INTRODUCTION TO MENTAL HEALTH NURSING

1. Introduction to mental health nursing

2.  An ability to make adjustments.
 Sense of personal worth, and importance.
 Own decision making and problem solving.
 Sense of personal security and feel secure in group,
understand other people problems and motives.
 Sense of responsibility.
 Give and accept love.
 Shows emotional maturity and tolerate frustration.
 Have a philosophy of life and purpose to his daily
activities.
 Has a variety of interests and well balanced with work,
rest and recreation.
 Lives in the world of reality not fantasy

3.  Mental Illness Mental and behavioral disorders are
clinically significant conditions characterized by
 alterations in thinking,
 mood/emotions, or behaviour
 associated with personal distress and impaired
functioning.
Characteristics;
 1.Change in thinking, memory, perception, feeling,
judgment and speech.
 2.Disturbance in day to day activities, work and
relationship with important others

4.  The disease was viewed by demonic possession, influence of
ancestral spirits, result of violating a taboo, neglecting ritual and
cultural condemnation.
 As a result they were beaten, tortured, to make body unsuitable
for demon.
 The scientific knowledge and truth begins.
 Pythagoras: (580-510 BC) developed the concept that brain is
the seat of intellectual activity.
 Hippocrates: (460-370 BC) described mental illness as
hysteria, mania, and depression.
 Plato (427- 347 BC) identified the relationship between mind
and body.
 Asciepiades: made simple hygienic measures, diet, bath,
massage in place of mechanical restraints.
 Aristotle suggested release of repressed emotions for the
effective treatment of mental illness.

5.  Evolution of Mental HealthThe scientific knowledge
and truth begins.
 Renaissances in Europe on old beliefs.
 The saddest period in the history of psychiatry.
 Demons cause hallucinations and delusions hence chain
the patients.

6. Some Important Milestones
 1773: The first mental hospital was set up in US,
Virginia.
 1793: Philippe Pinel removed the chains from
mentally ill patients confined in Bicetre, Paris and
brought a revolution in the country.
 1812: The first American textbook in Psychiatry
was written by Benjamin Rush.
 1912: Eugene Bleuler , a Swiss Psychiatrist coined
the term schizophrenia.
 1912: The Indian Lunacy Act was passed.

7.  1927: Insulin shock treatment was introduced for
schizophrenia.
 1936: Frontal lobectomy was advocated for the
management of psychiatric conditions.
 1938: Electroconvulsive Therapy (ECT) was used for
the treatment of psychosis.
 1939: Development of Psychoanalytical theory by
Sigmund Freud led to new concepts in the treatment of
mental illness.
 1946: The Bhore committee recommended setting of
five mental Hospitals in the Country.

8.  1949: Lithium was used for the treatment of mania.
 Chlorpromazine was introduced in
psychopharmacology.
 1963: The community mental health centers Act was
passed.
 1978: The Alma Ata declaration of Health for All by
2000 AD posed major challenge to Indian mental health
professionals.
 1981: Community psychiatric centers were set up to
experiment primary mental health care approach.

9.  1982: The central council of health, India’s highest
policy making body accepted the National Mental
Health Policy and brought out the National Mental
Health Programme in India.
 1987: The Indian Mental Health Act was passed and
constituted Central Mental Health Authority (CMHA)
and State Mental Health Authority (SMHA).
 1990: Formation of Action Group to pool opinion for
National Mental Health Programme.
 Integration of mental health care with general health
care,
 school mental programme, promotion of child mental
health, crisis intervention of suicide prevention,
halfway homes, IEC etc.

10.  2001: Current situation analysis (CSA) was done to
evolve a comprehensive plan of action to energize the
NMHP.
 2007: Eleventh five year plan emphasized up
gradation and strengthening of mental health hospitals.
 2013: WHO launched Mental Health Action Plan 2013-
2020.
 2013: The Mental Health Care Bill was introduced
 The bill abolishes the Mental Health Act 1987.

11.  2014: Government constituted a committee to create
policy for the country.
 1872: First training school for nurses based on the
Nightingale system was established by the New
England Hospital, USA.
 1921: Short training courses of 3 to 6 months were
conducted in Ranchi.
 1943: Psychiatric nursing was started for male
nurses. (Tamil Nadu)
 1952: Dr. Hildegard Peplau defined the therapeutic
roles of nurses in mental health setting.
 1953: Maxwell Jones introduced therapeutic
community.

