| Description |
The high drop-out rates and long waiting lists in mental health centers and clinics are problems frequently reported in the literature on mental health programs in the United States. Remington's study (1964) indicated that psychiatric nursing intervention was influential in increasing the follow through of applicants for psychiatric treatment and lowering the dropout rate of a mental health center. This study repeated and expanded Remington's study (1964) in order to clarify those aspects or factors of the psychiatric nursing approach which were apparently effective in increasing the follow through of applicants to mental health centers. Specifically^ the purpose of the study was to determine if the applicants were more likely to move into psychiatric treatment following (1) a planned psychiatric nursing approach, (2) a nursing contact designed specifically to encourage the return of application forms, or (3) the standard intake procedure of the mental health center. The main question under study was whether the psychiatric nursing approach per se, with its special quality and purpose, was more effective than a simple, friendly, informative contact, in increasing the return ofapplications and the follow through of applicants into treatment. In addition, the study explored the value of single rather than repeated home visits by the psychiatric nurse. In order to accomplish the purposes set forth, a second experimental group was added to Remington's (1964) design. The 102 applicants to the Community Mental Health Center were assigned alternately to three groups of 34 subjects each. Group A, the control group, was handled by the standard intake procedure of the Center and applications were mailed to the individuals requesting service. Subjects assigned to the two experimental groups (B and C) received the two different nursing approaches, and the investigator delivered the applications to these subjects within 24 hours after their initial contact with the Center. She answered any questions regarding the application forms and the treatment facility, and assisted the applicant in completing the required forms. At the same time she made a tentative appraisal of the nature, severity, and urgency of the applicant's problems. In Group B, the interaction was focused on assisting the applicant with the completion and return of the application. The nurse was interested, friendly,and assumed the role of information and direction giver. Any discussion of the applicant's problem, anxiety,or resistance to treatment was avoided. Group C subjects received the planned psychiatric nursing approach. The objectives were to establish a good relationship with the applicant and gain his confidence, to mobilize early family cooperation in treatment, to reassure the prospective patient that he was not hopeless, to arouse his expectations of being helped, and to permit the applicant and his family to test their motivation and interest in psychiatric treatment. The results indicated that (1) significantly more subjects in Group C,who received the planned psychiatric nursing approach, returned their applications than subjects handled by either the standard intake procedure (Group A) or the nursing approach focused on the admission procedure (Group B). (2) There was no significant difference in the number of subjects returning their applications following the nursing approach focused on the admission procedure (Group B) or following the standard intake procedure (Group A). (3) Significantly more subjects receiving the planned psychiatric nursing approach (Group C) appeared for their intake interview than subjects handled by the standard intake procedure (Group A). (4) There was no significant difference between the number of subjects appearing for intake following the friendly nursing approach focused on the admission procedure (Group B) and the standard intake procedure (Group A), or between the number of subjects receiving the nursing approach focused on the admission procedure (Group B) and the psychiatric nursing approach (Group C). The trend was in the expected direction, but the trend was not statistically significant. It was concluded that the psychiatric nursing approach was influential in assisting prospective patients to return their applications and follow through into treatment. |
