Psychological Adaptation / 06

Make sure to:

  • Understand the concept of psychiatry.
  • Understand the concept of psychiatric nursing.
  • Distinguish the historical context of psychiatric nursing and its evolution to contemporary practice.

In ancient times, mental illnesses were attributed to magical, mythological, or religious beliefs. Today, psychiatric disorders are viewed with the same objectivity as other medical conditions.

Over time, health professionals have focused their studies on mental illnesses and/or disorders. Psychiatry emerged as the discipline in charge of the study of all these pathologies that currently affect almost 450 million people worldwide. Studies conducted in Mexico indicate that 25% of people between the ages of 18 and 65 have some mental health issue, yet only 3% seek medical attention.

Today, specialists in the field aim to ensure that people with mental disorders achieve functional recovery outside the hospital, since in this way they integrate into their social environment and enhance their treatment outcomes positively (Health Department, 2018).

2.1 What is Psychiatry?

Malta (2023) recalls the concept and functions of psychiatry to have varied considerably over the years, along with the conception of mental illness in medicine and in society. It is said that in 1808, the term psychiatry was used for the first time by Professor Johann Christian Reil of Halle, Germany. He proposed that mental illnesses should be addressed by physicians and that psychiatry needs ethically trained physicians. In general terms, we can define psychiatry as the medical specialty that studies mental illnesses, their types, causes, courses and treatments. It is practiced by medical professionals who are referred to as psychiatrists. They are tasked with alleviating the symptoms of individuals with mental disorders or illnesses using various therapeutic methods available. In the following table there are various examples.

Table 1

Therapeutic Methods for the Care of Psychiatric Patients

Adapted from Stein et al. (2022). Psychiatric Diagnosis and Treatment in the 21st Century: Paradigm Shifts versus Incremental Integration. World Psychiatry, 21(3).

2.2 Psychiatric Nursing and its Historical Context

Psychiatric nursing results from the need to provide quality care that guarantees the well-being of the psychiatric patient. There have been many pivotal moments and figures in the history of psychiatric nursing education. Initially, it began in the same asylum where patients were treated.

During the American Civil War (1861-1865) Dorothea Lynde Dix, was a teacher who was part of a volunteers’ organization. She was among the first to document the conditions in asylums and the treatment received by patients. This inspired collective efforts to establish the first psychiatric centers and set the bases to the field of psychiatric nursing.

Years later, Linda Richards promoted the teaching of care for the mentally ill within the hospitals of England. She created training schools for the care of patients with mental disorders and her ideology centered around the notion that the mentally ill should be cared for with the same care as the patient who suffers from a physical illness. This could only be achieved through the specific preparation in the field of psychiatric nursing.

For some, Hildegard Peplau is recognized as the true mother of psychiatric nursing. Her work dates to the Second World War. It is considered that one of her greatest contributions to this field is her Theory of Interpersonal Relationships. The concept posits that when a patient is unable to identify or satisfy their human needs, the nursing staff intervenes so that the patient can identify and resolve them. Likewise, she established that the essential ingredients for quality care are knowing the care that the patient expects from nursing and focusing on effective communication and a proper nurse-patient relationship. As established by Chavez Guerrero et al. (2018), patient care constitutes the object of study and the duty of the nursing professional and to carry it out, people with interpersonal skills are required to provide specific and differential care for the vulnerable people who receive said care.

2.3 Evolution of Psychiatric Nursing

Nursing Interventions in the Mental Health Field

Nurses specializing in mental health or psychiatry are now trained in the context of mental health education and prevention, specific patient care, and providing quality attention during the patient's hospital stay. Like other specialties, the nurse is taking a crucial role in the multidisciplinary team, aiming to reintegrate the patient into daily life through rehabilitation and ongoing treatment.

Nursing care must be individualized based on the characteristics of each patient; hence, skills and competencies like intervention, decision-making, assessments, and regular evaluations are essential to provide appropriate care to the patient.

Table 1

Nursing Interventions in the Prevention of Mental Health Diseases

Adapted from Chavez Guerrero et al. (2018). Psychiatric Nursing: A Pillar in Mental health. CULCyT, 65(15). https://dialnet.unirioja.es/descarga/articulo/7209101.pdf

Nursing Interventions in the Care of Psychiatric Patients

Nursing professionals must closely monitor patients administered with psychopharmaceuticals to identify side effects, adverse reactions, or any incidents that could deteriorate their health or lead to complications from the treatment. Similarly, nursing staff should document any positive responses from patients resulting from the treatment.

As mentioned by Chavez Guerrero et al. (2018), specific skills and abilities must be available to assess and identify patients at potential risk of suicide or self-harm since these conditions are common among patients with a mental health condition.

The constant recording of vital signs such as heart rate, respiratory rate, blood pressure, oxygen saturation and body temperature must be carried out periodically, with the objective of identifying any event that compromises the hemodynamic stability of the patient. This may lead to complications, deteriorating their health or extending their hospital stay. Keeping up with the current knowledge of psychiatric nursing is of utmost importance to provide quality care and attention to the patient. As part of a dynamic field, the psychiatric nurses must strive to always provide the best attention possible, considering both the physical and mental needs of their patients.

Contemporary society consistently emphasizes balancing factors like physical well-being, socioeconomic stability, and job fulfillment. However, mental health is an aspect often overlooked by society at large. Therefore, it is imperative for healthcare, especially nursing personnel, to raise awareness, inform, and educate the public. The significant positive impact of maintaining good mental health is crucial for everyone.

Daily nursing practices, focused on prevention, care, and maintenance of mental health, yield successful outcomes, leading to positive societal changes. This is especially crucial in a society increasingly vulnerable to such pathologies and disorders.

  • Chavez Guerrero, B., Martinez Salinas, Y., Contreras Juarez, M., Rede Gonzalez, M., & Muñoz Livas, J. (2018, August). Psychiatric Nursing: A Pillar in Mental Health. CULCyT, 65(15), 75-84. https://dialnet.unirioja.es/descarga/articulo/7209101.pdf
  • Malta, L. (2023, July 12). What is Psychiatry? Discapanet. https://www.discapnet.es/salud/guias-y-articulos-de-salud/guia-sobre-salud-mental/que-es-la-psiquiatria
  • Mexican Health Department. (2018, November 4). Mental Disorders Affect 15 Million Mexicans. https://www.gob.mx/salud/prensa/421-trastornos-mentales-afectan-a-15-millones-de-mexicanos#:~:text=En%20M%C3%A9xico%2C%2025 %20per%20percent,from%20the%20Source%20(INPRF).
  • Stein, D. J., Shoptaw, S. J., Vigo, D. V., Lund, C., Cuijpers, P., Bantjes, J., & Maj, M. (2022). Psychiatric Diagnosis and Treatment in the 21st Century: Paradigm Shifts versus Incremental Integration. World Psychiatry, 21(3), 393-414.

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