Concepts and major mental disorders
Core meaning: Mental health is wellbeing and functioning; mental illness causes clinically significant disturbance and impairment.
Step-by-step learning
Appearance, behaviour, speech, mood, thought, perception, cognition and insight.
Neurosis, psychosis, intellectual disability, epilepsy, substance use and psychosexual problems.
Suicide, violence, neglect and vulnerability.
Therapeutic relationship, medicine and psychosocial support.
Relapse prevention and rehabilitation.
Key points to remember
- Psychosis may involve delusions, hallucinations and impaired reality testing.
- Substance dependence includes tolerance, withdrawal and loss of control.
- Use current respectful terminology for intellectual disability.
- Which finding suggests psychosis?
- What is tolerance?
- Differentiate neurosis and psychosis.
- Describe mental-status examination.
Levels of prevention in mental health
Core meaning: Prevention ranges from preventing risk factors to rehabilitation.
Step-by-step learning
Prevent emergence of social and environmental risks.
Promote mental health and prevent disorder.
Early detection and prompt treatment.
Limit disability and rehabilitate.
Measure incidence, duration and functioning.
Key points to remember
- School life-skills programmes are primary prevention.
- Screening and early treatment are secondary.
- Vocational rehabilitation is tertiary.
- Which level includes rehabilitation?
- Screening belongs to which level?
- Explain all levels of prevention with mental-health examples.
Treatment modalities
Core meaning: Mental-health treatment may combine medication, ECT, counselling, psychotherapy and diversional activities.
Step-by-step learning
Diagnosis, severity and urgency.
Explain treatment and legal requirements.
Monitor physical and mental status.
Symptoms, function and adverse effects.
Adherence, warning signs and follow-up.
Key points to remember
- ECT is considered for severe depression, catatonia and some urgent conditions.
- Psychotropic medicines require monitoring.
- Counselling supports coping and informed choices.
- Which condition may require urgent ECT?
- What is a major lithium toxicity sign?
- Discuss nursing responsibilities before, during and after ECT.
- Explain counselling principles.
Legal responsibility and violent-patient emergency
Core meaning: Emergency care prioritises safety, de-escalation, least restrictive intervention and lawful documentation.
Step-by-step learning
Remove hazards and call trained support.
Medical, substance-related or psychiatric.
Calm voice, space and clear limits.
Only when necessary and according to policy/law.
Vital signs, reason, duration and review.
Key points to remember
- Do not confront or crowd an agitated person.
- Restraint is not punishment.
- Continuous observation may be required.
- What is the first priority with a violent patient?
- When may restraint be considered?
- Explain emergency management of a violent patient.
- Discuss legal and ethical responsibilities in psychiatric nursing.
Common mental-health problems in Nepal
Core meaning: Common concerns include depression, anxiety, suicide, substance use, psychosis and stress related to violence, migration and disaster.
Step-by-step learning
Screen symptoms and function.
Use respectful health education.
Listening, safety and basic psychosocial care.
Clear pathway for urgent and specialist care.
Adherence, family support and relapse signs.
Key points to remember
- Ask directly about suicide when indicated.
- Imminent risk requires urgent safety measures.
- Community workers can support detection and referral.
- What is the safest response to suicidal intent?
- Discuss common mental-health problems in Nepal and the nurse’s role.
- Prepare a community suicide-prevention plan.