MENTAL HEALTH NURSING

1. PRINCIPLES AND
STANDARDS OF MENTAL
HEALTH PRACTICE
PRESENTED BY:
V. BOOMINATHAN
M.Sc. (N) 1st year
MTPG & RIHS

2. OBJECTIVES
At the end of the class the students will able to
• define principles and standards of practice
• enlist the Principles of Mental Health Nursing
• discuss the Principles of mental health nursing
• discuss the purposes of standard of mental health
nursing
• enlist the standards of mental health nursing
• sketch out the Professional performance
standards

3. INTRODUCTION
Ethical principles and standards promote and
ensure the optimal patient safe and care. Nurses
use the principle and standards to drive quality
improvement, continual professional development
and enable everyone to know what quality nursing
looks like.

4. DEFINITION
Principle in Mental Health Nursing are general
in nature and form guidelines for emotional care of
a patient these principles are based on the
concept that each individual has an intrinsic worth
and dignity and has potentialities to grow.
The standards of Mental Health Nursing
practice is to fulfill the professional obligations to
provide the a means of improving the quality of
care

5. Principles of Mental
Health Nursing

6. 1. ACCEPTANCE

7. 2.USE SELF- UNDERSTANDING
USED AS A THERAPEUTIC TOOL
A Psychiatric nurse should have a realistic self
–concept and should be able to recognize one’s
own feelings, attitudes and responses. His/ her
ability to be aware and to accept her own strengths
and limitations should help her to see the strengths
and limitations in other people too. Self-
understanding helps her to be assertive in life
situations without being aggressive and feeling
guilty.

8. Self-understanding methods..
• Exchange personal experience freely and
honestly with colleagues
• Discuss own personal reaction with an
experienced person
• Participate in group conference regarding
patient care.
• Keeping reflecting on why you feel or act way
you do

9. 3. Consistency
• Consistency means having certain routine
pattern that does not change from one day to
other.
• Consistency helps in knowing what to expect, in
psychiatric nursing consistency means there
should be consistency in the attitude of the staff,
ward routine and in defining the limitation placed
on the patient. This consistency in psychiatric
wards reduces fear and anxiety

10. 4.
4. Reassurance
• Attention to matters that are important to
him/her.
• Allowing patient to be as sick as he needs to be
• Complete awareness and acceptance of how
the patient actually feels.
• Doing things without asking anything of the
patient in return, such as improved behavior or a
show of appreciation.

11. 5. Patient behavior is changed through emotional
experience and not by rational interpretation
• Major focus in psychiatry is on feelings and not
on the intellectual aspect. Advising or
rationalizing with patients is not effective in
changing behavior
• Role-play and socio drama are a few avenues of
providing corrective emotional experiences to a
patient and facilitating insight into his own
behavior. Such experience can truly bring about
the desired behavioral changes

12. 6. Unnecessary increase in patients
anxiety should be avoided
The following are the approaches may increase
the patients anxiety and should, therefore, be
avoided;
• Showing nurses own anxiety
• Showing attention to the patients deficits
• Making the patient face repeated failures
• Placing demands on patient which he obviously
cannot meet
• Passing sharp comments and showing
indifference

13. 7. Objective observation of patient
to understand his behavior
Objectivity is an ability to evaluate exactly what
the patient wants to say and not mix up one’s own
feelings, opinion or judgment. To be objective, the
nurse should indulge in introspection and make
sure that her own emotional needs do not take
precedence over patients’ needs

14. 8. Maintain realistic nurse
patient relationship
• Realistic or professional relationship focuses
upon the personal and emotional needs of the
patient and not on nurse’s needs. To maintain
professional relationship the nurses should have
a realistic self-concept and should be able to
empathize and understand the feelings of the
patient and the meaning of his behavior

15. 9. Avoid physical and verbal
force as much as possible
• All methods of punishment must be avoided. If
the use is an expert in predicting patient
behavior, she can mostly prevent an ones of
undesirable behavior

16. 10. Nursing care is centered on
the patients as a persona and not
on the control of symptoms
• Analysis and study of symptoms is necessary to
reveal their meaning and their significance to the
patient. Two patients showing the same
symptoms may be expressing two different
needs.

17. 11. All explanations of procedures and
other routines are given according to the
parings level of understanding
• The extent of explanation that can be given to a
patient depends on his span of attention, level of
anxiety and level of ability to decide. But
explanation should never be withheld on the
basis that psychiatric patients are not having any
contact with reality or have no ability to
understand

18. 12. Many procedures are
modified but basic principles
remain unaltered
• In psychiatric nursing field, many methods
are adapted to individual needs of the
patients, but the underlying scientific
principles remain same. Some nursing
principles to be kept in mind are
 Safety ‘comfort , Privacy
 Maintaining therapeutic effectiveness
 Energy and material , Economy of time,

19. STANDARDS OF MENTAL
HEALTH PRACTICE

20. PURPOSES
• fulfill the profession’s obligation
• To provide a means of improving the quality of
care.
• These standards are a revision of the standards
enunciated by the division on psychiatric and
mental health nursing practice in 1973.
• Helps to avoid intelligently in getting involved in
personal issues.

