Introduction

Figure 13.1 The etiology of psychological and mental health disorders can be multifaceted, ranging from genetic and biological to environmental; often, specific causes are a combination of the types of factors or remain a mystery. (credit: “National Nurses Week: Capt. Stephanie Smiddy” by Staff Sgt. Shane Hughes/Air Force Medical Service, Public Domain)

Chapter Outline

13.1 Clinical Guidelines and Standards

13.2 DSM-5 Criteria and Use

13.3 Nursing Assessment and Care Plans

13.4 Promoting Recovery in Psychiatric Nursing

13.5 Special Considerations for PMH Practice

The American Psychiatric Nurses Association (2023) describes the practice of psychiatric-mental health (PMH) nursing as the provision of relationship-based care, holistic in scope, and oriented toward recovery and wellness. This practice encompasses work with individuals, families, and communities and in collaboration with an interprofessional team. PMH nurses incorporate cultural considerations, social determinants of health, and ethical/legal guidelines into their practice.

In the United States, individual state boards of nursing set the regulatory practice standards for each state. Additional guidelines and standards also exist at both federal and institutional levels for nurses to follow. Care planning is performed in conjunction with an interdisciplinary care team—psychiatrists, psychiatric-mental health nurse practitioners, clinical psychologists, licensed professional counselors, social workers, therapists, and other disciplines—with guidance by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) (2022) published by the American Psychiatric Association. The DSM-5-TR is the standard reference in clinical practice for the diagnosis of mental health disorders. These diagnoses form the basis for understanding the signs, symptoms, and recommended evidence-based approaches to treatment and care for the wide range of disorders that clients with PMH disorders may present.