Foundation Concepts of Psychiatric- Mental Health
Mental Health Nursing • is a state of emotional, psychological
and social wellness evidenced by
A. Core Concepts of Psychiatric- satisfying interpersonal relationships,
Mental Health Nursing effective behavior and coping, positive
self- concept and emotional stability. A
Introduction person’s mental health is a dynamic, or
ever changing state.
As you begin the study of psychiatric- • Mental wellbeing describes your mental
mental health nursing, you may be state - how you are feeling and how well
excited, uncertain, and even somewhat you can cope with day-to-day life.
anxious. The field of mental health often • Our mental wellbeing is dynamic. It can
seems a little unfamiliar or mysterious, change from moment to moment, day to
making it hard to imagine what the day, month to month or year to year.’
experience will be like or what nurses do Factors influencing a person’s mental
in this area. health can be categorized as:
Mental Health Nursing 1. Individual or personal – factors
include a person’s biologic make-up,
Mental Health Nursing is a specialized autonomy and independence, self-esteem,
field of nursing which focuses on meeting capacity for growth, vitality, ability to find
the mental health needs of the consumer, meaning in life, emotional resilience or
in partnership with family, significant hardiness, sense of belonging, reality
others and the community in any setting. orientation and coping or stress
The essence is in establishing a management ability orientation.
“therapeutic partnership”, a connectedness 2. Interpersonal or relationship – factors
between a nurse and client which is based include effective communication, ability
on empathy and trust. to help others, intimacy and a balance of
separateness and connectedness.
Core Concepts of Psychiatric- Mental 3. Social/Cultural or environmental –
Health Nursing factors include a sense of community,
access to adequate resources, intolerance
1. Mental Health, Mental Disorder and of violence, support of diversity among
Mental Illness people, mastery of the environment, and a
positive yet realistic view of one’s world.
The World Health Organization (WHO)
defines health as a state of complete Mental Illness
physical, mental and social wellness, and • includes disorders that affect mood,
not merely the absence of disease or behavior and thinking, such as depression,
infirmity. schizophrenia, anxiety disorders, and
addictive disorders.
,Factors contributing to mental illness: Mental wellbeing
• is just as important as physical
1. Individual factors include biologic wellbeing, and you need to maintain both
make-up, intolerable or unrealistic worries in order to stay fit and healthy.
or fears, inability to distinguish reality
from fantasy, intolerance of uncertainties, Historical Perspectives of the
a sense of disharmony in life, and a loss of Treatment of Mental Illness
meaning in one’s life.
2. Interpersonal factors include Ancient Times
ineffective communication, excessive • People believed that any sickness
dependency on or withdrawal from indicated displeasure of the Gods and was
relationships, no sense of belonging a punishment for sins and wrongdoing.
3. Social/Cultural factors include lack of • Those with mental disorders were
resources, violence, homelessness, viewed as either divine or demonic
poverty, and unwarranted negative view depending on their behavior. Individuals
of the world, and discrimination. seen as divine were worshipped and
adored; those seen demonic were
Mental Disorders ostracized, punished and sometimes
• often cause significant distress or burned at the stake.
impaired functioning or both. Individuals
experience dissatisfaction with self, Early Christian Times (1-1000 AD)
relationship and ineffective coping. • Primitive beliefs and superstitions were
strong.
• All diseases were again blamed on
demons, and the mentally ill were viewed
as possessed.
• Priests performed exorcisms to rid
sufferers of evil spirits. When that failed,
they used more severe and brutal
measures, such as incarceration in
dungeons, flogging and starving.
During the Renaissance (1300-1600)
• People with mental illness were
distinguished from criminals.
• Those considered harmless were allowed
to wander the countryside or live in rural
communities, but the more dangerous
lunatics were thrown in prison, chain and
starved.
