The document provides an overview of mental health and mental illness. It defines mental health as having positive self-esteem, growth, autonomy, realistic perceptions, and environmental mastery. Mental illness is characterized by disturbances in thinking, mood, and behavior that impair functioning. The document discusses components and indicators of mental health, characteristics of mentally healthy and ill individuals, the magnitude of mental health problems in India, misconceptions about mental illness, and the roles of mental health professionals and nurses.

1. INTRODUCTIONTOMENTALHEALTH
NURSING
Ms. DEEPALI GUPTA
FACULTY
JAMIA HAMDARD

2. ComponentsofMentalHealth
The
ability to
accept
self The
capacity
to feel
right
towards
others
The
ability to
fulfill life's
tasks
Rational
thinking
Learning
and
productivi
ty
Self-
awarenes
s
Effective
communi
cation

3. IndicatorsofMentalHealth
Jahoda (1958) has identified six indicators of mental health
which include:
1. A positive attitude towards self :This includes an objective
view of self, including knowledge and acceptance of strengths
and limitations. The individual feels a strong sense of personal
identity and security within the environment.
2. Growth, development and the ability for self actualization
This indicator correlates with whether the individual successfully
achieves the tasks associated with each level of development.
3. Integration Integration includes the ability to adaptively
respond to the environment and the development of a
philosophy of life, both of which help the individual maintain
anxiety at a manageable level in response to stressful situations

4. Cont.
4.Autonomy Refers to the individual's ability to
perform, in an independent self-directed manner; the
individual makes choices and accepts responsibility
for the outcomes.
5.Perception of reality This includes perception of the
environment without distortion, as well as the capacity
for empathy and social sensitivity- a respect and
concern for the wants and needs of others.
6. Environmental mastery This indicator suggests that
the individual has achieved a satisfactory role within
the group, society or environment. He is able to love
and accept the love of others.

5. CharacteristicsofaMentallyHealthyPerson
He shows emotional maturity in his
behavior, and develops a capacity to
tolerate frustration and disappointments
in his daily life.
• He has developed a philosophy of life
that gives meaning and purpose to his
daily activities.
• He has a variety of interests and
generally lives a well-balanced life of
work, rest and recreation.

6. CharacteristicsofaMentallyHealthyPerson
He has an ability to make adjustments.
• He solves his problems largely by his
own effort and makes his own decisions.
• He has a sense of responsibility.
• He can give and accept love

7. CharacteristicsofaMentallyHealthyPerson
He lives in a world of reality rather than
fantasy.
• He shows emotional maturity in his
behavior, and develops a capacity to
tolerate frustration and disappointments
in his daily life.
• He has developed a philosophy of life
that gives meaning and purpose to his
daily activities.

8. Definition
Mental and behavioral
disorders are understood
as clinically significant
conditions characterized
by alterations in thinking,
mood (emotions) or
behavior associated with
personal distress and/ or
impaired functioning.
(WHO, 2001)

9. CharacteristicsofMentalIllness
Changes in one's thinking, memory,
perception, feeling and judgment
resulting in changes in talk and
behavior which appear to be deviant
from previous personality or from
the norms of community These
changes in behavior cause distress
and suffering to the individual or
others or both
Changes and the consequent
distress cause disturbance in
day-to-day activities,work and
relationship with important others
(social and vocational
dysfunction).

10. Features of Mental Illness
Disturbances
in bodily
functions
Disturbances
in mental
functions
Changes in
individual and
social activities
Somatic
complaints

11. CONCEPTS OF NORMALAND
ABNORMAL BEHAVIOR
Medical Model:
Abnormal behavior is
caused by an underlying
disease that affects
neurochemicals in
addition to socio-
environmental factors.
Treatment of the
abnormal behavior
focuses on addressing
the underlying disease.
Nursing Model: A
holistic approach is used
to care for the person.
The nurse develops a
therapeutic relationship
with the person that
focuses on the person’s
bio psychosocial needs.
Nursing interventions are
determined by the
person’s reaction to the
therapeutic relationship
with the nurse.

12. Social Model:
Abnormal behavior is
defined by the patient’s
sociocultural
environment. A behavior
may be acceptable in
one society and
considered abnormal in
another society.
Communication
Model: The meaning of
behavior is dependent
on successful
communication.
Abnormal behavior
occurs when
communication is
clouded. Normal
behavior occurs when
communication is clear.
Degrees in clarity in
communication explain
degrees of abnormal
behavior.
Cont.

13. Cont.
Behavior Model
Behavior that is
adaptive, is normal,
maladaptive is
abnormal. Abnormal
behavior is a set of
faulty behaviors
acquired through
learning.
Psychoanalytic Model:
Freud proposed five
stages of
psychosexual
childhood development
(oral, anal, phallic,
latency, and genital).
Disruption in
psychosexual
childhood development
results in deviated
behavior as an adult.

