Introduction to

Psychiatric-Mental
Health Nursing
Chapter 1
Lecturer: Jomar D.
Devano, R.N.
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BASIC CONCEPTS
OF PSYCHIATRIC-
MENTAL HEALTH
NURSING
7TH Edition

Author:
LOUISE REBRACA SHIVES
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PSYCHIATRIC-
MENTAL HEALTH
NURSING
4TH Edition

Author:
SHEILA L. VIDEBECK
 Psychiatric Nursing
 itis a specialized area of nursing practice that uses theories of
human behavior as its scientific framework and requires the
purposeful use of self as its art of expression.

 involves the diagnosis and treatment of human responses to actual or

potential mental health problems.

 itis concerned with promoting optimum health for society –

focusing on prevention of mental illness, health maintenance,
manangement of or referral of mental and physical health problems,
diagnosis and treatment of mental disorders, and rehabilitation.
Historical
Development of
Psychiatric-Mental
Health Nursing
 Primitive
 people Era
believed spirits
possesed the body and
had to be driven away
to effect a cure.

 sickness indicated
displeasure of the gods
and was punishment for
sins and wrongdoings.
 Before
 the Christ
Greeks, Romans, and(B.C.)
Arabs
believed emotional disorders were
an organic dysfunction of the
brain.

 Hippocrates: proposed that mental

illness was a disturbance of four
body fluids, or “humors” – heat,
cold, dryness and moisture.
 Before Christ (B.C.)
Aristotle: concluded that the mind was
associated with the heart.

 Galen: emotional or mental disorders

were associated with the brain.
Middle ages
 mentally ill people
were excluded and
confined away from
society – lunatics,
witches, or demons
possessed by evil
spirits.
Before 1773

Bethlehem Royal Hospital, England (1403) – 1st mental hospital

Historical Development of
Psychiatric Nursing (Peplau, 1956)
 Phase 1: The Emergence of Psychiatric-Mental Health Nursing (1773-1881)

 Phase2: Development of the Work Role of the Nurse in Psychiatric-Mental

Health Facilities (1882-1914)

 Phase3: Development of Undergraduate Psychiatric-Mental Health Nursing

Education (1915-1935)

 Phase4: Development of Graduate Psychiatric-Mental health Nursing

Education (1936-1945)

 Phase5: Develpoment of Consultation and Research in Psychaitric-Mental

Health Practice (1946-1956)
Phase 1: The Emergence of Psychiatric-
Mental Health Nursing (1773-1881)

 identification of special institutions for individuals with

psychiatric disorders – Eastern Lunatic Hospital,
Williamsburg, Virginia.

 Benjamin Rush: the father of American Psychiatry, wrote

the 1st textbook on psychiatry.

 Johann Weyer: first psychiatrist.

Phase 1: The Emergence of Psychiatric-
Mental Health Nursing (1773-1881)

 Dorothea Lynde Dix: devoted her life to the cause of building

state mental hospitals and helped improved the humane treatment
of mentally ill people.

 EmilKraepelin (1856 to 1929) differentiated manic-depression

psychosis from schizophrenia and stated that schizophrenia was
incurable.

 Sigmund Freud (1856 to 1939) introduced psychoanalytic

theory and therapy.
Phase 1: The Emergence of Psychiatric-
Mental Health Nursing (1773-1881)
 Eugene Bleuler (1857 to 1939) described the psychotic disorder
of schizophrenia.

 Alfred Adler (1870 to 1937) focused on the area of psychosomatic

medicine, referring to organ inferiority as the causative factor.

 Carl Jung (1875 to 1961) described the human psyche as

consisting of a social mask (persona), hidden personal
characteristics (shadow), feminine identification in men (anima),
masculine identification in women (animus), and the innermost
center of the personality (self).
 Phase 2: Development of the Work Role of
the Nurse in Psychiatric-Mental Health
Facilities (1882-1914)
 McLean Hospital, Belmont Massachusetts (1882) – established
the first training school for nurses in the psychiatric setting.

 (1890) trained nurses were employed on nursing staff of state

mental hospitals.

 Annie Payson Call (1891) wrote the first psychiatric literature by a

psychiatric nurse.

 Mary E. May (1899) wrote the first paper about the work of a
nurse in a psychiatric facility: The Work of Nursing the Insane.
Phase 2: Development of the Work Role of the Nurse
in Psychiatric-Mental Health Facilities (1882-1914)
 Effie Jayne Taylor: first professor of psychiatric
nursing and outlined the curriculum of the
undergraduate psychiatric nursing program at
Johns Hopkin’s Phipps Psychiatric Clinic.
 Phase 3: Development of Undergraduate
Psychiatric-Mental Health Nursing
Education (1915-1935)
 Linda Richards (1915) first graduate nurse in the US - “first
American psychiatric nurse”.

 Journals published and textbooks focusing on psychiatric nursing

were written.

