With the introduction of newer issues and recent needs, the concepts in mental health nursing or psychiatric nursing expanded dramatically. From the need to provide nursing care for mental health patients during the end of the 19th century, nurses are nowadays commissioned to provide psychiatric-mental health services on a variety of settings.
A psychiatric nurse works on different settings such as community mental health programs, psychiatric hospitals and facilities, the academe and even in the criminal justice system. There are only two levels of psychiatric nursing: the basic and the advanced. Both of which have various responsibilities.
For the basic level, the psychiatric nurse will carry out the physician's orders. These are registered nurses who are equipped with the knowledge on developing, implementing and assessing nursing care plans; they also administer medications and provide direct nursing care. They are usually found in family-based settings, assisting the family members in dealing with a member's mental disorder. However, they may also be found in education settings where their primary role is to teach the public or other mental health care providers about mental health and psychological disorders. They may also assist with counseling and intervention.
On the other hand, registered nurses who also have a master's degree or a doctoral degree in mental health nursing could qualify as Psychiatric Nurse Practitioners. Having more advanced skills and knowledge on this field, they could practice assessments, diagnoses and treatments for patients of mental health. Depending on the state, they are also qualified to practice psychotherapy and case management, and prescribe medications. Also, they may choose to hold administrative positions in schools and hospitals and may also conduct researches of their own.
These are the basic roles of psychiatric nurses. But due to the development of further needs in the management of psychiatric disorders, the roles were expanded to meet the demands.
For example, the problems presented through the need of nursing care facilities in high security areas such as those similar in forensic nursing. The nurses working in this setting need to meet the balance between protecting the public from the potential harm caused by the patients and providing an environment that will also aim to offer therapeutic interventions.
Another change in the roles of psychiatric nurses is the extension of psychiatric services to prisons. This pose the challenge to psychiatric nurses to give the same mental health care services to inmates regardless of the boundaries set by the lack of facilities and trained people to do the work.
Lastly, the need to advance psychiatric custody to disordered individuals who are under the criminal justice system. As we may know, not all correctional institutions have dedicated units for inmates with psychiatric disorders. But in the past years, psychiatric facilities are being integrated into the criminal justice system. Because of the formation of the mental health courts, newer responsibilities were added to psychiatric nursing.
Mental health nursing, like many other professions, have met fundamental changes in the past recent years. This may be largely attributed to the improvements of newer facilities therefore newer needs for professionals which are mirrored in nursing professions. In many areas of psychiatric though, there is no doubt that there are fewer changes. However, as seen in the mental healthcare, these changes have prepared the way towards better systems and better people working in the field.
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