21. Standards of mental health
nursing:
1. THEORY
Theories were formulated based on scientific
phenomena of concern to nurse and to provide
basis for nursing interventions.
Hence nurse must apply appropriate theory
which is scientifically based to take necessary
decisions related to nursing practice.

22. CONT..
2. ASSESSMENT/DATA COLLECTION
To adopt nursing process in a systemic way,
assessment is the first step to carry out systematically to
enable the nurse to draw sound conclusions in order to
diagnose the client’s condition and to plan unnecessary
interventions to improve clients condition by promoting
their mental health.
The data will be gathered in a systemic manner
factual, realistic, accurate, and relevant information
related to psychology, psychiatry, psychological and
biophysical sciences.

23. CONT..
3. DIAGNOSIS/ OUTCOME IDENTIFICATION
The nurse utilize nursing diagnosis & standard
classification of mental disorders to express
conclusions supported by recorded assessment
data & current scientific premises.
Nursing’s logical basis for providing care rests
on the reorganization & identification of those
actual or potential health problems that are within
the scope of nursing practice.

24. CONT..
• The clinical nurse has to plan individualized
holistic interventions by identifying expected
outcomes through implementing nursing care
activities to attain the fullest extent of their
capabilities.
There are mainly 3 types of goals:
 Short term goal
 Long term goal
 Immediate goal

25. 4. PLANNING
The solving approach will be utilized in
developing nursing care plans. Nurse develops a
plan of care with specific goals that prescribes
interventions to attain expected outcomes,
delineating nursing actions unique to each client’s
needs
CONT..

26. Nurse will assist the client in meeting their
Activities of Daily Living (ADL) in a goal directed
way, to promote self-care activities in order to
achieve physical and Nursing care plans is used to
guide the therapeutic interventions which
effectively achieves the described outcome.
A combination of treatment modalities e.g.,
Psychotherapy along with drug therapy and
Comprehensive health services will be planned
to relieve the clinical manifestations of mental
illness.
5. IMPLEMENTTION
CONT..

27. • Rehabilitative and Restorative services will be
planned to achieve independence and to attain
to normalcy. Consultation services are aimed to
influence the client’s care plans and to bring
effective change in the systems. Nurse are
accountable for their services and practices,
which has to be prepared adequately
CONT..

28. 6. EVALUATION
Nurse has to evaluate their Nursing Activities by
assessing the client’s responses and progress in
attaining expected outcomes, revise the data
bases, Nursing Diagnosis and the modified
strategies in the form of Nursing Interventions.
Evaluation is a continuous, active process that
begins early in the relationship and continues
throughout.
CONT..

29. PROFESSIONAL
PERFORMANCE STANDARDS

30. CONT
7. QUALITY ASSURANCE BY PEER
REVIEW
• To evaluate quality of nursing care
provided to the clients, nurses will
participate in peer review discussions staff
evaluation programmes and assurance
process etc. to ensure the client’s
prognosis and who receives qualitative
care

31. 8. Continuing Education
The nurse assumes responsibility for
continuing education & professional
development & contributes to the
professional growth of others
CONT

32. 9: Interdisciplinary Collaboration
The nurse collaborates with other
health care providers in assessing,
planning, implementing & evaluating
programs & other mental health activities.
CONT

33. 10: Utilization of Community Health System
• The nurse participates with other members of
the community in assessing, planning,
implementing & evaluating mental health
services & community systems that include
the promotion of the broad continuum of
primary, secondary & tertiary prevention of
mental illness.
CONT

34. 11: Research
• The nurse contributes to nursing & the
mental health field through interventions in
theory & practice & participation in
research.
CONT

35. SUMMARY
So far we discussed about the
Introduction of Principles and standards of
Mental Health Practices, principles of Mental
Health Nursing, Purposes of Standards of
practices in Mental Health Nursing,
Standards of practices, and the professional
performance standards

36. ANY QUERIES ?

37. ASSIGNMENT
Write an assignment on the basic rights
of mentally ill patient.

38. RERERENCE
Teacher reference:
1. Mary C. Townsend (2019) “Psychiatric Mental Health
Nursing” eight edition, New Delhi ,2019 :Jaypee Brothers
Medical Publishers, page no 108-112
2. Niraj Ahuja,(2011) “A short Textbook of psychiatry”,
seventh edition, New Delhi,2011: Jaypee Brothers
Medical Publishers page no 172 - 198
3. Theodore. D (2009) “Textbook of Mental health Nursing”,
volume-1, New Delhi,2015: Reed Elsevier India page no
256 - 277
4. Boyd. M. A. (2015) “Psychiatric Nursing contemporary
practice”, Sixth edition, NewYork,2015:Lippincot Williams
and Wilkins 164 - 169

39. CONT
STUDENT REFERENCE:
• Mary C. Townsend (2019) “Psychiatric Mental Health
Nuring” eight edition,New Delhi ,2019 :Jaypee
Brothers Medical Publishers, page no 108 - 112
• Niraj Ahuja,(2011) “A short Textbook of psychiatry”,
seventh edition, New Delhi,2011: Jaypee Brothers
Medical Publishers page no 172 - 198