VIJAYAM'S MENTAL HEALTH NURSING

Contagious Spreading from one person to other.

Crisis :Atime of intense difficulty, trouble or danger.
A chronic or persistent disorder of the mental process caused by
brain
Dementia
diseases.
Distress :It is an aversive state in which a person is unable to adopt completely
to stressors which result in stress showing maladaptive behaviour.
Ethics :Moral principles that govern a person's behaviour or conduct of
an
activity.
psychological state of someone who is functioning at a satistactory
Mental Health The evel of emotional and behavioural adjustment.
Mental lllness :Any disease of the mind, the psychological state of someone who has
motional or behavioural problems serious enough to require psychiatric
emotior
intervention.
Obsessions :A compulsive, often unreasonable idea or emotion (or) Unwanted ideas.
Optimistic :Hopeful and confident about the future.
Perinatal care :Being the period around child birth.

In
Phobia Irrational fear of something.
It is an act of Restoring to its original state after disease.
Rehabilitation
Schizophrenia h.
ong-term mental disorder of a type involving a breakdown in the
relation between thought, emotion and behaviour, leading to faulty
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thinking.
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Self-esteem A feeling of pride in oneself.

Sympathetic : Feeling, showing or expressing sympathy.
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Violence Behaviour involving physical force intended to hurt, damage or kil some
one or something.
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of mind, wider knowledge concentration, charity,

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1.1. CONCEPT OF MENTAL self-control, sacrifice, uprightness, freedom from

HEALTH AND MENTAL pride" etc. In Bhagvad Gita, itself Lord Krishna
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ILLNESS emphasized on harmonious relation among

individuals which leads to sound mental health
Mental health is an integral part of public and adjustment.
health and is as important as physical health to All definitions say that a healthy individual is
the overall well-being of individuals, communities not only physically healthy but is also mentally
and societies. Indeed it has been said that there healthy. Mental health is an integral part
is no health without mental health and every one component of the total health.
has mental health needs.
Meftal Health:
In our Indian culture, various works are
Mentally healthy individual in all aspects
quoted as saying saying that purity and divinity
enjoys changes in life. He will take it as a
are the two main characteristics of mentally
challenge, thereby he will shine in a socially
healthy individual. In Bhagvad Gita also the
manner. It is an active quality of
nature of God is described as "fearless, purityeltective
individual's daily living.

1.2
 Unit-1: Introduction VIJAYAM'S

People who can carry out their roles in Definition:

society and whose behaviour is appropriate and 1. Mental illness occurs when a state of
adaptive are viewed as healthy. Mental health physical, mental, social, spiritual well-being
is a dynamic or ever changing state. is disturbed. In illness the individual shows
symptoms like depression, feeling ofanxiety,
Generally a person's behaviour can provide
physical complaints without any organic
clues to his or her mental health. In majority of
cause and sudden change in behaviour or
cases, mental health is a state of emotional, - By Dr. Bimla Kapo0or
mood.
psychological and social wellness evidenced by
behavioural disorders are
satisfying interpersonal relationships, cffective2Mental illness and
behaviour, coping, positive selfconcept and understood as clinically significant conditions
emotional stability. characterized by alterations in thinking, mood
(emotions) or behaviour associated with
Defipition: personal distress and impaired functioning/
s
XMental health is defined 'an adjustment
-
By WHO (2001)

In
bf human beings to the world and to each
other with a maximum of effectiveness and Concept of Mental Health (Normality) and
happiness'- By Karl Menninger (1947) Mental h.
llness (Abnormality):
The term "Normal" is derived from the
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2. The capacity of an individual to form
harmonious relationships with others and to word "norma" which means a
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participate in or contribute constrictively to Carpenter" square or rule. A norm

changes, in social environment therfore became a rule, pattern or
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standard.
- By WHO (1950)
*The term "Abnormal" with its prefix "ab"
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3. Mental health is defined as 'a dynamic state (away from) thus came to signify the
in which feeling and behaviour that is age deviance or variation from the normal.
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appropriate and congruent with the local and Concept of mental health and mental
- By Robinson (1983)
cultural norms illness is based on:
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Mental llness:
A clinically significant behavioural of Normality
psychological syndrome or pattern that occurs and Abnormality
Criteria
in a person and that is associated with present
distress (eg. a painful symptom) or disability
(eg. impairment in one or more important areas
of functioning), or with a significantly increased Based Based on
on Model Characteristics
risk of suffering death, pain, disability or an
important loss of freedom. and is not merely an
expectable and culturally sanctioned response
to a particular event (e.g. the death of a loved
one). Fig.1.1

1.3
 MENTAL HEALTH NURSING
VIJAYAM'S

I. NORMALITY AND ABNORMALITY CRITERIA

I. Normality and Abnormality Criteria

Criteria
A. Descriptive Criteria B. Explanatory

Adjustment 3. Psychological
1.Statistical 2. Non-statistical 1. Pathological 2.
Criterion Criterion
Criteria Criteria Criterion
(Medical)

a. Ethical b. Criteria c. Criteria for d. Legal

(or) for Social ideal (or) Criterion

In
Moral Conformity Perfection
Criteria

Fig.1.2 h.
la
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A. DESCRIPTIVE CRITERIA b. Criteria for social conformity:

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It indicates the types of behaviour Those who conform to societal norms

considered normal and abnormal. are considered normal and those who
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do not care for them are labelled

1. Statistical Criteria: "Average" criterian
abnormal
is normal.
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*Aperson is abnormal when he (or) she c. Criteria of ideal or perfection:

deviates from the "Average". e.g. Normal behaviour is equated with
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Average height and weight. perfect or ideal behaviour. Others are

called Abnormal behaviour.
Criteria of statistical view:
Any deviation from the average d. Legal Criterion: A law-abiding citizen
is normal but the one who violates the
All deviants from one another in some
dimensions. law is labelled abnormal.
is based on quantity and quality of B. EXPLANATORY CRITERIA
*It
individual. These are concerned with assumed
2. Non-statistical Criteria: process underlying abnormal behaviour, with
a. Ethical (or) Moral Criteria: For the way in which abnormal behaviour ditters
being taken as normal, the behaviour from normal behaviour.
should be appropriate and desirable 1. Pathological or Medical Criterion: It
from the view point of ethics (or) is based upon a behaviour
that depends
normality.

