The modern concept of the organization of mental health care involves the use of a biopsychosocial approach, which is the basis of community-oriented psychiatry. According to this perspective, when considering the causes of mental disorders, a set of factors is taken into account, such as biological, psychological, and social. Each of them has a certain pathogenetic potential and can be transformed during treatment. A wide variety of these factors determines the need for the participation of specialists, both medical and non-medical, in the treatment of patients with mental disorders. This paper aims at explaining how the mental health worker can support recovery as a goal in care.
The concept of community-based psychiatry emphasizes the importance of individual care. Patient-centered treatment is one of the key elements of high-quality health care and the main goal of improving health in general. This approach is associated with positive outcomes such as improved emotional well-being of patients and an overall reduction in the use of health services. This perspective implies the active participation of a patient in the therapy process. It is viewed as providing care that is responsive to the patient’s individual preferences and needs, as well as clinical solutions that align with the patient’s values. Therefore, mental health workers need to be attentive to patients. At the same time, patients should participate more actively in the consultations.
The mental health worker should pay more attention to primary health care to support the patient’s recovery. Collecting medical history data can form the basis of 70% of diagnoses. Therefore, it is extremely important to discuss the physical, social, and psychological aspects of the patient’s medical history, as well as the current situation. Communication skills such as active listening, open discussion questions, non-verbal rewards, paraphrasing, and strategic use of pauses can help focus on the patients’ core concerns during the consultation. The mental health worker may invite patients to summarize and explain treatment options and make joint decisions. For some conditions, especially bipolar disorder, where decision-making may be impaired during the illness, patients may have a preliminary plan in which they will state their treatment wishes in advance.
Treatment adherence can be improved through a shared decision-making model. The ultimate goal of this approach is a close collaboration between patient and doctor, which is critical for effective treatment. Success in the field of psychosocial therapy and rehabilitation makes it possible to set the task of not only stopping and preventing exacerbations but also achieving social and personal recovery. In primary care settings, there is a high discontinuation rate for patients with mental illnesses. Many of them do not adhere to the treatment plan several months after the first visit to the doctor. The way out of this situation is the need for the participation of patients in the development, planning, and practical implementation of strategies for the development of mental health care.
A complex approach is significant to support recovery as a goal in care. Education, employment, and housing affect personal health and well-being, as well as recovery. Recognizing this as part of the health problem and addressing these issues as a component of treatment is an urgent task of modern psychiatry. Currently, assistance should be aimed at social, economic, and legal support for individuals with mental disabilities in such areas as education, work, housing conditions, and participation in public life. It is necessary to create a network of institutions dealing with social support, employment, legal protection, and health issues. The organization of departments for relapse prevention and rehabilitation treatment can help improve the quality of medical care. Their functioning should help to support patients in the event of early discharge from the hospital to stimulate recovery.
A multidisciplinary approach is also important to support the recovery of patients. It reduces the degree of disability of patients, the duration of hospitalizations, improves the quality of life of people with mental illness, as well as promotes their integration into the public environment. Collaborative care is a multidimensional and coordinating model of intervention, in which care providers, mental health professionals, and patients are connected to assess patient adherence, monitor therapeutic progress, and deliver psychological support. This approach requires the involvement of a wide range of people involved in the diagnosis and treatment of mental disorders. Psychiatrists continue to provide major assistance, but occupational therapists, physical therapists, psychotherapists, psychologists, nurses, social workers, and lawyers can also play a role in strategies to improve the diagnosis and treatment. Encouraging and facilitating professional collaboration makes care for patients with mental disorders more effective.
Along with complex treatment, including medicines, occupational therapy, physiotherapy, cultural, educational, and leisure activities, some other types of psychosocial interventions must take place within the framework of mental health rehabilitation. They include educational programs in psychiatry for patients and their relatives, as well as the development of the skills of daily independent life. Training programs on the development of socially acceptable behavior, communication, and solving everyday problems may be helpful and support recovery. Mental health workers can help their patients to develop skills in mental health management. Cognitive-behavioral therapy is also important for improving memory, attention, and speech.
The need for research in the field of mental health and monitoring the effectiveness of new methods is recognized. The used indicators should be standardized and comparable at local, national, and international levels. The coordination of research, as well as partnership between practitioners, medical health workers, and researchers, are significant. There is a need for competent doctors and support workers, as well as the inclusion of mental health issues in primary curricula for healthcare providers. Various continuing professional education programs for mental health workers may increase their skills in supporting patients’ recovery. This will help to meet many of the needs of mentally ill individuals, their position in society, reduce the burden of illness, and improve the quality of life of both patients and their families.
The objectives of community-based psychiatry are to reduce the stigmatization of mental disorders, expand the range of services, create coordinated treatment programs, and provide an individual, patient-centered approach to mental health care. This perspective ensures that patients with mental disorders can keep in touch with their families, friends, work colleagues, and the community, which allows them to recognize their strengths and fosters further recovery. The mental health workers need to broaden the traditional definition, going beyond focusing only on the remission of symptoms. The involvement of social and functional factors that expand the capabilities of individuals with mental disorders may be helpful. The inclusion of a community-based approach in primary education programs for mental health workers can help to support recovery as a goal in care.