Community Care for Mental Patients

In 1963 the United States government passed the Community Mental Health Act because of terrible conditions found in public community mental institutions. This act gave money for the building of local community mental health centers. The community mental health act helps the patients receive a range of health services that includes outpatient therapy, inpatient care, emergency care, preventive care and after care. Effective community programs have proper coordination of patient services, short term and partial hospitalization, supervised residences and occupational training. Community mental health centers can supply medications, psychotherapy, inpatient, emergency and aftercare. The patients become better integrated into the community and function more effectively.

Short term hospitalization is only provided for a few weeks. There are day hospitals where the patient can go home at the end of the each day. After they have an improvement they are treated in aftercare. They usually have a lower re-hospitalization rate than extended institutionalization.

Supervised residencies are places where mental patients go to live because they are unable to live alone. The patients do supervised activities; have therapy sessions, and programs to help improve their social skills. They adjust to community life and avoid re-hospitalization.

Occupational training is workshops where mental patients are sheltered and can work to earn money. They are set up just like a real workplace and they manufacture things. They are taught social skills like getting paid money and are expected to be on time and come regularly.

There are some problems with community care. If there is poor coordination of services there could be an opening at a halfway house and a therapist may not know about the opening and then a mental patient will miss the benefit of the halfway house. The halfway house may change their staff around and the mental patient needs the same people providing continued contact. Another problem with poor coordination of services is that the halfway house/hospital may not tell the therapist about discharged patients and the ill person is released into the community without a plan for continued care. The community health centers have limited amounts of money so sometimes it’s difficult to offer all the services needed for severe mental patients.

My research found that there could be four possible solutions for improvement for the mentally ill within the community. The suggestions could be development of mobile crisis teams, more readily available family respite care, revision of the mental health laws related to competency, and change in the current confidentiality health laws. A mobile crisis team would help greatly. When someone falls you call for an ambulance, but when a mentally ill person has a mental breakdown within the community you call the police. Many times the police are not adequately trained in taking care of a mentally ill person. A mobile crisis team would have mental health professionals who would come out and are adequately trained to handle mentally ill people.

More respite care would help family members of mentally ill people have a break from taking care of their mentally ill family member. The ill person would be sent to short term housing so the family could be relieved from the care of the mentally ill person. This would help because the family could rest up and would be better able to take care of the mentally ill person when they returned.

There needs to be a change in the current mental health laws. Most schizophrenic people are not competent to make adequate decisions. As the current law operates a person’s competency is based on their age not their mental ability. If these laws were improved it could open doors for family members of the mentally ill so that the family could help them make competent decisions in their finances, health care, and living conditions.

The families feel completely powerless due to health confidently laws. When family is caring for a mentally ill, because of confidentiality laws, they are not allowed access to the health care decisions. By changing this law it would open doors to families so that they could better understand and assist in the medical care of their loved one.