Introduction to mental health nursing part 2

1. Introduction to mental
Health Nursing

2. Mental Health Team
Multidisciplinary approach to provide service
to mentally ill persons.
 A psychiatrist
 A psychiatric Nurse
 A clinical Psychologist
 A psychiatric social worker
 An occupational therapist/activity therapist
 A pharmacist and a dietician.
 A counselor.

3. Mental Health Team
 A psychiatrist: MD/DNB Psychiatry. Medical
diagnosis and treatment.
 Admission/discharge
 Psychopharmacology
 Administer ECT
 Psychotherapy
 Team meetings
 Legal responsibilities.

4. Mental Health Team
 A psychiatric Nurse: RN with specialized
training.
 Administer and monitor medications.
 Assist in physical and psychiatric treatment
 Interdisciplinary team meeting.
 Health Education
 Patients Records
 Advocate of patient.
 Relationship with patient’s family.

5. Mental Health Team
 A Clinical Psychologist: Masters/ Doctorate in
human psychology.
 Accountable of psychological
assessments/testing.
 Individual, family and marital therapy.
 A Psychiatric Social worker: Masters/
Doctorate.
 Family case work and community placement
of patients.
 Group therapy sessions.
 Social intervention at patient social
environment.

6. Mental Health Team
 An Occupational Therapist: Concerned
training.
 Accountable for recreational, occupational and
activity programmes.
 Assist the patients in gaining skills that help
them cope more effectively, retain employment
and use their leisure time.
 A Counselor: Concerned training.
 Provides basic supportive counseling and
assists in psycho educational and recreational
activities.

7. Nature of Mental Health
 It is a profession possessing its unique
history, ideology, knowledge and skills.
 It is both an art (nurse – patient relationship)
and a science (skills for the purpose of gaining
insight, effective change, healing mental and
emotional wounds and promoting growth).
 Understands the principles of nursing and
remain current in knowledge and practice.

8. The Philosophy of Psychiatric
Nursing Practice
 Every individual has intrinsic worth and
dignity and is worthy of respect.
 Each person functions as holistic and react to
environment as a whole.
 All behaviour of an individual is meaningful. It
can be understood from an internal frame of the
patient.
 Behaviour has perceptions, thoughts, feelings
and actions.
 Individuals vary in their coping capacities.
 All are prone for health and illness.

9. The Philosophy of Psychiatric
Nursing Practice
 Nursing is aimed to promote wellness,
maximize functioning and enhance self
actualization.
 IPR can produce change in growth of an
individual.
 Psychiatric nursing is based on psychosocial
and biophysical sciences.

10. Scope of Mental Health Nursing
 Nurse Generalist: a licensed nurse providing
primary mental health care. Holistic approach,
prevention programmes, community and day
care centers, psychiatric rehabilitation facilities,
homeless shelters etc.
 Nurse Specialist: Psychiatric Clinical Nurse
Specialist (CNS): have a master degree in mental
health nursing. Autonomous functioning,
prescription privileges, manages overall care of
emotional and psychiatric problems. Eg. Crisis
interventio0n specialists, Milieu Specialists,
Psychotherapists etc.

11. Scope of Mental Health Nursing
 Community Mental Health Nurse (CMHN):
Diagnosis, appropriate referrals, care and
rehabilitation of mentally ill people in the
community.
 Psychiatric Home Care Nurse: direct patient
care, behavioral management, crisis
intervention, psycho education, detoxification,
medication etc.
 Forensic Psychiatric Nurse: works with
individuals who have entered the legal system.

12. Scope of Mental Health Nursing
 Psychiatric Consultation - Liaison Nurse
PCLN: Psychiatric nurse who work in non-
psychiatric setting and provide necessary
support, guidance and counseling for those
affected with anxiety, depression and other
psychological problems.
 Case Manager: Nurse manager acts as
advocates by coordinating care and linking
patient with physician and other members of
health care team. Works in community and
helping in daily living of a mentally ill person
such as transportation, managing money, buying
things etc.

13. Scope of Mental Health Nursing
 Gero Psychiatric Nurse;
 Parish Nurse: An RN with spiritual mature.
Supports health education, social services, and
carry out non-invasive nursing care. Common in
US.
 Tele health / Tele nurse: Nurses engaged in
tele-nursing practice use technologies such as
internet, computers, telephones, digital
assessment tools & tele-monitoring equipment
to deliver nursing care. In India around 10
hospitals are having telemedicine departments.
Eg. Apollo hospitals, Narayana Hrudayalaya.

