NURS FPX 4065 Assessment 2 Preliminary Care Coordination Plan

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

Care coordination for adults experiencing psychiatric disorders within acute healthcare facilities requires a structured, multidisciplinary, and culturally responsive approach. Patients with severe mental illnesses are often at higher risk of experiencing physical, psychological, and social challenges. Addressing these issues through evidence-based strategies not only improves treatment outcomes but also enhances quality of life.

Physical Considerations and Best Practices

Risks

Adults with severe psychiatric conditions often develop comorbid physical illnesses due to multiple contributing factors such as limited access to healthcare, medication side effects, and unhealthy lifestyle practices. Cardiovascular diseases, type 2 diabetes, and respiratory disorders are particularly common. Research highlights that individuals living with long-term psychiatric conditions may have a 15–20 year reduction in life expectancy compared to the general population (Nielsen et al., 2021).

This increased risk is attributed to:

Limited use of preventive healthcare services.
Sedentary lifestyles, smoking, and poor dietary habits.
Metabolic complications linked to long-term use of antipsychotics and mood stabilizers.

Best Practices

To mitigate physical health risks, acute healthcare providers should integrate comprehensive health assessments with psychosocial interventions. These measures address both the physical and mental health dimensions of care, ensuring holistic patient management.

Intervention	Details
Routine Physical Health Checks	Regular screening for BMI, blood pressure, fasting glucose, lipid levels, and smoking status.
Lifestyle Interventions	Structured programs including smoking cessation, exercise routines, and dietary counseling. Evidence confirms that lifestyle-based interventions improve both mental and physical health outcomes (Koomen et al., 2022).

Embedding such practices into care coordination strengthens preventive care and supports long-term recovery for psychiatric patients.

Mental Illness

Definition

Mental illness encompasses clinically diagnosed disturbances in cognition, mood, or behavior. These disturbances stem from biological, psychological, or developmental dysfunctions and can significantly impair social, occupational, and emotional functioning (Stein et al., 2021).

Prevalence and Impact

Approximately 1 in 5 adults in the U.S. experiences a diagnosable mental health disorder annually (SAMHSA, 2023).
In Florida, around 2.89 million adults live with a mental health condition (National Alliance on Mental Illness [NAMI], n.d.).
By 2021, nearly 40.9% of Florida residents reported symptoms of anxiety or depression (NAMI, n.d.).

These statistics highlight the urgent demand for coordinated care plans, preventive strategies, and accessible treatment options that are integrated within healthcare systems.

Cultural Considerations and Best Practices

Barriers

Cultural stigma, misconceptions about psychiatric disorders, and the reliance on traditional healing practices often discourage individuals from seeking evidence-based mental healthcare. Furthermore, cultural values and beliefs may shape how patients perceive illness and treatment, creating disparities in access and compliance.

Best Practices

Practice	Application
Culturally Adaptable Care	Incorporating cultural values, traditions, and beliefs in treatment planning builds trust and improves adherence (Ahad et al., 2023).
Culturally Competent Education	Implementing community workshops, peer-led programs, and culturally tailored resources reduces stigma and promotes early intervention (Ahad et al., 2023).

When care is culturally sensitive, patients are more likely to engage, reducing stigma and improving mental health outcomes.

Psychosocial Considerations and Best Practices

Psychosocial health profoundly influences a patient’s ability to manage stress, regulate emotions, and engage in social interactions. For patients with psychiatric disorders, psychosocial support serves as a protective factor against relapse and hospitalization.

Evidence-Based Practices

Practice	Application
Psychological Interventions	Mindfulness-Based Cognitive Therapy (MBCT) integrates mindfulness with cognitive restructuring, reducing relapse in depression (Gkintoni et al., 2025).
Emotional Support & Coping	Training in relaxation techniques (e.g., yoga, breathing exercises, meditation) enhances resilience.
Group Psychotherapy	Provides peer support, improves social functioning, and fosters empathy, which strengthens recovery (Marmarosh et al., 2022).

Underlying Assumptions and Uncertainties

Assumptions:
- Lifestyle-based and MBCT interventions benefit most psychiatric patients.
- Culturally tailored strategies enhance treatment participation and reduce stigma.
Uncertainties:
- Effectiveness of stigma-reduction interventions across diverse populations remains inconsistent.
- Acute care facilities may face barriers including staff shortages, financial limitations, and resource availability when implementing care models.

SMART Goals

Goal 1: Implement weekly MBCT sessions for adult psychiatric patients in Florida, aiming for a 40% reduction in PHQ-9 scores within six months.
Goal 2: Organize biweekly culturally tailored workshops to reduce stigma and improve literacy. Success will be measured by a 60% improvement in survey-based awareness scores within six months.

Community Resources

Effective care coordination links acute care services with community-based organizations that provide continuous support for patients beyond hospitalization.

Organization	Services Offered	Contact Information
Mental Health Association of Central Florida (MHACF)	Free counseling, peer support, educational programs, professional referrals	Phone: 407-898-0110; Address: 605 E Robinson St., Suite 450, Orlando, FL 32801 (MHACF, 2025)
Caron Florida	CBT, DBT, family therapy, medication management	Phone: 1-855-548-0352; Address: 7789 NW Beacon Square Blvd, Boca Raton, FL (Caron Florida, 2024)
NAMI Florida	Advocacy, peer support, community awareness, educational services	Phone: 850-671-4445; Address: P.O. Box 302, Ocala, FL 34478 (NAMI Florida, 2025)
Care Resource	Sliding-scale counseling, behavioral health programs, free services for uninsured patients	Phone: 305-576-1234; Address: 3510 Biscayne Blvd, Miami, FL 33137 (Care Resource, 2025)

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/

Caron Florida. (2024). Mental health program. Caron Transformational Care. https://www.caron.org/treatment-programs/mental-health-program

Centers for Disease Control and Prevention. (2023). Mental health: Fast facts. CDC. https://www.cdc.gov/mentalhealth/

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

Mental Health Association of Central Florida. (2025). About us. 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. 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

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

Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health. U.S. Department of Health and Human Services. https://www.samhsa.gov/data/

NURS FPX 4065 Assessment 2 Preliminary Care Coordination Plan

World Health Organization. (2023). Mental health: Strengthening our response. WHO. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response