1.4
Unit-1:: Introduction
VIJAYAM'S
on functioning ofthe nervous system.
In According to Maslow (1970), mental
this way all abnormal people are
affected health individnals possessed the following
with some mental illness or discase.
characteristics:
2. Psychological Criterion: Psychological
functioning, whether dcfective *An appropriate perception ofreality.
or normal,
* The ability to accept oneself, others, and
is deciding factor of abnormal
/ normal
bchaviour-Higher mental functioning- human naturc.
according to environment. *The ability to manifest spontaneity.
3. Adjustment Criterion: A person is said The capacity for focusing concentration
to be normal or abnormal to the extent he nproblem solving.
feels adjusted or maladjusted with his
self *A need for detachment and desire for
and his environment. The normal people
privacy
always integrate or adjust their needs,
motives, interests and other cognitive
* Independence, autonomy.
aspects but abnormal people do not

In
*An intensity ofemotionalreaction.
integrate.
An identification ofhumankind.
The Criteia for Mental Health: h.
Satisfactory interpersonal relationships.
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Marie Jahoda (1958) has identified a list
*Strong sense of ethics.
of 6 indicators that she suggests are a
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Creativity.
reflection of mental health.
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* Apositive attitude towards self

*
II. BASED ONMODEL
Growth, Development and the ability to
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achieve self-actualization (according to Concepts of Mental Health (or)

age). Normality: There are several models for
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understanding what "normality" is.

Integration.
Models:
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*Autonomy.
1. Medical Model: Normal mental health
Perception of Reality. is conceptualized as absence of disease
Environmental mastery. or psycho pathology.

Physical
No Causative Factor Causative Factor
Social

No Disorder Disease/ Disorders

"Normalcy" "Abnormalcy"

Fig.1.3

1.5
 MENTAL HEALTH NURSING
VIJAYAM'S

2. Statistical Model: Statistically normal 7. Continuum Model: Normality and

mental hcalth falls within 2 standard abnormality as falling at the two ends of
disparate
deviations (SDs) of the normal distribution a continuum, rather than being
curve. entities.
3. Utopian Model: In this model, the focus
in defining normality is on "Optimal
Optimum Severe
Functioning".

Normalcyy Abnormalcy Abnormalcy

Normalcy Border line
Mentally healthy Mentally lllness
Fig.1.66
Optimum function Unsatisfied with his work

Maximum outcome Minimum outcome Other Conceptsof Normalcy:

In
Reality orientation.
Success/ Satisfaction Conflict/ Unsuccess
Self- awareness and self knowledge.
Fig.1.4
h.
*Slef -
-

esteem and self - acceptance.

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Ability to exercise voluntary control over
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4. Subjecetive Model: (Individual) It is behaviour.

absence of disability or distress or help-
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*Ability to form affectionate relationships.

seeking behaviour. Individual is not
affected by any disturbance through any *Pursuance of productive, goal - directive
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causes. activities.
5. Social Model: Normalcy believes that
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normal person is expected to behave in a Il1. BASED ON CHARACTERISTICS

socially permissive behaviour.
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6. Process Model: Normalcy as a dynamic

Characteristics of Normalcy:
and changing process rather than as a 1. Sociability: Here, an individual who
static concept. Along with this combined conforms to the traditions, modes of
with any other model mentioned here. accepted behaviour, forms and function
which prevail in the social environment
Normalcy called nom.
2. Healthy, Security and Balance: Mental

Should not
health is a normal state of well - being,
Should be
that is a positive but relative quality life.
Static
The normal individuals make conscious
Dynamic and
Changing process or unconscious efforts to maintain that
social, cconomic, physical and
Fig.1.5 psychological health, as well as security.

1.6
Unit-1:: Introduction VIJAYAM'S

3. Balance and Fulfillment of Needs: The

quality of the normal being is complete
fulfillment of his needs, which makes for
balance and strength that retain a
balanced outlook.
Characteristics of mentally_healthy
individual:/
Has ability to make adjustment.
2He solves his problems.

3. Has sense of personal worth, feels worth

and important.

4Has a philosophy of living.

5 Develop a capacity to tolerate

In
frustrations.
6: Shows emotional maturity. h.
la
-Enjoyment of play, leisure and spare time Fig.1.7 Characterstics of mentally
activities.
Healthy individual
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8. A well-adjusted person or a mentally

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healthy person can get along with other

people. Characteristics of Mentally ill
Individuals:
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9. Finds satisfaction and fulfillment in

exercising and expanding his potential. Abnormal means 'away from the normal'.
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The terms used in abnormality will include:

10.He feels secure in a group and shows
1. Abnormal as deviation from societal
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understanding of other people's problems

and motives. norms.
2. Abnormal as maladaptive.
HThe person shows emotional maturity in
his behaviour. 3. Abnormal behaviour.

12.The person has a variety of interests and 4. Maladaptive behaviour.

generally lives a well - balanced life of
5. Emotional disturbance.
work, rest and recreation.
6. Behavioural problems.
3The person is able to think for
himself
and can make his/her own decisions.
14Ability to accept criticism or blame.

1.7
 MENTAL HEALTH NURSING
VIJAYAM'S

In
Fig.1.8 Characteristics of Mentally ill individual

h.
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FACTORS INFLUENCING MENTAL HEALTH
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Nutrition
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Play
Perinatal care
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Happy home/ Parenting

Good Community services
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Factors influencing Adequate school

Mental Health
Early Prevention
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Treatment of Physical illness

Life Style
Right man for rightjob
Marital relationships

Fig.1.9

1. Nutrition: Balanced nutrition is important for the growth and development of an individual
eg.Vitamin deficiencies enhance personality problems. A sick person may have problems of
adjustment.
2. Play: When the children given the chance to play in thejr peer group of their mental health will
be promoted.

