EBP Quality Improvement in Mental Health Care Settings
This paper examines three mental health care settings — psychiatric hospitals, private practices, and assisted living (residential) facilities — through the lens of evidence-based practice (EBP) quality improvement. It identifies a representative practice problem for each setting: substance use disorder, depression, and dementia, respectively. The paper discusses stakeholder roles across settings and proposes an EBP quality improvement framework focused on substance use disorder in a psychiatric hospital. The theory of reasoned action and cognitive-behavioral therapy are presented as guiding frameworks, with an emphasis on collaborative, evidence-based interventions to improve patient outcomes and quality of life.
- Overview of Mental Health Care Settings: Describes three mental health settings and their missions
- Practice Problems Across the Three Settings: Identifies key disorders in each care setting
- Evidence-Based Treatment Approaches: Links treatment strategies to EBP frameworks
- Stakeholders in Mental Health Quality Improvement: Outlines stakeholder roles across all three settings
- Proposed EBP Quality Improvement Project: Proposes substance use disorder project using reasoned action theory
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What makes this paper effective
- Systematically compares three distinct mental health care settings, giving the paper clear organizational structure and allowing for direct contrast of strengths, weaknesses, and patient populations.
- Connects each setting to a specific, real-world practice problem (substance use disorder, depression, and dementia), grounding abstract concepts in clinical relevance.
- Grounds the proposed EBP project in a named theoretical framework — the theory of reasoned action — and links it explicitly to cognitive-behavioral therapy, demonstrating awareness of both behavioral theory and clinical intervention.
Key academic technique demonstrated
The paper demonstrates applied framework selection: the student identifies a theoretical model (theory of reasoned action) and explains why it fits the chosen practice problem (substance use disorder as a behavioral condition influenced by attitudes and social norms), then links it to a corresponding evidence-based intervention (cognitive-behavioral therapy). This theory-to-practice linkage is a core skill in nursing and health sciences graduate writing.
Structure breakdown
The paper opens with descriptions of three mental health settings and their missions, then transitions to comparative strengths and weaknesses. It next introduces a practice problem for each setting, followed by a section on treatment implications. Stakeholder analysis precedes the focused proposal section, which narrows to substance use disorder in a psychiatric hospital as the primary EBP quality improvement target. The structure moves logically from broad survey to focused proposal.
Overview of Mental Health Care Settings
There are various kinds of healthcare settings that mental health patients can choose for treatment, depending on their financial ability and the severity of their mental illness. The first healthcare setting explored in this project is a psychiatric hospital — the setting in which the author works. The other two settings are a private practice and an assisted living (residential) health facility.
A psychiatric hospital is an inpatient facility that serves patients in need of both long- and short-term services. Essentially, the mission of a psychiatric hospital is to provide care for patients with severe mental health illnesses (Dye, n.d.). The structures of a psychiatric hospital are similar to those of a regular hospital. In addition to treatment and diagnostic functions, a psychiatric hospital also manages administration, housekeeping, supply, and dietetics. Some sites also serve as training grounds for mental health professionals and as sites for research.
A private practice is a primary form of mental health facility. In this type of setting, a mental health professional uses an office-like structure to render mental health services (Dye, n.d.). A private practice may consist of a single business center with various offices where different mental health professionals operate. Private practices are owned by practitioners such as psychologists, counselors, and therapists, whose offices may be located in medical plazas, office parks, or homes. The mission of a private practice is to provide the relevant assistance to mental health patients (Dye, n.d.). In some instances, facilities may receive state funding or access grants. Patients are generally charged based on their ability to pay; however, most private practices do not provide inpatient services.
The third healthcare setting is the assisted living facility, also referred to as a residential facility. A residential health facility is a private or semi-private institution that can be expensive; in some instances, residents' assets may be liquidated to cover costs. The mission of an assisted living facility is to provide various services to people who cannot care for themselves due to permanent mental health conditions (Dye, n.d.). Persons are also placed in such facilities when they lack family members capable of caring for them. Residents are permitted to live as normally as possible — those who are able may work, receive visitors, or visit others outside the facility with minimal restriction (Dye, n.d.). Services provided in residential facilities include activities, meals, and housekeeping, all of which are important for residents with inhibiting conditions.