,In 1547 homes and the phrase insane asylum took
• Hospital of St. Mary of Bethlehem was on a negative connotation.
officially declared as the first hospital for Sigmund Freud and Treatment of Mental
the insane. Built in London, England. In Disorders
1775, visitors at the institutions were
charged a fee for the privilege of viewing The period of scientific study and
and ridiculing the inmates, who were seen treatment of mental disorders began with
as less than human animals. Sigmund Freud (1856–1939) and others,
such as Emil Kraepelin (1856–1926) and
Period of Enlightenment and Creation Eugene Bleuler (1857–1939). With these
of Mental Institutions men, the study of psychiatry and the
diagnosis and treatment of mental illness
• In the 1790s, a period of enlightenment started in earnest. Freud challenged
concerning persons with mental illness society to view human beings objectively.
began. He studied the mind, its disorders, and
• The insane were no longer treated as less their treatment as no one had done before.
than human. Many other theorists built on Freud’s
• The concept of asylum developed from pioneering work Kraepelin began
the humane efforts of Philippe Pinel in classifying mental disorders according to
France and William Tuke in England, as a their symptoms, and Bleuler coined the
safe refuge or haven offering protection at term schizophrenia.
institutions where people had been
whipped, beaten and starved because they Development of Psychopharmacology
were mentally ill.
• In the United States, Dorothea Dix
began a crusade to reform the treatment of
mental illness after a visit to Tuke’s
institution in England.
• She was instrumental in opening 32 state
hospitals that offered asylum to the
sufferings. Dix believed that society was
obligated to those who were mentally ill;
she advocated adequate shelter, nutritious
food and warm clothing. Move Toward Community Mental Health
• The period of enlightenment was short-
lived. Within 100 years after
establishment of the first asylum, state
hospital were in trouble. Attendants were
accused of abusing the residents, the rural
locations of hospitals were viewed as
isolating patients from their families and
Psychiatric Nursing Practice
, - In 1873, Linda Richards required schools to include an
graduated from the New England experience in psychiatric nursing.
Hospital for Women and Children
in Boston. a. Focus of Concern
- She went onto improve nursing - The phenomena of concern
care in psychiatric hospitals and describe the 13 areas of concern
organized educational programs that mental health nurses focus on
in state mental hospitals in when caring for clients.
Illinois. Student Concerns
- Richards is called the first - Student nurses beginning their clinical
American psychiatric nurse; she experience in psychiatric–mental health
believed that “the mentally sick nursing usually find the discipline to be
should be at least as well cared for very different from any previous
as the physically sick”. experience.
- The first training of nurses to - As a result, they often have a variety of
work with persons with mental concerns; these concerns are normal and
illness was in 1882 at McLean usually do not persist once the students
Hospital in Belmont, have initial contacts with clients. Some
Massachusetts. common concerns and helpful hints for
- The care was primarily custodial beginning students follow.
and focused on nutrition, hygiene,
and activity. What if I say the wrong thing?
- Nurses adapted medical–surgical - No one magic phrase can solve a client’s
principles to the care of clients problems; likewise, no single statement
with psychiatric disorders and can significantly worsen them. Listening
treated them with tolerance and carefully, showing genuine interest, and
kindness. caring about the client are extremely
- The role of psychiatric nurses important.
expanded as somatic therapies for
the treatment of mental disorders What will I be doing?
were developed. - In the mental health setting, many
- The first psychiatric nursing familiar tasks and responsibilities are
textbook, Nursing Mental minimal. Physical care skills or diagnostic
Diseases by Harriet Bailey, was tests and procedures are fewer than those
published in 1920. conducted in a busy medical–surgical
- In 1913, John Hopkins was the setting. The idea of “just talking to
first school of nursing to include a people” may make the student feel as
course in psychiatric nursing in its though he or she is not really doing
curriculum. anything. The student must deal with his
- It was not until 1950 that the or her own anxiety about approaching a
National League for Nursing, stranger to talk about very sensitive and
which accredits nursing programs, personal issues. Development of the
Mental Health Nursing • is a state of emotional, psychological
and social wellness evidenced by
A. Core Concepts of Psychiatric- satisfying interpersonal relationships,
Mental Health Nursing effective behavior and coping, positive
self- concept and emotional stability. A
Introduction person’s mental health is a dynamic, or
ever changing state.