1.8
 Unit-1: Introduction VIJAYAM'S

3. Perinatal care: If women are not properly with a feeling of physical well-being
facing the consequences, if they have not ordinarily enjoys a good position and is
accepted Motherhood adequately and if their enthusiastic and intellectually alert.
married life has not been too happy, there is
9. Life Style: The individual who follows a
a
risk of developing psychopathological"
reactions. hygienic regimen, pertaining to food, drink,
elimination, bathing, physical activity, work,
Happy Home/Parenting: If a Good home slecp, rest, relaxation, prevention of disease
or harmonious relationship between parents, and correction of defects is more likely to
Then parents understand the needs and have good mental health.
interests of their children and if there is an
10.Right Man for Right Job: According to the
atmosphere of happiness and freedom, it
qualification and the technical training a
contributes greatly to the mental health of
person has to be placed in his working
every member in family. eg. A mother who
environment, otherwise he will develop
gives affection and security to herchildren-
frustration and mental stress causes mental
contributes to their mental health, whereas a

In
illness/adjustment problems.
mother who is nervous, tense or self -

practices with children lays the foundations h.

centered and has over protective disciplinary 11.Marital Relationships: Healthy marital
relationships will promote mental health. Good
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ofill health. interaction among husband and wife, good
understanding among them will promote
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5. Good Community Services: Healthy

mental health.
community services provide healthy
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atmosphere to the society. It promotes mental 12.Inter-caste and Inter-Religious

health, prevents mental illness and Marriages: They promote the extend of their
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rehabilitative chronic mental illness. love and affection towards the both family
members more over they will be free from
6. Adequate School: School is a positive factor
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their community fixations.

in the development of sound mental health.
It provides a curriculum, enriched by 13.Guidance and Counselling: In order to
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activities, meeting the needs and interests of promote the mental health of the individuals
people. they can be given the guidance and
counselling in the colleges and schools.
7. Early Prevention: Prevention is better than Consultation at a critical period of growth
cure. Early prevention equals to health
and development may have a lasting effect
promotion. If in the early stage of life good
on the student's attitude toward mental
personal care, and treatment for the particular
health and illness.
disease like fever, neurological disease etc.,
are provided, it prevents severe mental illness. 14.Interpersonal Relationship with Society:
Social environment provider the knowledge,
8. Treatment of Physical Ilness: Persons
the skills, interest, attitudes, habits, values and
suffering from serious physical detects may
goals. So, social functioning promotes mental
have problems of adjustment on account of
health ofindividuals.
inferiority feeling which they have not been
able to deal with adequately. An individual

1.9
VIJAYAM'S MENTAL HEALTH NURSING

Other factors influencing a person's mental | Individual Factors dre:

health: makeup.
*Biological
in life.
*Sense of harmony
Individual Vitality.
Factors
to find meaning in life.
Ability
'Emotionalnegligence.
Spirituality.
Interpersonal Factors:
Factors
Effective communication.
Influencing Ability to help others.
Mental Health
*Intimacy and a balance of separateness.
Socio-cultural Factors:
Sense of community.
Access of adequate resources.
Intolerance of violence.

In
Fig.1.10

FACTORS INFLUENCING MENTAL ILLNESS

h.
la
al

Factors influencing mental illness

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Biological Psychological Socio-cultural

es

Factors Factors Factors

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Genetic illness Maternal deprivation Poverty

Constitutional factors Rejection by parent Unemployment
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Physical deprivation Over Protection Insecurity

*
Biochemical factors Strict discipline Migration
Brain damage Abnormal behaviour in Severe Competitions
Physiological factors adolescent Urbanization
Stress Alcoholism
Prostitution
Broken home

Fig.1.11

I. BIOLOGICAL FACTORS
1. Genetic Factors: Chromosomal increase or decrease may affect the development offetus.
e.g. Mongolism, Down's syndrome.
2. Constitutional Factors: Constitutional factors include physique, physical handicaped and
stress. e.g. Physical handicaps like blindness, deafness afect theself of an individual, as
these are stress situations for the adjustment.

1.10
 Unit-1 :: Introduction
VIJAYAM'Ss
3. Physical Deprivation: Severe malnutri-
matter (or) other personal problems
tion affects the physical and mental and they will fcel comfortable.
growth of the infant. e.g. They are more
*Ifparent-child relationship is not there,
prone to get many types of infection, MR
it may lead to develop abnormal
and mental depression. behaviour.
4. Biochemical Factors: Biochemical1 7. Stress: Failure in studics, job, adjusting to
abnormalities in the brain are considered
martial lifc, loss of money or status, death
to be the cause of some psychological
of a significant person ctc.
disorder. e.g. Marked decrease in
serotonin leads to depression. I. SOCIAL-CULTURAL FACTORS
5. Brain Damage: Any damage of the
*Poverty: Poor socio-cconomic status.
structure and functioning of the brain can Unemployment: Lack ofjob opportunity.
give rise to mental illness. e.g. infections, *Insecurity: Lack ofsecurity for life.
vascular problems (poor blood supply or Severe competitions: In studies, to get
bleeding), injury, tumors, intoxication, job.

In
degeneration, anoxia. Migration: Shifting from one place to
6. Physiological Factors: Stress can another place.
precipitate mental illness in individuals.
e.g. Pregnancy, child birth, menopause,
h.
*Urbanization: Shifting from village to
town.
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puberty. * Alcoholism: Alcohal
addiction.
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*Prostitiution: Failure of husband-wife

I1. PSYCHOLOGICAL FACTORS bounding.
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1. Maternal Deprivation: Broken home: Lack of support from

*Mothering separation of the child from family.
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mother affect the growth of the child. Others:

*The warmth of a mother passes onto *Predisposing factor.
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the child by touching, kissing or Precipitating factor.

hugging. *Primary factor.
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2. Rejection by Parents: It may cause Predisposing Factors:

feelings of anxiety, insecurity low self *These occur before the onset of the
esteem. disease or before psychopathology has
3. Over Protection by Parent: It may lead appeared.
to submissiveness, low self-evaluation *For example, rejection by parent is in the
during of his intellectual abilities. early age of the child but the disease may
4. Lack of Discipline: It results in come at the age of 16 to 18 or 30 to 40.
aggressiveness, antisocial behaviour. Precipitating Factors:
5. Strict Discipline: It may produce fear, *These are events that occur shortly
lack of friendly feeling towards others before the onset of disorder and appear
6. Abnormal Behaviour in Adolescent: to have induced it.
*During adolescence: Child shares his *For example, death of the father of an
feelings with their parents like studies adolescent boy may lead him into
depression.

1.11
 MENTAL HEALTH NURSING
VIJAYAM'S

Primary Factors:
*It is the condition without which the disorder would not have occured.
For example, in a head injury the primary causc.

