Positive Mental Health Program

1. Positive Mental Health Program Francis Acquah CMHN By PresenterMedia.com

2. Utilising Untouched Mental Health Nursing Skills in Private Practice Point 1 Point 2 Introduction Increased Need for Multi-Tasking in Credentialised Mental Health Nursing Case Example of CMHN using Multi-Skills Use of Goal Attainment Scaling Statistics Point 3 Point 4 Point 5

3. Introduction This paper describes the work of the “Positive Mental Health Program” (PMHP). The PMHP is a private practice of Credentialed Mental Health Nurses using diverse skills to manage a range of patients within the community in conjunction with psychiatrists and GPs. Beginning as a small practice in the northern suburbs of Melbourne, the PMHP commenced in July 2011, not long after the last Mental Health Nursing in Primary Care Conference in March 2011.

4. Referral Process • Patient and the families • Referral

5. Coordinated Approach to care Holistic care General Practitioner Employment Agencies Maternal & Child Care Services Credentialed Mental Health Nurse NAEMI other specialists Neurologists Psychiatrist Psychologist Mind Australia Drug & Alcohol Services

6. Multi-Tasking in Credentialed Mental Health Nursing • Coordinated approach to care.

7. Referral Resource Table 1. PMHP Referrals (June 1, 2011, to February 29, 2012) .

8. Referral Resource Table 2. PMHP Patient Profile (June 1, 2011, to February 29, 2012) .

9. Holistic Approach Support, education, liaison for families and carers are integral part of the services we offer. Formal Assessment Process The Program Staff carry out assessment through discussions which provide information about a person’s life story or reasons why they need to see a CMHN. The CMHN then discusses with the client or patient how PMHP may be able to help them. We make it clear that CMHNs work in conjunction with a psychiatrist and that we will arrange mental health reviews when appropriate. We gather additional information using various tools, including an extensive Life Skill Questionnaire. Part of the purpose of data collection using the Life Skill Questionnaire is to assist in developing a relationship with the patient, so that completion of the Questionnaire may occur over several sessions.

10. Case Example of CMHN using Less-Used Skills in a Multi-Discipline Program • Sally “not real name” • Case Study: Outline of Activities and Results • Plan: Review mental state. • Action: Sally met with a psychiatrist and medication was commenced. • Plan: Monitor mental state. • Action: Ongoing meetings organised with the CMHN. • Plan: Improve employment – Sally was working casually but not getting sufficient work. • Action: Contact made with Employment Agency to assist Sally to increase hours or find other better paid work. • Plan: Stabilise finances and accommodation. • Action: Contact made with Centrelink regarding income support and accommodation needs.

11. Case Example of CMHN using Less-Used Skills in a Multi-Discipline Program • Sally “not real name” • We established long term goals and short term goals. Long term goals • Return to school • Join the Police force • Learn how to drive • Begin budgeting and saving money • Attempt to improve relationship with grandfather Short term goals • Stabilise mood and commit to ongoing psycho-education • Attend work regularly • Research and prepare for returning to school • Speak to her employment agency • Contact her older sister regarding accommodation

12. Therapeutic Interventions

13. Goal Attainment Scaling • How are Client Achievements Rated Using GAS? • GAS is essentially conducted on a 5-point measure, with the degree of attainment captured for each goal area. An important part of GAS is the establishment of the clinical outcome that is viewed as ‘successful’ on an a priori basis ( i.e. before the intervention starts). • If the patient achieves the expected level by the relevant time, this is scored at 0. • If they achieve a better than expected outcome this is scored at: • +2 (much better than expected) • +1 (Somewhat better than expected) • 0 (Expected) • If they achieve a worse than expected outcome this is scored at: • -1 (Somewhat worse than expected) or • -2 (much worse than expected)

14. Exhibit 1:Blank Goal Attainment Scales

15. Exhibit 2:Blank Goal Attainment Scales

16. Exhibit 2: Examples of Goal Attainment Scales Level of expected

17. Credentialed Mental Health Nurses are now putting the pieces together