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Overview the changes in healthcare practice

During the last 5 years, nursing profession was passing through several comprehensive changes which increase the quality of nursing practice. The Institute of Medicine put the professions of nursing under the microscopic surveillance and enhances the changes. Several new attempts are taken to improve the healthcare landscape along with increasing professional expertise. Several programs, educational researchers are emphasizing the new opportunities for nurses.

Nurses who find psychology interesting and enjoy working in the mental health field are considered as mental health nursing or psychiatric nursing. The main aim and objective of this kind of nursing are to create a long-term relationship with the patient to overcome their difficulties. From last few decades, several changes have been observed in mental health nursing to improve the condition of the patient progressively. Mental health nurses work together to serve individuals with mental health issues and enhance their recovery process. The recovery process can be influenced by taking proper and effective initiatives (Bisk, 2017).

The transformation of the mental health services and the nursing practice was started from 1980’s onwards. The transformation phases can be categorized into 3 ways. They are-

  • Periods of De-Institutionalization
  • Developing wide-ranging models of care in society.
  • Diversification of service provision and delivery.

In the second half of 20th century, people with mental illness are taken to the psychiatric for better treatment and also introducing anti-psychotic drugs and mood stabilizers as an element of treatment. Gradually the society was realizing that unconventional behaviors of the individuals no longer needed to be admitted to the mental asylum. They can be recovered their abnormalities if they are appreciated in a positive way (Calzone et al., 2010). A community service provision expanded to established community mental health facilities. The new model is able to provide better services for the old age people suffering from mental illness along with the younger suffer. Poor community care services have been revised to make the recovery process smooth and supportive (Salmond and Echevarria, 2017). Innovation and Development and innovative services have been introduced in mental health treatment process throughout the world. Services are design in such a way that the process is able to identify and diagnose the illness at the initial stage. The process is also supported the mental condition of the patient and helps them in quick recovery.

The transformation of the mental illness services has not occurred easily. A considerable energy and enthusiasm were needed for the process. Several types of research have been indicated that a combination of few factors played an essential role to overcome the several barriers and to make the transformation of the services. They are discussed in below (Gilburt and Peck, 2014)-

  • Leadership growth in nursing

The IOM report highlighted that the exclusive patient-centred viewpoints can able to change the facilities and services of the mental health care centers. Advanced practice registered nurses are able to provide quality services to the patient.

  • Technological advancement

Technological advancement in past few years increases the scope of services. Through several technological devices, the nurse can able to monitor the mental health status of the patients. In another hand, the use of technologies also helps the nurses to obtain proper knowledge regarding the patient’s condition and treatment procedures (Magrath, 2017).

  • Innovations in service delivery

Several innovative services have supported the nursing care practices related to mental health services. In the present day, the community services are working together with health and social care professionals to obtain the better results and services.

  • Changes in roles and Culture

Professional roles and cultures are changing considerably to support the transformation. Some development has been accepted in supporting the development of the professions. However, this changes in some extent creating cultural clash among the community people. To provide the better support and services to the patient several new techniques and courses have been introduced. This can enrich the nurse regarding their duties and responsibilities.

  • Case management and care coordination

Case management has been developed as the standard of all community health services. The main component of the community mental health care teams needed to coordinate with their multidisciplinary nature along with medical, nursing and social care staff. The process of coordination ensures that the patient needs are adequately assessed and provided sufficient services for them.

  • Financial models

The most advanced transformation has been accompanied by the financial models that support the changes in the nursing practices. The cost-effective treatment process helps the patients to avail the services offered by the organizations. This cost-effective treatment procedure is able to change the nursing approaches.

In addition, it can be stated that the new nursing specialties, nurses are playing an essential role in mental healthcare practice. The modern nurse's sections, draws emerging nursing roles such as developing technologies, flying into crisis situations and local library are also influenced the transformation process. New specialties are able to increase the leadership opportunities along with healthcare facilities. An IOM report is indicating that more than half a million new nurses are entering into the professions before 2022. They will be responsible for providing better services and care for the community people.

Person- Centred perspective

Person-centred care is modes of thinking that see the people using health and social services as equal partners in planning and developing. This process arranges people and their family at the center of the decision and organizing the professional for better outcomes. Person-centred practice for mentally ill persons can able to provide proper treatment and care by the healthcare services. The persons are placed in the centered of the care and considered their specific needs. This person-centered practice is treating the patients who want to be treated. The process is also concerned regarding the dignity and respect towards their patients. The nurse is sharing humanity with their patients (Health innovation network, 2017). Person-centred care is not only providing the services to the mentally ill patient but also providing information. The process is about considering individual desire, values, socioeconomic conditions, family background, and lifestyle. After considering all such criteria’s, they are providing the appropriate solution to support their mental condition. Person-centred care also helps the patient through sharing decisions and helping the people to manage their healthcare problems(Person Centred Practice, 2008). This process of interaction is able to create a good relationship and valuable services. These involve working with people and their families and offer the best services. It is a process which creates a partnership between individuals and healthcare services (Hwns, 2017).

