Textbook of Mental Health & Psychiatric Nursing" by Bharat Pareek and Sandeep Arya. INTRODUCTION TO MENTAL HEALTH NURSING

1. UNIT 1
INTRODUCTION TO
MENTAL HEALTH
NURSING
Textbook of Psychiatric & Mental Health Nursing
Authors
Bharat Pareek
Sandeep Arya
Prepared by:- Meenakshi
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2. LEARNING OBJECTIVE
Define psychiatric nursing, mental health and
mental illness
Discuss the perspectives of mental health and
mental health nursing
Describe the evolution of mental health
services, treatment and nursing practices
Recognize the history and trends in
psychiatric nursing
Discuss the prevalence and incidence of
mental health problems and disorders
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3. Discuss the mental health act, national health
policy and national mental health policy
Describe the role and function of mental
health team and psychiatric nurse
Discuss the nature and scope of mental health
nursing
Describe the concept of normal and abnormal
behavior
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4. CHAPTER OUTLINE
Perspectives of mental health and mental
health nursing
Components and indicators of mental
health
General criteria for mental disorder
Evolution of mental health services
treatment and nursing practice
Prevalence and incidence of mental health
problems and disorders
National mental health act 1987
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5. National health policy and national mental health policy
National mental health programme
Mental health team
Scope of psychiatric mental health nursing:
Role and function of mental health nurse
Concept of normal and abnormal behavior
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6. PERSPECTIVES OF MENTAL HEALTH
AND MENTAL HEALTH NURSING
"A STATE OF WELL-BEING IN WHICH THE
INDIVIDUAL REALIZES HIS OR HER OWN
ABILITIES, CAN COPE WITH THE NORMAL
STRESSES OF LIFE, CAN WORK PRODUCTIVELY
AND FRUITFULLY, AND IS ABLE TO MAKE A
CONTRIBUTION TO HIS OR HER COMMUNITY.”
WORLD HEALTH ORGANIZATION
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7. MENTAL HEALTH ILLNESS CONTINUUM
Diagnosed with
serious mental
illness but cope
well and has
optimum
mental health
Optimum
mental health
with no illness
Poor Mental
health with
sever illness
Poor mental
health but no
clinical ly
diagnosable
illness
OPTIMUM MENTAL WELLBEING
MINIMUM
MENTAL
ILLNESS
MAIMUXM
MENTAL
ILLNESS
MINIMUM MENTAL
WELLBEING
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8. DEFINITION OF MENTAL HEALTH
“THE NORMAL
FUNCTIONING OF THE
MIND IN THE
APPROPRIATE SOCIAL
CONTEXT”.
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9. COMPONENTS OF MENTAL
HEALTH
•POSITIVE THOUGHTS ABOUT SELF, OTHERS,
FUTURE
•ACCEPTING AND EXPRESSING EMOTIONS
•BUILDING AND MAINTAINING HEALTHY
RELATIONSHIPS
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10. INDICATORS OF MENTAL HEALTH
•SELF ESTEEM
•PERSONAL GROWTH
•INTEGRATION
•AUTONOMY
•PERCEPTION OF REALITY
•ENVIRONMENTAL MASTERY
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11. MENTAL ILLNESS
“MENTAL AND BEHAVIORAL
DISORDERS ARE UNDERSTOOD AS
CLINICALLY SIGNIFICANT
CONDITIONS CHARACTERIZED BY
ALTERATION IN THINKING, MOOD
(EMOTION) OR BEHAVIOR
ASSOCIATED WITH PERSONAL
DISTRESS AND /OR IMPAIRED
FUNCTIONING.”
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12. GENERAL CRITERIA FOR MENTAL
DISORDER
•DISSATISFACTION WITH ONES CHARACTERISTICS, ABILITIES AND
ACCOMPLISHMENTS.
•IN-EFFECTIVE OR UNSATISFYING INTERPERSONAL RELATIONSHIP
•DISSATISFACTION WITH ONES PLACE IN THE WORLD E.G. LOW SELF
ESTEEM.
•IN EFFECTIVE COPING OR ADAPTATION TO THE EVENTS IN ONE’S LIFE.
•LACK OF PERSONAL GROWTH
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13. WARNING SIGNS FOR MENTAL ILLNESS
•MARKED PERSONALITY CHANGE.