1.2SCONCEPTIONS RELATED TO MENTAL ILLNESS

INTRODUCTION
Beliefs about mental illness have been characterized by süperstition, ignorance and fear. Althou
though
timeadvancesin scientific understanding ofmentalillness have dispelled many 1alse1deas, there
ipiO
Temaina number of popularmisconceptions, and some ofthemare:

In
Mentally ill
Mentally ill people
People
show bizarre
behaviour
h.
are unstable
and dangerous
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Mentally ill is
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Mental something to
illness is be ashamed
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contagious
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Mentallyill
Misconception iscaused by
of Mentally supernatural
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power or it is a
Marriage ill people result of course
can cure or possession
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mental illness of evil spirits

Mental illness
is something
Mental
that cannot
illness is Mental
be cured
hereditary hospitals are places
where only dangerousS
mentally ll individuals
are treated with
restraint as a major
approach
1

Fig.1.12

1.12
 Unit-1: Introduction VIJAYAM'SS

cMental ilness is somethingthat cannot be

cured: People assume that mental illness is
not curable and once it is attacked, it is a
life-longillness.
Mental hospitals are places where only
dangerous mentally ill individuals are
CMTWAY treated with restraint: People hesitate to
take their relatives to mental hospitals for
treatment because of fear. Further, an ex-
patient of a mental hospital as well as his
family members are often isolated.
Therefore, people seek help from mental
hospitals only as a last resort.

Fig.1.13
Mental ilness is hereditary: It is not a rule
that children of mentally ill patients should

In
Misconceptions of mentaly ill become mentally ill.

entally ill people show bizarre h.

8. Marriage can cure mental illness: A
mentally ill person can get worse if he gets
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behaviour: Patients in mental hospitals and married when he is ill, as marriage can
clinics are often picturized as a weird lot. become an additional stress. A patient who
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Most of patients may exhibit useless has recovered can get married and live a
bizzare behaviour like fwisting of hands normal life like any other person.
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variety postures, shouting. AA

Mental illness is contagious: The fear that
Mentally ill people are unstable and, it is contagious is the main false notion which
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dangerous: People always have a belief that leads people to view suspiciously, or object
mentally ill people harm others and are to marital relations with a person belonging
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unstable, changing their mood quickly. to the household of the mentally ill.
Mental illness issomething to be ashamed:
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People used to think that mental illness is a

very dangerous disease and it's shameful
L3PRINCIPLES OF MENTAL
their family and society will not acceptthem HEALTH NURSING
KMental illness is caused by supernatural
power forces provoked or unprovoked byi
patients, or it is a result of course
or_ INTRODUCTION

possession of evil spirits: Many people In Nursing field psychiatric Nursing attained
Consider that mental illness is not an illness,
|

specialized area. It's medical speciality.

a

but possession by spirit of the dead. Experts study the abnormal behaviour of the
individuals, its causes, manifestations, treatment
Another opinoion is that it is due curse
that is befallen on the patient or family and rehabilitation and prevention of mental illness.
because of past sins (or) misdeds in
previous life or evil spirits, black magic,
influence of bad stars.

1.13
 MENTAL HEALTH NURSING
VIJAYAMwS

DEFINITION OF MENTAL HEALTH NURSING:

combination of seience and art
PsychiatriC nursing is a "specialized area of nursing practice,
by employing theories of human behaviour applied in the
diagnosis and treatment or human respor
"Lalitha
to actual or potential mental health programme".

PRINCIPLES OF MH AND PSYCHIATRIC NURSING

respect as an individual
Principle focused on the specified utilization of client and treats him with
human being.
as well as physically ill
The principles are general which are applicable to mentally ill patients
where his illness is usually associated with emotional disturbance to some degree.
These principles are based on the concept that eachindividual has an intrinsie Worth and dignity
and he has potentiality to grow.

In
Accept the patient exactly as he is

h.
Use self understanding as therapeutic tool
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Use consistent behaviour to increase patient's emotional security
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Give reassurance to patient in subtle and acceptable manner

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Change patient's behaviour through emotional experience and

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not by rational inter pretation

Avoid unnecessary increase in patient's anxiety

Principles ofMental
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Health Nursing Demonstrate objective observation to understand and interpret

the meaning of patient's behaviour
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Maintain realistic nurse patient relationship

Avoid physical and verbal force as much as possible

Provide nursing care to the patient as a person and not on

control of symptoms of the disease that he has

Explain routines and procedure at patient's level of understanding

Many procedures are modified but basic principles

remain unaltered

Fig.1.14

1.14
Unit-1:: Introduction VIJAYAM'S

1. Accept the patient exactly cas he is: If| vi. Permit patient to express strongly-held
we accept paticnt as hc is, he fecls he is feelings: Alow the paticnt to cxpress his
lovcd and cared, emotional neutral, find strong feclings without disapproval (or)
unlearning of his sick behaviour is less punishment. e.g. Fecling's of anxicty,
threatening, art of living with himself and fcar, hostility, anger.
others. 2. Use self understanding as therapeutie
How to accept the patient: tool: Ifonc understands about sclt, it is casy
Be Non-judgemental to understand others. Understanding other's
i. and non-
punitive: fcclings or act, knowing why they are
behaving like that is vital.
We shouldn'tjudge the patient as good
(or) bad, right or wrong based on his We can understand ourselves better by:
bchaviour. Expressing our feclings frecly and frankly
shouldn't punish for undcsired with colleagucs.
We
behaviour. *Discussing our personal reaction with

In
experienced persons.
c.g.
*Participating in group conferences
Direct punishment: Chaining,
restraining, locking in a room.
h.
regarding our patient care.
la
Introspecting on why we feel (or) act the
Indirect punishment: Ignorning or
.way we do.
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withdrawing his importance.
3. Use consistent behaviour to increase
ii. Show interest in the patient as aperson:
patient's emotional security: Consistency
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e.g in our approach is to develop patient feeling

Observing patient's behaviour. to depend on others. Consistency must
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Spend time with patient reflect our attitudes, ward routine and
defining the limitation placed on patient.
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*Knowpatient likes and dislikes

Consistency could be demonstrated:
listening to him.
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Patient to be constantly and continuously

ii. Recognize and Reflect patient feelings exposed to an quietatmosphere
expressed: Nurse should develop skill in
identifying the feelings actually expressed Consistency to be maintained from nurse
*

by the patient. e.g. Patient may express to nurse and shift to shift to be preplanned.
that "I am a dead person". Here nurse Patient is allowed to feel as he does but
should identify patient's feeling worthless. limitations are put on his behaviour.
iv. Talk with a purpose: Always talk with | 4. Give reassurance to patients in subtle
patients based on his needs, wants and and acceptable manner:
interest. *Reassurance helps patients to build
V. Listen: Listening is one of the best confidence or Restoring his confidence.
communication skills. Through this we To reassure patient we need to know past
can identify patient's feelings, inner experiences of the patient and how it
thought and ideas. appears to them.

