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Abstract
The mental health practice model serves as a guideline for individual and institution-based practice when offering recovery-oriented mental health care. It targets public institutional settings. Therefore, it incorporates public health support in most of its formulations, perspectives, and rationale. The model has two themes. First, it is recovery focused because all the efforts directed to consumers contribute to their recovery. It seeks to give the beneficiaries a sense of identity, role, and purpose for their lives so that mental illness no longer burdens them. The model will be focusing on the positive outcome that is available in every case of mental health. It seeks to restore hope and optimism for consumers who have a mental illness or an experience with the problem. Second, the model focuses on assertive care management. It relies on sufficient staffing, coordination, and responsibility for treatment that goes to the clients.
Mental Health Practice Model
This model is based on the work of mental health case managers in designing interventions for respective cases such that they accomplish the consumer’s goals and access resources from the public mental health service bodies and the community. It seeks to equip and guide organizations to handle every case presented within the model and be able to respond to any crisis. Recovery is a leading term in mental health policy and service, and it has different meanings. For this model, there is a difference between clinical recovery and personal recovery. The restoration of social functioning and the cessation of symptoms will be the definition used for clinical recovery (Rook, 2013). Meanwhile, personal recovery covers the anticipation and results perceived by the person. It includes personal growth, healing, and self-determination, all happening holistically. Overall, the model sees recovery as a philosophy being pursued. Therefore, it combines aspects of clinical and personal recovery (Adler & Castro, 2013).
The model should make the transition from a biomedical view of mental health to a holistic approach to seeing and practicing health interventions for mental illnesses. Practitioners and the entire practice should be able to build on individual strengths by following the model. Given that the model seeks to empower a person as they undergo the recovery process, it will also attempt to balance the risk that people take when they are on a recovery journey. The aim will be to balance positive risk-taking needs and safety.
Data Collection
Data collection for the model concentrated on a literature review of international literature focused on mental illness recovery interventions. The review looked at organizational practice and individual practice, to highlight systematic issues affecting mental health practices. It also sought to bring out people’s experiences of care, with adult care being a major category for review. In some cases, literature referred to general populations, including children and youth. The highlight is that people need a sense of personhood when they are journeying towards recovery. On the other hand, data collection will be done by teams in charge during the implementation of the model, and it will cover all aspects of client care for use in subsequent decision-making tasks.
Overall Framework for the Model
The framework for mental health practice provides nine domains of working. The domains are cognizant of findings from the literature about the organizational practice and individual practice. The domains are the promotion of a culture of hope, development of autonomy and self-determination, collaboration using partnerships or meaningful engagements, as well as focusing on strengths and holistic and personal care. Others are family, careers, supporting people and their significant others, community participation, and citizenship, responding to diversity and reflecting and learning (Reiss-Brennan, 2014).
There will be the following considerations and approaches used to ensure that the entire model and those using it are all oriented to the recovery philosophy throughout the domains supported by this model. There will be core principles that will guide the practice. They will also determine the decisions and interactions that people have in the course of providing care in a particular area of health. There will also be the use of essential capabilities to ensure the principles are working. The capabilities include behaviors, attitudes, skills, and knowledge, which will rely on literature findings and best practices in health. Good practice examples will form the core of the approaches, where examples are chosen will exemplify the setting selected to provide mental health recovery. Lastly, good leadership arguments and examples will be taken to service leaders and managers such that they can describe and direct governance structures to realize the correct orientation of a recovery organization.
Mental health professionals will use optimistic language and support colleagues and families to celebrate recovery. They will research and understand environmental variables and then work towards supporting people’s recovery efforts. All messages and documentation will use the recovery-oriented language. Besides, practitioners will require knowledge of updated recovery outcomes. The organization will recognize the shared responsibility of workers and clients so that the resulting environment is secure for everyone. It will also get feedback from the clients and their significant others as a way of improving service delivery. Local policies will be used to ensure that the procedures taken as part of mental health services are embracing autonomy, self-determination, and choice.
Teams will be working with people in the context of their cultural identity and values to understand people’s triggers and incidences of not being well. The results will support interventions that work towards recovery for unique cases. All personnel will rely on inquisitive and active listening skills in communicating with patients and their families. They will also personalize cases and be supportive and positive with users of aspects of their lives to create friendly and professional relationships. Also, they will incorporate their professional skills to ensure that clients get appropriate choices and personalized support.
