PRINCIPLES & CONCEPT OF

MENTAL HEALTH NURSING

BY - MS. ARADHANA
MASIH
PRINCIPLES OF MENTAL HEALTH NURSING
1. Accept the Patient Exactly as a Human Being
• Recognize the patient as an individual with unique thoughts, emotions, and
experiences.
• Avoid judgment regardless of their mental condition, background, or behavior.
• Show unconditional positive regard to promote trust and therapeutic rapport.
2. Understanding
• Develop a deep knowledge of mental health conditions to provide
appropriate care.
• Understand that mental illness is not a choice, and symptoms may affect
behavior.
• Listen actively and be patient in communication.
3. Respect
• Treat the patient with dignity and respect, regardless of their condition.
• Respect their cultural beliefs, values, and personal space.
• Encourage autonomy and involve them in decision-making.
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4. Reassurance
• Provide emotional support and reassurance to reduce fear and anxiety.
• Use calm and soothing communication to help the patient feel safe.
• Offer encouragement to boost self-esteem and confidence.
5. Observation
• Observe the patient’s behavior, mood, speech, and nonverbal cues.
• Monitor for suicidal ideation, aggression, self-harm, or withdrawal.
• Keep track of medication effects and side effects.
6. Patient-Centered Care
• Prioritize the patient’s needs, preferences, and goals in care planning.
• Ensure that treatment is individualized and holistic.
• Foster collaboration between the patient, family, and healthcare team.
7. Procedure Explained to the Patient
• Always inform the patient before any procedure, intervention, or medication.
• Use simple and clear language to explain what will be done and why.
• Obtain informed consent where necessary.
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8. Verbal and Physical Force Must Be Avoided
• De-escalate situations using therapeutic communication rather than force.
• Use calm, non-threatening body language to manage agitation.
• Restraints and seclusion should only be a last resort and used per hospital policy.
9. Accountability
• Take responsibility for actions, decisions, and patient care outcomes.
• Adhere to ethical and legal standards of nursing practice.
• Maintain professional integrity at all times.
10. Confidentiality
• Protect the patient’s personal and medical information.
• Do not disclose information without consent, unless required by law (e.g., harm to
self or others).
• Follow HIPAA or similar privacy regulations.
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11. Altruism and Genuineness
• Altruism: Show selfless care and prioritize the patient’s well-being.
• Genuineness: Be honest, open, and authentic in interactions with patients.
12. Empathy
• Understand and share the patient’s emotions and struggles without judgment.
• Validate their feelings and experiences to promote trust.
• Different from sympathy—focus on understanding, not pity.
13. Immediacy
• Address issues as they arise, rather than postponing interventions.
• Provide real-time support and intervention to prevent crises.
• Encourage patients to express their current emotions and needs.
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5. Professional Intimacy
• Mental health nursing often involves deep emotional engagement with patients.
• A balance must be maintained between emotional support and professional
boundaries.
• Avoid dual relationships that could compromise care.
6. Empathy
• Understanding patients’ feelings and experiences helps in providing effective
care.
• Active listening and validation of emotions foster a therapeutic alliance.
• Empathy must be balanced with professional boundaries to prevent burnout.
7. Power
• Nurses hold a position of authority and influence over patients.
• Power should be used ethically, avoiding coercion or undue influence.
• Encourage shared decision-making to empower patients.
 CODE OF ETHICS FOR NURSES IN INDIA
The Indian Nursing Council (INC) has laid down ethical guidelines to ensure
professional conduct among nurses.
1. Responsibility to the Patient
• Provide safe, competent, and compassionate care.
• Respect patient confidentiality and privacy.
• Obtain informed consent before treatment or procedures.
2. Respect for Human Rights and Dignity
• Treat all patients equally, regardless of caste, religion, gender, or socioeconomic
status.
• Respect autonomy, allowing patients to make decisions about their care.
3. Confidentiality
• Maintain strict confidentiality of patient information.
• Share information only when required legally or for patient safety.
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4. Professional Competence
• Nurses must continuously update their knowledge and skills.
• Follow the best evidence-based practices in mental health nursing.
5. Ethical Use of Resources
• Ensure that hospital and mental health resources are used fairly and
efficiently.
• Avoid waste or misuse of medical supplies and funds.
6. Ethical Relationship with Colleagues
• Treat other healthcare professionals with respect and cooperation.
• Maintain ethical communication and collaboration in the healthcare team.
7. Advocacy and Protection of Patient Rights
• Advocate for mental health rights and access to quality care.
• Protect patients from abuse, neglect, or coercion.
 COMPONENTS OF INC'S PRACTICE STANDARDS FOR
PSYCHIATRIC-MENTAL HEALTH NURSING
• ASSESSMENT- The psychiatric nurse collects comprehensive data, including
mental status, patient history, and risk factors for psychiatric illnesses.
• DIAGNOSIS - Based on the assessment, the nurse identifies mental health
conditions, formulating nursing diagnoses (e.g., risk for self-harm, disturbed
thought processes).
• IDENTIFICATION - The nurse identifies expected patient outcomes, setting
realistic and measurable goals for recovery.
• PLANNING - Develops a care plan, including interventions such as therapeutic
communication, medication management, and psychosocial rehabilitation.
• IMPLEMENTATION - Executes the planned interventions, which may involve
counseling, administering psychiatric medications, and crisis intervention.
• EVALUATION - Reviews the patient’s progress, modifying the care plan as
needed based on treatment responses and outcomes.
 STANDARD OF PROFESSIONAL PRACTICES

•Ethics – Upholding ethical principles and advocating for patient rights.