1.15
VIJAYAM'S MENTAL HEALTH NURSING

Donot give false assurances to the patient 6. Avoid unnecessary increase in patient's
like"you will get well soon, you are a nice anxiety:
person, nothing to worry, you can marry'. *Anxiety is a feeling of fear for an
unknown object or event.
Reassure patient by following manner:
* Psychiatry patients already have some
Be truely interested in patient's problem. amount of anxiety due to their illness.
*Pay attention. Psychiatry nurse should not further
Accept and be aware how patient really increase the patient's anxiety by:
feels. Demanding the patient to complete the
set task, which he defenitely cannot
Accept patient's silence when he is not
meet.
interested to talk.
Making him to face repeated failure.
Provide patient with acceptable outlet of Using big sentences and professional
anxiety. terms talking with him.
5. Change patient's behaviour through Showing nurse's own anxiety.

In
emotional experience and not by 7. Demonstrate objective observation to
rational inter-pretation: understand and interpret the meaning
*In psychiatry we focus on the Patient's h.
of patient's behaviour:
*Objectivity is an ability to evaluate exactly
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feeling aspect rather than intellectual
what patient wants to say. Nurse should
aspect.
not mix up her own feelings, opinions or
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Telling and advising patient is ineffective judgements.

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in changing behaviour. Nurse should observe what the patient

To create emotional experiences in says and does. After that she needs to
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patient about his own behaviour, we can analyse it to draw motivation to his task
use role play, socio drama and or action.
Some indications for nurses when nurses
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transactional analysis.
lack their objectivity:
Understanding cannot be forced, as insight
N

and understanding of one's own behaviour *Justifyingherself.

is painful. Interpretation is only done when *To treat the patients certainly.
Evaluating patient's behaviour ofright (or)
patient is ready for it.
wrong.

8. Maintain realistic nurse-patient relationship:

Not on
Inter Personal Process Based on
Nurses need Nurse Patient Patients need

Professional relationsne

Fig.1.15

1.16
 Unit-1: Introduction VIJAYAM'S
*Nurse, patient realistic (or) protessional 10. Provide nursing care to the patient as
relationship focus upon the profession and a person and not on control of
emotional needs of patient and not on symptoms of the diseuse that he hus:
nurses need.
*Every bchaviour depends on cause, so
Such relationships are therapeutically first understand meaning behind his
oriented and planned and always based behaviour.
on patient's needs. Two paticnts showing the same symptoms
*It is a inter personal process. may be expressing two different needs.
e.g. In two patients, one can have
9. Avoid physical and verbal force as much
headache bccause of slccplessness and
as possible: of
other may have because
Any kind of force applied on patient results hypoglycemia.
in psychalogical trauma.
*Consider every patient as unique and
e.g. Physical force: Restraining the prepare nursing care plan depending an

In
violent patient to cot. basic cause.
*Depressed patient welcomes punishment 11.Explain routines and procedure at
(or) scolding as he is suffering from guilt h.
patient's level of understanding:
*Before doing any procedure, explain it to
la
(or) having done a mistake.
patient based on his level of understanding
While applyingforee on patient, following
al

to reduce anxiety.
points are kept in mind:
*Don't withheld explanation to psychiatric
W

Carry out procedure quickly, firmly, patient thinking that they are mad (or) no
efficiently with adequate help. contact with reality. It is their right to
es

Don't show anger on him know what's happening to them.

12.Many procedures are modified but
ot

* Attend his needs as usual

basic principles remain unaltered:
Once patient is controlled and
N

approachable, don't remind him again Many methods can be adopted but basic
about the incidence. scientific principle behind that should
remain the same.

Nursing Principles

Safety Comfort Privacy Therapeutic Economy of

effectiveness time, energy
and material

Fig.1.16

1.17
VIJAYAM'S MENTAL HEALTH NURSING

e.g. Suspicious patient may refuse oral praxia: Inability to carry out normal
tablets. In such cases same medication activities despite intact motor function.
can be changed into parental method (or) Autistic Thinking: Preoccupationstotally
disolved in fruitjuice but scientific principle removinga person from reality.
should remain the same.
*
Automatic Obedience: The patient
obeys every command though he has been
told not to do so.
1DEFINITION OF TERMS USED *Automatism: Undirected behaviour that
IN PSYCHIATRY consciously controlled as seen in
is not
complex partial seizures.

DEFINITION OF TERMS USED IN Avolition: Lack ofmotivation or inability

PSYCHIATRY
to initiate tasks e.g. social contacts,
grooming other aspects of ADL
Abreaction: A treatment procedure (Activities of Daily Living) usually present

In
whereby repressed painful experiences in schizophrenia.
voluntarily recalled to awareness. This
ventilation gives a therapeutic effect. h.
Battering: Is a harmful or offensive
touching of another person.
la
Abstract Thinking: Ability to appreciate
*Bipolar (mood) affective disorder
nuances of meaning, multidimensional
al

(BPAD): This disorder earlier known as

thinking with ability to use hypothesis
anic depressive psychosis (MDP) is
W

approximately.
Tcharacterized by recurrent episodes of
Addiction: Strong dependence, both mania and depression in the same patient
es

physically and emotionally on alcohol or at different times.

some other material.
*BluntedAffect:Areduction in emotional
ot

Affect: Ashort-lived emotional response experience.

N

to an idea or an event.
Bulimia: The uncontrolled ingestion of
Agitation: Presence of anxiety with large amount of food (binge eating)
severe motor restlessness. followed by inappropriate compensatory
Ambivalence: The co-existence of two methods to prevent weight gain and for
opposing, desires, feeling or emotion maintaining body shape.
towards the same person, object, a goal Cataplexy: Temporary loss of muscle.
not to do favour to dears. tone and weakness precipitated by a
*
Amnesia: Pathological impairment of variety of emotional states.
memory. *Catharsis: The expression of ideas,
Anhedonia: Inability to experience thoughts and supressed material
pleasure in any activity. accompanied by an appropriate emotional
response that produces a state of relief
*Apathy: Lack of emotional feeling.
in the patient.

