Lecture Notes: Professional Practice and the Role of the Mental Health Nurse

Importance of Mental Health Nursing

• Skills from mental health nursing applicable across various patient care scenarios.
• Exposure to psychiatric conditions in various settings, not just mental health facilities.
• All nurses will encounter patients with mental health issues, e.g., due to underlying conditions or family behaviors.

Role of Psychiatric Mental Health Nurses

• General Responsibilities

  • Partner with individuals to achieve recovery goals.
  • Provide health promotion, patient education.
  • Conduct screenings, evaluations, triage, case management.
  • Administer and monitor treatments, crisis intervention.
  • Engage in therapeutic communication and care coordination.
  • Work within interdisciplinary teams.

• Advanced Practice Nurses

  • Registered nurses with a Master's or Doctorate in Nursing.
  • Prescribe medications, provide psychotherapy, and comprehensive assessments.
  • Perform procedures, interpret labs, make referrals.

Professional Organizations and Standards

• American Psychiatric Nurses Association (APNA)
  • Establishes standards for psychiatric mental health nursing.
  • Works with the American Nurses Association (ANA) for continuing education.

DSM-5 (Diagnostic and Statistical Manual of Mental Disorders)

• Published by the American Psychiatric Association.

• Used globally as a guide for diagnosing mental disorders.

• Purposes of DSM-5

  • Standardize nomenclature and language.
  • Define characteristics/symptoms for diagnoses.
  • Identify underlying causes of disorders.

• Contents for Each Disorder

  • Diagnostic classification and ICD-10 code for billing.
  • Criteria sets for diagnosis (symptoms and duration).
  • Descriptive text detailing features, prevalence, risk factors, etc.

Preventing Mental Health Disorders

• Protective Factors

  • Promote mental health, buffer against adverse effects.
  • Include problem-solving skills, resilience, positive relationships, family support.

• Risk Factors

  • Increase likelihood of mental health disorders.
  • Examples include trauma, brain chemistry, lack of support.

Health Promotion and Prevention Strategies

• Primary Prevention: Reduce risk factors; strengthen protective factors (e.g., substance abuse programs).
• Secondary Prevention: Early detection and prompt intervention (e.g., screening tools, crisis centers).
• Tertiary Prevention: Support recovery, prevent relapse (e.g., support groups, counseling).

Treatment Settings and Discharge Planning

• Inpatient Units

  • Rapid assessment and stabilization.
  • Short-stay for emergencies, long-stay for chronic needs.

• Partial Hospitalization Programs

  • Transition from inpatient to independent living.
  • Day/evening treatment focusing on communication, social skills, coping.

• Residential Settings

  • Community settings with varying structures and services (e.g., group homes, assisted living).

• Intensive Outpatient Programs

  • Structured, high-frequency treatment programs for substance use and co-occurring disorders.

Interdisciplinary Team in Mental Health Settings

• Key Roles
  • Pharmacist, psychiatrist, psychologist, psychiatric nurse.
  • Social worker, occupational therapist, recreational therapist.
  • Vocational rehab specialist, behavioral health tech.

APNA Phenomena of Concern for Mental Health Nurses

• Promote optimal mental and physical health.
• Monitor alterations in thinking, perceiving, and communicating.
• Address emotional stress, life changes, end-of-life events.
• Focus on client autonomy, safety, and treatment barriers.