Introduction: A Future Perspective on Psychiatric Mental Health Nursing

O PENING ONE'S mind to a new conEept is risky. _The risk lies in the perceived loss of something familiar, comfortable, and valued. Integrating the biological approaches to psychiatric illnesses challenges this familiarity. The challenge is to integrate into practice a knowledge base that explains behavior, affect, mood and other known symptoms of serious mental illness. With the advent of biological psychiatry came what can be called a knowledge innovation (Drucker, 1985). The knowledge innovation for the decade of the brain combines science and technology expanding mental illness concepts once limited to psychological, behaviorial, and psychoanalytical theories and frameworks. Diagnostic tools once thought to be solely within the realm of physical illness are now being integrated into studying and treating mental illness. Advances in technology have made it possible to explain the functioning, purposes and interconnections of the brain with other body systems and the environment. This has advanced our knowledge of mental illness. Naisbitt (1984), the author of Megatrends, emphasizes the need for balance in describing the future. He states that, "technology and our human potential are two great challenges and adventures facing humankind today. The great lesson we must learn from the principle of high tech/high touch is a modem version of an ancient Greek ideal--balance" (p. 36). The knowledge-based innovation and new technology in biological psychiatry offer psychiatric mental health nursing an opportunity to exploit the change (Drucker, 1985) and redirect energy and excitement to newer models in caring for the seriously mentally ill. The patient, the consumer of our services, needs to be the focus in the future. The integration of the biological, neurophysiological, and genetic models into the caring framework of nursing will assure the balance that Naisbitt (1984) describes. Any knowledge-based innovation comes with an unsettling period, the natural and consistent consequence of any change process. A characteristic of a knowledge-based innovation is that at a certain point in its maturity, a process of convergence or integration of several different kinds of knowledge occurs (Drucker, 1985). The integration of the science of the brain only serves to enhance the practice of nursing (Robinson, 1986 & Pothier, 1988). "The practitioner uses science to develop a technology that allows them to intervene in the process of illness or enhance the process of health" (Krauss, 1987, p. 8). Psychiatric mental health nursing complements biological psychiatry with sophisticated care giving. The biological view of mental illness has replaced the psychological paradigm as the more dominant view (Liaschenko, 1989) and through this shift, a void in explaining behavior and symptoms associated with major mental illness is beginning to be filled. The biological view of mental illness integrated into the practice of nursing provides an opportunity for psychiatric mental health nursing to achieve a distinct and valued rrle in the care of patients who are seriously mentally ill. As psychiatry realigns with medicine and advances in treating the diseases of the brain, nursing practice can be distinguished and differentiated by the demonstrated ability to care. It is important to reinforce and regain a nursing identity in caring for the whole person (Martin, 1985). Nursing care that includes assessing the patients physical and psychological needs, in providing coping strategies, symptom recognition and management, and patient education. A few examples of caring in the practice or psychiatric mental health nursing are: caring by creating a therapeutic environment; caring in knowing when to set limits, caring in recognizing the timing and kind of challenge a patient is ready for, fostering positive experiences.