14. Scope of Mental Health Nursing
 Nurse Researcher: Nurse researchers design,
conduct & disseminate findings of research at
professional meets & in peer reviewed journals.
They are doctorally or post-doctorally prepared
persons who initiate or participate in all phases
of the research process.
 Psychiatric Nurse Educator:
 Nurse Administrator/Manager
 Nurse Pharmacologist: The psychiatric clinical
nurse specialist with prescriptive authority.
 Holistic Nurse: Integrates complementary and
alternative modalities such as relaxation,

15. Functions of Mental Health Nurse
INPATIENT PSYCHIATRIC WARD…
 Provide for environment safety including
protecting the patient & others from injury.
 Perform psychosocial, high risk & physical
assessment.
 Promotion of self care activities.
 Medication management.
 Assisting for somatic therapies.
 Accurately observing & documenting the
patient’s behavior.
 Providing opportunities for the patient to
make his own decisions & to assume

16. Functions of Mental Health Nurse
INPATIENT PSYCHIATRIC WARD
 Provide safe environment and protect from
injury.
 Perform psychosocial, high risk & physical
assessment.
 Promotion of self care activities.
 Medication management.
 Documentation of behaviour.
 Providing opportunities for the patient to
make his own decisions & to assume
responsibility for his life.

17. Functions of Mental Health Nurse
INPATIENT PSYCHIATRIC WARD
 Participation in various therapies, individual
interactions, formal & informal group situations,
role play, advocating on behalf of the patient &
so forth.
 Delivering psycho-education, social skill and
stress management strategies.
 Counseling the patient & family members.
 Interdisciplinary approach to care.
 Discharge planning & community referral &
follow up care.

18. Functions of Mental Health Nurse
PSYCHIATRIC OUTPATIEBT DEPARTMENT
 Performing clinical assessment.
 Assisting for psychometric assessment.
 Assisting or providing psychotherapy or
behavior therapy.
 Counseling the patient & family members.
 Conducting group therapy.
 Delivering psycho education.

19. Functions of Mental Health Nurse
ECT TREATMENT SETTING
 Preparing the patient for ECT.
 Providing care during the procedure.
 Assisting with post treatment.
 Providing reassurance to reduce anxiety.
 Delivering psycho education regarding ECT.

20. Functions of Mental Health Nurse
PSYCHOTHERAPY UNIT
 Establishing a therapeutic relationship with
the patient.
 Providing an opportunity for the patient to
release tension as problem are discussed.
 Assisting the patient in gaining insight about
the problem.
 Providing opportunity to practice new skills.
 Reinforcing appropriate behavior as it occurs.
 Providing consistent emotional support.

21. Functions of Mental Health Nurse
DAY CARE CENTERS OR DAY HOSPITALS
 Performing clinical assessment /observation/
documentation.
 Medication management.
 Teaching social skills.
 Counseling patient & family members.
 Delivering psycho education.
 Providing occupational or recreational therapy
& vocational assistance.

22. Functions of Mental Health Nurse
CHILD PSYCHIATRIC WARD
 Assessing the child and understand his
strengths and abilities.
 Monitor the child’s developmental levels &
initiate supportive interventions such as speech,
language or occupational skills as needed.
 Provide a safe therapeutic environment.
 Interdisciplinary approach to care.
 Teach the child adaptive skills such as eating,
dressing, grooming & toileting.
 Deliver psycho education and Medication
management, participate in therapies.

23. Functions of Mental Health Nurse
HOME SETTING
 Assessment of symptoms.
 Teaching the patient & family regarding
nutrition, exercise, hygiene & the relationship
between physical & emotional health.
 Stress management and Daily living kills
(bank accounts, rent, utility bills, use of the
telephone, grocery shopping).
 Medication management Oral/IV– monitoring
blood levels, toxicity, side effects & purposes.
 Acts as a case manager & coordinate an array
of services such as therapies.

24. Functions of Mental Health Nurse
COMMUNITY MENTAL HEALTH CENTERS
 Identification and referral of patients to
appropriate hospitals.
 Home visiting & providing direct care to the
patients in the community.
 Follow up care with special emphasis on
medication regimen, & side effects, patient’s
occupational function.
 Conducting public awareness programs to
remove misconceptions regarding mental disorders.
 Training of other care giving professionals in the
community.

25. Functions of Mental Health Nurse
HOSPICE CARE CENTERS
 Helping cancer patients or terminally ill individuals
through the grieving process.
 Provide supportive psychotherapy and support their
families.
EMERGENCY DEPARTMENTS
 Crisis intervention during natural disasters, accidents,
unexpected illnesses causing increased anxiety.
 Helping the mother in labor & to cope with stress.
 Providing support to bereaved patients in the event
of fetal demise, abortion, birth of an infant with
congenital abnormalities.

26. Functions of Mental Health Nurse
HOSPITALS FOR CRIMINAL INSANE, JAILS &
PRISONS
 Forensic psychiatric nurses assist patients
with self care, administration of medications &
monitor the effectiveness of the treatment.
 Provide psychotherapy & act as consultants.
 Assessment of potential for violence.
 Parole / probation considerations.
 Assessment of racial / cultural factors during
crime.
 Formal written reports to court.

27. Factors affecting Level of Mental
Health Practice
 Nurse Practice acts.
 Professional Practice Standards
 Nurse’s Qualification.
 Philosophy of health Care Organization.
 The person competence and initiatives
of the individual nurse.

28. Concepts of Normal and
Abnormal Behaviour
Medical Model
Statistical Model
Socio-cultural Model
Behaviour Model