•STRANGE IDEAS.
•EXCESSIVE ANXIETIES.
•PROLONGED DEPRESSION AND APATHY.
•MARKED CHANGES IN EATING OR SLEEPING PATTERNS.
•EXTREME MOOD SWINGS (HIGH OR LOW).
•ABUSE OF ALCOHOL OR DRUGS
•EXCESSIVE ANGER, HOSTILITY, OR VIOLENT BEHAVIOR
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14. SIGN AND SYMPTOMS OF MENTAL ILLNESS
•IMPAIRED JUDGMENT AND REALITY PERCEPTION
•IRRESISTIBLE BEHAVIOR
•SELF-HARMING BEHAVIOUR
•DISTURBANCE IN PSYCHOMOTOR BEHAVIOUR
•DISTURBANCE IN INTELLECTUAL FUNCTIONING
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15. PSYCHIATRIC NURSING
BRANCH OF NURSING CONCERNED
WITH THE PREVENTION AND CURE
OF MENTAL DISORDERS AND THEIR
SEQUEL. IT EMPLOYS THEORIES OF
HUMAN BEHAVIOR AS ITS
SCIENTIFIC FRAMEWORKS AND
REQUIRES THE USE OF SELF AS ITS
ART OR EXPRESSION IN NURSING
PRACTICE
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16. EVOLUTION OF MENTAL HEALTH
SERVICES TREATMENT AND NURSING
PRACTICE
Historically identified categories of periods
The period of persecution -1552 BC -1545AD
The period of segregation - 1546 AD -1745AD
The humanitarian period - 1746 AD -1825 AD
Beginning of scientific attitude - 1826 AD -1878 AD
The period of prevention - 1879 AD -1960 AD
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17. EVOLUTION OF MENTAL HEALTH NURSING
PRACTICES
PHASE I : EMERGENCE OF
PSYCHIATRIC, MENTAL
HEALTH NURSING (1773-1881)
PHASE II : DEVELOPMENT OF
THE WORK ROLE OF THE
PSYCHIATRIC NURSE (1882-
1914)
PHASE III: DEVELOPMENT OF
UNDERGRADUATE
PSYCHIATRIC NURSING
EDUCATION (1915-1935)
PHASE IV : DEVELOPMENT OF
GRADUATE PSYCHIATRIC
NURSING EDUCATION
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18. EVOLUTION OF MENTAL HEALTH NURSING
PRACTICES
•PHASE I : EMERGENCE OF PSYCHIATRIC, MENTAL HEALTH NURSING
(1773-1881)
•PHASE II : DEVELOPMENT OF THE WORK ROLE OF THE PSYCHIATRIC NURSE
(1882- 1914)
•PHASE III: DEVELOPMENT OF UNDERGRADUATE PSYCHIATRIC NURSING
EDUCATION (1915-1935)
•PHASE IV : DEVELOPMENT OF GRADUATE PSYCHIATRIC NURSING
EDUCATION (1936-1945)
•PHASE V: DEVELOPMENT OF CONSULTATION AND RESEARCH IN
PSYCHIATRIC NURSING PRACTICE.
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19. MENTAL ILLNESS TO MENTAL
HEALTH: INDIAN PERSPECTIVE
•AYURVEDA
•UNANI SYSTEM
•SIDDHA SYSTEM
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20. PREVALENCE AND INCIDENCE OF MENTAL HEALTH
PROBLEMS AND DISORDERS (INDIAN PERSPECTIVE)
National mental health survey of India 2015-16 reported that
every sixth Indian needs mental health help, 8% of people in
Karnataka have mental illness, mental problems more in 30–49
age group or over 60; low income linked to occurrence of mental
disorders and urban areas to be most affected were some of the
headlines in the mass media.
