Community Mental Health Nursing

Nabila Elaila, RN, BSN, MSc

Chapter 1
Introduction to Community Mental Health Nursing
Part A
 Community Mental Health Nursing
NURS4237
Syllabus 2020-2021
Course Outline
Purpose of Course:

This course to enable the student to acquire an understanding of the concepts and
principle of community mental health practice and the role of various agencies in
promoting mental health. It also familiarizes the students to learn measures that can
enhance their own mental health . Community mental health nursing course is a
theoretical course that explains human behavior in health and in illness, studies the
development of human personality and explains the coping processes throughout the
life cycle of human being.

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Course Objectives
1. Students will use & analyze the essential components and characteristics of therapeutic communication 
techniques and effective interpersonal skills in the provision of community mental health care of
individuals, families, and groups.
2. Students will discuss the scope and meaning of mental health& mental illness 

3. Students will identify selected theoretical perspectives on behavior and personality patterns of 
behavior with the client system
4. Students will differentiate adaptive and maladaptive patterns of behaviors with client system 

5. Students will define and differentiate defense mechanisms and evaluate the effectiveness of various 
defense mechanisms and behavioral responses .

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Contd…

 6. Students will determine which nursing interventions are appropriate for

various problematic client behaviors.
 7. Students will explore community resources that promote optimal client
and family adaptation to internal and external stressors appropriate to the
client's mental health care needs.
 8. Students will describe different treatment modalities that are used in
the care and treatment of mentally ill patients

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Teaching/Learning Methodology

 Learning strategies during the course will include:

 1. Lecture
 2. Audiovisuals
 3. Group discussion
 4. Presentation
 5.Community resourses visitation

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Assessment methods

Attendance and Participation 

1-Queses10% 
2-Assignments 10% 
3-Midterm exam 20% 

4-Final exam 60 % 

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Course Outline

1. Introduction to Community Mental Health Nursing

2. Mental health team / Mental health Facilities

3. The nurse as a care provider

4. Communication & Counselling

5. Theories of personality development

6. Coping & Defense Mechanisms

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Contd…

1. Understanding human behavior

2. Adjustment

3. Anxiety in daily living

4. Major areas where adjustment is needed

5. Theraputic measures in Mental Health Nursing

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 Chapter 1
Introduction to Community Mental Health Nursing
Nabila Elaila, RN, BSN, MSc

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INTRODUCTION

Community mental health nursing is the application of specialized knowledge of 

mental health to population communities nursing in preventing mental illness,
promoting & maintaining mental health of the people. It includes early diagnosis,
appropriate referrals, care & rehabilitation of mentally ill people.

 This chapter addresses current issues in mental health, and the role of the psychiatric
nurse.

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health

 The World Health Organization defines health as a

state of complete physical, mental, and social wellness,
not merely the absence of disease or infirmity. This
definition emphasizes health as a positive state of well-
being. People in a state of emotional, physical, and
social well-being fulfill life responsibilities, function
effectively in daily life, and are satisfied with their
interpersonal relationships and themselves.
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mental health

 mental health is a state of emotional, psychological,

and social wellness evidenced by satisfying
interpersonal relationships, effective behavior and
coping, positive self-concept, and emotional stability.
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Mental health has many components, and a wide
variety of factors influence it.
Factors influencing a person’s mental health
 1-Individual, or personal, factors include a person’s biologic makeup,
autonomy and independence, self-esteem, capacity for growth, vitality,
ability to find meaning in life, emotional resilience or hardiness, sense of
belonging, and coping or stress management abilities.
 2-Interpersonal, or relationship, factors include effective communication,
ability to help others, intimacy, and a balance of separateness and
connectedness.
 3- Social/cultural, or environmental, factors include a sense of community,
access to adequate resources, intolerance of violence, support of diversity
among people, mastery of the environment, and a positive, yet realistic,
view of one’s world.
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Mental Illness
Mental illness is maladjustment in living. It 
produces a disharmony in the person’ s ability to
meet human needs comfortably or effectively &
function within a culture . It includes disorders that
affect mood, behavior, and thinking, such as
depression, schizophrenia, anxiety disorders, and
addictive disorders. Mental disorders often cause
significant distress or impaired functioning or both.
Individuals experience dissatisfaction with self,
relationships, and ineffective coping. Daily life can
seem overwhelming or unbearable. Individuals may
believe that their situation is hopeless.

