Care of Clients with

Maladaptive Patterns of
Behavior
Introductory Concept
Objectives:
1. Define psychiatric-mental health nursing, mental health and
mental illness.
2. Discuss the evolution of mental health-psychiatric nursing
practice.
3. Identify the factors that influence mental health.
4. Appreciate the roles of psychiatric nurses.
5. Describe the qualities of a psychiatric nurse.
6. Discuss how to deal with some student concerns in dealing with
mentally-ill patients.
Definition of Terms

• Psychiatric-mental health nursing – involves the

diagnosis and treatment of human responses to
actual or potential mental health problems
Mental Health – is a positive state in which one is responsible,
displays self-awareness, is self-directive, is reasonably worry
free, and can cope with usual daily tensions

• the ability to solve problems; fulfill one’s capacity for love and
work; cope with crises without assistance beyond the support
of family or friends; and maintain a state of well-being by
enjoying life, setting goals and realistic limits, and becoming
independent, interdependent, or dependent as the need
arises without permanently losing one’s independence.
 Mental Illness

• an illness or syndrome with

psychological or behavioral
manifestations and/or
impairment in functioning
as a result of a social,
psychological, genetic,
physical/chemical, or
biologic disturbance.
Evolution of mental health-psychiatric nursing
practice
• Historically, mental illness was viewed as demonic possession, sin,
weakness, and people were punished accordingly.
• Period of enlightenment and creation of mental institutions (1970s)
• Asylum
• Insane asylum
• Sigmund Freud and treatment of mental disorders
• Sigmund Freud (1856-1939) – view human beings objectively
• Emil Kraepelin (1856-1926) – classification of mental disorders based on
symptoms
• Eugene Bleuler (1857-1939) - schizophrenia
• Development of psychopharmacology
• Chlorpromazine (Thorazine) – antipsychotic
• Lithium (antimanic)
• Benzodiazepines
• Move toward community mental health (1963)
• Deinstitutionalization – A deliberate shift from institutional care in state
hospitals to community facilities
Factors Influencing Mental Health
1. Individual or personal factors - biologic makeup , autonomy and
independence, self esteem, capacity for growth, vitality, ability to find
meaning in life, emotional resilience or hardness, sense of belonging,
reality orientation, and coping or stress management abilities
2. Interpersonal or relationship factors - effective communication,
ability to help others, intimacy, and a balance of separateness and
connectedness
3. Social/cultural or environmental factors - a sense of community,
access to adequate resources, intolerance of violence, support of
diversity among people, mastery of the environment , and a positive,
yet realistic, view of one's world
Roles of Psychiatric Nurses
QUALITIES OF A PSYCHIATRIC NURSE
• Self-awareness
• Self-acceptance
• Accepting the patient
• Being sincerely interested in patient care
• Being available
• Empathizing with the patient
• Reliability
• Professionalism
• Accountability
• The ability to think critically
Student Concerns
• What if I say the wrong thing?
• What will I be doing?
• What if no one will talk to me?
• Am I prying when I ask personal questions?
• How will I handle bizarre or inappropriate behavior?
• What happens if a client asks me for a date or displays sexually aggressive or
inappropriate behavior?
• Is my physical safety in jeopardy?
• What if I encounter someone I know being treated in the unit?
• What if I recognize that I share similar problems or backgrounds with clients?
The End