Establishing an NP Led Wellness and Recovery Center for Deinstitutionalized Individuals Historically, nursing, and medicine professions have been loath to utilize tools commonly linked with mercenary aspects of business, such as market research and decision analysis. In the contemporary health care setting, however, consumers hold numerous options for care providers. The division of the market or market segmentation into different subgroups allows the determination of target markets and the buildup of marketing policies specific to the needs and interests of the selected subgroups. Market analysis allows the identification of policies for nurse practitioners to enhance their practice in a way that centers on the interests and needs of the selected market. While scores of the nurse practitioner's dream of operating their own businesses, those that have set up their own practice understand that it requires a compelling passion for owning a business, and for the profession.

A nurse practitioner is an advanced practice nurse who offers care to patients. A nurse practitioner conducts comprehensive and focused physical assessment, treatment and diagnose acute sicknesses and injuries. About fifteen percent of all nurse practitioners are in their own private practice. This paper explores the effects of deinstitutionalization and reduction of bed capacity in psychiatric wards, and assesses NPs perception of the value of establishing their own business, and the role of a nurse practitioner in minimizing and addressing the effects of deinstitutionalization. This work investigated whether establishment of community mental health facilities can moderate the link between deinstitutionalization, homelessness, suicide, stigma, social isolation and other factors linked to deinstitutionalization.

A case study approach with qualitative and quantitative analysis was employed, and the findings indicated that deinstitutionalization following closure of state-run psychiatric facilities in Alabama increased the suicide rates, homelessness, stigma, inadequate treatment and social isolation. Results indicated that substantial community mental health resources prevent the negative effects of deinstitutionalization. In conclusion, closing state-run mental health facilities increases suicides, stigma, inadequate treatment, social isolations, diseases such as TB for mental health patients living in the streets, social isolation, but a rise in community-based mental health centers and privatization of the mental health market are promising and reduces the negative effects of deinstitutionalization.

TABLE OF CONTENTS

Abstract

Introduction

5

Project Organization

7

Problem Statement

8

Background Information

9

Purpose of the Project

11

The Nature of the Project

13

Research Questions

15

Theoretical Framework

15

Figure One: Conceptual Framework Model

17

Definition of Key Terms

18

Scope and Limitations

19

Summary

20

Chapter 2: Literature Review

20

Introduction

20

The Role of Nurse Practitioners

22

Deinstitutionalization

23

Nurse Practitioners as Business Owners

25

Conclusion

27

Summary

28

Chapter Three: Methodology

28

Introduction

28

Population and Sample

36

Data Collection Instruments

36

Ethical and Legal Considerations

37

Data Analysis

37

Validity

38

Methodology Appropriateness

39

Feasibility and Appropriateness

40

Summary

40

Chapter Four: Findings

40

Introduction

40

Data Analysis

41

Conclusion

43

Chapter Five: Discussion

43

Introduction

43

Interpretations and Inferences from the Findings

44

Implication of Analysis for Leaders

46

Recommendations

46

Conclusion

47

Reference List

48

Chapter One

Introduction

Deinstitutionalization burdens the community given the lack of sufficient resources and infrastructure to house persons who require permanent care for psychological, neurological conditions and other behavioral disorders. Complexity to adjust to community life for people with mental health problems calls for help from social workers and psychiatric rehabilitation, which fosters recovery and hope for patients. Deinstitutionalization provides prospects for Psych/MH Nurse Practitioners to set up their own facilities to care for deinstitutionalized mental health patients. Psych/MH Nurse Practitioners offer primary health care to persons with mental health issues in different settings. Their roles stresses of clinical leadership, research, consultation and expert clinical practice.

The objective of deinstitutionalization is to enhance quality of life and treatment of people with mental disorders. The actuality of deinstitutionalization has turned it into a polarizing concern. While some studies report that deinstitutionalization leads to positive upshots, others confirm that people living in homes or other independent community settings hold great deficits in crucial facets of health care provision. Opponents of deinstitutionalization indicate that scores of patients move from inpatient mental health hospitals to residential homes or nursing homes that are less equipped or staffed to achieve the requirements of the mentally ill.

In several cases, the act of moving patients from mental health institutions shifts the care burden to...