 Harriet Bailey (1920) – wrote the first textbook of psychiatric

nursing: Nursing Mental Diseases.

 new treatment approaches were introduced: electroconvulsive

therapy (ECT).
 Phase 4: Development of Graduate Psychiatric-
Mental Health Nursing Education (1936-1945)
 (1937) clinical experiences in psychiatric hospitals were
standardized:

 students were given the opportunity to care for patients with varying
degrees of mental disorders including organic origin.

 (1939) approximately half of the nursing schools provided

psychiatric nursing courses for students.

 (1955) psychiatric nursing became a requirement for licensure.

Phase 4: Development of Graduate Psychiatric-
Mental Health Nursing Education (1936-1945)
 National League of Nursing Education developed
curriculum guidelines for graduate education:
 60 to 80 hours of theoretical instruction, and
 12 to 16 weeks of clinical experience.
Phase 5: Development of Consultation and Research
in Psychiatric-Mental Health Practice (1946-1956)
 passage of Mental Health Act of 1946.

 Helen Render (1947) wrote Nurse-Patient Relationships in Psychiatry.

 (1956) National League of Nursing Education formed a committee to

review and revised a proposed guide for the development of an
advanced clinical course in psychiatric nursing.

 Brown Report: stressed that the interest in the field of psychiatry

should be stimulated to facilitate research focusing on the prevention
and cure of mental illness.
1956 and beyond.
 Phenothiazines and other major tranquilizers were
developed and used to treat the major symptoms of
pyschoses.

 (1963) the Community Mental Health Act authorized

funding for the establishment of community health centers
to provide services to the public.

 20th Century - Psychiatric nursing began to evolve as a

clinical specialty.
Standards of
Psychiatric-Mental
Health Clinical
Nursing Practice
 Standards
 authoritative statements used by the nursing profession to
describe the responsbilities for which nurses are
accountable.

 provides
direction for professional nursing practice and a
fremework for evaluation of practice.

 defines the nursing profession’s accountability to the

public and the client outcomes for which nurses are
responsible.
Scope and Standards of Psychiatric-Mental
Health Nursing Practice (ANA, 2000)

 STANDARDS OF CARE
Standard I. Assessment
Standard II. Diagnosis
Standard III. Outcome Identification
Standard IV. Planning
Standard V. Implementation
Standard Va. Counseling
Standard Vb. Millieu Therapy
Standard Vc. Promotion of Self-care Activities
Standard Vd. Psychobiologic Interventions
Scope and Standards of Psychiatric-Mental
Health Nursing Practice (ANA, 2000)
Standard Ve. Health Teaching
Standard Vf. Case Management
Standard Vg. Health Promotion and Health
Maintenance

Advance Practice Intevention Vh-Vj: (APRN-PMH)

Standard Vh. Psychotherapy
Standard Vi. Prespective Authority and Treatment
Standard Vj. Consulation
Scope and Standards of Psychiatric-Mental
Health Nursing Practice (ANA, 2000)
Standard VI. Evaluation

 STANDARDS OF PROFESSIONAL PERFORMANCE

Standard I. Quality of Care
Standard II. Performance Appraisal
Standard III. Education
Standard IV. Collegiality
Standard V. Ethics
Standard VI. Collaboration
Standard VII. Research
Standard VIII. Resource Utilization
Psychiatric-
Mental
Health
Nursing
Today
 Use of Psychiatric-Mental Health
Nursing Skills in Career Opportunities

Obstetric Nursing
 helping the mother in labor and support person cope
with anxiety or stress during labor and delivery.
 providing support to bereaved parents in the event of
fetal demise, inevitable abortion, or the birth of an
infant with congenital anomalies.
 providing support to a mother considering whether to
keep her child or give the child up for adoption.
 Use of Psychiatric-Mental Health
Nursing Skills in Career Opportunities

Forensic Nursing
 providing services to incarcerated clients.
 acting as a consultant to medical and legal
agencies.
 serving as an expert witness in court.
 providing support for victims of violent crime.
 Use of Psychiatric-Mental Health
Nursing Skills in Career Opportunities

Oncologic Nursing
 helping cancer patients or other terminally ill
individuals on oncology units work through the
grieving process.
 providing support groups for families or terminally
ill individuals on oncology units through the
grieving process.
 Use of Psychiatric-Mental Health
Nursing Skills in Career Opportunities

Industrial (Occupational Health) Nursing

 implementing or participating in industrial substance abuse
programs for employees and thier families.
 providing crisis intervention during an industrial accident or
the acute onset of a physical or mental illness.
 teaching stress management.

Public Health Nursing

 assessing the person both physically and psychologically.
 Use of Psychiatric-Mental Health
Nursing Skills in Career Opportunities
Office Nursing
 assisting the client by explaining somatic or emotional
concerns during assessment.
 providing support with the problem-solving process when
people call the office and the physician is unavailable.
 acting as a community resource person.

Emergency Room Nursing

 providing crisis intervention as the need arises.
Introduction to
Psychiatric-Mental
Health Nursing
Chapter 1
Lecturer: Jomar D.
Devano, R.N.