The management of a health institution implementing the model will be tasked with the authorization and support for the employees to prioritize space and time that is needed for proper joint practice. The attitude required of health professionals will be that of recognizing and valuing people’s resilience and strength. As a team, professionals will work on fostering willingness within their organization to try new things. They will also support people who are trying new things. Depending on their capabilities, they can make room for other staff members to practice their skills and benefit the organization and then encourage peer support (Reiss-Brennan, 2014).
All personnel tasked with caregiving will routinely ask about clients’ wishes and support needs. They will review goals, values, and interests, and then use the information as the basis of care personalization. They will network and build collaborative programs with health service providers working in non-mental capacities to ensure a holistic approach to mental health recovery for clients. Besides, they will seek information concerning services that a customer has had before being referred to them for a particular service. Professionals will be encouraged to make home visiting and conduct environmental assessments as a way of improving outcomes. They will actively find flexibility in responding to client needs or availability. The management will encourage regular case conferences to sustain a culture of improvement and support clients’ access to a broad spectrum of services.
Social Marketing and Working in Teams
The application of commercial marketing principles in healthcare allows health care professionals to make effective health interventions at the community level. Here, techniques that work in the commercial sector are applied in the health care setting as methods of promoting behavior change socially in cases like smoking and sexual behavior. For this model, the behaviors of focus are self-determination, eating disorders, hyperactivity, and attention deficit among others. The model will bring out health communication strategies that have been successful in other health interventions. They include the use of mediated, interpersonal, and other forms of communication. There will also be the use of marketing approaches to communication, like the placement of messages in health premises such as clinics. Public awareness campaigns that promote and disseminate information at a community level outreach program will also be handy (Evans, 2006).
However, there is recognition of the increase in the number of health challenges relating to mental health that can affect the effectiveness of the respective delivery channels. Therefore, the model will combine social marketing elements and teaming strategies. The idea is to promote a holistic approach that has relevant resources to respond to any emerging challenges of message and intervention delivery. Teaming is a traditional social work practice that has worked well with mental health programs. Different perspectives of individuals who have diverse educational, professional, and personal life experiences integrate when practicing as a team. Therefore, a barrier emerges and protects against personal bias. Instead, informed decision-making and learning based on working solutions or non-working ones that need improvement prevail.
The aim will be to have everyone working toward the same goal through teamwork and social marketing strategies. Team members need to respect their mutual interests. They must understand and recognize the value of all team members. Team membership will rely on individual cases. Members will work together to determine the purpose of their mental health intervention and agreed on the decision-making pathway, the client’s strengths and needs, and action required to facilitate recovery on a given timeline. The mental health practice team will be central to this model.
Teams will be built according to localized needs and resources for a particular organization. They will include professionals, caregivers, community stakeholders, and clients. The communication approaches and working strategies that teams use must follow all health regulations currently in place (Reiss-Brennan, 2014). They must also be respectful of organizational rules. There will be a distinction between the people making up the team and the meetings that they hold to facilitate communication and coordination of their work. The nature of meetings will depend on case urgency and the need for intervention. On the other hand, membership in teams will be dynamic and flexible, reflecting changes in client needs during the recovery process, as well as the availability of resources like funding, policy guidelines, and level of demand for mental health services in the organization (Akland, 2012).
The belief of teamwork and social marketing approach emanates from the fact that consumers need adequate involvement in their care. Working collaboratively with consumers and their caregivers, as well as family members provides a community approach that is necessary for sustaining a recovery-oriented program that this model advocates. Besides, the model also follows the value of population-based planning and service delivery, which implies that practitioners and organization management will work towards providing services as close as possible to the clients.
On social marketing, the model will follow six basic stages of social marketing best practices. It will work on developing plans and strategies using behavior theory. It will then select communication channels and materials following a particular behavior change that is required, as well as knowledge of the target community. The third stage is to develop and pretest materials for use. The fourth stage is to use qualitative methods for the intervention. The communication program/campaign goes live at the fifth stage, and the last phase is about the assessment of its effectiveness in terms of the exposure and awareness created. In the evaluation phase, the focus is also on reactions to messages used in the campaign and any behavioral outcomes, such as signups to specified clinics by individuals seeking diagnosis and treatment of mental health problems. The social marketing intervention will be a loop, where the assessment feeds into the planning and strategizing stage to being the process (Thornicroft & Tansella, 2013).