•Education – Engaging in lifelong learning and professional development.
•Evidence-Based Practice – Applying current research and best practices
in care.
•Communication – Collaborating effectively with patients, families, and
healthcare teams.
•Leadership – Demonstrating leadership in practice and policy-making.
•Collegiality & Collaboration – Working with colleagues to enhance
nursing practice.
•• Resource Utilization – Using resources efficiently while maintaining
.
quality care.
•Environmental Health – Promoting a safe and healthy work environment.
CONCEPTUAL MODELS IN MENTAL HEALTH NURSING

1. Existential Model
Concept:
• Based on existential philosophy, this model emphasizes personal meaning,
free will, and individual responsibility.
• Key theorists: Viktor Frankl, Rollo May, Irvin Yalom.
• Mental illness arises when a person struggles with meaninglessness, isolation,
freedom, or death anxiety.
Key Principles:
✔ People create their own meaning in life.
✔ Authenticity is essential for mental well-being.
✔ Anxiety is a natural response to existential concerns.
Application in Mental Health Nursing:
• ✅ Help patients explore personal meaning and purpose in life.
✅ Encourage self-acceptance and decision-making.
✅ Use therapeutic communication to validate emotions.
✅ Assist in managing existential anxiety and fears of death, isolation, or
freedom.
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2. Psychoanalytical Model
Concept:
• Developed by Sigmund Freud, this model focuses on the unconscious mind,
early childhood experiences, and internal conflicts.
• Id, Ego, and Superego shape personality and behavior.
• Mental disorders result from unresolved unconscious conflicts and the use of
defense mechanisms.
Key Principles:
✔ Unconscious motives influence behavior.
✔ Past childhood experiences shape personality.
✔ Mental illness results from repressed conflicts.
Application in Mental Health Nursing:
• ✅ Identify defense mechanisms like denial or repression.
✅ Use therapeutic listening to explore past traumas.
✅ Refer for psychoanalysis or psychotherapy if needed.
✅ Help patients develop insight into their thoughts and emotions.
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3. Behavioral Model
Concept:
• Focuses on observable behaviors rather than unconscious processes.
• Developed by B.F. Skinner (Operant Conditioning) and Ivan Pavlov
(Classical Conditioning).
• Mental disorders are seen as learned behaviors that can be modified.
Key Principles:
✔ Behaviors are learned through reinforcement and punishment.
✔ Maladaptive behaviors can be unlearned through behavioral therapy.
✔ Environment plays a key role in shaping behavior.
Application in Mental Health Nursing:
• ✅ Use behavior modification techniques (reward systems, token
economy).
✅ Implement exposure therapy for phobias or anxiety.
✅ Encourage positive reinforcement for healthy behaviors.
✅ Teach coping skills and relaxation techniques.
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4. Interpersonal Model
Concept:
• Developed by Harry Stack Sullivan and expanded by Hildegard
Peplau.
• Focuses on relationships and communication as key factors in mental
health.
• Mental illness arises from interpersonal conflicts and social isolation.
Key Principles:
✔ Mental health is shaped by social interactions.
✔ The nurse-patient relationship is a key tool for healing.
✔ Effective communication can improve mental well-being.
Application in Mental Health Nursing:
• ✅ Develop a therapeutic nurse-patient relationship to foster trust.
✅ Help patients improve communication and social skills.
✅ Act as a teacher, counselor, and role model.
✅ Facilitate group therapy to enhance interpersonal connections.
ROLE OF THE NURSE IN MENTAL HEALTH NURSING

1. Therapeutic Relationship & Communication

• ✅ Establish trust and rapport with patients.
✅ Use therapeutic communication (active listening, empathy,
validation).
✅ Encourage expression of emotions in a safe environment.
2. Assessment & Diagnosis
• ✅ Conduct mental status examinations (MSE).
✅ Assess mood, cognition, behavior, and risk factors.
✅ Identify psychiatric symptoms and coping mechanisms.
3. Crisis Intervention
• ✅ De-escalate aggressive or suicidal behavior using crisis
management techniques.
✅ Implement suicide prevention strategies (monitoring, safety
planning).
✅ Provide emotional support during acute episodes.
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4. Medication Administration & Monitoring
• ✅ Administer psychotropic medications (antidepressants, antipsychotics,
mood stabilizers).
✅ Monitor for side effects, adherence, and effectiveness.
✅ Educate patients and families on medication management.
5. Psychoeducation & Health Promotion
• ✅ Teach coping skills, stress management, and emotional regulation.
✅ Educate patients and families about mental illnesses and treatment
options.
✅ Promote healthy lifestyle choices (nutrition, sleep, exercise).
6. Behavioral & Psychosocial Interventions
• ✅ Use behavioral therapy techniques (positive reinforcement,
desensitization).
✅ Facilitate group therapy and social skill development.
✅ Support rehabilitation and recovery efforts.
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7. Advocacy & Ethical Care
• ✅ Ensure patients' rights and confidentiality are respected.
✅ Advocate for mental health resources and stigma reduction.
✅ Support patients in decision-making and autonomy.
8. Collaboration & Teamwork
• ✅ Work with psychiatrists, psychologists, social workers, and
occupational therapists.
✅ Refer patients to community resources and support groups.
✅ Participate in treatment planning and case management.