everyone is informed about the client’s progress and any changes to their care plan.

The nurse should advocate for clients by ensuring that their rights are respected, their needs are addressed, and their voices are heard in the decision-making process. Additionally, the nurse can provide clients with information about their mental health condition and treatment options, as well as coping strategies and resources to support their recovery. This increases compliance and follow-up.

Finally, the nurse can follow up with clients after they have received treatment to ensure that they are following their care plan, taking their medications, and attending any necessary appointments. If clients are not reaching goals, the nurse should evaluate why, and make any necessary changes to the client’s nursing care plan.


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