Evidence Based Practice in Mental Health Nursing

• Milieu and therapeutic relationships 

• – Using a safe, structured environment and supportive nurse–patient relationships to promote healing and positive behavior.

• Trauma-informed care reduction of medications

• – Recognizing past trauma and responding with empathy and safety, which can reduce the need for restraints and medications.

• Professional boundaries 


• – Maintaining appropriate nurse–patient limits to ensure care stays ethical, safe, and therapeutic.

• Client-centered care – 
therapeutic relationships

•  – Focusing on the patient’s values, needs, and preferences while building trust and collaboration.

• Social Determinants of Mental Health

  • Individual factors

• Client’s birthplace, residence, job, education, and age

• Factors that affect mental health

• Socioeconomic status 

• Food security

• Living conditions 

• Family support 

• Overall health condition 

• Employment status

• Social Determinants of Mental Health

• Increased risk for a negative impact on mental health

• Lower income

• Compromised living conditions

• Food insecurity 

• Lack of family support, 

• Lack of sense of belonging to a community

• Unemployment 

• Chronic health issues

• Discrimination

• Serious Mental Illness (SMI)

• Disfunction in daily living - chronic

• Potential client impact

  • Co-occurring and comorbid illness

  • Shorter life expectancy

  • Limited access to quality health care

  • Unhealthy lifestyle habits 

  • Reduced quality of life

  • Stigma

• Social Problems: Stigma

• Self-stigma

  • Low self esteem

  • Loss of hope

  • Loss of emotional self-regulation

  • Reduction in treatment compliance

• Professional stigma

  • Negative thoughts or fear of client

  • Reduced quality of client care

• Reducing or resolving stigma

• Issues: Living with a Serious Mental Illness

• Daily living

  • Unemployment

  • Housing

  • Additional Concerns

• Impact on families

• Common treatment issues

  • Medication adherence

  • Relapse

• Community and treatment resources

• Scope and Standards for Mental Health Nursing

• Assessement/ data collecting 

• Analysis 

• Planning 

• Implementation 

• Evaluation 

• Trauma-Informed Care

  • Framework 

• Safety

• Compassion and trustworthiness

• Support and collaboration 

• Empowerment 

• Consider issues of

  • Culture

  • History

  • Gender

• Client-centered

• Adverse Childhood Experiences

• Abuse: Physical or emotional

• Neglect: Physical or emotional

• Witnessing traumatic events

• Experiences of parental or caregiver separation

• Experiences of family member or caregiver mental illness or substance use

• Experience of family member or caregiver incarceration

• Adverse Childhood Experiences: Consequences

• Increased risk

  • Social difficulties 

  • Academic difficulties

  • Risky behaviors 

  • Disruption in daily living abilities

• Increased risk in developing

  • Serious mental health issues 

  • Chronic medical issues 

• Holistic Nursing and Therapeutic Use of Self

  • Treating client as whole

• Physical

• Emotional and psychological 

• Socially 

• Spiritual

• Therapeutic use of self

• Therapeutic Communication 

• Therapeutic Relationships

  • Working alliance 

• Therapeutic Communication

  • Building trusting

  • Techniques

    • Therapeutic

    • Nontherapeutic