- Aug 12, 2008
- Southend on sea
The following article puts forward a case for specialism in mental health. Good idea or not?
http://www.mentalnurse.org.uk/index.php/2009/02/21/specialism-in-mental-health/Another one of those ideas has been bobbing about my head lately - and Shrink has posted a similar theme on Dementia specialism . So here is my expanded working-adult-age version.
A big general hospital has a medical ward, a surgical ward, renal ward, maternity ward, oncology ward, cardiac ward. It makes sense. Medical and nursing teams with specialist skills become experts in the treatments of these conditions.
Mental health generally has locked and unlocked wards.
I know there are specialist units for eating disorder. Some places even have units for Personality Disorder. There are even “Rehab” units. But generally speaking - Mental Health service users all get lumped into one unit.
The elderly melancholia mixes with the young who are drug addicted and the middle aged with schizophrenia. The manic bipolar female shares a residence with a man with mild intellectual difficulties.
Why aren’t there separate specialist wards for these clinical presentations? The term oft used is “DRG” - Diagnostic Related Groups” - people who share similar diagnoses or presentations.
I’ve worked in a place that kinda did this. We had acute (high acuity) ward; sub-acute (moderate acuity) ward; sociopaths & “PeeDees” ward; an intellectually impairment ward and a mixed rehab ward. It still mixed DRGs as there were so many co-morbidities; but the nature of the business of each unit meant that the clinical teams became experts in handling those presentations. They weren’t spreading themselves across too many domains and were able to concentrate on specific areas of mental health.
My wish list? Off the top of my head - units at acute; sub-acute and continuing care that cater specifically for:
Yes there will be co-morbid cross-overs - but less so than having everyone in one acute unit.
As one of the 4 biggest burdens of disease worldwide; I’m sure there’s enough populous to fill these types of units and properly train the staff who work on them in the highly specific responses/interventions each one demands. I even think this would lead to a higher quality of intervention and improved outcomes.