There are no specific definitions for person-centered care as the process is working together to provide the better services and experiences to their patient. The different aspects of person-centered care are –

  • Respecting the patient’s values and keeping them at the center of care and providing preferences of their needs.
  • Coordinating and integrating to ensure good communication, information, and services.
  • Provide the emotional support and sense of safety to the patient.
  • It is centred responsibility to make sure that the people have accessed appropriate care which they actually need.

Person-centred care is a concern to provide high-quality healthcare services for the individual with mental illness. Several works need to be done to help the healthcare services to become more person-centered (Thinklocalactpersonal, 2017). These processes have been started from past few decades. The importance of person-centred care are stated below-

  • It can able to improve the quality of the services available for the individual patient.
  • Helps people to get proper services and care which they actually need.
  • The process is able to help the people to become more active regarding their health.
  • The process is also able to reduce the pressure on health and social services.

Several types of research have been found that person-centred care has an important impact on the quality of the care and services. Additions of experienced people in the person-centred care are able to satisfy the customers. The process is also able to encourage the mentally depressed people to lead healthy lifestyle along with proper exercise and sufficient food. The person-centred care is also encouraging the people to be more efficient regarding their decision-making capabilities. As a result, they are able to get sufficient services for the specific needs and health outcomes. The staff of the person-centred care is able to satisfy the patients by providing better services and relationships with the patients and their family.

Researchers are able to identify several important factors which are associating with the effectiveness of person-centred care. The important factors include-

  • The centred are able to identify the individual needs of the patient.
  • Seeing the patient as an expert about their own health and care.
  • They are sharing power and responsibility for better services.
  • The centred are taking holistic approaches to identify patients need and providing appropriate care.
  • The centred are able to ensure that the services are flexible and accessible for the individuals.
  • The staffs of person-centred care are supportive and well trained in communicating with their patients and their families.
  • They are considering their patient as a human being and behave with dignity and respect.

Finding from observations

The several types of research have been found that the nurse generally positive attitude towards their mentally ill patients and their thought are less stigmatized compared to society. Moreover, the nurses have derived their behavior from their experiences and showing positive behavior with the patients. In many cases, positive organizational attitude can also influence the nurses to respect the mentally ill people and understand their needs. The educational advancement can able to abolish the stigma regarding the mental health of the society (Hanrahan and Aiken, 2008). To improve the quality of the services in hospitals for mental health people several attempts has been taken by the federal government. The government has taken several initiatives to identify the adverse events in hospitals related to mental health care practice and introducing several initiatives to control such errors. The mental health care nurses reported that if they get proper support from the management they can able to provide better services to the ill persons. However, the proper training and education are essential for the nurse to control the patient respectfully and without decreasing their dignity. The nurses are suffering from several hurdles in hospitals which decrease their interest and intensity towards their job(Mårtensson, Jacobsson and Engström, 2014). The management should take different strategies to support the mental health patients and their services.

Analysis of current caring tools

Nursing has positive effects on the patient’s life. Nurses can capable to provide appropriate services for their patients which help them to heal their mental problem and provide them safety and security. The spiritual activities through the nursing care are capable to propose sufficient services for their patients. Sound professional practices with an innovative environment are able to improve patient’s mental health along with the community. The high quality of nursing care thriving in a healthy work environment can cure mental healthcare related complications and provide better services for their customers (Gelinas, 2015).

Mental health problem is one of the leading problems in the world. Huge populations are suffering from mental illness. For this reasons, proper identification and measuring tools are essential to provide better services to the patients.

  • Global Mental Health Assessment Tool:

The GMHAT can be a useful tool help in detecting the mental disability among the population in middle and low-income countries. Identification of mental health problem is important to provide proper treatment and prevent chronic illness. This tool will help to identify the problem and providing evidence based treatment. This process will help to treat the patients in the correct way. Moreover, the process will help to identify a range of mental disorder and appropriate treatment guideline. It is a computer-based tool which can be used after proper training and it can be handled by any nursing staff of the organization (Sharma et al., 2010).

