Mental Health Mental Illness

By
Sandra Rondeau RN, DNP
 Mental health
1. “A state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity.”

2. State of well-being in which each individual is able to realize his or her own
potential, cope with the normal stresses of life, work productively, and make a
contribution to the community.

3. State of well-being in which each individual is able to realize his or her own
potential, cope with the normal stresses of life, work productively, and make a
contribution to the community.
4. Mental illness refers to all psychiatric disorders that have definable diagnoses
 Cont..
Mental disorders are manifested in significant dysfunctions related to:
developmental, biological, or psychological disturbances in mental
functioning
Mental Health Continuum
Risk factors and protective factors

 Individual attributes and behaviors- characteristics inborn and learned to

manage thoughts and feelings.
 Biological and genetic factors- ex prenatal exposure to drugs and ETOH,
individual attribute of resilience.
 Social and economic circumstances- affected by family, peer groups.
 Environmental factors-
 Perceptions of mental health and mental illness-
 Social influences on mental healthcare- decade of the brain, surgeon general
report on mental illness, the Human Genome Project, New Freedom
commission of mental health, Institute of Medicine
Risk factors and protective factors

 Quality and safety education for nurses- Patient centered care, teamwork and
collaboration, evidenced-based practice, quality improvement, safety,
informatics.
 Research- changes from the previous DSM-5 diagnosis based studies to
Research Domain Criterea which challenges researchers to seek causes for
mental disorders at the molecular level.
 Legislation and Mental Health Funding-mental health parity, Patient
Protection and Affordable Care Act.
 Epidemiology of Mental Disorders- incidence and prevalence.
 Nursing care is based on responses to illness. (treat the problems associated
with illness.
Psychiatric-mental health nursing

 Develop new skills for dealing with a variety of behaviors.

 Work with individuals, couples, families, and groups in every nursing setting.
 Focus of psychiatric-mental health nursing as “promoting mental health
through the assessment, diagnosis, and treatment of human responses to
mental health problems and psychiatric disorders”
 “A nursing diagnosis- is a clinical judgment concerning a human response to
health conditions/life processes, or vulnerability for that response by an
individual, family, group, or community” (Herdman & Kamitsuru, 2014, p. 25).
 The NIC (Bulechek et al., 2013) defines a nursing intervention as “any
treatment, based upon clinical judgment and knowledge, that a nurse
performs to enhance patient/client outcomes”
Psychiatric-mental health nursing

 Basic level registered nurses- professionals whom completed a nursing

program, passed the state licensure examination, and are qualified to work in
most any general or specialty area.
 RN-BC- after 2 years and 2,000 clinical hours in a psychiatric setting and 30
hours of continuing education in psychiatric nursing and competence in an
examination by the American Nurses Credentialing Center (the credentialing
arm of the ANA).
 Advanced Practice- psychiatric-mental health advanced practice registered
nurse (PMH-APRN) is a licensed registered nurse with a Master of Science in
Nursing (MSN) or Doctor of Nursing Practice (DNP) in psychiatric nursing
Future issues for Psychiatric-mental
health nurses
 Educational challenges- caring for more acutely ill patients, decreased
clinical sites for student nurses.
 Aging population-with increased dementia issues.
 Cultural diversity-requiring increased cultural competence.
 Science, technology and electronic healthcare-Telepsychiatry through audio
and visual media.
 Advocacy and legislative involvement- patient advocacy
1. When providing respectful, appropriate nursing
care, how should the nurse identify the patient and
his or her observable characteristics?

 a. The manic patient in room 234

 b. The patient in room 234 is a manic

 c. The patient in room 234 is possibly a manic

 d. The patient in room 234 is displaying manic behavior

2. Which statement made by a patient
demonstrates a healthy degree of
resilience? Select all that apply.

 a. “I try to remember not to take other people’s bad moods personally.”

 b. “I know that if I get really mad I’ll end up being depressed.”

 c. “I really feel that sometimes bad things are meant to happen.”

 d. “I’ve learned to calm down before trying to defend my opinions.”

 e. “I know that discussing issues with my boss would help me get my point
across.”
3. Which statement demonstrates the nurse’s
understanding of the effect of environmental factors
on a patient’s mental health?
 a. “I’ll need to assess how the patient’s family views mental illness.”

 b. “There is a history of depression in the patient’s extended family.”

 c. “I’m not familiar with the patient’s Japanese’s cultural view on suicide.”

 d. “The patient’s ability to pay for mental health services needs to be

assessed.”
4. When considering stigmatization, which statement
made by the nurse demonstrates a need for
immediate intervention by the nurse manager?

 a. “Depression seems to be a real problem among the teenage population.”

 b. “My experience has been that the Irish have a problem with alcohol use.”

 c. “Women are at greater risk for developing suicidal thoughts then acting on
them.”

 d. “We’ve admitted several military veterans with posttraumatic stress

disorder this month.”
5. Which of the following activities would be
considered nursing care and appropriate to be
performed by a basic level nurse for a patient
suffering from mental illness?

 a. Treating major depression

 b. Teaching coping skills for a specific family dynamic

 c. Conducting psychotherapy

 d. Prescribing antidepressant medication