14. Humanistic Model
Humanistic Model: Maslow’s Hierarchy identifies five
levels of need. A person needs to meet lower level
needs before striving for higher level needs.
Self-actualization: Acceptance of facts, problem
solving, morality, creativity
Esteem: Confidence, self-esteem, respects for
others and respected by others, achievement
Love/Belonging: Sexual intimacy, friendship,
family
Safety: Health, security, morality
Physiologic: Food, sleep, sex, water, excretion

16. Cont.
Existential Model: A
person should be in
contact with their
emotions and needs
based on current
experience. A person
focused on past
experiences may
become self-
alienated and is
likely to display
abnormal behavior.
Interpersonal Model:
A person’s behavior
is governed by the
desire to be satisfied
and to avoid anxiety.
The nurse‘s
therapeutic
relationship with the
patient develops
trust that is used to
satisfy the patient’s
needs.

17. MAGNITUDE OF THE PROBLEM IN
INDIA
The prevalence of psychiatric disorders is 58.2 per thousand which means that
there are about 5.7 crore people suffering from some sort of psychiatric
disturbance. Out of this 4 lakh people have organic psychoses, 26 lakh people
have schizophrenia and 1.2crore people have affective psychosis; thus there
are about 1.5 crore people suffering from severe mental disorders, besides
12,000patients in government mental hospitals in the country (Reddy et al,
1996).

18. MAGNITUDE OF THE PROBLEM IN
INDIA
In 2017, 197·3 million (95% UI 178·4–216·4) people had mental disorders
in India, including 45·7 million (42·4–49·8) with depressive disorders and
44·9 million (41·2–48·9) with anxiety disorders. We found a significant, but
modest, correlation between the prevalence of depressive disorders and
suicide death rate at the state level for females (r2=0·33, p=0·0009) and
males (r2=0·19, p=0·015).(The lancet psychiatry)

19. MISCONCEPTIONS ABOUT MENTAL
ILLNESS
Mental illness is caused by supernatural power and is the
result of a curse or possession by evil spirit: Many people do
not consider mental illness as an illness, but possession by
spirits or curse that has befallen on the patient or family
because of past sins or misdeeds in previous life.
• Mentally ill people show bizarre behavior: Patients in mental
hospitals and clinics are often picturised as a weird lot, who
spend their time exhibiting useless bizarre behavior like
twisting of hands, etc.
• Mentally ill people are dangerous: People who have or had a
mental illness are viewed with suspicion and as dangerous
persons.

20. Cont.
Mental illness is something to be ashamed of this idea
arouses an unsympathetic, cruel attitude towards a
mentally ill person. This is the reason why many
people hide mental illness in the family.
• Mental illness is not curable: People object to have
normal relationship with mentally ill people, or to give
them employment even after being cured, or even to
accept them as neighbors.
• Mental illness is contagious: The fear that it is
contagious is the main false notion which leads
people to view suspiciously, or object to marital
relations with a person belonging to the household of
the mentally ill.

21. Cont.
Mental illness is hereditary: It is not a rule that children of mentally ill
patients should become mentally ill.
• Marriage can cure mental illness: A mentally ill person can get worse
if he gets married when he is ill, as marriage can become an
additional stress. A patient who has recovered can get married and
live a normal life like any other person.
• Mental hospitals are places where only dangerous mentally ill
individuals are treated and restraint is a majorform of treatment:
People hesitate to take their relatives to mental hospitals for treatment
because of fear. Further, as ex patient of a mental hospital, he, as well
as his family members are often isolated. Therefore, people seek help
from mental hospitals only as a last resort.

22. MENTAL HEALTH TEAM OR
MULTIDISCIPLINARY TEAM
A Psychiatrist
A Psychiatric nurse
A Clinical psychologist
A Psychiatric social worker
An Occupational therapist or
an Activity therapist
A Pharmacist and a dietitian
A Counselor

23. Nature of Mental Health
It is a profession possessing its unique history,
ideology, knowledge and skills.
It is both an art (nurse – patient relationship)
and a science (skills for the purpose of gaining
insight, effective change, healing mental and
emotional wounds and promoting growth).
Understands the principles of nursing and
remain current in knowledge and practice.

24. Scope of Mental Health Nursing
Nurse Generalist: a
licensed nurse providing
primary mental health
care. Holistic approach,
prevention programmes,
community and day care
centers, psychiatric
rehabilitation facilities,
homeless shelters etc.
Nurse Specialist:
Psychiatric Clinical Nurse
Specialist (CNS): have a
master degree in mental
health nursing.
Autonomous functioning,
prescription privileges,
manages overall care of
emotional and psychiatric
problems. Eg. Crisis
interventio0n specialists,
Milieu Specialists,
Psychotherapists etc.

