Student Name
Capella University
NURS-FPX4065 Patient-Centered Care Coordination
Prof. Name
Date
Preliminary Care Coordination Plan for Adult Mental Health Patients in an Acute Health Setting
This preliminary care coordination plan is designed for adult patients with mental health conditions admitted to acute healthcare facilities. Such patients often face overlapping physical, cultural, and psychosocial challenges that complicate treatment and recovery. A structured and collaborative approach is essential to ensure holistic well-being, continuity of care, and long-term quality of life.
Physical Considerations and Best Practices
Risks
Adults diagnosed with severe psychiatric disorders frequently develop coexisting medical conditions. Common risks include cardiovascular illnesses, diabetes, respiratory diseases, and metabolic dysfunctions. Studies demonstrate that these patients have a 15–20-year reduced life expectancy compared to the general population (Nielsen et al., 2021). Lifestyle limitations, poor dietary habits, barriers to healthcare, and adverse effects of psychotropic medications contribute to these risks.
Best Practices
Addressing these risks requires consistent integration of medical and preventive interventions:
- Routine Health Monitoring: Regular health assessments including BMI, blood pressure, glucose levels, and cholesterol are essential for early detection.
- Lifestyle-Focused Interventions: Encouraging structured exercise programs, smoking cessation, and nutritional counseling can significantly reduce the risk of chronic illness and improve overall health outcomes (Koomen et al., 2022).
- Medication Supervision: Monitoring psychotropic medication side effects ensures timely adjustments and helps minimize long-term complications.
Table 1. Physical Considerations and Best Practice Approaches
| Physical Consideration | Best Practice Approach |
|---|---|
| Higher risk of cardiovascular, respiratory, and metabolic diseases | Regular screenings (BMI, cholesterol, blood pressure, glucose) |
| Reduced lifespan due to psychiatric illness | Structured lifestyle programs (exercise, balanced diet, smoking cessation) |
| Adverse side effects of psychotropic medication | Close supervision and early pharmacological intervention |
Mental Illness
Mental illness involves disruptions in thought processes, emotions, and behavior that interfere with cognitive abilities and daily functioning. These disorders may stem from biological, psychological, or developmental origins (Stein et al., 2021).
In the United States, nearly 20% of adults experience some form of mental illness annually. In Florida alone, 2.8 million adults reported mental health challenges, and about 41% experienced depression or anxiety symptoms in 2021 (National Alliance on Mental Illness [NAMI], n.d.). This prevalence highlights the necessity of developing coordinated, evidence-based care strategies to improve patient outcomes.
Cultural Considerations and Best Practices
Barriers and Challenges
Cultural stigma, myths about mental illness, and strong traditional beliefs often prevent patients from pursuing psychiatric treatment. Individuals from diverse backgrounds may hesitate to seek professional help due to fear of discrimination, lack of understanding, or community disapproval.
Best Practices
To provide culturally sensitive care, healthcare systems must adopt the following strategies:
- Culturally Adaptable Care: Care plans should align with patients’ cultural values and beliefs to build trust and engagement (Ahad et al., 2023).
- Culturally Competent Education: Education campaigns tailored to cultural contexts reduce stigma and increase knowledge. These may include workshops, family education sessions, and community events.
- Accessible Communication: Offering education in multiple languages ensures inclusivity and enhances understanding.
Table 2. Cultural Considerations and Recommended Best Practices
| Cultural Challenge | Recommended Best Practice |
|---|---|
| Stigma and negative misconceptions | Deliver culturally sensitive health education |
| Reluctance to pursue professional treatment | Integrate cultural beliefs into care planning |
| Limited awareness of mental illness | Provide multilingual and culturally specific education resources |
Psychosocial Considerations and Best Practices
Psychosocial factors significantly influence recovery for individuals with mental illness. Patients may experience emotional dysregulation, strained interpersonal relationships, social isolation, and poor coping mechanisms. These challenges interfere with effective decision-making and community participation.
Evidence-Based Practices
- Mindfulness-Based Cognitive Therapy (MBCT): Combining mindfulness strategies with cognitive behavioral therapy improves resilience and reduces relapse of depression (Gkintoni et al., 2025).
- Stress and Coping Support: Mind-body practices such as yoga, meditation, and controlled breathing enhance stress management.
- Group Psychotherapy: Encouraging peer-based therapy helps patients develop support networks, strengthen belonging, and enhance dignity (Marmarosh et al., 2022).
