Authors (including presenting author) :
Chan KH, Tam CY, Wan YY, Chan BY, Leung SH, Poon TK, Li WSV
Affiliation :
Family Medicine and Primary Healthcare, Kowloon Central Cluster
Introduction :
Mental health problems are common among individuals with medical conditions due to due to a complex interplay of psychological, physical, and social factors. For example, the prevalence of diabetes mellitus is higher in depressed individual to non-depressed individuals (21.26% vs. 13.75%) (Cai 2024). Additionally, more than a quarter of people with hypertension reported symptoms of depression and anxiety (Abdisa, 2022). As frontline healthcare professionals, nurses have both the opportunity and obligation to address mental health challenges and provide essential care to individuals experiencing psychological distress. However, the majority of nurses working in primary health care (PHC) setting have limited experience in handling patients with common health problems.
Objectives :
1. Promote mental health in society
2. Launching Mental Health Initiatives in PHC setting
3. Empower general nurses to manage patients with common mental health problems
Methodology :
1. Classroom training
Mental health content is included in included in the Post Registration Certificate Course in Primary Health Care Nursing. Nurses working with PHC setting are required to undergo this training to equip themselves and advance their practice. In addition, the Institute of Mental Health, Castle Peak Hospital provides a 13.5-hour training course, namely the Certificate Course in Mental Health. This course provides comprehensive lectures on the knowledge and skills necessary to effectively manage patients with common mental illnesses.
2. Coaching
One-to-one coaching is provided by an experienced psychiatric nurse through nurse sessions in the Integrated Mental Health Program (IMHP). These include sit-in nurse sessions for the observation of at least 20 cases, followed by discussions. Direct supervision is then arranged for management of at least 20 cases.
3. Case Studies:
Real-life cases are used to help nurses understand the manifestations of mental health issues and develop appropriate care plans. For difficult or complicated cases, case conference with psychiatrist consultants from Kowloon Hospital is available through bi-monthly liaison meetings.
4. Collaborative Learning:
Nurses are encouraged to engage in discussion and share knowledge and experiences to learn from each other's best practices in mental health care.
Result & Outcome :
Result:
Eight general nurses have been trained to provide mental health care across four General Out-patient clinics in Kowloon Central Cluster (KCC). Delivering 10 sessions weekly, with a service capacity of over 50 patients. These nurses conduct early-risk assessment to facilitate timely interventions and specialist referrals. By fostering a safe and nonjudgmental environment, they encourage open emotional expression. Additionally, promote mental health awareness, challenge stigmas and teach stress-management. More they enhance positive coping strategies, driving more candid conversations about mental health.
Discussion:
Integrating mental health services into primary health care delivers significant benefits but come with challenges such as limited resources, stigma, and insufficient training. These obstacles, however, present opportunities for progress. By investing in training, promoting awareness, and fostering collaboration among healthcare providers, general nurses can be empowered to effectively address mental health issues with PHC settings.
Reference :
Abdisa L., Letta S., Nigussie K., (2022). Depression and anxiety among people with hypertension on follow-up in Eastern Ethiopia: A multi-center cross-sectional study.
Frontiers in Psychiatry, 13, 853551. https://doi.org/10.3389/fpsyt.2022.853551
Jingda Cai, Songyan Zhang, Renrong Wu, Jing Huang, (2024)
Association between depression and diabetes mellitus and the impact of their comorbidity on mortality: Evidence from a nationally representative study, Journal of Affective Disorders, Volume 354, 2024, Pages 11-18, ISSN 0165-0327, https://doi.org/10.1016/j.jad.2024.03.003.