12.  1956: One year post- certificate course in psychiatric
nursing was started at NIMHANS.
 1958: All the wards in Agra Mental Hospital were
ordered to be kept open and all ward locks were
removed from the charge of the ward attendant.
 1963: Journal of Psychiatric Nursing and Mental
Health services was published.

 1965: The Indian Nursing Council included psychiatric
nurse as a compulsory course in B.Sc Nursing
Programme.

13.  1967: The TNAI formed a separate committee to set
guidelines to conduct classes and clinical training for
nursing students.
 1973: Standards of Psychiatric and Mental Health
Nursing Practice were enunciated to provide a means of
improving the quality of care.
 1975: M.Sc in Psychiatric Nursing started.
 1986: Psychiatric nursing was included in GNM.
 1991: Indian Society of Psychiatric Nurses started.
 2010: ISPN published its journal.

14. Indian Society of Psychiatric Nurses
 ISPN started in the year 1991 at NIMHANS under the
guidance of Dr. Reddemma.
 Purpose
 To enhance the advanced knowledge and skills in the field
of psychiatric nursing.
 To provide a platform for discussion and deliberation on
evidence based practice.
 To create awareness and translate the research finding into
practice.
 ISPN publishes a journal called Indian Journal of
Psychiatric Nurses.
 It also Organizes National and International conferences.

15. 1. Trends in Health Care:
 Increased mental problems.
 Provision of quality and comprehensive services.
 Multi-disciplinary team approach.
 Providing continuity of care.
 Care is provided in alternative settings.
2. Economic Issues
 Industrialization
 Urbanization
 Raised standard of living.
3. Changes in the Illness Orientation
 Shift from Illness to prevention.
 Quantity of care to quality of care.
 Specific to holistic care.
4. Changes in the Care delivery
 Institutional services to community services.
 Genetic to counseling services.
 Nurse patient relationship to nurse patient partnership.

16. 5. Information Technology
 Telenursing
 Telemedicine
 Mass media
 Electronic Systems.
 Nursing Informatics.
6. Consumer Empowerment
 Increased consumer awareness.
 Increased community awareness.
 Demand health care at affordable cost and more humane rates.
7. Deinstitutionnalization
 Shifting Mental Health care from hospital to Community.
8. Physician Shortage and Gaps in service.
 Physician shortage provide opportunity for new roles in nursing such as Nurse
Practioner.
9. Demographic Changes
 Increasing number of elderly group.
 Type of family.
10. Social Changes
 Intergroup and intragroup loyalty maintenance.
 Peer Pressure.

17.  There is a lack of clearly enunciated definition of the role of a
professional psychiatric nurses.
 Greater emphasis to encourage master degree in psychiatric nursing
to encourage teaching non-professionals.
 Offer diploma in psychiatric nursing to avoid shortage of trained
professionals.
 Maintain minimum standards of psychiatric nursing care in mental
hospitals ie, 1:3.
 Fill vacant positions in concerned educational and practicing
institutions.
 Integration of service and training.
 Formation of District Mental Health Team comprising of 2
psychiatric nurses and 1 Psychiatrist.
 Integration mental health services in PHCs and Sub centers.
 Joined working of hospitals and training centers to build the gap of
theory and practice. If not, the hospital staff will have lack of up
gradation of knowledge and training centre staff will have lack of up
gradation of skills.

18.  The recent prevalence of psychiatric disorders in the country is 18 – 207 per
1000 population and the world scenario is also almost the same.
 Most of these patients live in rural areas.
 Most of the time the person visiting a general clinic is not diagnosed for his
mental problems rather other diagnosis is made which cause financial burden
to the patients.
World Scenario (According epidemiological survey by WHO in 14 countries) (a
12 months prevalence in the year 2000-2001)
 Anxiety disorders : 2.4% to 18.2%
 Mood disorders: 0.8% to 9.6%
 Substance disorders 0.1–6.4%
 Impulse-control disorders 0.0–6.8%
Indian scenario (According to an epidemiological study by Ganguli HC, 2000)
 All Mental disorders 73/1000 population (rural: 70.5 and urban 73)
 Affective disorder (depression): 34/1000
 Anxiety Neurosis: 16.5/1000
 Mental Retardation: 5.3/1000
 Schizophrenia: 2.5/1000