Importantly, audiences will be segmented based on their perceived familiarity with elements of mental health practice and vulnerability to mental illness programs. There will be the use of commercial marketing targeting family members and caregivers, subject to funding by state health departments, national health department or other partners. The preferred behavior outcome for the approach will be to have the target audience show up for membership recruitment as part of mental health practice teams for their communities. The intention will be to grow the holistic approach to recovery.
There will be a heavy influence of persuasion theory in implementing the social marketing strategy. The theory mentions that people need engagement for them to be persuaded fully. They have to think favorably about the message, which takes time and continued exposure. In this regard, the stages of marketing described above will be instrumental in delivering the right information for determining the preferred intensity and length of the various campaigns run as part of this model.
The aim will be to change public attitudes on mental health and the behavior of people towards those having mental health issues. Another aim will be to maintain behavior gains made at the community level towards mental health. The social marketing approach will involve mental health practice teams as described previously. It will have three levels of implementation. There will be national engagement relying on mainstream media, and then community involvement relying on local events and the main influencers. Lastly, it will include individual action and empowerment interventions that focus on personal initiatives of mental health team members. The messages delivered in all campaign levels will be similar to increase their persuasion capacity. Health organizations will be tasked with the development of free tools and materials for sensitizing their clients and workers, while other institutions will be assisted by the mental health team at the community level to develop sufficient approaches for message delivery.
Funding Considerations and Sources
Funding for the model will come from the federal budget. Public institutions using the model will be able to qualify for funding based on their ability to meet the mental health needs of their clients. They will be able to demonstrate that the model assists them to expand mental health services for adults, children, and the youth. The model seeks to constitute a community level awareness of mental health problems and support collaborative approaches to care. Therefore, it allows for modification to fit into the current programs that a health institution could be implementing for psychiatric care clients. The model will be a working guideline for community-driven processes that identify the unmet mental health needs.
Besides reliance on federal funding, institutions and state departments of health will provide annual or multiple-year plans based on this model to seek funding from appropriate state funding agencies. Disclosure of financing will also allow gaps to be filled with other vehicles of financing, such as research grants that members of a mental health practice team may qualify for. Organizations are also capable of transferring their revenues and other financing allocations to the interventions under the model when they fit with their overall mandate. Such cases will include caregiving organizations for the elderly that have to deal with mental health problems as part of their mandate of providing care. The organizations already receive public funding at state and national levels; thus, they will only be carrying out their mandate as part of their adoption of this mental health practice model
Another source of funding will be the respective programs on the improvement of health that target different communities. For example, health intervention programs in schools can introduce aspects of this model in their intervention and allow funds allocated for general health improvement to be channeled to specific mental health interventions (Rossen & Cowan, 2014).
Another funding option will be community-based funding in recognition of the fact that states are actively moving away from centralized financing in running state-operated facilities. Instead, they are actively devolving health units and funding to the community level. One aim of the approach is to make it responsive to emerging medical needs and promote efficient resource allocation. A paper by Seiber, Sweeney, Patridge, Dembe, and Jones (2012) showed that an appropriate state funding formulae consider funding factors used by other states, legislative requirements for the given state, the available data, and local variation factors for the funding formula. In this regard, financing of this model will be affected by staffing and health care access policies that a particular state’s legislation has. Individual and corporate participants in the program will have to abide by the existing frameworks of public health delivery to qualify for government funding through state and federal support under various programs, such as direct hospital allocations, research grants, Medicaid, and staff salaries.
The model also includes volunteers who will only need facilitation for their services. They include community health workers, family members, and other stakeholders in communities (Balan & Pauna, 2014). They will be able to use their influence, community roles, and other privileges to access resources, such as transportation and accommodation in the course of fulfilling social marketing and other direct forms of mental health practice interventions.
Decision Support
The decision support for the model focuses on mental health promotion, primary care and access to services, adequate services for people having a severe mental illness, caring about caregivers, and preventing suicides. This model recognizes that mental health services need a comprehensive knowledge base. Therefore, a critical component will be the development of an information system that allows teams to deploy resources well and make fast and efficient decisions (Ganga, Kutty, & Thomas, 2014).
