Intro

1. Nursing Care of Clients with
Mental Health Disorders

2. Understanding Mental Health and
Mental Illness

3. Characteristics of Mental Health
• Interpret reality accurately
• Have a healthy self-concept
• Able to relate to others
• Achieve a sense of meaning in life
• Demonstrate creativity/productivity
• Control behavior
• Adapt to change and conflict

4. Figure 1-1 A person with a healthy self-concept accepts herself as she is, including the fact that she has cerebral palsy. Source:
PhotoEdit Inc.

5. Figure 1-2 Finding a sense of meaning in life is part of mental health. This hiker finds meaning in nature. Source: Omni-Photo
Communications, Inc.

6. Mental Disorders
 Symptoms related to thinking, feeling, or
behavior
 Caused by genetic, biological, social, chemical or
psychological influences
 Result in impairment of functioning
 Meaning of illness related to culture
 Diagnostic and Statistical Manual of Mental
Disorders definitive source for information
 People are not defined by their illness

7. Five-Axis Diagnosis System
• Axis I: Clinical Psychiatric Disorders
• Axis II: Personality Disorders or Mental
Retardation
• Axis III: General Medical Conditions
• Axis IV: Psychosocial and Environmental
Problems
• Axis V: Global Assessment of Functioning

8. Role of the Nurse
• Part of the multidisciplinary treatment team
• Plans and provides care for the client
• Collect data regarding the client’s mental and
physical diseases, life stressors, and diseases
effects on ability to function
• Nurses focus on client’s response to illness

10. Incident of Mental Disorders
 Major problem for people all over the world
 Incidence underestimated
 Mental illness makes up 5 of the 15 leading
causes of disability in developed countries
 Half of people in the US with major
depressive disorder will have a psychiatric or
substance abuse disorder in their lifetime

11. Figure 1-5 Risks and prevention factors for mental illness.

12. Figure 1-6 Educating adolescents about avoiding drug abuse is a primary prevention strategy for mental illness.
Source: PhotoEdit Inc.

13. Stigma of Mental Illness
• Mark of disgrace on mental illness in our
culture
• May feel too ashamed of mental illness to
seek treatment
• Physicians may hesitate to diagnose a mental
illness for fear of labeling their client

14. Stigma of Mental Illness
• Nurses should advocate for clients and avoid
negative labeling
• Do not explain medical illness according to
fears and guesses
• Base practice on evidence, not assumptions

15. Historical Perspectives
• Mental illness documented back to
Hippocrates
• Treatment aimed at punishment
• In the 1790s Phillippe Pinel started “moral
treatment” of the mentally ill
• Dorothea Dix crusaded for facilities to treat
mentally ill
• Mental health nursing became part of the
curriculum for nurses in the early 1900s
• Psychotropic drugs invented in 1950s

16. Figure 1-3 The “tranquilizing chair”was used to control people with mental disorders in the 19th century. Source: National Library
of Medicine.

17. Figure 1-4 “The crib”was used to control people with mental disorders in the 19th century. Source: Stock Montage, Inc./Historical
Pictures Collection.

19. Vulnerability of the Mentally Ill
 Among the most vulnerable in our society
 Disease prevents speaking effectively for
themselves
 National Alliance for the Mentally Ill
(NAMI) acts as an advocate providing
support, education, and political advocacy
 Person who uses mental health services is
called a consumer, not a client or patient

20. Vulnerability of the Mentally Ill
• Most important role of nurse is as an
advocate
• Ask for mental health consultation is an
important act of client advocacy

21. Figure 1-7 There are more charitable donations to benefit homeless animals than for homeless people. Source: Photo
Researchers, Inc.

22. Resources
 The National Alliance for the Mentally Ill has information for
consumers and their families
http://www.nami.org/
 National Institute of Mental Health has information regarding
symptoms, diagnosis, and treatment of various mental illnesses.
http://www.nimh.nih.gov/index.shtml
 Psychiatryonline has information from the Diagnostic and
Statistical Manual of Mental disorders available for many mental
illnesses.
http://dsm.psychiatryonline.org/book.aspx?bookid=22