Community Mental Health Nursing (RCMN)
ASSESSING A CLIENT IN THE COMMUNITY
This is a form of assessment done by the RCPN on a client in the community to identify risk factors and causes of mental ill health. This can be done during the nurse's routine activities in the community or through a distress call made to the RCPN on psychiatric emergencies by client, family member/caregiver and or an opinion leader.
Purpose
- Assess clients to identify risk factors, causes of mental ill health and refer appropriately
- Help mitigate crisis in the family and promote conducive home environment
- Early identification of new clients for prompt management
- Prevent injury to self and others
- Prevent destruction of property
- Provides a baseline data for further management
- Reduce stigmatization
- Inform decision on resource allocations
Indications
- Assessing a client in the community to identify risk factors and causes of mental ill health.
- Responding to a distress call on psychiatric emergencies from the client, family, caregiver or an opinion leader.
- Early identification of new clients for prompt management.
Equipment
- A Well-Equipped Home Visit Bag (refer to content)
- Community Map
- Manual/electronic area register/ records of the client
- Means of Transportation
Preparation
- Read the community map or GPS and identify the location of the client.
- Carry a well-equipped home visit bag and arrange transportation.
Procedure steps
- Read map of the community or use GhanaPost Global Positions System (GPS) address to identify the location of the centre
- Announce your presence, enter on response, greet and introduce yourself to client, family and significant other
- Establish rapport (refer to procedure) and enquire about the general health of client
- Explain purpose of visit
- Ensure privacy and confidentiality by asking the client to identify a suitable place for the assessment
- Ensure the environment is clean, safe and conducive for the assessment
- Enquire about:
- Biographic data
- Family history of mental illness
- Present and past psychiatric history
- Present and past medical history
- Assess client on the following:
- Appearance/Behaviour/habits
- Perception/orientation/insight
- Thought/Speech
- Mood
- Cognition/memory/judgement
- Draw a care plan based on needs identified
- Educate client and family on prevailing health issues
- Refer problems beyond scope to the nearest mental health unit or health facility
- Inform client about your next visit
- Leave your contact with client and or caregiver and encourage them to call in case of emergency
- Document the care and findings in the report book
- Express appreciation and depart
Precautions
- Ensure the environment is clean, safe and conducive for the assessment.
- Ensure privacy and confidentiality by asking the client to identify a suitable place for the assessment.
- Assess for risk of injury to self and others, and for destruction of property.
- Refer problems beyond scope to the nearest mental health unit or health facility.
Aftercare
- Inform the client about the next visit.
- Leave contact details with the client or caregiver for emergencies.
Nursing considerations
- Enquire about biographic data, family history of mental illness, and present and past psychiatric and medical history.
- Assess appearance, behaviour, habits, perception, orientation, insight, thought, speech, mood, cognition, memory and judgement.
- Draw a care plan based on the needs identified.
Patient education
- Educate the client and family on prevailing health issues.
- Refer problems beyond scope to the nearest mental health unit or health facility.
Documentation
- Document the care and findings in the report book.
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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