As you begin the study of psychiatric- • Mental wellbeing describes your mental
mental health nursing, you may be state - how you are feeling and how well
excited, uncertain, and even somewhat you can cope with day-to-day life.
anxious. The field of mental health often • Our mental wellbeing is dynamic. It can
seems a little unfamiliar or mysterious, change from moment to moment, day to
making it hard to imagine what the day, month to month or year to year.’
experience will be like or what nurses do Factors influencing a person’s mental
in this area. health can be categorized as:
Mental Health Nursing 1. Individual or personal – factors
include a person’s biologic make-up,
Mental Health Nursing is a specialized autonomy and independence, self-esteem,
field of nursing which focuses on meeting capacity for growth, vitality, ability to find
the mental health needs of the consumer, meaning in life, emotional resilience or
in partnership with family, significant hardiness, sense of belonging, reality
others and the community in any setting. orientation and coping or stress
The essence is in establishing a management ability orientation.
“therapeutic partnership”, a connectedness 2. Interpersonal or relationship – factors
between a nurse and client which is based include effective communication, ability
on empathy and trust. to help others, intimacy and a balance of
separateness and connectedness.
Core Concepts of Psychiatric- Mental 3. Social/Cultural or environmental –
Health Nursing factors include a sense of community,
access to adequate resources, intolerance
1. Mental Health, Mental Disorder and of violence, support of diversity among
Mental Illness people, mastery of the environment, and a
positive yet realistic view of one’s world.
The World Health Organization (WHO)
defines health as a state of complete Mental Illness
physical, mental and social wellness, and • includes disorders that affect mood,
not merely the absence of disease or behavior and thinking, such as depression,
infirmity. schizophrenia, anxiety disorders, and
addictive disorders.
,Factors contributing to mental illness: Mental wellbeing
• is just as important as physical
1. Individual factors include biologic wellbeing, and you need to maintain both
make-up, intolerable or unrealistic worries in order to stay fit and healthy.
or fears, inability to distinguish reality
from fantasy, intolerance of uncertainties, Historical Perspectives of the
a sense of disharmony in life, and a loss of Treatment of Mental Illness
meaning in one’s life.
2. Interpersonal factors include Ancient Times
ineffective communication, excessive • People believed that any sickness
dependency on or withdrawal from indicated displeasure of the Gods and was
relationships, no sense of belonging a punishment for sins and wrongdoing.
3. Social/Cultural factors include lack of • Those with mental disorders were
resources, violence, homelessness, viewed as either divine or demonic
poverty, and unwarranted negative view depending on their behavior. Individuals
of the world, and discrimination. seen as divine were worshipped and
adored; those seen demonic were
Mental Disorders ostracized, punished and sometimes
• often cause significant distress or burned at the stake.
impaired functioning or both. Individuals
experience dissatisfaction with self, Early Christian Times (1-1000 AD)
relationship and ineffective coping. • Primitive beliefs and superstitions were
strong.
• All diseases were again blamed on
demons, and the mentally ill were viewed
as possessed.
• Priests performed exorcisms to rid
sufferers of evil spirits. When that failed,
they used more severe and brutal
measures, such as incarceration in
dungeons, flogging and starving.
During the Renaissance (1300-1600)
• People with mental illness were
distinguished from criminals.
• Those considered harmless were allowed
to wander the countryside or live in rural
communities, but the more dangerous
lunatics were thrown in prison, chain and
starved.
