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Nurse-led treatment engagement interventions for persons with severe mental illnesses in community settings
Revathi Somanathan1, Sailaxmi Gandhi2, T Sivakumar3
1Mental Health Nursing, Ramaiah University of Applied Sciences, Bangalore 560054, Karnataka, India. revathi.somanathan@gmail.com.
Abstract:
This review aims to gain a deeper understanding of the current interventions used in high-income and low- and middle-income countries worldwide on treatment engagement among persons with severe mental illnesses. Treatment engagement involves cultivating therapeutic partnerships to address patients' unique needs and challenges. This multifaceted process requires sensitivity, collaboration, and a tailored approach to promote positive outcomes. Effective treatment engagement reduces the chances of relapse and rehospitalization and helps individuals steer through their daily lives and social relationships. Through literature analysis, it was found that individual, situational, and environmental factors affected treatment engagement. Community nurses are crucial in promoting behavioral changes by engaging patients and applying tailor-made interventions. Applying problem-solving, coping skills, and strategies to address factors influencing adherence, motivational interviewing, and telephone follow-ups yielded significant results. The interventions recommended in community settings are tele-aftercare programs and home visits to address issues of dropped-out persons with severe mental illnesses and ensure continuity of treatment. Accessible, non-stigmatizing, non-coercive, informal, and appropriate services are suggested. These interventions can improve treatment engagement, medication adherence, and therapeutic alliance, thereby reducing symptoms and improving patients' quality of life.
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