This chapter provides an overview of risk factors and how they are categorized. It describes the impact of protective factors on the development of a mental illness. Although the stress-vulnerability-coping model was originally developed to explain the development of schizophrenia, it is now used to understand other psychiatric disorders as well. The chapter addresses the important risk factors associated with major classifications of psychiatric-mental health disorders and describes preventive strategies to reduce the impact of risk factors for developing a psychiatric-mental health disorder. In actuality, attentional disorders may begin during the first part of life, but often continue into adulthood. The mental illnesses under this category include attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Genetics/biology and temperament are two important intrapersonal risk factors for the development of psychiatric-mental health disorders that may begin at infancy and progress to adolescence and adulthood.

Psychiatric-mental health nursing care is practiced in multiple settings across the health care continuum. Patients of all ages in need of psychiatric-mental health nursing care can be found in hospitals, community agencies, and residential settings. Critical thinking and clinical decision making are crucial elements to ensure that the patient’s needs are assessed, relevant problems are identified, and therapeutic nursing interventions are planned, implemented, and evaluated. Clinical decision making based on critical thinking is similar across all clinical settings. One unique dimension of critical thinking in psychiatric-mental health nursing is the importance of the interpersonal relationship as a major healing factor in delivering psychiatric nursing care. This chapter focuses on how psychiatric nurses integrate the concepts of critical thinking, clinical decision making, and the nursing process within the interpersonal relationship to address patient needs and delivery of nursing care.

Schizophrenia spectrum disorder (SSD) is a broad term applying to illnesses involving disordered thinking and disturbances in reality orientation and social involvement. Although symptoms of PSYCHOSIS are often intermittently or continuously present, the underlying THOUGHT DISORDER is the most prominent cause of disability associated with this group of psychopathologies. The term SCHIZOPHRENIA refers to a diagnostic category within the group of SSD. Types of schizophrenia includes: schizophreniform disorder, schizoaffective disorder, delusional disorder, and brief psychotic disorder. This chapter covers the historical aspects and epidemiology of SSD and includes a detailed description of thought disorders. It describes relevant psychodynamic, cognitive behavioral, genetic, and neurobiological influences, along with common pharmacotherapy and nonpharmacotherapy strategies used in the treatment of SSD. The chapter discusses application of the nursing process from an interpersonal perspective, including a plan of care for a patient with a thought disorder.

This chapter describes the vulnerable populations most often encountered by psychiatric-mental health nurses (PMHN). It addresses the major mental health issues commonly involved and the nurse’s role when working with each of these populations. The chapter explores the specialty practice of forensic nursing, and describes the requirements for practice and the forensic nurse’s roles and functions. In the emergency or trauma setting, forensic nurses work with victims of automobile accidents, suicide attempts, disasters, work-related injuries, and traumatic injuries. In the area of interpersonal violence, the forensic nurse may work with victims of domestic violence or sexual assault, child or elder abuse, human trafficking, and physical or psychological abuse. In patient-care facilities such as hospitals or nursing homes, they may help investigate accidents, injury, neglect, and inappropriate medication or other treatments.

This chapter discusses the five phases of Joyce Travelbee’s model and also discusses the importance of these theories in the professional practice of psychiatric-mental health nursing. It examines Hildegard Peplau’s and Travelbee’s theories to patient care delivery in the clinical setting and incorporates the models of interpersonal relationships in professional psychiatric nursing practice. An interpersonal relationship is the connection that exists between two or more individuals. Observation, assessment, communication, and evaluation skills serve as the foundation for an interpersonal relationship. Development of any interpersonal relationship requires the individual to have a basic understanding of self and what that individual brings to the relationship. The interpersonal relationship in nursing is often considered to be the one-to-one relationship between the nurse and patient. However, the nurse also needs to develop interpersonal relationships with the patient’s family and key individuals in the patient’s environment.

Psychiatric-mental health professionals need to have a comprehensive knowledge foundation about mental illness and the theoretical underpinnings associated with it. Definitions of theory, as well as theories of mental health and illness, abound. Variation in these definitions can be influenced by or contingent on a number of factors, including the disciplinary and specialty perspective. This chapter provides an overview of various prominent theories of mental illness. Mental health and psychology are associated with numerous theories, such as grand, middle-range, and micro-level theories. The chapter describes the work of influential theorists, researchers, and practitioners from several disciplines, including but not limited to nursing, medicine, and psychology. It presents theoretical concepts and explanations of the potential etiology of mental illness from within the framework of psychodynamic, behavioral, cognitive, social, humanistic, and biological theory. The chapter includes pertinent definitions, historical background, epidemiological incidence and prevalence rates, and comparative disease burden of mental illness.

Multiple physical changes can impair the mental health of the aging individual. These changes include: acid-based imbalances, dehydration, electrolyte changes, hypothermia or hyperthermia, and hypothyroidism. This chapter reviews the most common mental health disorders affecting the elderly population and trends affecting care delivery. Moreover, chronic, unresolved pain has been associated with an increased risk of a mental health disorder such as depression, suicide, or anxiety. The aging individual may exhibit signs and symptoms of insomnia such as sleeping for short periods during the night, sleeping during times of normal social activities, arising early in the morning while others sleep, and experiencing daytime sleepiness. The chapter concludes by applying the nursing process from an interpersonal perspective to the care of an elderly patient with a mental health disorder.

This chapter defines the term self and components of recovery. It identifies the principles of dialogue, describes ways to develop greater self-awareness, and also defines therapeutic communication. The chapter discusses the key concepts of therapeutic communication and explains the significance of therapeutic communication to establish and maintain therapeutic nurse-patient relationships. It examines techniques of therapeutic communication and barriers to effective therapeutic communication. The chapter also examines the foundations of Emotional Connection, emPowerment, and Revitalization (eCPR) and the five intentions of eCPR. It presents the role of nurses in helping relationships and integrates three important trends in mental health care: use of self, the recovery paradigm, and the dialogical practice. A combination of eCPR and the Open Dialogue is well suited to reestablishing connections between the person in distress and his or her natural network.

This chapter describes the types of abuse and provides an overview of the historical aspects and epidemiology related to abuse and violence. Violence is demonstrated through physical, sexual, economic, or psychological abuse, or a combination of methods. The abuse is used to dominate the person. Domestic violence involving abuse perpetrated by an intimate partner, immediate family member, or other relative accounted for more than one fifth of all nonfatal violent crime against victims during the aggregate period of 2003 to 2012. Some cases of elder abuse involve intimate partner violence (IPV), but many cases also involve abuse by an adult child of the victim. Abusers may be dependent on their victims for financial assistance due to personal issues, substance abuse issues, or psychiatric problems. The chapter concludes with a discussion of the nursing responsibilities from an interpersonal perspective when caring for victims of abuse and their victimizers.

Feeding and Eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning. Eating disorders include pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge eating disorder. This chapter addresses the historical perspectives and epidemiology of eating disorders and describes eating disorders and the development of a greater phenomenological understanding of eating disorders through collaborative case conceptualization. It also describes biological, sociocultural, familial, and psychological factors that may potentially contribute to eating disorders along with common treatment options, including pharmacotherapy, psychoanalytical approaches, cognitive and behavioral treatments, group and family therapy, supportive therapy, and nutritional therapies. The chapter presents application of the nursing process from an interpersonal perspective, including a plan of care for a patient with an eating disorder.