As per INC Syllabus

1. Principles of Mental Health
Nursing

2. Introduction
• Principles are formulated based on the
concept that every individual has an
intrinsic worth and dignity, potentialities
and capabilities.
• Principles form the guidelines which will
help the client to meet his emotional needs
and also bring about desirable changes in
his behaviours

3. Principles
• Accept the patient exactly as he is
• Self understanding is used as a therapeutic tool
• Consistency is used to contribute to patient's
security
• Reassurance to be given in and acceptable and
realistic manner.
• Patient behaviour can be changed through
emotional experience not by rational
interpretation:

4. • Avoid unnecessary increase in patient’s
anxiety
• Observe objectively to understand and
interpret the patient behaviour
• Maintain realistic professional relationship
• Verbal and physical force must be avoided if
possible
• Nursing care centred on patient as a person
not on control of symptoms

5. • Routine procedures explained at patient's
level of understanding.
• Positive reinforcement to be used wherever
is possible:
• Structured activity schedule as a part of
psychiatric nursing:
• Many procedures are modified but basic
principal remain unaltered.

6. Patient should be accepted exactly as he/she is
• Be non-judgemental and non-punitive
• Show interest in the patient as a person
• Being aware of her likes & dislikes
• Recognize the feelings which the patient express.
• Talk with a purpose: Conversation with a patient
must have a goal.
• Allow patient to express strongly held feelings.

7. Self understanding is used to as a therapeutic tool
• Exchange personal experience freely and
openly with colleagues.
• Discuss your personal reaction with an
experienced person.
• Participate in group conference regarding
patient care.

8. Consistency is used to contribute to patient's
security
• Why consistency?
– Not knowing what to expect, or fear of the unknown
produces anxiety.
– Patient must feel that she can depend on the people
working in the ward.
• How should consistency operate?
– Patient to be continuously exposed to an atmosphere of
acceptance
– Consistence to be maintained from nurse & shift to shift

9. Reassurance to be given in a suitable &
acceptable manner.
• Reassure the patient
• Be truly interested in patient problems.
• Pay attention to the matters that are
important to the patient, however
insignificant it may be.

10. Patient's behaviour is changed through emotional
experience, not by rational interpretation.
• Help the patient feel emotionally secure to enable
her to develop & use understanding of his/her
own behaviour.
• Understanding cannot be forced.
• Interpretation is only done when patient is ready
for it, i.e. secure enough to tolerate it & able to
apple it to alter her behaviour.

11. Unnecessary increase in patient's anxiety should
be avoided
• What factors, situation, topics or approaches
can increase anxiety?
– Direct contradiction of patient's psychotic ideas.
– Demands on patient which she obviously cannot meet
– Indiscriminate use of professional terms..
– Calling attention to patient's defects.
– Lack of proper orientation

12. Observe objectively to understand and
interpret the patient behaviour
• Continuous close observations are the
most important function of the
psychiatric nurse.
• This helps to interpret the behaviour and
avoid untoward incidences.

13. Maintain a realistic professional relationship.
• Such a relationship is therapeutically oriented &
is always based on patient's needs.
• Nurse keeps analysing the interaction between
herself & the patient to prepare herself to guide
the patient towards mature behaviour.
• Nurse must differentiate between patient's
demands & actual needs.

14. Verbal & physical force must be avoided if possible
• Any kind of force applied on patient results in
psychological trauma.
• Anger or annoyance should not be shown.
• No verbal comments should be made during the
procedure, except to tell the patient.
• Never let the patient feel that she is being punished,
attend to her needs as usual.
• Nursing team must have self-control & understanding
in carrying out the procedure.

15. Nursing care centered on patient as a person,
not on control of symptoms.
• Every behavior symptom is meaningful.
• Two patients showing the same symptom may
be expressing different needs.
• Analysis and study of symptoms are necessary to
reveal their meaning and their significance to the
patient.

16. Routine & procedures explained at
patient's level of understanding.
• Every patient has a right to know what is
being done & why it is being done.
• Every procedure should be explained at her
level of understanding.

17. Many procedures are modified but basic
principles remain unaffected
• All nursing procedure like parental injections,
dressing, enemas, RT feedings are same as for
other physically ill patients.
• But it will be modified according to the
situation without changing the basic principles
of the procedures