25. Scope of Mental Health Nursing
Community Mental Health Nurse
(CMHN): Diagnosis, appropriate
referrals, care and rehabilitation of
mentally ill people in the community.
Psychiatric Home Care Nurse: direct
patient care, behavioral management,
crisis intervention, psycho education,
detoxification, medication etc. Forensic
Psychiatric Nurse: works with individuals
who have entered the legal system.

26. Scope of Mental Health Nursing
Psychiatric Consultation -
Psychiatric nurse who work in
non- psychiatric setting and
provide necessary support,
guidance and counseling for
those affected with anxiety,
depression and other
psychological problems.
Case Manager: Nurse manager
acts as advocates by coordinating
care and linking patient with
physician and other members of
health care team. Works in
community and helping in daily
living of a mentally ill person such
as transportation, managing
money, buying things etc.

27. SCOPE OF MENTAL HEALTH NURSING
Nurse Researcher: Nurse researchers design, conduct & disseminate findings of research at
professional meets & in peer reviewed journals. They are doctorally or post-doctorally prepared
persons who initiate or participate in all phases of the research process.
Psychiatric Nurse Educator
Nurse Administrator/Manager
Nurse Pharmacologist: The psychiatric clinical nurse specialist with prescriptive authority.
Holistic Nurse: Integrates complementary and alternative modalities such as relaxation,

28. Functions of Mental Health Nurse
INPATIENT PSYCHIATRIC WARD
Provide for environment safety including protecting the patient & others
from injury.
Perform psychosocial, high risk & physical assessment. Promotion of
self care activities.
Medication management.
Assisting for somatic therapies.
Accurately observing & documenting the patient’s behavior.
Providing opportunities for the patient to make his own decisions & to
assume

29. INPATIENT PSYCHIATRIC WARD
Provide safe environment and protect from injury.
Perform psychosocial, high risk & physical assessment.
Promotion of self care activities.
Medication management.
Documentation of behaviour.
Providing opportunities for the patient to make his own decisions & to
assume responsibility for his life.

30. INPATIENT PSYCHIATRIC WARD
Participation in various therapies, individual interactions, formal & informal group
situations, role play, advocating on behalf of the patient & so forth.
Delivering psycho-education, social skill and stress management strategies.
Counseling the patient & family members.
Interdisciplinary approach to care.
Discharge planning & community referral & follow up care

31. FUNCTIONS OF MENTAL HEALTH NURSE
PSYCHIATRIC OUTPATIENT DEPARTMENT
Performing clinical assessment.
Assisting for psychometric
assessment.
Assisting or providing
psychotherapy or behavior therapy.
Counseling the patient & family
members.
Conducting group therapy.
Delivering psycho education

32. FUNCTIONS OF MENTAL HEALTH
NURSE ECT TREATMENT SETTING
• Preparing the patient for ECT.
• Providing care during the procedure.
• Assisting with post treatment.
• Providing reassurance to reduce anxiety.
• Delivering psycho education regarding ECT.
FUNCTIONS OF MENTAL HEALTH NURSE PSYCHOTHERAPY
UNIT
• Establishing a therapeutic relationship with the patient.
• Providing an opportunity for the patient to release tension as
problem are discussed.
• Assisting the patient in gaining insight about the problem.
• Providing opportunity to practice new skills.
• Reinforcing appropriate behavior as it occurs.
• Providing consistent emotional support.

33. FUNCTIONSOFMENTALHEALTHNURSEDAYCARECENTERSOR
DAYHOSPITALS
Performing clinical assessment /observation/ documentation.
Medication management.
Teaching social skills.
Counseling patient & family members.
Delivering psycho education.
Providing occupational or recreational therapy & vocational
assistance.

34. FUNCTIONS OF MENTAL HEALTH
NURSE CHILD PSYCHIATRIC WARD
Assessing the
child and
understand his
strengths and
abilities.
Monitor the
child’s
developmental
levels & initiate
supportive
interventions
such as speech,
language or
occupational
skills as needed.
Provide a safe
therapeutic
environment.
Interdisciplinary
approach to care.
Teach the child
adaptive skills
such as eating,
dressing,
grooming &
toileting.
Deliver psycho
education and
Medication
management,
participate in
therapies.

35. FunctionsofMentalHealthNurseHOMESETTING
• Assessment of symptoms.
• Teaching the patient & family regarding nutrition, exercise,
hygiene & the relationship between physical & emotional
health.
• Stress management and Daily living kills (bank accounts,
rent, utility bills, use of the telephone, grocery shopping).
• Medication management Oral/IV– monitoring blood
levels, toxicity, side effects & purposes.
• Acts as a case manager & coordinate an array of services
such as therapies.