1.18
 VIJAYAM'Ss
Unit-1:: Introduction
Circumstantiality: Digression into attention, pcrception, thinking, memory,
unnecessary details that distract from the psychomotor behaviour, emotion and the
central theme, however, the patient sleep-wake cyclc.
returns back to the original theme after Delusion: False belicfnot true to fact and
digression. not ordinarily accepted by other member's
on
Compulsion: Pathological necd to act explanation.
an impulse that, if resisted, produces Primary Delusion: It is one that
anxiety, repetitive behaviour in response appears suddenly and with full
to an obsession or performed according conviction, but without any previous
to certain rules, with no truc end in itself events leading upto it. Such delusions
other than to prevent something from are suggestive of schizophrenia.
occurring in the future (the patient fears
Secondary Delusion: It can be
something bad will occur in future if he
understood as derived from some
does not indulge in such behaviour).
preceding morbid experience.
Concrete Thinking: Thought processes

In
Delusional Mood: Occasionally when a
are focused on specifies rather than
generalizations. These individuals are person first develops a delusion, the first
unable to comprehend abstract meanings. h.
experience in a change of mood, often a
feeling of anxiety with the foreboding that
la
Confabulation: The unconscious filling some event is about to take place and the
of memory by imagined or untrue
al

delusion follows. In German this change

experiences due to memory impairment.
of mood is called wahnstimmung, a term
W

It is most often associated with organic

usually translated as delusional mood.
pathology.
Delusional Perception: In some
es

Catatonia: of psychologically
A state
occasions when a person first develops a
induced immobilization at times delusion, the first change may be attaching
ot

interrupted by episodes of extreme

agitation. It is seen in schizophrenia.
new significance to a familiar percept
without one reason. For example, a new
N

Conversion: The transference of a arrangement of objects on a colleague's

mental conflict into a physical symptom desk may be interpreted as a sign that
to release tension or anxiety. the patient has been chanced to do god's
Crisis: A situation in which customary work. This is called delusional perception.
problem solving or decision making *Delusion of Granduer: An individual's
methods are not adequate. exaggerated conception of his
Cyclothymic: Swings of mood (or) importance, power or identify, abeliefthat
elation and depression. he is somebody special, or is born witha
*Delirium: An etiologically non-specific special mission in life, or is related to the
syndrome characterized by concurrent most important people of his time.
disturbances of consciousness
and

1.19
 MENTAL HEALTH NURSING
VIJAYAM'S
A belicf that *Depersonalization: Experience of
Delusion of Persection:
harassed, spied, unrealness, feelings of separation,
he is being attacked, isolation, unreality, loss of feelings and
cheated or conspired against.
personal identity.
It is the
Delusion of Reference:
dclusions-that cvents, object, behaviour of Derealization: A level of consciousness
in which a person is unaware of
the
others have got a particular or unusual
significance for onc-self, usually of a position of sclf in relation to find
surrounding or other persons.
negative nature. For instancc, the person
may falsely believe that others are talking Dissociation: The act of separating and
about him (such as the belicf that people detaching a strong emotionally charged
on television or radio are talking about the conflict from one's consciousness.
person). Dysthymia: A state of chronic low-level
Delusion of Control: This refers to the depression lasting for more than two
belief that the patient will, thought or years that may lead to more severe

In
feelings are being controlled by external depression, if untreated.
forces. Effect: Absence or near absence
Delusion of Infidelity (or) Delusion of
*

h.
Flat
of any sign ofaffective expression,
monotonous face immobile.
voice,
la
Jealousy: This is the delusion that one's
own (or) wife is unfaithful to him.
Flight ofldeas: The client's thoughts and
al

*Delusion of Guilt: Belief that one is a conversation move quickly from one topic
sinner and is responsible for the ruin of
W

to another so that one train of thought is

his family or society. not completed before another appears.
es

Somatic Delusion: Belief involving Flight of ideas are commonly seen in

functioning of the body e.g. belief that the mania.
a psychological
ot

brain is rotating or melting. *Functional: Having

Nihilistic Delusion: The delusional belief rather than an organic pathology
N

that others, one-self or the world, do not Fugue: Dissociative fugue is

exist. Most commonly seen in major characterized by episodes of wandering
depressive episode. away (usually from home).
Dementia: Diffuse brain dysfunctions Echolalia: Pathological repetition by
characterized by a gradual progressive imitation of the speech of another.
and chronic deterioration of intellectual
function,judgement, orientation, memory, Echopraxia: Pathological repetition by
imitation of the behaviour or action of
affect or emotional stability, cognition and
another.
attention.
*Denial: Unconscious refusal to face *Egocentric:Self-centered, preoccupied
thought, feeling, wishes, needs or reality with one's own needs and lacking interest
factors that are consciously intolerable. in others.

1.20
Unit-1: Introduction VIJAYAM' s
*Ego-dystonic: Denoting aspeccts of a *Tactile (or) Somatic lallucination:
person's thoughts, impulses, and behaviour False sensation of things occurring in
or
that are felt to be repugnant, distressing, to the body, most often visceral in origin.
unacceptable, or inconsistent with the self *Ilypochondriasis: Exaggerated concern
coception. with one's physical health, not based on
Grandiosity: A person's exaggerated organic pathology.
conception of his or her importance, *lIysteria: Characterized by many
power of identity, grandiose delusions, also
somatic symptoms that cannot be
referred to as mega lo mania, are present explained adequately on the basis of
with the client believes he or she posseses physical and laborating examination.
unrecognized talent or insight, or have
Ideas of Reference: Incorrect interaction
made an important discovering.
of incidents and external events as having
Grief: Grief is a normal appropriate a particular or special meaning specific
emotional response to an external and that a person, Ideas of reference are held
consciously-recognized loss. Grief is a
by people who are unduly self-conscious.

In
normal, common, necessary reaction to
lusions: Misinterpretation of external
the loss ofa beloved, individual or object
stimuli. Most likely to occur when the
to which a person is emotionally attached.
Hallucination: A false sensory
h.
general level of sensory stimulation is
la
reduced. Also more likely to occur when
perception in the absence of an actual
the level of consciousness is deduced e.g.
external stimulus. Hallucination may be
al

acute organic syndrome.

described in terms of their sensory
*Inpulsiveness: Emotional instability and
W

modality as visual, auditory, olfactory,

gustatory, tactile. lack of impulse control seen in personality
disorder
es

*Auditory Hallucinations:False
perception of sound usually voices, but *Labile: Means moving from point of point
or unstable. This term is more associated
ot

also other noises which are quite clear.

The voices give instructions to some with affect in which are rapid and abrupt
N

patients who may or may not feel obliged changes in emotional feeling tone
to carry them out. Some may even givea unrelated to external stimuli.
running commentary on his actions. Libido: Freud defines libido as "that force
Visual Hallucination: False perception by which sexual instinct is represented in
involving sight consisting of both formed the mind".
images (for example, people) and The ID holds the individual's instincts
unformed images, most common in and drives for pleasure, and these instincts
medically determined disorders. provide energy for the personality. This
*0lfactory Hallucination: False energy is called libido, the energy with
perception of smell most common in which sexual instincts function in all
medical disorders. phases of life.
Gustatory Hallucination: False
perception of touch or surface sensation
* Malingering: Delibarate stimulation or
exaggeration of an illness or disability that
as from an amputated limb.
in fact is non-existent or minor.

