With older adults at an increased risk of depression due to chronic illness and adults and adolescents accessing mental health services in growing numbers, physicians and psychiatrists are having difficulty keeping up with the increased volume of patients and families seeking mental health assistance. Local resources are limited, and current community mental health entities are overwhelmed and overburdened. As a result, we are seeing physicians using, with greater frequency, home health services, which incorporate psychiatric skilled nursing as a specialty.
The Center for Medicare Services (CMS) defines home health psychiatric nurses as those nurses who have had specialized training in a psychiatric facility or hospital, or who have advanced degrees in psychiatric mental health nursing. These nurses, under the direction of a physician or psychiatrist, can help provide supportive interventions for patients with depression, dementia, psychosis, Alzheimer’s, personality disorders, bipolar disorder, schizophrenia, substance abuse and other psychiatric disorders. The psychiatric nurse can provide active psychiatric interventions and psychoactive treatments, and is able to educate the patient and families on crisis and symptom management.
Psychiatric home health services take place in the home and provide 24-hour availability, medication management, case management, addiction assistance, disease management, resource education and coping skills training with a major emphasis on patient and family education. These services are provided by experienced psychiatric nurses and are designed to reduce hospitalizations, provide in-home oversight and communication with the physician, facilitate access to mental health services for continued support and facilitate community living and quality of life.
The psychiatric home health nurse is able to work in patients’ homes, where they develop comprehensive plans of care that address the patients’ physical, psychological, support system, social and environmental needs. The psychiatric home health nurse provides teaching and caregiver tools to assist with coping techniques, strategies to maintain functional status, instruction on safe and supportive home environments, dementia management including dealing with agitation and aggression and the effects of caregivers’ burden. These home visits provide a unique perspective to the physician providing valuable information about the patient’s home environment including living conditions, safety concerns, and family dynamics.
In summary, home health agencies that specialize in psychiatric nursing can help physicians and community mental health providers as we address the current crisis in the lack of mental health services available. With trained psychiatric nurses available 24 hours a day, home health agencies can provide early detection in the home, communicate valuable information to the treating physicians and assist in providing safe and effective care. Home health agencies can provide much-needed education to patients and their families on psychiatric and mental health conditions and can help them access community mental health support and resources.
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