Psychiatric Nursing Community Concepts

Part I

1. Introduction to Community Mental Health

1.1  Exploration of the meaning of community

1.2  Consideration of the shift to client centred community care and understanding the role and required competencies of the community psychiatric nurse in this approach to care

1.3  Defining the continuum of care for mental health services and the philosophy of least restrictive environment

1.4  Identification of the varied mental health services and programs within the mental health system framework including crisis response, advocacy, housing, supportive employment

1.5  Introduction to Best Practices Models of Assertive Community Treatment and Case Management

1.6  Exploration of the Best Practices concept of recovery in mental health specifically the Recovery Model / Psychosocial Rehabilitation

2. Introduction to Community Health Practice

2.1  The history and evolution of the philosophy and policies supporting the concept of health and the foundation of community practice.

2.2  Introduction to the framework for Health Promotion in Canada.

2.3  Identification of the determinants of health and evidence based practice of the adopted “population health approach.”

2.4  Introduction to the use of basic epidemiologic, demographic and statistical measures of community health including accepted descriptive measures of health.

2.5  A review of the levels of prevention in community practice

3. Supporting Health through an Ecological Perspective

3.1   A review of the jurisdiction responsibility of Federal, Provincial and Municipal government for health and socials service delivery.

3.2   Introduction to legislation defining principles underlying the health care systems of Canada defined as Canadian Health Act

3.3   Identification of the overall determinants of health of all Canadians and distribution of health status related to such issues as poverty, education, literacy and personal health practice.

3.4   A focus on the ecological perspective of health identifying the roles of physical and social environments of community well being.

Part II

1. A Model of Community Practice: Community as Partner Model

1.1  Introduction to the purpose of models as a guide to health care practices.

1.2  Application of the Betty Neuman’s  Systems Model including the Community as Partner model and the model’s descriptor; core, subsystems, flexible line of defense, normal line of defense and lines of resistance.

1.3  Identification of various community stressors.

1.4  A focus on the assessment, diagnosis, planning, intervention and evaluation in the process of working with Community as Partner approach

2. Community Assessment

2.1  Introduction to phase one assessment of community as partner model.

2.2  Introduction to the use of a model or framework the community assessment called the community assessment wheel identifying  eight subsystems within the community;  Economics, Recreation, Physical Environment, Education, Safety and Transportation, Politics and Government, Health and Social Services and Communications.

2.3  Identification of various sources of community data.

2.4  A focus on the methods of data collection for accurate assessment including strengths and weaknesses of approaches

3. Community Analysis and Diagnosis

3.1    Introduction to phase two of the community process through analysis and formation of community diagnosis.

3.2    Identification of the accepted format of a community diagnosis. 

3.3    A focus of working with a team to synthesize data through methods of classification, summarization, and interpretation for development of tentative community diagnosis.

3.4    A review of guidelines and principles conducive to positive team environment.

4.Community Partnership for Health Planning

4.1    Introduction to the varied influences in formulation of community focused planning.

4.2    Identification of the systematic processes and plan for partnering with community that allow for prioritizing diagnosis, identifying goals, collaborative relationships, and potential barriers and resources that allow for identification of actions to achieve the desired outcome of community goals. 

4.3    A focus on several change theories including Kurt Lewin’s (1958) and Reinkemeyer’s (1970) stages of planned change and the transtheoretical model to assist in partnering with the community for a planned change

5. Implementation: The Action Phase

5.1  Introduction to the process of intervention and the varied influences in active participation of the community.

5.2  Identification of the value of community ownership of the plan and strategies to facilitate promotion of ownership for successful implementation.

5.3  A review of the levels of prevention and a focus on the three types of intervention education, engineering through policy formulation and enforcement.

5.4  Recognition of the agencies such as Health Canada and the role of legislation such as Report on the Health of Canadians (1996) in implementing community change.

5.5  Emphasis on the role of social support and social marketing forces and access to advocacy in the implementation phase

6. Evaluation

6.1  Introduction to the principles, strategies and processes of the evaluation of the effectiveness of a program and the multiple purposes of evaluation.

6.2  Identification of a model for program evaluation.

6.3  A review of the components of evaluation of relevancy, progress, cost efficiency, effectiveness, and outcome.

6.4  Recognition of the multiple methods of data collection and evaluation tools and the strengths and weaknesses of approaches.

6.5  Emphasis on the importance of evaluation for decision making, revision of plan, continued funding.

6.6  A review of the importance of the logic model plan identifying a plan for evaluation prior to evaluation process being undertaken