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Factors contributing to mental illness

 . Individual factors include biologic makeup, intolerable or

unrealistic worries or fears, inability to distinguish reality from
fantasy, intolerance of life’s uncertainties, a sense of disharmony
in life, and a loss of meaning in one’s life.
 Interpersonal factors include ineffective communication,
excessive dependency on or withdrawal from relationships, no
sense of belonging, inadequate social support, and loss of
emotional control.
 Social/cultural factors include lack of resources, violence,
homelessness, poverty, an unwarranted negative view of the
world, and discrimination such as stigma, racism, ageism, and
sexism
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How do mental health and mental illness
intersect?
Sometimes our mental health comes under strain from life events – a 
relationship break-up, difficult work situation or family problems. All
of us have varying thresholds for how much we can cope with before
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Risks to mental health can include: 8

• Discrimination

• Exposure to trauma

• Family history of mental illness

• Low income

• Medical illness

• Poor access to health services

• Poor self-esteem

• Poor social skills

• Social inequalities

• Substance use nabila elaila

things you can do to improve your mental health

1-Helping others 

2-Finding a type of exercise or physical activity 

3-Getting good sleep 

4- Eating healthy food 

5-Connecting with others, building and maintaining positive relationships 

6- Learning strategies to manage stress 

7-Having realistic expectations (no one is happy and positive all the time) 

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Contd…

8-Learning ways to relax (such as meditation) 

9-Counteracting negative overcritical thinking 

10-Doing things you enjoy and that give you sense of accomplishment 
11- Flexibility Having rigid expectations can sometimes create added stress 
linked to some types of psychopathology

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The end ^_^
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 LEARNING OBJECTIVES

After reading this chapter, you should be able to:

-List three responsibilities of the learner.
-Explain why learning is defined as "a change in behavior. “
-List five essentials for developing one's potential.
-Identify one's life role and appropriate behaviors for each role
-Explain why role confusion is dangerous for a health care provider.
-List five guidelines for personal growth

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Introduction

In the near future you will graduate and assume a

position in an agency that provides health services
to the community. What changes are needed
before you, the student of today, can become you,
the health care provider of tomorrow?
You, the Student
Obviously, you must acquire knowledge, learn to
apply it appropriately to a wide variety of situations,
and develop skill in performing certain procedures.
Contd…

Your teachers have organized for you

meaningful sequence of learning experiences.
They will guide your step-by-step progress
toward a future role in the field. Your teachers,
however, cannot do the whole job. The desire
to learn, willingness to make the necessary
effort, and determination to gain as much as
possible from each learning experience must
come from you.
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 Learning Versus Memorizing

Learning has been defined as a change in behavior. If you can

answer
the questions on a test, but do not apply that information in
appropriate clinical situations, have you really learned? Do you
approach assignments as though you are a tape recorder, storing
information that can be played back on demand? Such an
approach to study is not true learning .

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 Developing Mental Skills

Do you constantly ask yourself how a new idea can be used? Does
new information guide you in selecting appropriate behavior for
situations where that information is relevant? If you can answer "Yes"
to these questions, then you are truly learning. You are using mental
processes such as thinking, reasoning, selecting, decision-making, and
evaluating for conscious control of your behavior

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Developing your PotentialThink of
yourself for a moment as a person and
explore some of the ways you can strive to
develop your potential for learning. These
same approaches, applied to your future
career, will help you develop your potential
for becoming a nurse

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 Taking a New Look at Yourself
The immediate task is to undertake a study of yourself.,
you say
"I already know myself." Do you really ? The ability to be
honest with yourself is absolutely necessary
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Willingness to Change
The first question to ask yourself is, "Am I willing to make changes in
myself?" Willingness to change is necessary so that you can learn 
and grow as a person. Remember, learning was defined earlier as a
change in behavior.
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Strengths and Weaknesses
Your next question might be, "What are my strengths and my
weaknesses?" To develop your potential, you must know your weak
points, for these will need your attention and greatest effort. For
example, do you have a habit of putting off a task until the last
minute? An honest appraisal of your personal traits, including your work
habits, is the key to planning ways of developing your potential. If
you eliminate those behaviors that interfere with good performance,
you will improve your ability to perform well in a variety of situations.

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Adapting to New Conditions
A third question to ask yourself is, "How well do I adapt to change?"
Are you still clinging to habits formed early in your school years? If
so, these habits are probably not working very well in your present
educational program. Time is short, and there is much to be learned before you
qualify as anurse. You must assume primary responsibility for learning. You will need
to develop new habits
appropriate to your new role and, possibly, to higher standards of
performance.

