Antipsychotics: Understanding These Increasingly Prescribed Medications

As AJN‘s June issue CE article on antipsychotic medications makes clear, the history of the treatment of mental illness provides many cautionary tales:

Theories about the causes of mental illness have included the belief that a person is possessed by spirits, demons, or the devil; that she or he has a weakness of character; or that the person had a “refrigerator” mother, someone whose coldness led to the child developing insanity. Those with mental health issues were treated with . . . therapies that are now considered to be questionable and inhumane: being chained . . . in institutions . . . and put into insulin-induced comas; having a lobotomy; being subjected to malarial therapy, exorcism, and prayer; being placed into ice water baths . . .

Images courtesy of the estate of Bryan Charnley. Full image caption below.

In the past century, as our understanding of various aspects of mental illness has increased (there’s still a long way to go), so has the range of available treatments, from psychotherapy to a constantly expanding arsenal of first- and later-generation drugs, many with substantial adverse effect profiles. The use of psychotropic medications continues to increase in the United […]

NP’s Model Helps Prevent Mental Health Issues from Slipping Through the Cracks

Brenda Reiss-Brennan, PhD, APRN.

When psychiatric NP Brenda Reiss-Brennan started her independent family therapy practice in 1978, she began to get referrals from primary care providers who were unsure how to handle their patients’ mental health needs. Working with one patient at a time limited her ability to reach many people, so in 1984 she developed a model to train other nurses, primary care providers, and clinics in treating patients with mental illness. The model eventually caught the attention of Intermountain Healthcare, a nonprofit health care system located in Salt Lake City, Utah, which piloted a program featuring the model in its primary care settings.

The care model, which became known as Mental Health Integration (MHI), integrates the treatment of mental health conditions such as anxiety, depression, and substance abuse into the primary care system. Instead of handing out a referral to an external provider and losing patients to follow-up, the MHI model ensures that patients’ mental health conditions and general health care needs are treated in the same primary care practice. Patients receive education materials, are screened for suicide, and are provided a safe environment in which to discuss their mental health concerns. “Patients and families are treated with […]

2016-12-15T16:34:32+00:00 December 12th, 2016|Nursing, nursing roles|0 Comments

Psychiatric Nursing: The Seemingly Unreachable Patient

By Jennifer Rodgers for AJN. Illustration by Jennifer Rodgers for AJN

In many fields, we must keep doing the same thing over and over without any apparent results. Nurses, for example, may find that their efforts to make a patient safe, to reach a patient, to ease a patient’s suffering have little visible effect. This is just part of the work, but some patients will inevitably pose a greater personal challenge than others.

Five Words,” the Reflections essay in the May issue of AJN, written by former psychiatric nurse Tania Renee Zayid, is about one of those patients and the feelings of hope and disappointment his nurse experiences in his presence. In it, she writes:  […]


Peggy McDaniel, BSN, RN, an occasional contributor to this blog, works as a clinical liaison support manager of infusion, and is currently based in Brisbane, Australia.

800px-Billiards_balls By Andrzej Barabasz (Chepry)/via Wikimedia Commons

I see, crossing my path as I ride my bike along the beach, a man in his mid-20s with sandy, sun-streaked blond hair and a long sharp nose that’s a dark, angry red. His gait is deliberate, arms and legs moving in sharp angles. Occasionally I’ve seen him sitting along the path, eyes staring out across the sea, chin on fist, always alone. As my bike glides by, I glance over at his face, which lacks all expression.

It occurs to me that the reason, perhaps, that I take notice of this man is because he reminds me of a patient I once had—Charles (not his real name)—who shared that expressionless gaze and deliberate gait, one that took him nowhere in particular as he covered miles every day.

I was working as an inpatient psych nurse and attending school to finish my BSN degree. Charles was intermittently admitted to our unit. He lived on the street, for the most part, and since I lived downtown, I’d occasionally notice him walking. It’s been too long for me to remember what brought him into the hospital. I’m sure it was a variety of things. A person had to be a danger to themselves or others to stay very long in the unit, […]