PPT of Videbeck's Mental Health Nursing 3rd Edition

1. PowerPoint Presentation to
Accompany Videbeck’s Psychiatric
Mental Health Nursing
Third Edition

2. Chapter 1
Foundations of Psychiatric
Mental Health Nursing

3. Mental Health
• WHO definition: state of complete
physical, mental, and social wellness, not
merely absence of disease or infirmity
• State of emotional, psychological, and
social wellness evidenced by:
– satisfying interpersonal relationships
– effective behavior and coping
– a positive self-concept
– emotional stability

4. Factors Influencing a Person’s Mental Health
• Individual factors:
– biologic makeup, autonomy and independence, self-
esteem, capacity for growth, vitality, ability to find
meaning in life, emotional resilience or hardiness, a sense
of belonging, reality orientation, and coping or stress
management abilities
• Interpersonal factors:
– effective communication, ability to help others, intimacy,
and a balance of separateness and connectedness
• Social/cultural factors:
– a sense of community, access to adequate resources,
intolerance of violence, support of diversity among people,
mastery of the environment, and a positive, yet realistic,
view of one’s world

5. Mental Illness
•Historically viewed as possession by
demons, punishment for religious or
social transgressions, weakness of will
or spirit, and violation of social norms
•Today seen as a medical problem,
although some stigma from previous
beliefs remains

6. Mental Illness (cont’d)
•Mental disorder is “a clinically
significant behavioral or psychological
syndrome or pattern that occurs in an
individual and that is associated with
distress or disability or with a
significantly increased risk of suffering
death, pain, disability, or an important
loss of freedom” (American
Psychological Association [APA])

7. The DSM-V-TR is a taxonomy published by
APA and is used by all mental health
professionals. It describes all
mental disorders according to
specific diagnostic criteria.
The DSM-V-TR is based on
a multiaxial classification
system:
Diagnostic and Statistical Manual of
Mental Disorders, 5th edition, Text
Revision

8. ► Axis I: all major psychiatric disorders
except mental retardation and
personality disorders
► Axis II: mental retardation,
personality disorders, maladaptive
personality features, and defense
mechanisms
► Axis III: current medical conditions

9. ►Axis IV: psychosocial and
environmental problems, including
problems with primary support group,
social environment, education,
occupation, housing, economics,
access to health care, legal system
►Axis V: Global Assessment of
Functioning (GAF) score

10. Historical Perspective
•Ancient times: sickness represented
displeasure of the gods, punishment
for wrongdoing; treatments included
starving, urging, bloodletting
•Period of Enlightenment (1790s) saw
the creation of asylums or safe havens
to offer protection
•Sigmund Freud and others studied
mental disorders scientifically by the
1900s

11. Historical Perspective (cont’d)
•Psychotropic drugs first available in
1950
•Deinstitutionalization began with the
Community Mental Health Centers Act
of 1963

12. Mental Illness in the 21st Century
•56 million Americans have a mental
illness (DHHS, 2002)
•Hospital stays shorter, but more
numerous: revolving door
•Increased aggression among mentally
ill clients
•An increased number of people with
mental illness are incarcerated

13. Mental Illness in the 21st Century (cont’d)
•Homeless population of persons with
mental illness, including substance
abuse, is growing
•Most health care dollars still spent on
inpatient psychiatric care; community
services not adequately funded
•Healthy People 2010 mental health
objectives strive to improve care of
mentally ill persons

14. Mental Illness in the 21st Century (cont’d)
•Community-based care includes
community support services, housing,
case management, residential services
outside the hospital (see Chap. 4)
•Cost containment efforts include
utilization review, HMOs, managed
care, case management
• Cultural considerations: diversity
increasing in U.S. in terms of ethnicity
and changing family structures

15. Psychiatric Nursing Practice
• Psychiatric nursing practice emerged in
1873 when Linda Richards said, “The
mentally sick should be at least as well
cared for as the physically sick”
• 1882 was first formal training of nurses in
mental health
• First psychiatric textbook in 1920
• This is a relatively new field in
comparison with other areas

16. Psychiatric Nursing Practice (cont’d)
•Standards of Psychiatric-Mental Health
Clinical Nursing Practice developed in
1973, revised in 1982, 1994, 2000
•Psychiatric Mental Health Nursing
Phenomena of Concern: 12 areas of
concern that mental health nurses
focus on when caring for clients

17. Student Concerns
• Saying the wrong thing
• What student will be doing
• Fear of no one talking to student
• Bizarre or inappropriate behavior
• Physical safety
• Seeing someone known to the student

18. Self-Awareness Issues
• Everyone has values, beliefs, ideas;
nurses need to know what theirs are,
not to change them, but to prevent
unknown or undue influence on their
nursing practice
•Hints to increase self-awareness: keep
a journal, talk to trusted coworkers,
examine points of view other than
one’s own