  • Improving Access to Psychological Therapies (IAPT):

It is an initiative to increase the provision of evidence-based mental health treatment for the common mental problem. According to this process, mental health professional are trained the patients adequately and trying to improve their mental health status.

  • Galatean Risk and Safety Tool:

It is a clinical support system which helps in the decision-making process. It is used to assess the risk associated with mental health problem. It can able to change the clinical and organizational approaches and their facilities. It is a software-based tool which needs special knowledge and training (Impact.ref, 2017).

Recommendation for the improvement

  • Educational Structure

Educational structures include the content of educational programs along with teaching methods and educators competent have played an important role in the adoption of better care by the nurses in a mental health problem. An effective educational structure is able to influence the quality of care and extent of attending to patient secular problems. Reconstruction of nursing lessons is essential to incorporate holistic care in the nursing student. The incorporation of a behavioral lesson in nursing courses can able to improve the holistic approach of nursing practice. Proper teaching methods and educator’s competency in the instructive structure can play a vital role in learning and transfer of substantial knowledge of holistic care in clinical practice. Therefore several studies indicating that the nurses believed that the main concern of their courses is to become competent in doing their regular routine task and they had very scanty opportunity to consider the patient’s needs. Through an effective educational process, the concept of the holistic care in hospitals or in clinical practice can be introduced (Jasemi et al., 2015).
The educational structural changes will definitely ensure the quality of services in the mental healthcare practice. Through this process, nurses will get a better understanding regarding the patient’s mental health condition, needs, and their individuality. The proper application of dignity and respect will improve the future aspects of caring.

  • Professional Environment

The professional environment includes workloads, management and limited conformity of the clinical environment. Workloads are one of the aspects in a nursing environment which can affect the quality of care. Many types of research on nursing workloads suggested that heavy workloads on nurses can restrict the opportunity to consider patient needs. Dissatisfaction with the management can also emphasize the poor work quality. A healthy environment with proper management is promoting holistic care which improves the quality of services. The positive environment also influences nurse’s performance and increase their capability of learning. The professional environment can affect the formation of holistic care and act as a facilitator to improve the quality of services. The unsuitable professional environment is considered as barriers to holistic care provisions (McClellan, 2013).
The professional environment in healthcare practice can improve quality of the services through the nurse. The constructive and encouraging work environment can help the nurse to work positively and passionately. Form the personal point of view positive professional environment should be incorporated for better results.

  • Motivational Factors

Motivational factors such as person traits and person experiences are considered as influential factors which generate the holistic perceptions of the patient’s. This also encourages the nurses to understand the patient’s diverse needs and provide appropriate services. A person trait plays an important role in expanding the relationship with patients and helps in identifying their various needs. These approaches also help in developing holistic perception on the part of nursing. Also, mortality rates and religiousness can bring holistic care and in many cases, it is able to overcome the defects in the educational and clinical systems. The positive behavior of the nurses towards the patient and an expanding relationship with the patient and their family are considered as person traits of the nurses. The person traits can be influenced by achieving successful cooperation with colleagues, intimacy with work culture, commitment and consciousness of an individual. Studies found that nurses with emotional and social temperament are able to identify the patients need quickly and offer accordingly. The same studies also reveal that such kinds of nurses are more dependable and intelligent along with flexible, conscientious and highly motivated. The principles and beliefs of the nurses have a great impact on their working culture. The person experiences of the nurses can also influence the services and their behavior. A better person experience can influence the understanding process of patients needs and also encourage holistic perception. Nurse’s person experiences on hospitalization can influence the quality of the services. It has been observed that such kind of experiences can influence the nurse’s attention to the patient’s and their needs. These can motivate the nurses in a positive way.

Motivational factors are essential to improve the service quality and efficiency. Positive motivations can increase the acceptance of patient’s needs. Incorporations of motivational factors in the hospital and healthcare clinic can motivate the nurses to show positive behavior towards their patients and job responsibility.

  • Use of proper analyzing tools

Use of different analyzing tools in healthcare set up can help to recognize the exact condition of the patients and enhances the chance of improvement by providing a proper solution. It is essential for every mental health care unit and hospitals to evaluate their flaws and introduce the new strategies which improve the health care facilities.

  • Use of technologies

Use of technological device in health care unit will able to minimize the errors and improve the quality of services. Safety of emerging technologies is essential to decrease the errors. Proper labeling and using techniques of the equipment will diminish the chances of errors.


It can be concluded that the approach of nursing practice can be changed by integrating positive behaviors and educational approach of the nurse. Education and awareness can progress the transformation of the healthcare facilities. Sympathetic behavior towards the patients and their families should be introduced to enhance the quality of the services.


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