MENTAL HEALTH

( PSYCHIATRIC)
NURSING

A Presentation on
TRENDS and ISSUES

Points for Discussion

A) Trends
Introduction
History
Psychiatric Nursing In
Globalization era
Present scene
Changes and Challenges
Current trends
Trends in the Role of a
Psychiatric Nurse

B) Issues

Legal Aspects

Terminologies
Types of laws
Legal Issues

Ethical Aspects

Principles
Dilemmas
Issues

Trends in Psychiatric Mental

Health Nursing

History

In the
Globalization Era

De
Institutionalization

Psychotropic Drugs

How do we integrate with

Mental Health Community?
Experience and Education
Role and Functions
Relationships with other
professions
- Leininger(1973)

Present Scene of Mental

Health
450 million people affected worldwide
Mental problems common to all
countries
1 in every 4 persons going for health
services has atleast one emotional
problems
Mental problems of Clients with Chronic
disorders
Unavailability of cost effective treatment
Lack of recognition, awareness and
action

Issues around Mental health

Nursing
Hard to justify scientifically
due to the lack of Research
results
Less ready to face the free
market
Role differentiation based on
education and experience is
unclear.
Become Psychiatric Nurse is
not an option for students!

Changes and
Challenges

a) Demographic
Changes

Type of family

Increasing No. of
Elderly

b) Social changes
Intergroup and
intra group
loyalty
maintenance
Peer Pressure

c) Economic changes
Industrializatio
n
Urbanization
Raised
Standard of
Living

d) Technological
changes
Mass media
Electronic
Systems
Information
Technology

e) Mental Health care

changes
Increased
awareness in
public about
Mental health
Need to
maintain
mental
stability
Increased
mental health
problems

Current trends in Mental

health carte

Educational Programmes for Psychiatric Nurse

Development of Code of Ethics
Legal aspects in Psychiatric Nursing
Promotion of Research in Mental Health
Nursing
Cost effective Nursing Care
Focus of Care
World Health Day
Mental Health Global Action Programme
Health and Human Rights
Revision of Hospital Medical Code
Getting ready for DSM-5

New Trends in the Role of a

Psychiatric Nurse

New Trends in the Role of a

Psychiatric Nurse
Primary Mental Health Nursing

New trends
Child Psychiatric Nursing

Issues in Psychiatric Mental

Health Nursing

Legal Aspects

Basic Terminologies
Civil Law: Civil law defines
the rights and duties of the
individuals in relation to
each other. Civil law
protects the private and
property rights of the
individuals and businesses.
I.
.
.
II.

Tort
Intentional
Unintentional
Contract

 Criminal Law: Criminal law

defines certain acts as
offences against the state
and in doing so makes them
punishable. The criminal law
is enforced by or on behalf
of the State. Criminal law
provides protection from
conduct deemed injurious to
the public welfare

 Statutory Law: A statutory law

is a law that has been enacted
by legislative body, such as
country or city council, the state
legislature or the parliament. An
example statutory law such as
the Indian Nursing Council Act.

Common Law: Common

laws are derived from
decisions made in previous
cases. These laws apply to a
body of principles that
evolve from court decisions

 Right to Confidentiality is a
basic one, and especially so in
psychiatry. Although social
attitudes are improving,
individuals have been
discriminated against in the past
for no other reason than for
having a history of emotional
illness.
Informed Consent is a clients
permission granted to a
physician to perform therapeutic
procedure, before which
information about the procedure
has been presented to the client

 Restraints generally refers

to a set of leather straps
that are used to restrain the
extremities of an individual
whose behaviour is out of
control and who poses an
inherent risk to the physical
safety and psychological
well-being of the individual
and staff.
Seclusion is another type
of physical restraint in which
the client is confined alone

 False Imprisonment is the

deliberate and unauthorized
confinement of a person
within fixed limits by the use
of verbal or physical means.
Gravely Disabled is
generally defined as a
condition in which an
individual, as a result of
mental illness, is in danger
of serious physical harm
resulting from inability to
provide for basic needs,

 Negligence: The omission

(of a person) to do
something which a
reasonable person, guided
by those ordinary
considerations which
ordinarily regulated human
affairs, would do or the
doing of something which a
prudent and reasonable

 Malpractice:The failure of
one rendering professional
services to exercise that
degree of skill and learning
commonly applied under all
the circumstances in the
community by the average
prudent reputable member
of the profession with the
result of injury, loss or
damage to the recipient of
those services or to those
entitled to rely upon them.

 Libel: Written Defamation

Slander: Oral defamation
Invasion of Privacy: is a
charge that may result when
a client is searched without
probable cause.
Assault is an act that
results in a persons genuine
fear and apprehension that
he or she will be touched
without consent.
Battery is the unconnected

Types of Laws

Legal Issues
Right to Confidentiality is
a basic one, and especially
so in psychiatry. Although
social attitudes are
improving, individuals have
been discriminated against
in the past for no other
reason than for having a
history of emotional illness.

Informed Consent
Informed Consent is a
clients permission granted
to a physician to perform
therapeutic procedure,
before which information
about the procedure has
been presented to the client
with adequate time given
for consideration about the
pros and cons.

3 major elements of informed consent

Restraints and
Seclusion
Restraints generally refers to a

set of leather straps that are

used to restrain the extremities
of an individual whose behaviour
is out of control and who poses
an inherent risk to the physical
safety and psychological wellbeing of the individual and staff.
Talking down- a less Restrictive
measure
Seclusion is another type of
physical restraint in which the
client is confined alone in a

False Imprisonment
False Imprisonment is the
deliberate and unauthorized
confinement of a person
within fixed limits by the use
of verbal or physical means.

Commitment Issues
Voluntary Admissions

Malpractice and
Negligence
Negligence is the
Malpractice is the
failure of one
rendering
professional
services to exercise
that degree of skill
and learning
commonly applied
under all the
circumstances in
the community by
the average prudent
reputable member
of the profession
with the result of
injury, loss or
damage to the

omission (of a
person) to do
something which a
reasonable person,
guided by those
ordinary
considerations
which ordinarily
regulated human
affairs, would do or
the doing of
something which a
prudent and
reasonable person
would not do.

Failure to prevent
Dangerous Client
behaviour
Tarasoff Duty to warn
An interesting Love
story???!!!

Law suits that occur

in Psychiatric Nursing
Breach of Confidentiality
Defamation of Character
Libel
Slander

Invasion of Privacy
Assault
Battery

How to avoid
Liability?
Practice within the scope of the nurse practice act.

Ethical Aspects

Ethical Principles
Autonomy

Ethical Dilemmas in Mental

Health

An ethical dilemma is a
situation in which ethical
principles conflict or when
there is no one clear course
of action in a given
situation.

Ethical Decision
Making

 Assessment
Subjective and Objective data

Problem Identification
Conflict

Plan
Explore benefits and Consequences
Principles and Theories
Select an alternative

Implementation
Evaluation

Lets Decide!

Should a client who is

loud and intrusive to
other clients on a
hospital unit be
secluded from the
others?

When a therapeutic relationship has ended, can a health care professional nurse ever
have a social or intimate relationship with someone he or she met as a client?

Are clients who are

psychotic necessarily
incompetent or do
they still have the
right to refuse
hospitalization and
medication?