1.21
 MENTAL HEALTH NURSINGG
VIJAYAM'S

Manipulation:A behaviour patterr *Perseveration: Persistent repctition of

characterized by exploitation of words or themes beyond the point of
interpersonal contact, indiscriminate use relevancc.
of intepersonal relationship to mect onc's Pseudodementia: Similar clinically to
own end without any consideration for the dementia but has a non-organic cause and
other person in the relationship. irreversible.
*Mannerism: Ingrained, habitual *Psychometry: The science oftesting and
involuntarymovement, measuring mental and psychological
Narcissism: Obsessive and exclusive ability, efficiency, potentials and
interest in onc's own sel. functioning

*Narcoanalysis: A procedure by which a *Psychopathology: The study of

chemical is injected into a person which significant causes and processes in the
encourages him to ventilate the development ofmental disorders.
unconscious desires and motives which Stupor: A state in which the individual

In
he cannot recollect during conscious does not reach to his surrounding and
state. It is therapeutic and diagnostic
procedure commonly used in neurotic h.
appears to be unaware of them.
Commonly seen in a catatonic and
la
disorders. depressive disorders.
Negativism: Motiveless resistance to all Tungentiality: A form of thinking/speech
al
*

attempts to be moved or to all instnctions. in which the client tends to wander away
W

Neologism: A word newly coined or an from the intended point and never
everyday word used in a special way, not returning to the original idea.
es

readily understood by others. For *Thought Insertion: Subject experiences

example, Head shoe for hat (or) cap. thoughts imposed by some external force
ot

Obsession: Pathological persistance of on his passive mind.

an irresistible thought or feeling that Thought Withdrawal: Thoughts cease
N

cannot be eliminated from consciousness and subject experiences them as removed

by logical effort, associated with anxicty. by external forces.
Puranoid: An adjective applied to Trance: A sleep-like state of reduced
individuals who are oversuspiciou.
consciousness and suggestibility.
Para-Suicide: Any act deliberately *Verbigeration: Senseless repetition of
undertaken by one person which mimics
Some words or phrases over and over
the act of suicide, but which does not result
again.
in a fatal outcome.
Waxy Flexibility: Parts of body can be
Phobia: Persistent, irrational, placed in positions that will be maintained
exaggerated and invariably pathological
for long periods of time, even if very
dread of specific stimulus or situation,
uncomfortable flexible like wax. The end
results in a compelling desire to avoid the
result is called catalepsy.
feared stimulus.

1.22
 VIJAYAM'S
Unit-1: Introduction

1.5 EW OF DEFENSE MECHANISMS v

psychiatricnursing
Defense

In
MechaniSmS la
h.
Fig.1.17 Defense Mechanisms
al
DEFINITION:

When psychological equilibrium is threatened by severe emotional trauma, frustrations or conflicts,

W

themind resorts to a variety of protective subterfuge and detours called mental mechanism.
es

unconsciously.
An Intrapsychic process which provides relief from conflict and anxiety, operates
- VMD Namboodri, 2005
ot
N

Varied
effots
and
activities
Defense
Mechanisms
A Goal

Obstacles
An individual blocking the goal
Process of adjustment nr2

Fig.1.18 Use of Defence Mechanism

S1.23
 MENTAL HEALTH NURSING
VIJAYAM'S
MENTAL MECHANISMS ARE:7Sublimation: Certain impulses like sexual,
THE DIFFERENT because of
for maternal aggression and others
JeCompensation: To offset or make up direct
their social impliçations denywomen
some fecling of inadequacy,
whether real
engage in impression. e.g. (Unmarried
or imagined, many individuals interested in children may give
expression
various forms of compensatory activity. e.g. internal urges by engaging
totheir expressed
When an individual is unable to spcak
in orphanage work.
English, can speak Hindi language. acquire
others for their 8. Identifications: It is possible to
2Projcction: Blaming personal qualities by identifying
oneselfwith
difficulties. Others are seen as responsible objects. By doing
mistakes and appropriate individuals and
for one's own shortcomings, individual indirectly gratifies his
wish
responsible so an
misdeeds; and others are seen as like
thoughts for superiority. e.g. Eamous persons
for one's unacceptable impulses,
eg{ A student who fails in hi singers, actors, politicians etc.)
and desires.
exams may feel that the teacher was unfair 9. Withdrawal: Fear of
failure or criticism,

In
experiences, is
Rationalization: It is the substitutions of based on unfortunate earlier
3 common cause for timidity,
exclusiveness,
acceptable reasons for the real or actual
reasons motivating behaviour. e.g. If a
h.
and other forms of retract.
who is going to run for marathon
e.g. A student
may be
la
person does not get a job while others are
selected in an interiew, he may rationale that withdrawn because he doesn't have energy
al

the interviewer did not spend enough tim and it is even hard for him to win.
with him to get impression of his strength.. 10:Negativism: Stubborness and general
W

ARepression: Through repression, an negative attitude are frequently retaliatory

individual forces certain feelings orthoughts
es

reactions against unfair or discriminatory

into his unconscious mind. e.g.{A student treatment. e.g. A girl who is always blamed
who is caught for her malpractice by the and punished for the mischief of other
ot

examination hall writing her

invigilator in the children may acquire the habit of not
experience terribly
N

exams may find the responding to her parents and gradually may
excludes it fromm
painful as she become negativistic to the authority.
consciousness and becomes amnesic with
regard to the guilty experience. TFantasy: Fantasy is a process of gratifying
frustrated desires by imaginary
SaRegression: A return to an earlier stage of achievements. e.g. |If a person is
life or a earlier level of development to overwhelmed by the prëssure of a task he
retreating in response to stress. e.8/An
has undertaken, he may imagine the
individual fixated at the oral stage might
competition of the task and the feelings of
begin eating or might become very verbally
satisfaction and pride he will experience at
aggressive as a means of escape. its competition.
bDisplacement: It is the transfer of an
emotion to a mental object or idea. Unable12:Reaction Formation: Preventing
to express anger to boss for fear of being
unacceptable or undesirable thoughts or
fired displaces anger into others (spouse, behaviours from being expressed by
pet). exaggesating opposites thought or type of