The key to decision support aims in the model is having appropriate strategies for recruiting qualified and experienced staff for respective organizations’ departments of mental health. It includes the development of a workforce that has the community’s interest at heart. The workforce must include psychiatrists, mental health nurses, clinical psychologists, and therapists. Getting the right numbers of professionals will be an important factor in supporting the effective functioning of teams and efficient decision making. The model advocates for inter-agency workshop plans to assist in ensuring that the employees are not undergoing significant stress in their jobs.
The inter-agency workshop plans will allow different institutions and community groups to work together to facilitate the skill mix. As a result, it will be possible to tackle current and future shortages of resources, especially staffing resources. The collaboration will be among mental health service departments and can have links with criminal justice agencies (Evans, 2014).
Another important element to support decisions will be the creation of a workforce representing the communities served. The service delivered must be culturally competent. Besides, members of the mental health practice team, especially the trained specialists, will have equal opportunities.
The activities covered in the model will include workforce planning to ascertain staffing positions for mental health nursing, psychiatry experts, clinical psychology, social work, care, and support staff, as well as professionals allied to medicine to pave way for collaborative work. Also, the model will rely on a national leadership program that combines the needs of mental health service leaders and general management programs. The leadership program will encourage the advancement of individual staff careers into specialties and associated management positions.
The model will use current sources of information supported by various states’ departments of health, as well as the federal department of health. The common sources of information will include reports on health needs assessments on respective communities, clinical guidelines, and clinical audits performed as part of ensuring public health service units offer excellent services. Individual nursing community organizations that act as knowledge repositories for nurses and other medical practitioners, such as the American Nursing Association will also be included (Cleary, Deacon, & Hunt, 2011).
Decision making will consider evidence-based practice when practicing the model. They will focus on interventions that are best practices and whose outcomes are proven as successful through the available evidence. Also, the model advocates for early intervention to reduce the decision-making burden and increase resource utilization for dealing with mental health problems in a community (Chapleau, Seroczynski, Meyers, Lamb, & Buchino, 2012). In this regard, the establishment of a skilled and supported multidisciplinary workforce is necessary. Moreover, the staffing considerations highlighted above will be critical in ensuring that adequate capacity for making decisions is realized to translate to efficient service delivery.
References
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Akland, G. (2012). Community engagement: A model mental health partnership. Journal of Community Engagement and Scholarship, 4(1), 71-71.
Balan, M., & Pauna, C. B. (2014). Models of mental health care financing in Europe. Annals- Economy Series, 3, 23-27.
Chapleau, A., Seroczynski, A. D., Meyers, S., Lamb, K., & Buchino, S. (2012). The effectiveness of a consultation model in community mental health. Occupational Therapy in Mental Health, 28(4), 379-395. Web.
Cleary, M., Deacon, M., & Hunt, G. E. (2011). Mental health nursing role models: What is valued? Journal of Psychosocial Nursing and Mental Health Services, 49(8), 6-7.
Evans, J. M. (2014). Health systems integration: competing or shared mental models?International Journal of Integrated Care, 14(4). Web.
Evans, W. D. (2006). How social marketing works in health care. British Medical Journal, 332(7551), 1207–1210. Web.
Ganga, N. S., Kutty, V. R., & Thomas, I. (2014). Determinants of positive mental health: A path model. Mental Health Review Journal, 19(1), 47-60. Web.
Reiss-Brennan, B. (2014). Mental health integration: Normalizing team care. Journal of Primary Care & Community Health, 5(1), 55-60. Web.
Rook, L. (2013). Mental models: a robust definition. The Learning Organization, 20(1), 55-60. Web.
Rossen, E., & Cowan, K. C. (2014). Improving mental health in schools.Phi Delta Kappan, 96(4), 8-13. Web.
Seiber, E. E., Sweeney, H. A., Partridge, J., Dembe, A. E., & Jones, H. (2012). Mental health community based funding: Ohio’s experience in revising its funding allocation methodology.Community Mental Health Journal, 48(5), 604-610. Web.
Thornicroft, G., & Tansella, M. (2013). The balanced care model for global mental health. Psychological Medicine, 43(4), 849-863. Web.
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