ALL INDIA INSTITUTE OF MEDICAL SCIENCES

RAIPUR, CHHATTISGARH
College of Nursing

ASSIGNMENT ON
CURRENT TRENDS AND ISSUES IN MENTAL HEALTH NURSING

SUBMITTED TO SUBMITTED BY  
Mrs.j.jeayrekha MS shalini sahu

Assistant professor MSc nursing 1st year

AIIMS RAIPUR AIIMS RAIPUR

Psychiatric nurse faces various challenges because of changes in the
inpatient care approach. Some of these changes that affect her role are
as follows:

Trends in Health Care

 Increased mental health problems
 Provision for quality and comprehensive services
 Multidisciplinary team approach
 Providing continuity of care
 Care provided in alternative settings

Economic Issues

 Industrialization
 Urbanization
 Raised standard of living

Changes in Illness Orientation

 Shift from illness to prevention (modification of style), specific to
holistic, quantity of care to quality of care

Changes in Care Delivery

 Care delivery is shifted from institutional services to community
services, genetic services to counseling services, nurse patient
relationship to nurse-patient partnership.

Information Technology
 Telenursing
 Telemedicine
 Mass media
 Electronic systems
 Nursing informatics

Consumer Empowerment
Increased consumer awareness
 Awareness of the community in early detection and treatment of
mental illness as well as proper utilization of available psychiatric
hospitals
 Patients are health care consumers demanding quality health
care services at affordable cost with less restrictive and more
humane rates.

Deinstitutionalization
 Bringing mental health patients out of the hospital and shifting
care to community.

Physician Shortage and Gaps in Service

 Physician shortage can provide the opportunity for new roles, for
example, nurse practitioner. In respect to gaps in services, nurses
always meet the needs of people for whom services are not
available, for example, home visiting nurse.

Demographic Changes
 Increasing number of the elderly group
 Type of family (Increased number of nuclear families).
Change in Patient Needs

 Wanting a more holistic orientation in health care.

Challenges in Psychiatric Nursing

The issues discussed in this section raise many challenges for mental health
psychiatric nurses. The most common challenge faced by them are:

1) The Changing Trends in Practice: From Hospital to Community

Shoaer hospital stays have increased the need for community based support
for people with both acute and long term illness. The acutely ill who are
discharged to &he community continue to need expert professional care and
intensive care. These changes in the environment of health care practices
have posed many challenges for nurses. Psychiatric nurses have to assume
a leadership role and work closely in community to provide and improve
access to mental health care services to the masses. Nursing training
emphasis needs to be on preparation of nurses who have the orientation and
have specialized training in providing community mental health care services,
home care services and extended health care services.

2) Need for Preparation of Nurses in Advanced Skills and Knowledge

Many nurses find that the job qualifications for positions they have
traditionally held now demand they acquire new skills and knowledge. The
hospitals need to be staffed with trained psychiatric nursing personnel.
Therefore, they must keep on updating their knowledge in the areas of
psychopharmacology, group interventions, evidence based therapies and
disease management. There has to be training of nurses for M Sc. Nursing
in psychiatric nursing. Every nurse working in the psychiatric ward should
have a Diploma in Psychiatric Nursing or some sort of relevant training.

3) Technological Changes
Mental health nurses must master computer technology and refine their
business and accounting skills. In this way, they can use new developments
in their environment to deliver better patient care.

4) Need for Quality Patient Care and Consumer Empowerment

The current environment demands psychiatric mental health care which is
high on quality and low on costs. Consumer empowerment has been an
emerging movement over the past decade. This makes it essential for nurses
to market their skills to ensure that they will be included among the mental
health care providers of the future. There standards of practice in the field
of psychiatric nursing need to be developed.

5) Skills Required for Working with Vulnerable At Risk Groups

Mental health nurses need to continue their commitment to working with the
underserved population, the elderly, children, adolescents and the seriously
mentally ill, because they have much to offer with regard to the care and
well being of these vulnerable groups. Whatever the environment; individuals,
families and communities will continue to experience significant mental health
problems. Thus, the need for psychiatric nurses to be competent
professionals will also exist.
Educational Programs for the Psychiatric Nurse

 Diploma in Psychiatric Nursing (The first program was offered in

1956 at NIMHANS, Bengaluru)
 MSc in Psychiatric Nursing (The first program was offered in
1976 at Rajkumari Amrit Kaur College of Nursing, New Delhi)
 Mphil in Psychiatric Nursing (1990, MG University, Kottayam)
 Doctorate in Psychiatric Nursing (offered at MAHE, Manipal; RAK
College of Nursing, Delhi; NIMHANS, Bengaluru, National
Consortium for PhD in Nursing under RGUHS, Karnataka, etc)

 Short term training programs for both the degree and diploma
holders in nursing

Standards of Mental Health Nursing

The development of standards for nursing practice is a beginning step

towards the attainment of quality nursing care. The adoption of
standards helps to clarify nurses areas of accountability, since the
standards provide the nurse, the health agency, other professionals,
patients, and the public, with a basis for evaluating practice. Standards
also define the nursing profession’s accountability to the public. These
standards are therefore a means for improving the quality of care for
mentally ill people.

Development of Code of Ethics

This is very important for a psychiatric nurse as she takes up

independent roles in Psychotherapy, behavior therapy, cognitive
therapy, individual therapy, group therapy, maintains patient’s
confidentiality, protects his rights and acts as patient’s advocate.

Legal Aspects in Psychiatric Nursing

Knowledge of the legal boundaries governing psychiatric nursing
practice is necessary to protect the public, the patient, and the nurse.
The practice of psychiatric nursing is influenced by law, particularly in
its concern for the rights of patients and the quality of care they
receive.

The patient’s right to refuse a particular treatment, protection from

confinement, intentional torts, informed consent, confidentiality, and
record keeping are a few legal issues in which the nurse has to
participate and gain quality knowledge.

Promotion of Research in Mental Health Nursing

The nurse contributes to nursing and the mental health field through
innovations in theory and practice and participation in research.

Cost-effective Nursing Care

Studies need to be conducted to find out the viability in terms of cost

involved in training a nurse and the quality of output in terms of
nursing care rendered by her.

Focus of Care

A psychiatric nurse has to focus care on certain target groups like the
elderly, children, women, youth, mentally retarded and chronic
mentally ill.
REFERENCES;-
Agarwal et a1 (2004), Mental Health An Indian Perspective, .1946-2003,
Directorate General of Health Services, Ministry of Health and Family
Welfare, New Delhi.

Kapoor, Bimla (2003), Reprint, Text Book of Psychiatric Nursing. Vol. 11.
Stuart, Gail W. and Laraia, Michele T. (2005), Principles and Practice of
Psychiatric Nursing, 8th edition, Missouri: Mosby.

Varcardis, Elizabeth (1998), Foundations of Psychiatric Mental Health

Nursing, 3rd edition, Philadelphia: W.B. Saunders Compan

Elsom, S. (2001). The active participants in Mental Health Services. In

Meadows, G. & Singh, B. (Ed.), Mental Health in Australia, Collaborative
Community Practice (pp. 136-162).

Melbourne: Oxford University Press.  Grigg, M. (2001) The role of the

psychiatric nurse. Australasian Psychiatry 9(2), 143-145. Peck, E. &
Norman, I. (1999). Working together in adult community mental health