Table 3. Psychosocial Considerations and Evidence-Based Practices
| Psychosocial Need | Evidence-Based Practice |
|---|---|
| Emotional instability | Mindfulness-Based Cognitive Therapy (MBCT) |
| Stress and anxiety | Yoga, meditation, relaxation techniques |
| Social isolation | Group psychotherapy for mutual support |
Underlying Assumptions and Uncertainties
- It is assumed that MBCT and lifestyle interventions are beneficial across all patient populations.
- It is assumed that culturally sensitive education universally reduces stigma.
- Uncertainty exists about the effectiveness of stigma-reduction interventions across different cultural groups.
- Limited healthcare resources may restrict the implementation of best practices in acute care settings.
SMART Goals
- Goal 1: Organize weekly MBCT sessions for adults with psychiatric conditions in Florida.
- Target: 40% reduction in depressive symptoms within six months, measured using PHQ-9 scores.
- Goal 2: Conduct biweekly culturally tailored educational workshops to increase awareness.
- Target: 60% improvement in patient knowledge of mental illness and reduction in stigma, assessed via pre- and post-intervention surveys over six months.
Community Resources
Accessible community resources are essential in maintaining continuity of care and providing support for patients after discharge.
Table 4. Community-Based Mental Health Resources
| Resource | Services Provided | Contact Information |
|---|---|---|
| Mental Health Association of Central Florida (MHACF) | Peer counseling, free therapy, mental health education | Phone: 407-898-0110 Address: 605 E Robinson St., Suite 450, Orlando, FL 32801 |
| Caron Florida | CBT, DBT, individual/group therapy, psychiatric medication management | Phone: 1-855-548-0352 Address: 7789 NW Beacon Square Blvd, Boca Raton, FL |
| NAMI Florida | Advocacy programs, patient support, mental health awareness workshops | Phone: 850-671-4445 Address: P.O. Box 302, Ocala, FL 34478 |
| Care Resource | Affordable therapy, psychiatric services, community-centered programs | Phone: 305-576-1234 Address: 3510 Biscayne Blvd. Miami, FL 33137 |
References
Ahad, A. A., Sanchez-Gonzalez, M., & Junquera, P. (2023). Understanding and addressing mental health stigma across cultures for improving psychiatric care: A narrative review. Cureus. https://doi.org/10.7759/cureus.39549
Care Resource. (2025). Behavioral health. Care Resource. https://careresource.org/services/behavioral-health/
NURS FPX 4065 Assessment 2 Preliminary Care Coordination Plan
Caron Florida. (2024). Mental health program. Caron Transformational Care. https://www.caron.org/treatment-programs/mental-health-program
Gkintoni, E., Vassilopoulos, S. P., & Nikolaou, G. (2025). Mindfulness-based cognitive therapy in clinical practice: A systematic review of neurocognitive outcomes and applications for mental health and well-being. Journal of Clinical Medicine, 14(5), 1703. https://doi.org/10.3390/jcm14051703
Koomen, M., van, J., Deenik, J., & Cahn, W. (2022). Lifestyle interventions for people with a severe mental illness living in supported housing: A systematic review and meta-analysis. Frontiers in Psychiatry, 13, 966029. https://doi.org/10.3389/fpsyt.2022.966029
Marmarosh, C. L., Sandage, S., Wade, N., Captari, L. E., & Crabtree, S. (2022). New horizons in group psychotherapy research and practice from third wave positive psychology: A practice-friendly review. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(3), 643. https://doi.org/10.4081/ripppo.2022.643
MHACF. (2025). About us. Mental Health Association of Central Florida. https://mhacf.org/learn-more/
NAMI Florida. (2025). Mission. National Alliance on Mental Illness Florida. https://namiflorida.org/about-nami-florida/mission/
National Alliance on Mental Illness. (n.d.). Mental health in Florida. National Alliance on Mental Illness. https://www.nami.org/wp-content/uploads/2023/07/FloridaStateFactSheet.pdf
Nielsen, R. E., Banner, J., & Jensen, S. E. (2021). Cardiovascular disease in patients with severe mental illness. Nature Reviews Cardiology, 18(2), 136–145. https://doi.org/10.1038/s41569-020-00463-7
NURS FPX 4065 Assessment 2 Preliminary Care Coordination Plan
Stein, D. J., Palk, A. C., & Kendler, K. S. (2021). What is a mental disorder? An exemplar-focused approach. Psychological Medicine, 51(6), 894–901. https://doi.org/10.1017/S0033291721001185