People-Centred Organization of Psychiatric Services

Abstract

‘Person-centeredness’ in mental health is a holistic approach with an attitude of respect for the individual and his or her unique experience and needs as a patient. Mental health care delivery needs to be reorganized in a way which is sensitive to the needs of the users. NICE Guidelines (NICE in Common mental health disorders: identification and pathways to care. National Institute for Health and Clinical Excellence, London, [19]) recommendations can serve as a template for organizing mental health care in a person-centred manner. Care by a single multidisciplinary community team and active involvement for the service user in decision-making, in the background of optimism, empathy, dignity and respect for the patient is the basic premise. People receiving hospital care should be assured that control, restraint and compulsory treatment including rapid tranquillisation, will be used competently, safely and only as a last resort with minimum force. The system should ensure that service users feel less stigmatized in the community and health care system, including within mental health services. The person-centred service should ensure care and support across all points on the care pathway, access to care, comprehensive assessment, community care, access to interventions in crisis, hospital care, discharge and transfer of care and assessment and treatment under legal provisions. Greater participation by patients in healthcare decision-making should be assured at each level and views of service users should be used to monitor the efficacy of the service. A simple model of person-centeredness at four levels—assessment, hospital care, family and community care and rehabilitation is introduced and briefly described. Professional associations of mental health professionals may contribute to the formulation of person-centred organization of mental health care in each country which suits its social, cultural and economic realities. They should be incorporated to the national health policy of each nation.