Mental health care is limited by days of
service or dollar amounts; in contrast, in-
surance for medical illnesses rarely has
The population in the United States is be-
coming increasingly diverse in terms of cul-
ture, race, ethnicity, and family structure.
Psychiatric nursing was recognized in the
late 1800s although it was not required in
nursing education programs until 1950.
Psychiatric nursing practice has been pro-
foundly influenced by Hildegard Peplau and
June Mellow, who wrote about the
nurse–client relationship, anxiety, nurse
therapy, and interpersonal nursing theory.
The American Nurses Association has
published standards of care that guide
psychiatric-mental health nursing clinical
Common concerns of nursing students
beginning a psychiatric clinical rotation
include fear of saying the wrong thing, not
knowing what to do, being rejected by
clients, being threatened physically, recog-
nizing someone they know as a client, and
sharing similar problems or backgrounds
Awareness of one’s feelings, beliefs, atti-
tudes, values, and thoughts, called self-
awareness, is essential to the practice of
The goal of self-awareness is to know oneself
so that one’s values, attitudes, and beliefs
are not projected to the client, interfering
with nursing care. Self-awareness does not
mean having to change one’s values or be-
liefs unless one desires to do so.
For further learning, visit .
American Nurses Association. (2000).
Scope and Stan-
dards of Psychiatric-Mental Health Nursing Practice.
Washington, DC: American Nurses Publishing,
American Nurses Foundation/American Nurses
American Psychiatric Association. (2000).
statistical manual of mental disorders
(4th ed., text
revision). Washington DC: Author.
Appleby, L., & Desai, P. N. (1993). Length of stay and
recidivism in schizophrenia: A study of public psy-
chiatric hospital patients.
American Journal of
Baly, M. (1982). A leading light.
Nursing Mirror, 155
Department of Health and Human Services. (2002). The
Department of Health and Human Services on men-
tal health issues.
Department of Health and Human Services. (2000).
Healthy People 2010.
Washington, DC: Author.
Doona, M. (1984). At least well cared for . . . Linda
Richards and the mentally ill.
Gollaher, D. (1995).
Voice for the mad: The life of
New York: The Free Press.
Haugland, G., Siegel, C., Hopper, K., & Alexander, M. J.
(1997). Mental illness among homeless individuals
in a suburban county.
Psychiatric Services, 48
International Association of Psychosocial Rehabilitation
Services (IAPRS). (1990).
A national directory: Orga-
nizations providing psychosocial rehabilitation and
related community support services in the United
Boston: Center for Psychiatric Rehabilitation,