CPMHN(C) key terms

A way of understanding mental illness as the product of interacting biological, psychological, and social forces, so that assessment and care address body and brain factors, personal history, coping style, relationships, culture, and living conditions together.

The theory that positive symptoms of schizophrenia, such as hallucinations and delusions, arise from excess dopamine activity in mesolimbic pathways, while negative and cognitive symptoms reflect reduced prefrontal dopamine. It underpins antipsychotic drug action and side effects.

Unconscious mental strategies that reduce anxiety by distorting or managing distressing thoughts and feelings, such as denial, projection, rationalization, and sublimation. They become clinically important when used rigidly enough to impair functioning, relationships, or treatment engagement.

A practice standard in which the nurse examines their own power, biases, and cultural assumptions and creates care where Indigenous and other marginalized patients feel respected, safe, and able to shape the services they receive.

An approach that assumes people may have experienced violence, neglect, or systemic harm, and organizes care around safety, trustworthiness, choice, collaboration, and empowerment so that routines and interactions avoid re-traumatizing patients.

A structured, largely observational assessment of appearance, behaviour, speech, mood and affect, thought form and content, perception, cognition, insight, and judgement, used to describe current mental functioning and to track change over time.

A structured inquiry into suicidal ideation, intent, plan, access to means, prior attempts, substance use, and protective factors, combined with clinical judgement to determine the level of risk and the safest, least restrictive plan of care.

The error of attributing a patient's new symptoms to their existing psychiatric or developmental diagnosis, which delays recognition of physical illness, medication toxicity, or pain. Nurses prevent it by investigating every change in behaviour and vital signs.

Information gathered from family, community workers, prior records, or other clinicians, with the patient's consent wherever possible, to confirm history and observations that the patient cannot or will not provide during the interview.

An individualized written plan developed with the patient that states strengths, prioritized problems, measurable goals, nursing and interprofessional interventions, and evaluation dates, and is revised as the person's needs and preferences change.

The deliberate use of the nurse's personality, communication, empathy, and self-awareness as a clinical tool, while maintaining objectivity and boundaries, to build a helping relationship that promotes the patient's growth and health.

Purposeful, patient-centred interaction using open questions, reflection, silence, clarification, and empathy to explore feelings, build trust, and support informed choices, while avoiding advice-giving, false reassurance, and excessive self-disclosure.

The patient's unconscious redirection onto the nurse of feelings, expectations, and conflict patterns originally linked to important figures from their past, which can intensify reactions to limit setting, discharge planning, or perceived rejection.

The nurse's own emotional reactions, assumptions, and unresolved conflicts triggered by the patient, which can distort judgement, lead to avoidance or over-involvement, and are managed through self-reflection, clinical supervision, and team consultation.

The agreed limits of the nurse-patient relationship that keep the focus on the patient's needs and protect both parties, covering self-disclosure, gifts, touch, social media contact, and dual relationships such as treating a friend.

Movement side effects of dopamine-blocking drugs, including acute dystonia, parkinsonism, akathisia, and tardive dyskinesia. They range from distressing to irreversible and require prompt recognition, reporting, and often anticholinergic treatment or a medication change.

A rare, life-threatening reaction to antipsychotics marked by high fever, severe muscle rigidity, altered consciousness, and autonomic instability with elevated creatine kinase; the drug must be stopped immediately and emergency medical treatment started.

A potentially fatal excess of serotonergic activity, usually from combined serotonergic drugs, causing agitation, tremor, clonus, hyperreflexia, sweating, fever, and diarrhea; recognition requires stopping the offending agents and urgent medical management.

Poisoning from lithium that presents with coarse tremor, vomiting, diarrhea, ataxia, confusion, and seizures, often triggered by dehydration, sodium loss, renal change, or interacting drugs such as NSAIDs; levels and renal function guide urgent treatment.

Required blood work and clinical checks for people taking clozapine, because it can cause severe neutropenia, myocarditis, seizures, and constipation; absolute neutrophil counts determine whether dispensing continues, so missed tests interrupt treatment.

A cluster of increased waist size, high blood pressure, impaired glucose tolerance, and abnormal lipids that raises cardiovascular risk and is common with second-generation antipsychotics, requiring baseline and ongoing weight, glucose, and lipid monitoring.

A structured, time-limited talking treatment in which patients learn to notice and test unhelpful thoughts and to change avoidance and behaviour patterns; nurses support homework, psychoeducation, and skill practice alongside the therapy.

An intensive treatment combining individual therapy, group skills training, telephone coaching, and team consultation, teaching distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness, chiefly for people with borderline personality disorder and repeated self-harm.

A controlled seizure induced under general anesthesia and muscle relaxation to treat severe depression, catatonia, or dangerous mania; nursing care includes consent checks, fasting, medication review, and monitoring for confusion and memory effects.

A graded set of communication and environmental strategies, such as calm speech, giving space, offering choices, and reducing stimulation, used to lower agitation and prevent violence before any consideration of restraint or seclusion.

A philosophy holding that people with mental illness can live satisfying, contributing lives defined by their own goals, with nursing support for hope, empowerment, strengths, self-management, and meaningful roles rather than symptom elimination alone.

A pragmatic approach that accepts ongoing substance use or other risk behaviour and works to reduce its dangers through supplies, education, safer-use strategies, and non-judgemental engagement, without requiring abstinence as a precondition for care.

An interprofessional, outreach-based team model providing intensive, long-term, around-the-clock support in the community for people with severe mental illness and frequent hospital use, with shared caseloads and low staff-to-client ratios.

Structured teaching about a diagnosis, its symptoms, medications, early warning signs, and self-management, delivered to patients and families in accessible language so they can make informed decisions and act early when symptoms worsen.

A collaborative plan naming the person's early warning signs, triggers, coping strategies, supports, and steps to take if symptoms return, written while the person is well and shared with family and the care team.

The negative labelling, stereotyping, and discrimination that people with mental illness or substance use face, which reduces help-seeking, housing, and employment; nurses counter it through language, advocacy, and challenging assumptions.

The conditions in which people are born, grow, work, and age, including income, housing, food security, education, and racism, which shape mental health risk and access to care and belong in nursing assessment.

The professional and legal duty to protect personal health information and share it only with consent or where law requires, such as imminent risk of serious harm, child protection concerns, or a court order.

The legal and ethical obligation, when a patient poses a serious threat to an identifiable person, to take reasonable steps such as warning, notifying police, or arranging admission, even without the patient's consent.

A voluntary agreement to assessment or treatment made by a person with capacity after receiving and understanding information about purpose, benefits, risks, alternatives, and the right to refuse.

The functional ability to understand relevant information, appreciate how it applies to oneself, weigh options, and communicate a choice; it is assessed per decision, can fluctuate, and is presumed present unless shown otherwise.

Legal detention in hospital for assessment or treatment without the person's consent, permitted only when statute-defined criteria such as mental disorder plus risk to self or others are met and properly documented and reviewed.

The principle that care must use the smallest intrusion on a person's liberty, dignity, and rights that will safely meet the clinical need, moving from voluntary, community-based options to restraint only as a last resort.

Physical, mechanical, or chemical restriction of movement, or confinement alone in a locked room, used only when less restrictive measures have failed, for immediate safety, with orders, monitoring, documentation, and debriefing required.

Working with the patient and other professionals, sharing information and negotiating roles and decisions, to produce a coordinated plan of care; it requires respect, clear communication, and shared accountability for outcomes.