Mental Health and Psychosocial Nursing
Core concepts
Mental health nursing emphasizes therapeutic communication, safety assessment, and least restrictive interventions. Know suicide risk factors and protective factors, the difference between psychosis and delirium, and the signs of serotonin syndrome, neuroleptic malignant syndrome, and lithium toxicity. Understand the therapeutic relationship: boundaries, confidentiality limits, and de-escalation before restraint.
Traps in questions
Questions often ask for the priority when a patient expresses hopelessness. The first action is direct, nonjudgmental assessment of suicidal ideation and plan, not changing the subject or offering false reassurance. Another trap is choosing a restrictive intervention before verbal de-escalation and environmental measures. Also watch for questions that confuse therapeutic responses (reflecting, clarifying) with nontherapeutic ones (advising, minimizing, probing).
Worked example
A patient says, "Everyone would be better off without me." Rule of thumb: ask directly about thoughts of self-harm and a plan, ensure safety, and stay with the patient. Asking does not increase risk; it clarifies it and guides intervention.
Study strategy
Practice rewriting nontherapeutic responses into therapeutic ones, and memorize the hallmark signs of the major psychiatric medication emergencies.