Principles of Mental Health Nursing

A specialty branch of nursing that provides services to individuals with primary health needs related to mental, emotional, and developmental problems, especially serious disorders and persistent disabilities.
Focuses on the maintenance, promotion, and restoration of optimal mental health for individuals, families, community groups, and society.

Carer: employs psychotherapeutic intervention to perform effective psychiatric nursing care safely, legally, and ethically.
Care co-ordinator: works in partnership with the healthcare team, client, families, caregivers, and the community to prevent illness, promote, and protect mental health.
Manager: demonstrates effective managerial, supervision, and leadership skills in mental health nursing practice.
Researcher: applies knowledge and skills in nursing research to improve nursing and healthcare practices.
Nursing professional: maintains own physical, mental, and emotional well-being, develops, and maintains nursing as a profession.

Provide counseling for problem-solving of patients.
Assess the patient's mental status and level of functioning.
Provide training on self-care activities to encourage independence.
Carry out crisis intervention during the acute stage of mental illness.
Administer medication with relevant teaching and observation.
Supervise colleagues and supporting staff in patient care in clinical settings.
Provide health teaching and health promotion programs to improve patients' health.

Mental Health Nursing emphasizes the therapeutic nurse-patient relationship, which can help patients develop a positive attitude about managing their health, boost satisfaction with the service, and maximize the effectiveness of psychosocial interventions.
Therapeutic communication involves transmitting and interpreting verbal and nonverbal messages and may include counseling techniques.
The communication becomes therapeutic when the nurse listens, facilitates a goal-directed conversation, and guides the patient's communication in a helpful and comforting form.

Involves managing the patient's surroundings as therapeutic as possible for the patient.
Comprises principles related to an environment promoting mental health and desired behaviors.
Elements of milieu therapy include:
- Utilizing every component of the physical and social environment to promote therapeutic change.
- Acknowledging the milieu as a therapeutic strategy for mental illness.
- Using the milieu as a context for learning and practicing adaptive behavior.

Patients with mental illness have complicated health conditions that reduce their wellness and quality of life.
Complicated health conditions include:
- Lower life expectancy.
- Increased risk of cardiovascular disease.
- Comorbid psychiatric conditions.
- Poor diet, poor sleep, and higher consumption of alcohol.
Mental health nursing needs a holistic wellness approach to care for patients with psychiatric illnesses to maximize their response to treatment and improve overall health outcomes.
Murphy-Moller wellness model illustrates five major wellness domains:
- Biological Domain: focuses on a person's overall health, including exercise, nutrition, rest, and good health practices.
- Psychological Domain: focuses on the attitudes and behaviors of a person, including enjoying life, managing wellness, and being responsible for one's own behavior.
- Sociological Domain: focuses on environment and relationships, including enjoying nature, having resources and residence, and having interpersonal relationships.
- Cultural Domain: focuses on how individuals organize themselves socially, including customs, language, and values.
- Spiritual Domain: focuses on meaning and purpose in patients' lives, including positive attitude, embracing truth, and developing hope and forgiveness.

Safety: involves patients, family, and staff, and may be threatened by self-harm, use of restraint and seclusion, psychiatric medications, fall risk, and other factors.
Treatment Adherence: involves facilitating good adherence to treatment, which can be affected by financial considerations, medication side effects, illness denial, and other factors.
Trauma-Informed Care (TIC): aims to prevent re-traumatization and symptom exacerbation for traumatized patients and to facilitate their participation in treatment, regardless of the traumatic experience.

Suffering is the condition of bearing pain or distress, which can have emotional, spiritual, and psychological impacts.
Identifying psychiatric patients' suffering is more complex than identifying a patient with apparent physical symptoms.
Suffering from mental illness influences more than the individual experience, and can disrupt connections and interactions with significant others.
Patients' relatives or original social networks may ostracize them, worsening their level of distress.
The nurse can foster increased resilience and alleviate patients' suffering by promoting positive changes, such as improvement in interpersonal strength, increased connectedness in relationships, and greater appreciation of life.