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Using Experience to Learn
A fourth question is, "Do I learn from my experiences?" Let us take a
look at how two people reacted to an embarrassing experience. When
Mary and Sue gave oral reports, they both showed signs of
nervousness and performed poorly. Mary reviewed the situation, admitted to
herself that she had put little effort into this assignment, and made plans to be
well-prepared for the next oral report.
Sue, on the other hand, used the same approach to prepare her next
oral report, which proved to be another poor performance.
Mary used her experience constructively, making careful plans to
prevent a recurrence of this particular embarrassment. Sue, on the
other hand, allowed the experience to create self-doubt and fear of
oral reports. Do you think she will develop either skill or confidence? Which of
these students will grow as a person? Are you a Mary or a Sue, in relation to
learning from experience?
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Role Perception
program of study will help you understand you care provider. Certain behaviors that
are appropriate for personnel in a nursing service may not be appropriate for
personnel in a different service. Also, there are differences in nursing service roles
based on level Nursing assistants, licensed practical nurses, registered nurses, head
nurses, and supervisors all have specific roles within nursing. There are numerous
roles within the hospital laboratory: pathologist, medical technologist, clinical
laboratory assistant, laboratory aide, and others future role as a health

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Contd…
functions and educational preparation of each.
Knowing one's role is essential to effective functioning; it is also
essential to self-understanding.
On the other hand, if you can accept a defined role, function within that role to the fullest
extent of your educational preparation, and accept the limitations of the role without feeling
"put down," then you are likely to find much satisfaction as a nurse.

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You, a Person with Several Life Roles

How many roles do you play? Probably several. You are a student
now and hope to have a role as nurse in the future.
You may be a husband, father, wife, mother; or you may be living in
your parents' home, still in a dependent role. Even if you are living on
your own, you still have the role of child to your parents, if they are
living, in addition to the other roles in your life

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Role and Relationship with Others
There are similarities in the child-parent relationship
and the teacher student relationship during the
school years. In a health occupations education
program, the teacher-student relationship is
between two adults, even though one adult is a
student. What difficulties in role perception might
occur if the student is a mature, fifty-year-old
person, and the teacher is a twenty-five-year-old
health professional
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Making a Distinction Between Roleshe
roles you play at home, in your mosque /church activities, as a health
occupations student, and as a neighbor are all different. To someextent,
each role requires different behavior patterns. Do not confuse the health
care provider role with other roles in your personal life.
Some friends may try to get "free medical advice"; but the role of
friend and the role of health care provider are different. Medical practice
acts, which are state laws, make it illegal for nonphysicians to diagnose
and prescribe. Therefore, this type of role confusion is dangerous

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Guides for Growth
Becoming an effective health care
provider is a process that extends
over a period of time. It requires
continuous effort throughout one's
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Value of Self-Study
In undertaking a self-study, you will be making an investment in your
own future. Hopefully, this study will start you on a lifetime process
of striving for personal growth. You should continuously evaluate
your habits and modify those that do not get the desired response from
others. There will always be some people with whom you do not "hit
it off," but you can learn to relate to most people in ways that promote
understanding and minimize unfavorable feelings. As you become
skillful in using a large repertoire of human relations skills, you will
grow in self-understanding, in tolerance, and in your ability to accept
others as they are
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Value of Studying Human Behavior
Note that the sequence of growth is from understanding self to
understanding others. Therefore, the ability to understand others is
limited until you have begun to understand yourself.

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Striving for Personal Growth
Approaches
Now let us summarize some ways you can try to understand yourself
and set goals for personal growth and achievement as a student and
health care provider.
- Recognize that learning occurs only if you make the effort to learn, if
you are willing to change, and if you recognize opportunities for
learning.
- Study yourself in relation to specific traits, such as willingness to
change, ability to be honest with yourself, and readiness to correct
weaknesses and change habits.

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 Contd…
- Identify your strengths and make full use of them to achieve your
Goals.
- Identify your weaknesses the traits or habits you need to change in
order to be more effective in your roles.
- Study your various roles in terms of desirable behavior. Identify
differences, such as habits used at home that are not appropriate at
school: interpersonal relations between a parent and child that are not
appropriate between the health care provider and a pediatric patient;
relations between friends that are not appropriate between a hospital
employee and a patient.
- Study your various roles in terms of desirable behavior. nabila elaila
 Contd…
-Study your ability to make distinctions between different life roles and
change behaviors accordingly.
-Study your tendency to use old habits in new situations. Do you allow
habits to determine your behavior in any situation? Do you need to
improve in adapting your behavior to each situation?
-Mentally review past experiences to understand how your own
behavior contributed to the outcome. Consider the important question,
''Would the outcome of that experience be improved if I had behaved
differently?" This practice can serve as a "rehearsal" for future similar
experiences.
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Sondos lafi
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