36. FunctionsofMentalHealthNurseCOMMUNITYMENTAL
HEALTHCENTERS
Identification and referral of patients to appropriate
hospitals.
Home visiting & providing direct care to the patients in
the community.
Follow up care with special emphasis on medication
regimen, & side effects, patient’s occupational function.
Conducting public awareness programs to remove
misconceptions regarding mental disorders.
Training of other care giving professionals in the
community

37. FunctionsofMentalHealthNurseHOSPICECARECENTERS
• Helping cancer patients or terminally ill individuals through
the grieving process.
• Provide supportive psychotherapy and support their
families.
EMERGENCY DEPARTMENTS
• Crisis intervention during natural disasters, accidents,
unexpected illnesses causing increased anxiety.
• Helping the mother in labor & to cope with stress.
• Providing support to bereaved patients in the event of
fetal demise, abortion, birth of an infant with congenital
abnormalities.

38. PSYCHIATRYINANCIENTVEDICINDIA
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146221
The ancient Indian
scripture, Atharva-
Veda, mentions that
mental illness may
result from divine
curses. Descriptions of
conditions similar to
schizophrenia and
bipolar disorder
appear in the Vedic
texts. A vivid
description of
schizophrenia is also
found in Atharva-Veda
Great epics such as
the Ramayana and the
Mahabharata made
several references to
disordered states of
mind and means of
coping with them. The
Bhagavad Gita is a
classical example of
crisis intervention
psychotherapy.
According to Sushruta,
the physician
(chikitshak), the drug
(dravya), the
attendants or the
nursing personnel
(upasthata), and the
patient (rogi) are the
four pillars on which
rests the success of
the therapy.

39. PSYCHIATRYINANCIENTVEDICINDIA
Close to the roots of Hindu mythology, Najabuddin
Unhammad (1222 AD), an Indian physician
propagated the Unani system of medicine as he
described seven types of mental disorders;
Sauda-a-Tabee (Schizophrenia); Muree-Sauda
(depression); Ishk (delusion of love); Nisyan
(Organic mental disorder); Haziyan (paranoid
state) and Malikholia-a-maraki (delirium).
Psychotherapy was known as Ilaj-I-Nafsani in
Unani Medicine. The great saga ‘Agastya’
formulated a treatise on mental diseases called
as ‘Agastiyar kirigai Nool’, in which 18 psychiatric
disorders with appropriate treatment methods
were described.

40. HistoryofPsychiatricNursing
In 1963, President John F. Kennedy in United States passed the Community Mental Health Act which proposed the deinstitutionalization of
mentally ill persons.
Psychiatric nursing was included in the basic nursing curriculum by the International Council of Nurses in 1961.
The registration of psychiatric nurses was done by 1920 in the UK and degree courses in psychiatric nursing began in the USA.
The first psychiatric nursing textbook,Nursing Mental Diseases was authored by Harriet Bailey, in 1920.
In 1913 Johns Hopkins University was the first college of nursing in the United States to offer psychiatric nursing as part of its general
curriculum.
Linda Richards, the first psychiatric nurse graduated in the United States in 1882 from Boston City College.
In the 1840s, Florence Nightingale made an attempt to meet the needs of psychiatric patients with proper hygiene, better food, light and
ventilation and the use of drugs to chemically restrain violent and aggressive patients. ( (Reddemma K & Nagarajaiah, 2004))

41. History of Psychiatric Nursing
• In fourth century AD, during the period of Emperor Ashoka,
hospitals with 15 beds for mentally ill with two male and two
female nurses. In1964-65 Psychiatric nursing was included in
curriculum. (Reddemma K & Nagarajaiah, 2004)
• For the first time in India, 11 British nurses along with one
matron were brought from the UK to work in the mental hospital
at Ranchi in the 1930s.
• Short training courses of three to six months were conducted in
Ranchi in 1921, which were recognized by the Royal Medical
Psychological Association.
• During 1948-50 four nurses were sent to the U.K.by Govt. of
India for mental health nursing diploma.
• From 1943, the Chennai Government organised a three
months’ psychiatric nursing course (subsequently stopped in
1964), for male nursing students at
the Mental Hospital, Chennai (in lieu of midwifery).

42. History of Psychiatric Nursing
• During 1954 Manzil Medical Health centre, Lucknow gave
psychiatric nursing orientation course of 4 - 6weeks duration.
• Govt. of India decided to start training psychiatric nurses during
1953-54 and started the first organized course at All India
Institute of Mental Health (presently NIMHANS).
• In 1964–1965, the Indian Nursing Council (INC) made it a
requirement to integrate psychiatric nursing in the nursing
diploma and degree courses.
• In 1967, a separate Psychiatric Nursing Committee was formed
in the Trained Nurses Association of India.
• Diploma in Psychiatric Nursing is conducted in three institutions
in India.
• Master of Psychiatric Nursing (MPN) programme is conducted
in many institutions.
• Doctoral programme in psychiatric nursing (Ph.D.) at
NIMHANS, Bangalore