1.24
 VIJAYAM'S
Unit-1: Introduction
behaviour. e.g{ Woman angry at boss and
wanting to quit becomes overly kind and
generous towards bOSs and expresses desire
to keep working
there. Our
SUndoing:Symbolically negating or Team
cancelling out an experience that one finds
intolerable. e.g.Joes-is nervous about his
new job and yells at his wife. On his way
home he stops and buys her some flowers Fig.1.19 Mental Health Team
and buys himself a new video game
14.Sublimation: Rechannelling of drives or
impulses that are personally or socially Skills required for effective team wark:
unacceptable into activities that are Interpersonal skills.
constructive. e.g-lA mother whose son was
Tolerance

In
killed by a drunken driver channels her anger
persistently against drunken drivers. Patience
5Antrojection: Integrating the betiefs and h.
Understanding
la
values of another individual into one's own Humanity
ego structure. e.g{ Children integrate their
al

parent's value system into the process of - Warmth

conscience formation, a child says ,to a
W

Acceptance
friend. Don't cheat its wrong.)
Empathy
es

Non-judgemental attitude
ot

Knowledge
MENTAL HEALTH TEAM
1.6
N

Mental disorders
Symptomns-
INTRODUCTION
Behaviour
Team never fails'means,team work gets
success for any team" Team work skills

Team wokmeans the combined, coordinated Collaborating

and dedicated effort of eachand every member Sharing
in the team.
Integrating
To achieve targated goal ofteammembers)
Communication skills
Tocomplete steps of assessment, diagnosis,
treatment and rehabilitation ofmentally ill patient
there is a need of good team.

1.25
 MENTAL HEALTH NURSING
VIJAYAM'S

Members of the Mental Health Team

Psychiatric Psychiatric
Psychiatrist Psychiatric Registered Clinical para
Nurse Psychologist social worker
Nurse professionals
clinical specialist

Aids
Psychiatric Nursing
ECT Technician
Auxiliary personal
Occupational Therapist
Recreational Therapies
Diversional play Therapies
Creative art therapist

In
Clergyman

Fig.1.20 h.
la
Psychiatrist: 2. Psychiatrie nurse clinical specialist:
al
1.
Education and Experience: M.Sc (N), Post
Education and Experience: PG in
graduate research work.
W

psychiatry with 2-3 year of residence

Responsibilities:
training, 2 years of clinical practice and
es

* Primary, secondary, tertiary prevention of

completion of an examination.
Responsibilities: Accountable for: mental disorders.
ot

* Provide individual, family, group psycho

Mental Disorders: therapy.
N

i Diagnosis *Participate research work/ activity.

i. Treatment *Administering and monitoring
ii. Prevention medications.
* Prescribes as leader in the mental * Physical training.
health team. Participating in inter disciplinary team
meetings.
Functions as leader in the mental
health team. *Maintain patient records.
3 Clinical Psychalogist
Admission of patient
Administering ECT Education and Experience:
Doctoral degree in clinical psychology
Conducting individual and family
therapy
Registered with the clinicalpsychalogist's.
association.

1.26
 Unit-1:: Introduction VIJAYAM'SS

Responsibilities: Psychiatric para workers:

Conduct psychalogical, diagnostictests. i. Psychiatric Nursing aid:
Interpret and evaluate the findings oftest. *Have high school training and trained
Implement a behavioural modification on job.
programme. *Maintain therapeutic environment and
*Participates in research activity. provide under supervision.
Gives family, individual, group, marital i. ECT Techniciun:
psycho therapies. *Undergotraining for 6-9 months.
4Psychiatric Social Worker: Keep ready ECT machine and
Education and Experience: Graduate in articles.
social work Give ECT under supervision of
*

PG (post graduate) in psychiatric social psychiatrist or anaesthetist.

work. ii. Auxillary Personal:
Responsibilities: *Voluntary house keepers or Clerical

In
Assess individual, fämilysupport system. staff.
*Helps in dischargeplanning.
Counselling forjob placement.
h.
*Requires Inservice education to
interact with patient therapeutically.
la
Skilled in interview technique and group
iv. Occupational Therapiest:
al

dynamics.
* Undergo specialized training.
* Uses manual and creative techniques
Conducts group therapy sessions.
W

to assess the inter personal response

5. Registered nurse: of the patient.
Education and Experience: B.Sc (N)
es

degree (or) GNM, PcBsc, diploma in Improves patients functional ability.

psychiatric nursing, diploma in administration. * Works for early recovery and
ot

rehabilitation of patient.
Responsibilities:
. Recreational Therapiest:
N

Care of mentally ill patients.

Holistic care by assessing patients mental, Bachelor degree or persons with
experience fulfulling this role.
social, physical, psychological and
spiritual needs. Plan activities to stimulate patient's
Making nursing diagnosis, formulating muscle co-ordination, interpersonal
evaluating, rendering appropriate nursing relationship and socialization.
care. *Encourage patient to participate in
*Update her knowledge participating in play activities.
continuing education, in service education, vi. Diversional Therapiest:
workshops and open university course Makes observation of patient during8

*Evaluate effectiveness of Medical play behaviour.

Treatment. *Observes client type of toy selection,
reaction to the toy.
*Divert client mood.

1.27
 MENTAL HEALTH NURSING

VIJAYAM'S
vii. Creative Art Therapiest:
Graduate through colours.
feelings
Encourage patients to express their
vii. Clergy Man:
Religious person. patients,
week andhas spiritual talk with the
Comes to hospital once a
in

Overview
to the world ana to each
other with
adjustment of human beings
Mental health: Is an

In
maximum happiness. well-being is
illness: Ocuurs when a siate of physical, mental, social, spiritual
Mental
disturbed. h.
Mentally healthy person is able to make adjustment,
able to solve his problems, matured
la
and feels satisfied himself.
al

emotionally disturbed, donot follow

Mentally ill persons show maladaptive behaviour,
others.
societal norm and feel dissatisfied thermselves and
W

believed that mental ilness is not a curable

In the previous days or olden days people
disease and feel ashamed of it, if affected any one of their
family members, but now a
es

Treatment of mental
days due to scientific advancement people ready to come out for
illness, but still it required more awarness about mental illness.
ot

follow
Mental health nursing is a specialized area of Nursing practice. So, it needs to
N

and
some principles like accepting patient, understanding self, emotional security
reassurance etc.
Nurse should be well-versed about the use of terms in psychiatry
severe
Defense mechanisms are used like tool to control or balance equilibrium of
emotional disturbances. Commonly used defense mechanisms are denail, repression,
projection etc.
Team work never fails. So, we need to prove it in psychiatry. Many members play
various roles to fulfill elient needs in mental health

1.28