Comprehensive Psychiatric Emergency Program (CPEP) is a program that the health sector developed to provide psychiatric emergency services. The Office of Mental Health (OMH) developed CPEP to reduce overcrowding which was largely experienced in the hospitals’ emergency rooms. The OMH designed the program to reduce hospital congestion and respond to psychiatric emergencies in rural and urban areas. It has a range of objectives, including offering crisis interventions in communities, managing inpatient admissions, timely triage and assessments, and linkages to other health services. This study will reflect on working in a CPEP program.
I carried out the practicum in a community clinic in the mental health department. I had an encounter with the population of patients suffering from psychiatric disorders. The clinic utilized the treatment philosophy that incorporates a multidisciplinary approach that connects therapeutic practices with philosophical theories to diagnose and treat mental illnesses. Working with the clinic enabled me to understand that mental is prevalent in our communities, and the government, through the health department, should pay much attention to the issue. The large number of patients who visited the clinic seeking psychiatric services indicates that mental illness might become a health crisis in the future if not tackled early. This observation resonates with the research conducted by World Health Organized, which reported that mental health issues are on the rise because of the harsh economic times and increased social disadvantages (WHO, 2013).
The experience at the clinic increased my knowledge and understanding of how mental health affects individuals’ behavior and status. The exposure also revealed to the student that those at high risk of psychiatric problems are the poor, refugees, unemployed, drug addicts, victims of violence. Additionally, I learned that mental illness is interconnected with social and physical health outcomes. Therefore, they should not be separated to avoid challenges for dealing with patients with medical and psychiatric diseases (Shah et al., 2016). This was supported by the fact that psychiatric patients who visited the clinic were also diagnosed with HIV/AIDS and carcinoma. The experience was different from the prior practice because I was able to gain new knowledge and information based on practical experience.
I seek to gain additional knowledge in areas such as; understanding the cost and burden caused by mental illness. Over the years, state economic reports have indicated that psychiatric problems have increased families’ expenditure on health services because families of patients who have mental illness have to bear the cost of treatment of their loved ones. Additionally, families may face a considerable burden taking care of those with mental illness because of societal stigmatization, discrimination, rejection, and isolation associated with mental illness. Another area for learning would be to gain knowledge on the situation of psychiatric institutions and the state of human rights of the mentally ill. Previous reports have indicated the poor living conditions of the mentally ill mental health institutions. They live in unhygienic environments with inadequate food or clothing. Some patients have also been admitted and treated involuntarily and even locked up for more extended periods, thus separating them from the community leading to loneliness (Di Lorenzo et al., 2018).
The psychotherapeutic techniques I was exposed to and which also require further exploration include cognitive-behavioral therapy (CBT), which can treat depression, addiction, and anxiety. CBT incorporates cognitive and behavioral techniques to help patients understand the feelings and thoughts that affect individual behaviors. Therefore, it functions to change negative thoughts and behaviors by assisting people to avoid thoughts that may contribute to problematic behaviors such as drug abuse (Teater, 2013). Another technique used was humanistic therapy, which aims at helping people realize their potential and emphasizes the importance of self-actualization, self-exploration, and free will. The medical staff and counselors encouraged patients who visited the clinic to be their authentic selves to have a fulfilling life. This view encourages people to be unique in their ways; therefore, other peoples’ lives and achievements should not tie them down, but they can also work hard to accomplish outstanding achievements.
My objective for the remaining period is to gather information on children’s CPEP which focuses on assessing, diagnosing, and treating children with mental illness. Reports have shown that children and adolescents lack specialized staff to examine and treat them, despite the rising numbers of children and adolescents visiting psychiatric emergencies (Gerson et al., 2017). This group should be managed separately and not be combined with the adult patients. My strategy is to investigate the role and efforts put by the government and private agencies, the hospitals, and the community members to ensure that children acquire proper treatment and whether or not they are effectively implemented.
My knowledge of PMHNP has changed because I have realized that the PMHNPs play a crucial role in ensuring the mental well-being of community members. In this setting, PMHNPs can administer medication, fight stigmatization against the mentally ill, visit patients, talk and listen to patients, and ensure patients have access to all nursing care requirements. If the preceptor is not a PMHNP, I would ensure the practicum also becomes a learning opportunity for them to become agents of change in society at the end of the program.
The world cannot ignore the roles of CPEP in promoting societal mental well-being cannot be ignored. Therefore, governments and other change-oriented stakeholders should support such programs for the world to see the end of mental illness menace.
Di Lorenzo, R., Vecchi, L., Artoni, C., Mongelli, F., & Ferri, P. (2018). Demographic and clinical characteristics of patients involuntarily hospitalized in an Italian psychiatric ward: a 1-year retrospective analysis. Acta Bio Medica: Atenei Parmensis, 89(Suppl 6), 17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357598/
Gerson, R., Havens, J., Marr, M., Storfer-Isser, A., Lee, M., Rojas Marcos, C., … & Horwitz, S. M. (2017). Utilization patterns at a specialized children’s comprehensive psychiatric emergency program. Psychiatric services, 68(11), 1104-1111. https://www.researchgate.net/profile/Mollie-Marr/publication/317628483_Utilization_Patterns_at_a_Specialized_Children%27s_Comprehensive_Psychiatric_Emergency_Program/links/5eb84f32299bf1287f78a9d7/Utilization-Patterns-at-a-Specialized-Childrens-Comprehensive-Psychiatric-Emergency-Program.pdf
Shah, R. N., Campbell, K., Essock, S. M., Mekinulov, B., & Rajparia, A. (2016). Information Sharing Across Institutions to Enhance Operations of Psychiatric Emergency Rooms in New York City. Psychiatric Services, 67(2), 156-158. https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201500285
Teater, B. (2013). Cognitive Behavioural Therapy (CBT). The Blackwell companion to social work, 423-427. https://www.researchgate.net/profile/Barbra-Teater-2/publication/264932879_Cognitive_Behavioural_Therapy/links/57656db908aeb4b998070cfa/Cognitive-Behavioural-Therapy.pdf
World Health Organization. (2013). Investing in mental health: evidence for action. https://apps.who.int/iris/bitstream/handle/10665/87232/9789241564618_eng.pdf