The three settings have various strengths and weaknesses. All three are important in mental health care because they provide crucial diagnostic and treatment services to mentally ill patients. In a psychiatric hospital, for example, patients with severe mental illnesses are treated in inpatient wards because they may pose a risk to themselves or others (Dye, n.d.). Residential health facilities serve patients with permanent mental health conditions who lack adequate family support. The main drawback of these facilities is cost. Some residential facility fees are prohibitive, creating a significant barrier for economically disadvantaged patients who may lack adequate insurance, investments, or pensions. In private practices, patients are generally charged according to their ability to pay, though access to inpatient services remains limited (Dye, n.d.).
Practice Problems Across the Three Settings
There are various problems that patients present with in the settings described above. In a psychiatric hospital, the practice problem explored here is substance use disorder. According to Mayo Clinic (2017), substance use disorder relates to an individual's uncontrolled use of psychoactive drugs. The type of drug determines the speed and risk of addiction. Symptoms include engagement in risky activities, cutting back on social or recreational activities, failing to meet work responsibilities, spending excessive money on drugs, and experiencing intense cravings (Mayo Clinic, 2017). Symptoms vary by substance. For example, individuals using cannabis, hashish, or marijuana may present with exaggerated food cravings, anxiety, slowed reaction time, difficulty concentrating, decreased coordination, dry mouth, red eyes, and a sense of euphoria (Mayo Clinic, 2017). Because individuals with addiction problems do not always seek help on their own, healthcare providers must collaborate with friends and family members of those struggling with addiction.
The practice problem explored in the private practice setting is depression. According to Unutza and Park (2012), depressive disorder is one of the most common mental health problems in primary care. Persons with depression may present with symptoms including loss of interest in previously pleasurable activities, extreme sadness, poor general health outcomes, and fatigue (Unutza & Park, 2012). The primary need in a private practice setting is a population-based and systematic approach that applies evidence-based interventions. Providers collaborate with other professionals to promote positive outcomes.
In a residential health facility, dementia is a particularly common practice problem. According to Mayo Clinic (2021), dementia is a group of diseases that affect an individual's social and cognitive functioning. In older people, dementia is often caused by Alzheimer's disease; it may also result from the loss or damage of nerve cells. Risk factors that cannot be reversed include Down syndrome, family history, and age. Modifiable risk factors include head trauma, air pollution, smoking, diabetes, depression, and cardiovascular disease. Common signs and symptoms of dementia include hallucinations, anxiety, depression, personality changes, confusion and disorientation, memory loss, and difficulty reasoning or handling complex tasks (Mayo Clinic, 2021). Management of dementia requires the deployment of various strategies.
References
Dye, F. (n.d.). What are the different types of mental health facility? https://www.wise-geek.com/what-are-the-different-types-of-mental-health-facility.htm
Fishbein, M., & Ajzen, I. (2010). Predicting and changing behavior: The reasoned action approach. Taylor and Francis Group, LLC.
Logsdon, R. G., McCurry, S. M., & Teri, L. (2007). Evidence-based interventions to improve quality of life for individuals with dementia. Alzheimers Care Today, 8(4), 309–318.
Mayo Clinic. (2017). Drug addiction (substance use disorder). https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
Mayo Clinic. (2021). Dementia. https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013
Substance Abuse and Mental Health Services Administration (US), Office of the Surgeon General (US). (2016). Facing addiction in America: The Surgeon General's report on alcohol, drugs, and health [Internet]. Early intervention, treatment, and management of substance use disorders. https://www.ncbi.nlm.nih.gov/books/NBK424859/
Unutza, J., & Park, M. (2012). Strategies to improve the management of depression in primary care. Primary Care, 39(2), 415–431.
World Health Organization. (2003). Quality improvement for mental health.
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