19.  According to health information of India 2005 mental
morbidity rate is not less than 18-20/1000
 According to WHO studies in India the life time
prevalence of mental disorders is12.2 to 48.6 %.
 According Ministry of Health and Family welfare,
India, 10000 people every year suffer from acute
psychosis.
 Schizophrenia and bipolar disorders is prevalent at a
rate of 200/10000 population.
 This burden is likely to increase by 15% in 2020.
(Ghanashyan B & Nagarathinam S)

20.  In April 2011 the GoI constituted a policy group.
 Based on the recommendations of the experts
 The National Mental Health Policy was considered in accordance
with World Health assembly resolution.
 It incorporates an integrated, participatory rights and evidence
based approach.
VISION
 Promote mental health
 Prevent mental illness
 Enable recovery from mental illness.
 Promote destigmatization
 Promote desegregation
 Provide accessible, affordable and quality mental health and
social care to all persons through life span within right based
framework.

21. GOALS (LONG TERM DESTINATION)
 To reduce distress, disability, exclusion morbidity and
premature mortality associated with mental health
problems.
 To enhance understanding of mental health in the
country.
 To strengthen the leadership in the mental health sector
at the National, State and District Levels.

22.  To provide universal access to mental health care.
 To increase access and utilization of comprehensive mental
health care services.
 To increase the access of the said services to vulnerable
groups including homeless, remote areas, deprived
(education, economy and socially) sections
 To reduce prevalence and risk factors of mental problems.
 Reduce suicide and its attempts.
 Respect the rights of mentally people and protect them
from harms.
 Reduce stigma associated.
 Equitable distribution of skilled human resources.
 Enhance financial allocation and utilization in the sector.
 Identify and address the social, biological and
psychological determinants of mental health problems.

23. 1. Effective governance and delivery mechanisms for
mental health
Develop policies, programmes, laws regulations and
budget.
Motivate society and other administrative
machineries to implement and monitor the plans.

24. 2. Promotion of Mental Health
Redesign Anganwadi centers and train the workers and
teachers to protect children from developing abnormal
behaviour.
Offer (LSE) Life Skill Education programme to school
children. Life-Skills-Education-in- India.pdf
Individual attention by teachers for early symptoms.
Improve teacher student relationship for free communication.
 Assist adults in handling stressful life circumstances.
 Use mass media to disseminate mental health information.
 Improve life conditions such as homelessness,
overcrowding, water, toilets, sanitation and nutrition to
prevent mental illness.
 Improve women mental health and prevent harm to women.
 Use Ayurveda and Yoga to promote mental Health.
 Involve mentally ill people in social, economical and other
activities, do not discriminate

25. Actions 3. Prevention of mental illness, reduction of
suicide ant attempted suicide.
 Implement programs to address alcohol and other drug
abuse.
 Restrict the distribution of specific drugs and highly
toxic pesticides.
 Frame guidelines for media reporting suicide.
 Decriminalize attempted suicide.
 Train community leaders to prevent it.

26. Actions 4. Universal access to mental health services.
 All multispecialty govt. hospitals should provide family
centric mental health services.
 Increase community based rehabilitation services like day
care centers, short stay facilities etc.
 Caregivers should be given professional inputs and
promoted for personal growth.
 Screening and early detection.
 Resolve shortage psychiatric beds in hospitals.
 Improve infrastructure.
 Improve monetary benefits and tax benefits to care givers.
 Provide assisted home living and also care homeless
patients.

27. 5. Availability of Trained professionals
 Reduce the gap between requirement and
availability of psychiatrists, nurses, psychologists etc.
 Improve number and quality of the training
programmes.
 Training programmes must incorporate biomedical
and psychosocial interventions in the interventions for
the patients.

28. 6. Community participation for mental health and development
 Simplify procedures for disability certification of persons with
mental illness.
 Protect the rights of mentally ill and modify the legislations
accordingly.
 Promote participation in life activities of mentally ill such as
education, housing, employment and social welfare.
 Involve them in community programmes such as village
health, sanitation, water etc and public activities.
 Provide opportunity for mentally ill for feedback in mental
health services.

