PRINCIPLES OF MENTAL HEALTH NURSING

Running head: PRINCIPLES OF MENTAL HEALTH NURSING
PRINCIPLES OF MENTAL HEALTH NURSING
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PRINCIPLES OF MENTAL HEALTH NURSING1
Psychiatric medications are licensed psychoactive drugs that are administered in order
to induce an effect on the chemical composition of the brain and the nervous system. These
drugs are usually used for treating the patient with mental disorders and are generally
prescribed in a psychiatric setting. The drugs are made up of synthetic chemical compounds.
From the mid-20th century, these are widely used in treating a wide range of mental diseases
thus, reducing the need to stay in the hospitals for an extended period, lowering the cost of
mental healthcare and hospitalisation (Kronenfeld et al., 2017). The use of psychotropic
medication is stated to control behaviours and manage the signs and symptoms of mental
illness; however, criticisms are associated. The aim of the essay is to understand the
controversies related to the use of psychotropic drugs and the identification of the challenges
that the registered nurses (RNs) face while administering the drug to the client. It can be
noted that a significant amount of risk of harm is posed to the professional as the client have a
tendency of hurting self or other due to the psychological distress. The experts must be aware
of it and adopt strategies to control them. Thus, the way adopted by RNs for promoting
recovery-oriented practice will be assessed in the essay.
The introduction of psychotropic drugs has brought various changes in the treatment
process of mental illness. This lead to the better option of treating the patient without the
need of confining them in a psychiatric setting or using constraints. This was the primary
reason because of which many countries had moved to deinstitutionalisation lead to the
closure of many mental health hospitals allowing patients to be treated at home, general
hospitals, or small care centre. It also results in discontinuation of the use of physical
restraints such as straitjackets. The most prescribed psychiatric drugs as per the record of
2013 are alprazolam, citalopram, sertraline, escitalopram, fluoxetine, bupropion XL,
trazodone and duloxetine. According to the study conducted by Tomba, Guidi and Fava
(2018), during the industrialisation period, when the healthcare facilities supported in

PRINCIPLES OF MENTAL HEALTH NURSING2
improving physical health, the frequency of psychosocial disorder was rising. The causes of
such a drastic increase is a debatable issue. As per the US Surgeon General, it was estimated
that about one in five children and adolescents exhibited signs and symptoms of the
recognised disorder in a period of one year. Among the subjects, 5% of the population
suffered from severe functional impairment. In a more recent study by Cummings and
Wiggins (2016), it was observed that the onset of the mental illness begins as early as 14
years and significant symptoms manifest in preschools. As stated by Goldberg and Ernst
(2018), a psychotropic drug is a classification of psychiatric medications that has an impact
on the mood, a behaviour thought, and perception of the human being. The psychotropic
drugs include both prescribed as well as misused drugs whose use is often misleading and has
a negative impact on the body and the mind. The incidents of violent and aggressive
behaviour are common among adult mental health inpatients settingsthe ues of restrictive
interventions such as seclusion, restraint, sedating drugs are used for managing them.
Houghton, Ong, & Bolognani (2017) opined that coercise and restrictive practice have risks
that may harm the patients physically and psychologically. The interventions are expensive
and legal asoecst are aasociated with them. According to the Substance Abuse and Mental
Health Services Administration (SAMHSA) and data from the National Survey on Drug and
Health, it was noted that there were 47 million adults above the age of 18 that had presented
mental illness in 2018. The use of the psychotropic drug has been recognised to treat a
number of the disorder. They are responsible for altering the level of chemicals present in the
brain or neurotransmitters that include dopamine, gamma-aminobutyric acid (GABA),
serotonin and norepinephrine. Five major classes of legally used psychotropic medications
that include anti-depressants, anti-anxiety, antipsychotics, mood stabiliser, and stimulants
(Vickery, Mathews & Vickery, 2019). Evidence states that some drugs have severe side
effects on the brain as a result; they require specific monitoring processes and requirements

PRINCIPLES OF MENTAL HEALTH NURSING3
by healthcare practitioners before prescribing or administering them. The benefits of
psychiatric drugs are stated to be exaggerated; however, the harms are underplayed because
of poor trial design. As per the report of the British Medical Journal (BMJ), more than half a
million people who are above the age of 65 years have a high mortality rate due to the use of
psychiatric drugs in the western world on an annual basis. The benefits of using such drugs
are minimal and thus, the treatment needs to be exclusively used in case of acute scenarios
(Modern Healthcare, 2015).
As per the new guidelines, the change needs to be an acknowledgment and the
withdrawal of clinics in order to help patients to discontinue the use of such medications that
need to be promoted. As per another study conducted by Cummings and Wiggins (2016), the
benefits of using psychotropic drugs are overemphasised; however, the harms are not
highlighted. The reason for this is because of biasness in randomised controlled trials (RCTs),
not blinded in an appropriate manner, and not fully assessed about the effects of the drugs on
brain functioning. For example, it can be seen that in most of the studies, the patients have
undergone usage of the drugs and, thus, exhibit symptoms such as abstinence and withdrawal
symptoms. Thus, in the result section, the benefits of the treatment were exaggerated and
increased the harm in the placebo group (Roitto et al., 2019). Before coercision, the patiuents
are subjected to professional control and the interaction of staffs and patient is found to act as
a trigger. The trigger include power, controlling action by staffs and loss of autonomy. This
led to protest behaviour in the form of aggression or violence. Various controversies are
associated with the use of these drugs that need to understand for gaining insight about its
effect on the human body. As per the report of 27 February 2010, patients who had to seek
psychiatric help for mood disorders have a high chance of being diagnosed with a disease that
does not exist or treated with a drug that effective than a placebo (Psychiatric Times, 2020).
As per the author, American psychiatry is moving to a direction where a large number of the