Mental health in the community: part one

Physical health problems present the need for patient referral to a community caseload. However, community nurses may often find that their patient has an underlying mental health problem that either preceded their physical health complaint or was caused by it. As a community nurse, you may be the first to pick up on the problem. We cannot assume that the GP will be aware of any symptoms, so as nurses we have a duty to work with primary care and help find support for the patient, while also offering the immediate support required and any follow up, within the boundaries of the nurse's professional role. We cannot assume that patients will always open up and it may help using a gentle and open approach to engage a patient in conversation, as appropriate, about any worries or concerns, ability to cope, thoughts about the future and so on, all while taking care not to push for responses when the patient may feel uncomfortable.