While the debate for deinstitutionalization goes on, healthcare professionals, advocates for mentally ill persons and families calls for augmented accessibility and availability of permanent psychiatric in-patient and intermediate care for persons requiring more structured care setting. Scores of experts indicate that through enhancing community-based programs and extending in-patient care to satisfy the requirements of mentally ill people, the state will attain enhanced treatment upshots, better life quality and augmented access to mental health care.
To achieve the goal of deinstitutionalization, a wellness and recovery center for deinstitutionalized individuals is paramount. Such establishments provide detailed services created to support people with mental health issues. These establishments offer skill building activities and curriculum, community-founded peer support and family education. Expectation of wellness and recovery centers is for patients to obtain enhanced overall wellness and health, to set and attain personal objectives independently within the community or within the patients' families. Wellness and recovery centers require the services of nurse practitioners, nurse technicians and social workers to provide psychiatric assessments, management of medicine, general care, supervision of in-patients and on-site patients and follow-up care. Nurse technicians monitor the physical wellness of patients. All these services have the potential to address issues linked to the ongoing deinstitutionalization in the state of Alabama.

Nurse practitioners have the potential to examine their own goals and visions for developing individualized practice models. Aspects that affect the healthcare system that include electronic record maintenance, technology, efficient payment systems, high cost, lack of access to health care and other variables that influence health maintenance, illness prevention and health promotion have formed novel and exciting prospects for nurse practitioners that allows them to establish their own practices. In light of the issues regarding deinstitutionalization and the closure of state-run psychiatric facilities, which is likely to create more problems in the community, Psych/MH Nurse Practitioners can assist curbing the increasing gap left by state-run psychiatric services and facilities through setting up a wellness and recovery center.

Project Organization

Chapter One of this study covers the statement of the problem, background to the study, the purpose of the study, the significance of the study, the nature of the project, research questions or hypothesis and theoretical framework. Chapter one also covers the scope and limitations of the project, definitions of significant terms besides providing a summary of the entire chapter. Chapter two covers the literature review and provides information that guides the research study, and it offers a synthesis of literature and research studies on the role of Psych/MH Nurse Practitioners and how a nurse practitioner can establish his/her own practice. This section ends with a coherent conclusion summarizing major points, and details how the literature review contributes to the research topic.

Chapter 3 covers the methods used in collecting the research data. This section starts with a concise introduction, project design, instruments used in data collection, target population, sample and sampling procedures, data collection, management and data analysis, validity and reliability of the methodology used, appropriateness of the methods, besides a practical summary of the entire chapter. Chapter four covers the research findings through putting into consideration the demographics, research questions, data analysis procedures, and reliability and validity of the research methods. Chapter 5 provides a coherent discussion and interpretation of the findings, implications of the study, recommendations and culminates with a summary highlighting the purpose of the project, major findings and recommendations for future research.

Problem Statement

Statistics from National Alliance on Mental Health Illness indicate that out of the 4.7 million people in Alabama, 187,000 adults live with critical mental health illnesses, and approximately fifty one thousand children live with staid mental health conditions (NAMI, 2010). In 2006, five hundred Alabamians committed suicide caused by unmanaged or under-treated mental illnesses. Statistics indicate that the state loses one life every fifteen minutes through suicide making suicide the 11th leading cause of demise overall, and the 3rd leading cause of death among young adults and youth aged between fifteen and twenty four years. Between the year 2006 and 2007, 64% of Alabama students aged over fourteen years and living with critical mental health disorders dropped out of high school despite receiving special education services (NAMI, 2010).

The state of Alabama closes most of its state-run psychiatric facilities, an aspect that l creates an increased demand for psychiatric services following deinstitutionalization of mental health patients. Closing down all, but two state mental health facilities leaves the state with few providers of psychiatric services to achieve the increased need for mental health facilities and services. The Department of Mental Health in Alabama stresses that it is crucial to prepare the community for return of patients before patients are released from mental health hospitals.

Deinstitutionalization has instigated the elimination of state mental health hospitals, and has led to ninety percent decrease in facilities and resources needed in psychiatric hospitals. It places a great burden on communities, which do not have the resources and infrastructure to treat people with mental health needs. The state faces resistance to the placement of transitional homes in residential communities because these homes become a nuisance to the community. However, most communities accept facilities that are well managed, and those with enough resources to cater for the needs of the ex-patients.

Background Information

Mental health officials from Alabama plans to dismiss…