Psychiatric Nursing: Theory, Principles, and Trends Chapter 1: Psychiatric Nursing: Theory, Principles, and Trends Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Role of the Licensed PMH Nurse Determined at local, state, and national levels To collaborate with other core mental health disciplines including psychiatry, psychology, social work, and marriage and family therapy

Core Mental Health Licensed Disciplines Psychiatric Mental Health Nursing Psychiatry Psychology Psychiatric Social Work Marriage and Family Therapy (Designated by the U.S. Department of Health and Human Services)

The U.S. Department of Health and Human Services Designate mental health licensed disciplines to professionally serve the nation in the promotion of mental health, the prevention and treatment of mental disorders, and the restoration of health.

Universal Agreement An integral part of total health An inseparable component of overall health, welfare, and safety Quality of life, effective daily functioning, and overall perception of well-being are closely linked to sound mental health (New Freedom Commission on Mental Health, 2003; World Health Organization, 2002; National Institutes of Medicine, 2006)

Psychiatric Mental Health Nursing Defines patients as individuals, families, communities, and organizations Is an art and a science, and involves the use of principles and theories from varied sources

Fundamental Objectives Promotion and protection of mental health Prevention of mental disorders The treatment of mental disorders Recovery and rehabilitation

Levels of Prevention Primary - helps reduce the incidence Secondary - helps reduce the prevalence Tertiary - helps reduce the residual effects of the disorder and promotes rehabilitation

Figure 1-2 Comprehensive care model for psychiatric mental health nursing.

Mental Health Basic right of all, regardless of race, age, gender, or socioeconomic status Basic for functioning, productivity, and general well-being

Mental Health, cont’d Healthy individuals live productive, creative, and satisfying lives; experience relatively low internal and external stress; Are cognitively, emotionally, physically, and behaviorally stable; have realistic perceptions; Have ordered thought patterns and feelings of overall well being; are able to function autonomously and in harmonious relationships with others.

Mental Disorder Defies simple definition Identified by the patient’s response to the disorder Manifestations are specific for each disorder Some examples include impaired perception; cognition, mood, affect, behavior, or a combination of some or all of these.

Mental Health Care Reform Patient Protection and Affordable Act Health Care and Education Reconciliation Act Institute of Medicine (IOM) and the Future of Nursing

Recommendations for Nursing Nurses to practice to the full extent of their education and training; Seek and achieve higher levels of education in improved systems; Partner fully with physicians and other health care professionals to redesign health care; Function within effective information infrastructures and data collection.

Global Burden of Disease Psychiatric disorders are significant burden in terms of human suffering and economic and social costs Unipolar depression ranks second among all other noninfectious health-related causes by the year 2020

Figure 1-3 Approximately 26 Figure 1-3 Approximately 26.2% of the adult population of the United States has a diagnosable mental disorder; 9% to 13% are seriously mentally ill. (From Kessler R et al: Prevalence, severity, comorbidity of 12-month survey replication, Arch Gen Psychiatr 6:617-627, 2005.)

Social Stigma Disgrace of the shame of mental illness May experience exclusion, rejection, alienation, overt and covert ridicule, exploitation, and sometimes even violence. Labeling Victims of bias