Integrated Care – ‘Schizophrenia’: A Challenge for Psychiatric/Mental Health Nursing

Abstract

This chapter focuses on providing integrated psychiatric/mental health (P/MH) nursing care and crucially advances the robust argument that ‘schizophrenia’ can and should be approached from at least two different points of view and two general models. The two perspectives, broadly speaking, are the categorical (biomedical, biological psychiatry) view, based in detecting symptoms and the fulfilment of diagnostic criteria as a dichotomic decision, and the dimensional view, with more of a tradition in humanistic psychology and an emphasis on psychosocial interventions, all embedded in a recovery context. Thus, P/MH nurses provide integral, humanistic and person-centred attention/responses in which interpersonal therapeutic relationships form the basis for all their interventions and care. The authors here are referring to a special and genuine relationship in which the patient can be himself, have his/her own feelings and express them freely, knowing that nurses shall not make value judgements or manifest disapproval. After examining both approaches, the chapter proceeds to consider in detail the key aspects of this approach to care and pays particular attention to helpful, therapeutic responses to and management of individualized experiences of ‘schizophrenia’. The chapter concludes by asserting that, under the principles of acceptance, membership and reciprocity, interpersonal relationships represent the most encouraging approach, recovering the sense of self and understanding psychotic experiences in a biographical context. Therefore, with this client population, P/MH nursing must be framed in a psychosocial perspective, to better comprehend what is happening to service users, responding with interpersonal skills and covering needs from the base of a therapeutic person-centred relationship.