MENTAL HEALTH
AND
PSYCHIATRIC NURSING
CLINICAL HANDBOOK
Zabidah Putit Beatrice Andrew Judin
Saptuyah Haji Baki
Universiti Malaysia Sarawak
MENTAL HEALTH
AND
PSYCHIATRIC NURSING
CLINICAL HANDBOOK
© UNIMAS Publisher, 2019
All rights reserved. No part of this publication may be reproduced, stored in retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher.
Published by UNIMAS Publisher, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak, Malaysia.
Printed by
Lee Ming Press Sdn. Bhd. (895250-H) No. 48, Jalan Ellis,
93350 Kuching, Sarawak, Malaysia.
Perpustakaan Negara Malaysia Cataloguing-in-Publication Data Zabidah Putit
MENTAL HEALTH AND PSYCHIATRIC NURSING CLINICAL HANDBOOK / Zabidah Putit, Beatrice Andrew Judin, Saptuyah Haji Baki.
ISBN 978-967-2298-18-2
1. Mental health--Handbooks, manuals, etc.
2. Psychiatric nursing--Handbooks, manuals, etc.
3. Government publications--Malaysia.
I. Beatrice Andrew Judin.
II. Saptuyah Haji Baki.
III. Title.
616.89
i
Contents i
Preface v
Forward vii
Chapter 1: Evolution And Theory 1
Evolution of psychiatric - mental health 2
Theoretical bases for psychiatric mental health nursing 6 Neurobiological
Psychoanalytic Social/Social cultural Cognitive
Genetics
Chapter 2: Legal And Ethical Issues In Mental Health
And Psychiatric Nursing 15 Mental Health Act 2001 and Mental Health Regulations 2010
Sarawak 16
Legal and Ethical Issues 17
Admission of patient to the psychiatric ward 19
Admission procedure 21
Discharge of patient from the psychiatric ward 24
Discharge procedure 26
Contents
ii
Chapter 3: Major Psychiatric Disorder 29
Schizophrenia 30
Depressive Disorder (Major Depression) 34
Bipolar Affective Disorder 37
Chapter 4: History Taking 47
Chapter 5: Mental Status Examination 57
Chapter 6: Psychiatric Nurse – Patient Relationship 65 Chapter 7: General Management Of Mentally Ill People
(Treatment Modalities)
71
Chapter 8: Pharmacology therapy 75
Antipsychotic/Major tranquilizer 76
Anxiolytic/Antianxiety/Minor tranquilizer 78
Antidepressant 79
Anticonvulsant/Mood stabilizer 81
Chapter 9: Psychosocial Management 83
Group psychotherapy 84
Family therapy 87
Behavior therapy 88
Cognitive therapy 95
Milieu therapy 96
Interpersonal therapy/Individual therapy 100
Chapter 10: Psychoeducation 103
Understanding mental illness 104
Understanding client 104
iii
Understanding the treatments 105
Crisis intervention 105
Rebuild client’s life 105
Recovery of the illness 106
Client’s right and advocacy 106
Healthy lifestyle 106
Moving forward 106
Chapter 11: Rehabilitation 107
Social skill training 108
Occupational therapy in hospital settings 109
Life skill programme 109
Vocational rehabilitations 110
Job placement 111
Wellness management 112
Chapter 12: Community psychiatric nursing 115
Chapter 13: Seclusion and restraint 119
Seclusion 120
Restraint 121
Procedure on restraining patient with aggressive behavior 124
Care of patient under restraint 126
Chapter 14: Care of patient : Suicide 129
Chapter 15: Care of patient : Extra Pyramidal Syndrome (EPS) 135 Chapter 16: Care of patient : Electro Convulsive Therapy (ECT) 139
Reference 151
iv
Appendix 155
Index 157
v
Preface
The motivation to write MENTAL HEALTH & PSYCHIATRIC NURSING CLINICAL HANDBOOK originated in our own experiences in teaching both theory and practice for the undergraduate nursing students.
Unsolicited emails and narratives of the students' experiences in using our class teaching notes denote that their understanding is enhanced by our notes that are structured, precise and easy to follow. This handy procedure book is written to accomodate for students’ easy understanding.
The first part of the book introduces the student to the evolution and theories in psychiatric nursing. Later, the legal and ethical issues that need to be addressed in Mental Health and Psychiatric Nursing.
The Common Psychiatric disorder is presented as this is the core of understanding mental illness. The book further elaborates on the mental state examination that serve as the basis to evaluate one’s mental state, the management of the mentally ill and the various nursing procedures and nursing care that we believe help enriched the students in learning psychiatric nursing.
While this book is targeted for undergraduate students, we recommend that the diploma programme students and the lecturers and tutors to read it too.
vii
Foreword
Mental health and psychiatry nursing has evolved rather quickly with the advancements in neuroscience and the introduction of newer antipsychotic drugs and therapeutic modalities.
This has a significant impact on the health care delivery system and mental health. Psychiatric nurses are increasingly challenged to continue providing safe and high-quality care to patients with mental illness and their families whether in the hospital or community.
Yet, practical skill book of this kind can hardly be found in bookstores, let alone in Malaysia. It is perceived as timely to publish a manual procedure book to complement undergraduate nurses’ acquisition of mental health and psychiatric nursing skills through a well-structured and easy to follow manual procedure, which list down the steps of performing a clinical nursing procedure together with its rationales.
Professor Dr. Hj Ahmad Hata Rasit
Deputy Vice Chancellor (Academic and International) Universiti Malaysia Sarawak.
1
Evolution
Theory and
Mental Health and Psychiatric Nursing Clinical Handbook Evolution and Theory
2
In the late 18th century, the biologists put forward that mental illness was due to some biological etiology that could be treated with physical treatments. Likewise the psychosocial theorists relate mental illness to various social stressors.
Evolution of Psychiatric-Mental Health
Prior to 19th century, mental illness was believed and viewed as possession by evil spirits and supernatural forces.
