VNSW Mental Health Home Care Program: In Harmony with the Consumer Movement

It is becoming increasingly understood and appreciated just how much healing and comfort extend beyond the physical. There is a decided mental well-being component as well, recognized by Visiting Nurse Services in Westchester (VNSW), the White Plains-based home health care agency that several years ago created a program of psychiatric healthcare – in the patient’s home, for maximized comfort and effect. Under this unique program, VNSW’s registered nurses, with advanced psychiatric training, conduct home visits to develop a plan to treat mental health issues in conjunction with medical/surgical needs, and to support community integration for its patients. Adjunct services complementing the mental health component include home health aides, medical/surgical nurses, social workers and relevant rehabilitation therapies.

The transformation of mental health services as we know them today began in the 1970s with the development and influence of consumer organizations. Consumers are typically defined as individuals who are current or past clients of mental health services. The movement campaigns for increased choice, empowerment, improved services and user-defined alternatives. Individuals consider themselves consumers of mental health services rather than passive patients. They are seeking to reform the mental health system in order to have this greater choice and to gain access to the best services and treatments available. Individuals desire more control over their own treatment and a voice in the public mental health system. Some consider themselves survivors rather than consumers but, despite the name by which they choose to define themselves, the ultimate the goal is the same: to recover and live a full life in the community.

Building a life in the community is part of the recovery process. A goal of all treatment is for individuals to be active members of the community. In order for this to be accomplished it is important to identify a person’s strengths, capacities, preferences and needs, as well as, their knowledge of their local community, its opportunities, resources and potential barriers. This will enable the individual to find their niche in the community in which they reside. Two main components to building a life in the community are housing and employment.

Employment is an important component to assimilating into the community. For some, the individual needs assistance capitalizing on skills and education they already have. For others, it is necessary for them to receive job training so that they have the skills needed to obtain a job. There are many job-training programs in the community that assist individuals, including those with a disability, to learn a variety of job skills. The consumer movement has had a substantial influence on increasing the utilization of consumers as employees in the traditional mental health agencies, as well as other human service agencies.

Patient independence and the ability for the patient to recover at home are among the primary objectives at Visiting Nurse Services in Westchester. VNSW’s services allow individuals with all levels of mental illness the ability to remain in their homes and involved in the community mental health programs that are an integral part of their treatment. The agency’s ability to monitor psychiatric symptoms and medication compliance – in addition to teaching the skills needed by each individual to help manage their specific psychiatric needs- empowers patients to obtain their optimal level of independent functioning/living. VNSW’s nurses regularly observe individuals in their homes, enabling the agency to provide feedback to caseworkers on the appropriateness of the patients housing and often to assist in obtaining housing with increased or decreased supportive services. VNSW nurses have the ability to help the patient advocate for their desired housing needs as they see the person in their environment and are well aware of their needs and ability to remain safely in their homes.

At Visiting Nurse Services in Westchester, patients are considered partners – the agency works together with patients toward recovery and reaching a maximum level of independent functioning. The staff supports and encourages patient independence and its services strengthen care coordination. VNSW’s mental health program is an important adjunct service to community mental health services. The program provides daily visits 365 days per year, if needed. VNSW works collaboratively with the patient, supportive and intensive case managers, and the agency’s flexible visitation schedule is designed to accommodate patients’ day treatment attendance. Although VNSW is not itself a consumer affiliated agency, the organization works closely with its patients to empower them to receive the care and treatment they desire to meet their mental health needs. VNSW’s nurses offer their patients support and monitoring to ensure success during times of stress and transition.

In addition to nursing care, VNSW provides a full range of rehabilitative therapies, social work and home health aide services; psychiatric patients receive comprehensive care from a coordinated team of health care professionals versed in, and sensitive to, their complete history and needs, providing a complete package of essential multidisciplinary services to help them, following a hospital discharge, to attain and maintain optimal health and functioning in their communities.

With its dedicated Mental Health Home Care Program, Visiting Nurse Services in Westchester is achieving this objective, emphasizing treatment of the whole person with the agency’s core multidisciplinary approach. For details, visit www.vns.org, call (914) 682-1480 Ext. 648 or e-mail MentalHealth@vns.org.

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