Deinstitutionalization, and more recently, earlier discharges from psychiatric inpatient units, have created and intensified the need for case management in community mental health. Nurses have been at the forefront of providing this case management. This literature review provides a synthesis of research and policy on the contribution of mental health nurses to community case management. The focus of this review is on the proportion of case management that mental health nurses undertake, the caseloads of case managers, and the interventions that mental health nurses most frequently perform in the community. The professional compositions of mental health case management workforces have been associated with economic imperatives, professional priorities, and the choice of case management models. The influence of mental health nurses in the case management workforce is particularly strong in the U.K. and Australia, but less so in the U.S.A. where social workers and people without mental health qualifications perform similar roles. Although heavy caseloads seem to be common among case managers, the research in this area is quite weak. The interventions that mental health nurses perform most often include case management (e.g., coordinating care), counselling, and medication management. Caring for the physical health of consumers might often be overlooked.
Purpose
New South Wales (NSW) correctional system houses 30% of prisoners in Australia and at this time has only had a single documented case of COVID-19 amongst its prisoner population. The coordinated response by Justice Health and Forensic Mental Health Network (The Network) undertaken with the support of NSW Ministry of Health, in partnership with Corrective Services NSW (CSNSW), Youth Justice and private jails has ensured that the NSW correctional system has remained otherwise COVID-free.
Design/methodology/approach
A research study of how a range of partners which support the operations of NSW Correctional System developed an effective approach for the prevention a COVID-19 epidemic amongst its inmates.
Findings
Establishment of effective partnerships, early coordination of representatives from all aspects of the NSW correctional system, limited access to the correctional environment, reduced prison population and strict isolation of all new receptions have all contributed to maintaining this COVID-free status despite other NSW settings with similar risk profiles, such as aged care facilities and cruise ship arrivals, experiencing serious outbreaks.
Research limitations/implications
Although Australia/New Zealand context of suppressed community infection rates for COVID-19 (which are approaching elimination in some jurisdictions) is in contrast to the situation in other parts of the world, the principles described in this paper will be useful to most other correctional systems.
Practical implications
Modelling was used to underline our approach and reinforced the veracity of following this approach.
Originality/value
The Network and CSNSW has been able to mount an effective, integrated response to the COVID-19 pandemic, which has been sustainable through the first peak of COVID-19 cases. This case study catalogues the process of developing this response and details each intervention implemented with inventive use of tables to demonstrate the impact of the range of interventions used.
People with serious mental illness (SMI) are more likely to have poorer health and poorer health behaviours, and therefore are at greater risk for cardiometabolic health comorbidities compared to those without SMI. Referral to a specialist cardiometabolic health care nurse may result in increased detection of poor cardiometabolic health in at-risk individuals. In this article, we present the results of the physical health measures of people with serious mental illness who have accessed a community mental health service in a regional centre and argue for the need for a multidisciplinary approach. Our data show the high prevalence of obesity, hypertension, low activity, smoking and nicotine dependence, alcohol misuse disorders, and poor diet among people with serious mental illness. The high prevalence of at-risk factors for poor cardiometabolic health in people with serious mental illness adds support for the role of a specialist cardiometabolic health care nurse in the detection and referral for multidisciplinary treatment to improve the physical health outcomes for people with serious mental illness.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.