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21. VULNERABLE GROUPS TO MENTAL
DISORDERS
CHILDREN
AND
ADOLESCENT
S
INDIGENOUS
POPULATION
S
•WOMEN AND
OLDER
ADULTS
DISABLED
INDIVIDUALS
MIGRANTS
VICTIMS OF
VIOLENCE,
CONFLICTS
AND
DISASTERS
INDIVIDUALS
WITH LONG
MENTAL
HEALTH
SUFFERING
MENTAL
HEALTH
PATIENTS
LONG TERM
HOSPITALIZE
D
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22. COMMON CHALLENGES / ISSUES OF
MENTAL HEALTH IN INDIA
•STIGMA RELATED TO MENTAL DISORDERS
•LACK OF AWARENESS IN COMMON PEOPLE
•DELAYED TREATMENT SEEKING BEHAVIOR
•LACK OF LOW COST DIAGNOSTIC TEST
•LACK OF EASILY AVAILABLE TREATMENT
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23. MENTAL HEALTH ACT, 1987
•The Mental Health Act has 10 chapters
•Chapter 1:New terminology and definitions
•Chapter 2 : Deals with establishment of mental health authorities
•Chapter 3 :
•Lays down the guidelines for establishment and maintenance of psychiatric hospitals and nursing
homes
•Chapter 4: Deals with the procedures of admission and detention in psychiatric hospitals
•Chapter 5 :Deals with the inspection, discharge, leave of absence and removal of mentally ill persons
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24. •Chapter 6 :Deals with the judicial inquisition
•Chapter 7: Deals with the liability to meet the cost of maintenance of mentally ill
persons
•Chapter 8: Aimed at the protection of human rights of mentally ill persons
•Chapter 9 : Deals with the penalties and the procedure, while
•Chapter 10: Proves for miscellaneous sections.
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25. NATIONAL MENTAL HEALTH PROGRAMME
The Government of India has launched the National Mental Health Programme
(NMHP) in 1982, keeping in view the heavy burden of mental illness in the
community, and the absolute inadequacy of mental health care infrastructure in
the country to deal with it.
COMPONENTS
❖ Treatment of Mentally ill
❖ Rehabilitation
❖ Prevention and promotion of positive mental health.
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26. •AIMS
•Prevention and treatment of mental and neurological disorders and their associated
disabilities.
•Use of mental health technology to improve general health services.
•Application of mental health principles in total national development to improve quality
of life.
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27. •OBJECTIVES
•To ensure availability and accessibility of minimum mental health care for all in
the foreseeable future, particularly to the most vulnerable and underprivileged
sections of population.
•To encourage application of mental health knowledge in general health care and
in social development.
•To promote community participation in the mental health services development
and to stimulate efforts towards self-help in the community.
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28. •SERVICES
•Daily Out-patient (OPD) services
•• Ten bedded in services facility (IPD)
•• Referral service
•• Liaison with Primary Health Center (PHC)
•• Provide follow up service
•• Community Survey if feasible
•• Remove stigma of mental illness
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29. MENTAL HEALTH TEAM
•Psychiatrists
•Clinical psychologists
•Psychiatric Nurses
•Occupational therapists
•Social workers
•Support workers
•Community support workers
•Psychotherapists
•Counselors
•Befrienders
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30. LEVELS OF PSYCHIATRIC MENTAL
HEALTH NURSING PRACTICE
BASIC LEVEL
basic level nursing
practical is characterized
by interventions that
promote and foster health
and mental health, assist
clients to regain or
improve their coping skill,
or abilities, and prevent
further disability.
ADVANCE
LEVEL
❖ Psychotherapy
❖ Psychopharmocology
interventions
❖ Case management
❖ Consultation liaison
❖ Clinical supervision
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31. CONCEPT OF NORMAL AND
ABNORMAL BEHAVIOR
• STATISTICAL INFREQUENCY (STATISTICAL MODEL)
• SOCIAL MODEL
• BEHAVIORAL MODEL
• DEVIATION FROM IDEAL MENTAL HEALTH
• MEDICAL MODEL
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32. CHAPTER SUMMARY
Mental health refers to our cognitive, and/or emotional well being.
Mental health nursing is a specialized area of nursing practice,
employing the theories of human behavior as it is a science, and the
purposeful use of self as it is an art, in the diagnosis and treatment of
human responses to actual and potential mental health problems”.
Appox. 450 million people suffer with mental disorders worldwide.
Normal behavior is basically behavior that is socially acceptable. The
definition of the word abnormal is simple enough: deviating from the
norm. However, applying this to psychology poses a complex problem:
what is normal? Whose norm? For what age? For what culture? Some
would simply classify what is "good" as normal and what is "bad" as
abnormal.
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