This document provides an overview of psychiatric-mental health nursing. It begins by listing the learning objectives, which include describing mental health and illness, discussing the DSM-5 for diagnosis, important historical landmarks in psychiatry, current treatment trends, nursing standards of practice, and common student concerns. The document then defines mental health and illness and discusses factors influencing mental health. It provides the history of psychiatry from primitive beliefs to modern developments. Key milestones in psychiatry and psychiatric nursing are outlined, along with the development of psychopharmacology and modern psychiatric nursing. Common concerns of psychiatric nursing students are also identified.

1. Asst. Prof. Dr. Hassam-M
Psychiatric–Mental Health Nursing
2022-2023
Foundations of Psychiatric–
Mental Health

2. LEARNING OBJECTIVES
After reading this chapter, you should be able to:
1. Describe the characteristics of mental health and mental illness.
2. Discuss the purpose and use of the American Psychiatric
Association’s Diagnostic and Statistical Manual of Mental Disorders,
fifth edition (DSM-5).
3. Identify important historical landmarks in psychiatric care.
4. Discuss current trends in the treatment of people with mental
illness.
5. Discuss the American Nurses Association (ANA) standards of
practice for psychiatric–mental health nursing.
6. Describe the common student concerns about psychiatric nursing.
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3. Introduction
As you begin the study of psychiatric–mental health nursing, you
may be excited, uncertain, and even somewhat anxious. The field
of mental health often seems a little unfamiliar or mysterious,
making it hard to imagine what the experience will be like or
what nurses do in this area. This chapter addresses these concerns
and others by providing an overview of the history of mental
illness, advances in treatment, current issues in mental health, and
the role of the psychiatric
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4. MENTAL HEALTH AND MENTAL ILLNESS
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Mental health and mental illness are difficult to define
precisely. The culture of any society strongly influences its
beliefs and values, and this in turn affects how that society
defines health and illness.

5. Mental Health
o W H O : defines health as a state of complete physical, mental,
and social wellness, not merely the absence of disease or
infirmity. 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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6. Mental Health
No single universal definition of mental health exists. Generally,
a person’s behavior can provide clues to his or her mental health.
In most cases, 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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7. Mental Health
Factors influencing a person’s mental health can be categorized
as individual, interpersonal, and social/cultural:
o Individual: factors include a person’s biologic make up,
autonomy and independence, self-esteem, capacity for growth,
vitality, ability to find meaning in life, emotional resilience or
hardiness, sense of belonging, reality orientation, and coping
or stress management abilities.
o Interpersonal, or relationship, factors include effective
communication, ability to help others, intimacy, and a balance
of separateness and connectedness.
o Social/cultural, or environmental, factors include a sense of
community, access to adequate resources, intolerance of
violence, , mastery of the environment.
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8. Mental Illness
• Mental illness 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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9. DIAGNOSTIC AND STATISTICAL MANUAL OF
MENTAL DISORDERS
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10. Psychiatry
• It is a branch of medicine that deals with the
diagnosis, treatment and prevention mental
illness.
• Psychiatric Nursing
Psychiatric nursing deals with the promotion of
mental health, prevention of mental illness, care
and rehabilitation of mentally ill individuals both
in hospital and community .
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11. History of Psychiatry
Primitive beliefs regarding mental illness:
• Individual had been dispossessed of his/her
soul
• Management: Returning the soul to the client
• Broken a taboo or sinned against another
individual or god
• Management : Ritualistic purification
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12. History of Psychiatry
Evil spirits or super natural/magical powers
entered the body:
Management :
Exorcism (prayer, noise making)
• Brutal beating, starvation, Burning, amputated
and tortured
• Oral preparation of a purgative made from
sheep dung and wine
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13. Important Milestones
1773: The first mental hospital in the US was
built in Williamsburg, Virginia
1793: Philip Pinel removed the chains from
mentally ill patients confined in Bicetre, a
hospital outside Paris i.e. the first revolution in
psychiatry
1812:The first American text book in psychiatry
was written by Benjamin Rush, who is referred
to as the father of American Psychiatry
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14. Important Milestones
1912: Eugene Bleuler, a Swiss psychiatrist
coined the term Schizophrenia
1935: Insulin shock treatment was introduced
for schizophrenia
1936: frontal lobotomy was advocated for the
management of psychiatric disorders
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15. Important Milestones
1937:Electro Convulsive Therapy (ECT) was
used for the treatment of psychoses
1856–1939: development of psychoanalytical
theory by Sigmund Freud led to new
concepts in the treatment of mental illness.
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16. Development of Psychopharmacology
A great leap in the treatment of mental illness began in about
1950 with the development of psychotropic drugs, or drugs used
to treat mental illness. Chlorpromazine (Thorazine), an
antipsychotic drug, and lithium, an antimanic
agent, were the first drugs to be developed.
Monoamine oxidase inhibitor antidepressants; haloperidol
(Haldol), an antipsychotic; tricyclic antidepressants; and
antianxiety agents, called benzodiazepines, were introduced. For
the first time, drugs actually reduced agitation, psychotic
thinking, and depression. Hospital stays were shortened.
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17. Development of Modern Psychiatric Nursing
In 1873, Linda Richards graduated from the New
England Hospital for Women and Children in
Boston. She went on to improve nursing care in
psychiatric hospitals and organized educational
programs in state mental hospitals in Illinois.
Richards is called the first American psychiatric
nurse; she believed that “the mentally sick
should be at least as well cared for as the
physically sick”
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18. Development of Modern Psychiatric Nursing
The first psychiatric nursing textbook, Nursing
Mental Diseases by Harriet Bailey, was
published in 1920. In 1913, Johns Hopkins was
the first school of nursing to include a course in
psychiatric nursing in its curriculum.
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19. Development of Modern Psychiatric Nursing
1952: Dr.Hildegard Peplau defined the
therapeutic roles that nurses might play in the
mental health setting.
She described the skills and roles of the psy.
Nurse in her book “interpersonal relations in
Nursing” . It was the first systematic and
theoretical frame work developed for Psy. Nsg.
.
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20. Development of Modern Psychiatric Nursing
• 1953: Maxwell Jones introduced therapeutic
community.
• 1960: The focus began to shift to primary
prevention and implementing care and
consultation in the community
• The name psychiatric nursing changed in to
mental health nursing. 1970’s when it was
known as psychosocial nursing.
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21. Development of Modern Psychiatric Nursing
• 1980: Scientific advances in the area of
psychobiology, brain imaging techniques,
knowledge about neurotransmitters and
neuronal receptors , molecular genetics
related psychiatry etc. emerged.
• These contributed to the shift from
psychodynamic models to more balanced
psychobiological models of psychiatric care.
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22. Nursing organization :
• The national league for nursing ,established in
1937, recommended the inclusion of mental
health and psychiatric nursing in school
curricle.
• The American nursing association , found in
1958, established the conference group on
psychiatric nursing
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23. Common Concerns of Psychiatric Nursing
Students and Students Expectations
1.Saying the wrong thing
2. Fearful of being rejected by the patients.
3.Anxious because of the newness of the experience.
4.Fearful of psychiatric patients stereotyped as different.
6.Fearful of physical danger or violence.
7.Insecure in therapeutic use of self.
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24. Home work
• Psychiatric–Mental Health Nursing Phenomena of Concern
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Thank
you for
listening