NRSB331-Week_1-Lecture.pptx

Psychiatric/Mental Health Nursing

• Course Code: NRSB 331

• Instructor: Prof. Jerry Cervantes, MSN, RN

Attitude Towards Stress

• Quote by Dr. Hans Selye: "Adopting the right attitude can convert a negative stress into a positive one."

Course Objectives

• Discuss the history of psychiatric care.

• Define mental health and mental illness.

• Analyze cultural influences on mental health attitudes.

• Describe psychological adaptation responses to stress.

• Identify adaptive/maladaptive behaviors on the mental health continuum.

Mental Health

• Definition: Successful adaptation to stressors resulting in age-appropriate thoughts, feelings, and behaviors congruent with cultural norms (Townsend, 2012).

• Components:

  • Think rationally

  • Communicate appropriately

  • Learn and grow emotionally

  • Be resilient

  • Have a healthy self-view

Mental Illness

• Definition: Clinically significant disturbance in cognition, emotional regulation, or behavior reflecting dysfunction in underlying mental functioning (APA, 2013).

• References: DSM-IV (2000), DSM-5-TR (2022).

History of Psychiatric Care

• Early beliefs linked mental illness to evil spirits.

• Cruel treatments were common in efforts to purge individuals of spirits.

Significant Milestones

• First mental hospital in America: Philadelphia, mid-18th century (1752).

• Benjamin Rush: Initiated humane treatment; father of American psychiatry.

• Linda Richards: First American psychiatric nurse; established the first school of psychiatric nursing (1882).

• National Mental Health Act (1946): Laid groundwork for psychiatric nursing education and deinstitutionalization.

Theoretical Foundations

• Key Theorists:

  • Erik Erikson

  • Abraham Maslow

  • Sigmund Freud

  • Allan Horwitz

  • Hildegard Peplau

  • Hans Selye

• Each theorist offers insights into behavior and coping mechanisms across different life stages.

Erik Erikson's Stages of Development

1. Infancy (Trust vs. Mistrust)

2. Early Childhood (Autonomy vs. Shame and Doubt)

3. Preschool (Initiative vs. Guilt)

4. School Age (Industry vs. Inferiority)

5. Adolescence (Identity vs. Role Confusion)

6. Early Adulthood (Intimacy vs. Isolation)

7. Middle Adulthood (Generativity vs. Self-absorption)

8. Older Adult (Ego Integrity vs. Despair)

Maslow's Hierarchy of Needs

• Explains motivation through five levels of needs.

• Focus on human potential and patient strengths in nursing.

Freud’s Psychoanalytic Theory

• Three Levels of Awareness:

  • Conscious

  • Preconscious

  • Unconscious

• Personality Structure:

  • Id: Pleasure principle

  • Ego: Reality tester

  • Superego: Moral component

Cultural Influences on Mental Health

• Allan Horwitz’s Concepts:

  • Incomprehensibility: Difficulty understanding behavior motivations.

  • Cultural relativity: Normality is culture-dependent.

Stress Responses and Adaptation

• Adaptation: Restoration of homeostasis.

• Stress management: Use of coping strategies.

Anxiety and Grief

• Anxiety is common; can be mild (adaptive) or severe.

• Grief can be anticipatory or delayed; response length varies.

• Maladaptive Grief Responses: Prolonged, delayed, distorted.

Coping Strategies

• Adaptive Strategies:

  • Awareness/Cognitive reframing

  • Relaxation techniques

  • Social support

  • Exercise

  • Creative outlets

Knowledge Checks

• Case studies illustrate practical application of concepts.

• Importance of self-awareness and supervision in clinical settings.