Transcript community care diagram

Learning Objectives
• ALL will understand the history of community
care
• MOST will be able to explain the key features
of community care
• SOME will evaluate the worth of community
care for patients with schizophrenia through a
piece of psychological research
DO NOW: read through the BBC news article and
produce a mini timeline of how community care
has come to be what it is today
DO NOW FEEDBACK: TIMELINE SUMMARY
COMMUNITY
CARE: caring for,
and treating,
patients in the
community
What do we mean by the
‘community’ where will the
person be?
PAIRWORK
• We are going to consider the relative
advantages and disadvantages for the patient
of HOSPITALISATION versus CARE IN THE
COMMUNITY
PAIRWORK - PLAN
• Each pair has a basic description of what happens
in both hospitalisation and community care
1. YOU are going to decide, as a pair, what are the
advantages and disadvantages of these
treatment options for the patient
2. NEXT you will ANALYSE which treatment option
would be the best for a variety of patients
3. FINALLY you will look at some new ‘wildcard’
information and see if this changes your views
on the treatment options
COMMUNITY CARE: basic info
• Community care aims to give continued support to
the patient outside the hospital ward
• Case management – a way of tailoring help to each
individual’s needs. A patient will be allocated to named key
worker (CPN or community psychiatric nurse) who has to
assess and co-ordinate care
• Occupational therapists can give advice about building
social skills
• Patient can attend day clinics and day centres within the
community
• Patients may be provided with supported accommodation
where they have their own bedsit, but a member of staff
also lives on the premises
HOSPITALISATION: basic info
• The patient will be on a ward specifically for mental health problems. The
ward will be run to a set routine in terms of meal times etc
• The patient is closely observed in terms of behaviour and receives regular
medication from trained medical staff
• A person with schizophrenia may choose to enter a hospital if she feels her
symptoms are out of control. There are also situations when a person with
schizophrenia may be forced to go to the hospital or sectioned. These are:
 Violence to others. If a person with schizophrenia threatens others, he
can be committed. However, only a small percentage of people with
schizophrenia are violent.
 Suicide threat. For a hospital to take the threat of suicide seriously, the
person issuing it needs to have a plan, and the means to carry out the
plan.
Patient Examples
• Dave is diagnosed with paranoid schizophrenia. He frequently
hears voices which state that they will kill him unless he does
as they say. The voices recently asked him to kill his father.
• Joe is diagnosed with residual schizophrenia. Joe lost his job
during a more active phase of the disorder and has no family.
He has had problems in the past with remembering to take his
medication which has led to his schizophrenia relapsing
• Sam is diagnosed with disorganised schizophrenia. Sometimes
her speech is jumbled and she has problems expressing
emotion. Sam is 18 and has a very loving family.
Patient Example 1: Dave
• Dave is diagnosed with paranoid
schizophrenia. He frequently hears voices
which state that they will kill him unless he
does as they say. The voices recently asked
him to kill his father.
Patient Example 2: Joe
• Joe is diagnosed with residual schizophrenia.
Joe lost his job during a more active phase of
the disorder and has no family. He has had
problems in the past with remembering to
take his medication which has led to his
schizophrenia relapsing
Patient Example 3: Sam
• Sam is diagnosed with disorganised
schizophrenia. Sometimes her speech is
jumbled and she has problems expressing
emotion. Sam is 18 and has a very loving
family.
WILDCARD TIME – does this change
your decision!?
• HOSPITALISATION
Hospitals can
be seen as
places which
increase some
of the
symptoms of
schizophrenia
Hospital wards provides very little
information about how to survive and fend
for your self in the outside world
Institutionalisation does have some
benefits:
A controlled environment allows for close
monitoring, support and appropriate
treatment
It can prevent harm to the self and others
WILDCARD TIME – does this change
your decision!?
POLITICS
Community care requires large
financial investment if community care
is to be effective: the current
government have made many cuts to
the care system which means for
some this is not possible
However, services are
often patchy depending
on available funding in
local areas and the
burden on families
increases
Some patients simply ‘slip
through the net’ and do
not receive the care and
attention that they need,
with very negative
consequences for the
individual and others e.g.
the murder of Jonathan
Zito
STEIN AND
TEST’S
RESEARCH
Christopher Clunis was jailed indefinitely after
stabbing Jonathan Zito, 27, through the eye at
Finsbury Park station in December 1992.
The case caused outrage when it was revealed
that Clunis, now 45, who had a history of
violent behaviour, had been released under the
controversial 'care in the community'
programme just weeks before the killing.
Eight days before the attack, Clunis, who had
stopped taking his medication, was found
wandering the streets with a screwdriver and
breadknife, threatening children.
Until the 1960s patients were
hospitalised – advances in
drug treatments means the
incidences of long-term care
has been significantly
reduced
Hospitals can be
seen as places
which increase
some of the
symptoms of
schizophrenia
Community care aims to
give continued support to
the patient outside the
hospital ward
Case management
– a way of tailoring
help to each
individual’s needs
A patient will be
allocated to named
key worker (CPN)
who has to assess
and co-ordinate care
Community care
Occupational therapists
can give advice about
building social skills
Patient can attend
day clinics and day
centres within the
community
Patients may be provided with
supported accommodation where
they have their own bedsit, but a
member of staff also lives on the
premises
Hospital wards
provides very
little information
about how to
survive and fend
for your self in the
outside world
Many mental
hospitals have
now been
replaced by
community care
programmes
Institutionalisation does have
some benefits:
A controlled environment allows
for close monitoring, support and
appropriate treatment
It can prevent harm to the self
and others
However, services are often patchy
depending on available funding in
local areas and the burden on
families increases
Some patients simply ‘slip through the
net’ and do not receive the care and
attention that they need, with very
negative consequences for the
individual and others e.g. the murder
of Jonathan Zito
Learning Objectives
• ALL will understand the history of community
care
• MOST will be able to explain the key features
of community care
• SOME will evaluate the worth of community
care for patients with schizophrenia through a
piece of psychological research
‘The most suitable treatment for schizophrenia is
medication and this treatment should take place
in an institution.’ Discuss this view (12 marks)
Answer the following question
Briefly evaluate the role of
community care in the treatment of
schizophrenia (4 marks)