,In 1547 homes and the phrase insane asylum took
• Hospital of St. Mary of Bethlehem was on a negative connotation.
officially declared as the first hospital for Sigmund Freud and Treatment of Mental
the insane. Built in London, England. In Disorders
1775, visitors at the institutions were
charged a fee for the privilege of viewing The period of scientific study and
and ridiculing the inmates, who were seen treatment of mental disorders began with
as less than human animals. Sigmund Freud (1856–1939) and others,
such as Emil Kraepelin (1856–1926) and
Period of Enlightenment and Creation Eugene Bleuler (1857–1939). With these
of Mental Institutions men, the study of psychiatry and the
diagnosis and treatment of mental illness
• In the 1790s, a period of enlightenment started in earnest. Freud challenged
concerning persons with mental illness society to view human beings objectively.
began. He studied the mind, its disorders, and
• The insane were no longer treated as less their treatment as no one had done before.
than human. Many other theorists built on Freud’s
• The concept of asylum developed from pioneering work Kraepelin began
the humane efforts of Philippe Pinel in classifying mental disorders according to
France and William Tuke in England, as a their symptoms, and Bleuler coined the
safe refuge or haven offering protection at term schizophrenia.
institutions where people had been
whipped, beaten and starved because they Development of Psychopharmacology
were mentally ill.
• In the United States, Dorothea Dix
began a crusade to reform the treatment of
mental illness after a visit to Tuke’s
institution in England.
• She was instrumental in opening 32 state
hospitals that offered asylum to the
sufferings. Dix believed that society was
obligated to those who were mentally ill;
she advocated adequate shelter, nutritious
food and warm clothing. Move Toward Community Mental Health
• The period of enlightenment was short-
lived. Within 100 years after
establishment of the first asylum, state
hospital were in trouble. Attendants were
accused of abusing the residents, the rural
locations of hospitals were viewed as
isolating patients from their families and
Psychiatric Nursing Practice
, - In 1873, Linda Richards required schools to include an
graduated from the New England experience in psychiatric nursing.
Hospital for Women and Children
in Boston. a. Focus of Concern
- She went onto improve nursing - The phenomena of concern
care in psychiatric hospitals and describe the 13 areas of concern
organized educational programs that mental health nurses focus on
in state mental hospitals in when caring for clients.
Illinois. Student Concerns
- Richards is called the first - Student nurses beginning their clinical
American psychiatric nurse; she experience in psychiatric–mental health
believed that “the mentally sick nursing usually find the discipline to be
should be at least as well cared for very different from any previous
as the physically sick”. experience.
- The first training of nurses to - As a result, they often have a variety of
work with persons with mental concerns; these concerns are normal and
illness was in 1882 at McLean usually do not persist once the students
Hospital in Belmont, have initial contacts with clients. Some
Massachusetts. common concerns and helpful hints for
- The care was primarily custodial beginning students follow.
and focused on nutrition, hygiene,
and activity. What if I say the wrong thing?
- Nurses adapted medical–surgical - No one magic phrase can solve a client’s
principles to the care of clients problems; likewise, no single statement
with psychiatric disorders and can significantly worsen them. Listening
treated them with tolerance and carefully, showing genuine interest, and
kindness. caring about the client are extremely
- The role of psychiatric nurses important.
expanded as somatic therapies for
the treatment of mental disorders What will I be doing?
were developed. - In the mental health setting, many
- The first psychiatric nursing familiar tasks and responsibilities are
textbook, Nursing Mental minimal. Physical care skills or diagnostic
Diseases by Harriet Bailey, was tests and procedures are fewer than those
published in 1920. conducted in a busy medical–surgical
- In 1913, John Hopkins was the setting. The idea of “just talking to
first school of nursing to include a people” may make the student feel as
course in psychiatric nursing in its though he or she is not really doing
curriculum. anything. The student must deal with his
- It was not until 1950 that the or her own anxiety about approaching a
National League for Nursing, stranger to talk about very sensitive and
which accredits nursing programs, personal issues. Development of the
