Paper
Friday, 21 July 2006
This presentation is part of : Psychiatric/Mental Health Issues and Strategies
Developing an Integrated Comprehensive Quality Mental Health System in a Rural Community
Margaret Fleming, RPN, FFNRCSI, MS, St. Davnet's Hospital, Monaghan, Ireland
Learning Objective #1: Understand the strategic shift from a closed to an open systems approach and how novel services can be established given vision, commitment and management expertise.
Learning Objective #2: Recognise the importance of inter-sectoral collaboration, partnerships, alliances and team working to build networks of knowledge people and agencies promoting inclusivity, citizenship,empowerment and recovery
Cavan Monaghan Mental Health Service undertook a service research programme to evaluate all service practices and care needs of service user groups. Following this research the service undertook to develop an integrated, comprehensive, high quality, individualised system of care and supports that would meet the mental health needs of people in a rural community. The aim was to develop three specialist multidisciplinary teams: A community mental health team with a clinical focus on acute mental illness in crisis with availability of homebased treatment, A community rehabilitation team with a clinical focus on severe and enduring mental illness with availability of assertive outreach and a psychiatry of later life team with a clinical focus on mental ill health in later life This strategic shift took the service from a closed to an open system based on the following principles: Centrality of service users’ needs and rights, Delivery of individual treatment packages in the setting of home, family and community, Responsiveness, Empowerment, Participation, Partnership and Citizenship. Quantitative data as reflected in the Activities of Irish Psychiatric Hospitals 2002, 2003 and 2004 has shown dramatic changes in the range of service indices. Qualitative analysis of stakeholders has shown considerable satisfaction with the new service programme. The hallmark of this reform agenda is that the individual is unique and that all interactions with the individual are highly integrated, that is a client centred system. Delivering a client centred system requires a whole systems approach, a move from a closed to an open system to achieve this principle. Developments within the Cavan Monaghan Mental Health service have shown that a highly integrated, comprehensive, person centred, quality service can be achieved within existing resources, given vision, commitment and management expertise. Financial constraints are not of central importance.

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