29. 7. Research
 More investment and fund allocation in building
research capacity for both new and existing
organizations.
 Foster partnership between centers of excellence for
mental health and medical colleges and district centers
to promote research.
 Evaluate the potential of traditional, alternative
therapies to address mental health problems.
 Facilitate dissemination of research findings and
translate it into action.

30.  NHP formulated in 1983 and revised in 2002.
Objectives
 To achieve an acceptable standard of good health
amongst the general population.
 Increase approach to decentralized public health
system.
 Establish new infrastructure and update existing
infrastructure.

31. Recommendations for Mental Health
 Upgrade infrastructure of institutions at central
government expense to protect the rights of vulnerable
group of the society.
 Promote decentralization of mental health services
for more common categories of disorders.

32.  Indian mental health act (MHA) was drafted by the parliament
in 1987 but it came into effect in all states & union territories
of India in April 1993.
 This act replaces the Indian lunacy act of 1912.
REASONS FOR ENACTMENT
 The attitude of the society towards the mentally ill has
changed considerably & it is now realized that no stigma should
be attached to such illness, as it is curable practically when
diagnosed at an early stage. Thus the mentally ill individuals
should be treated like any other sick persons & the environment
around them made as normal as possible.
 The experience of working of the indian lunacy act,1912 has
revealed that it has become outmoded with rapid advancement
of medical science & the understanding of nature of malady. It
has therefore become necessary to make fresh legislation in
accordance with the new approach.

33. OBJECTIVES OF MENTAL HEALTH ACT
 To regulate admission into psychiatric hospitals &
psychiatric nursing homes.
 To protect society from the presence of mentally ill
persons.
 To protect citizens form being detained in psychiatric
hospitals/ nursing homes without any sufficient cause.
 To regulate maintenance charges of psychiatric hospitals/
nursing homes.
 To provide facilities for establishing guardianship of
mentally ill persons who are incapable of managing their own
affairs.
 To establish central & state authorities for mental health
services.
 To regulate the power s of the government for establishing
licensing & controlling psychiatric hospitals/nursing homes.
 To provide legal aid to mentally ill persons at state expense
in certain cases.

34. 
Multidisciplinary approach to provide service to mentally ill persons.
 A psychiatrist
 A psychiatric Nurse
 A clinical Psychologist
 A psychiatric social worker
 An occupational therapist/activity therapist
 A pharmacist and a dietician.
 A counselor.
A psychiatrist: MD/DNB Psychiatry.
 Medical diagnosis and treatment.
 Admission/discharge
 Psychopharmacology
 Administer ECT
 Psychotherapy
 Team meetings
 Legal responsibilities.


35. A psychiatric Nurse: RN with specialized training.
 Administer and monitor medications.
 Assist in physical and psychiatric treatment
 Interdisciplinary team meeting.
 Health Education
 Patients Records
 Advocate of patient.
 Relationship with patient’s family.

36. A Clinical Psychologist:
 Masters/ Doctorate in human psychology.
 Accountable of psychological assessments/testing.
 Individual, family and marital therapy.
A Psychiatric Social worker: Masters/ Doctorate.
 Family case work and community placement of
patients.
 Group therapy sessions.
 Social intervention at patient social environment.

37.  Concerned training.
 Accountable for recreational, occupational and activity
programmes.
 Assist the patients in gaining skills that help them cope
more effectively, retain employment and use their
leisure time.
A Counselor: Concerned training.
 Provides basic supportive counseling and assists in
psycho educational and recreational activities

38.  Nurse Generalist: a licensed nurse providing primary mental health
care. Holistic approach, prevention programmes, community and day
care centers, psychiatric rehabilitation facilities, homeless shelters etc.
 Nurse Specialist: Psychiatric Clinical Nurse Specialist (CNS): have a
master degree in mental health nursing. Autonomous functioning,
prescription privileges, manages overall care of emotional and
psychiatric problems. Eg. Crisis interventio0n specialists, Milieu
Specialists, Psychotherapists etc.
 Community Mental Health Nurse (CMHN): Diagnosis, appropriate
referrals, care and rehabilitation of mentally ill people in the
community.
 Psychiatric Home Care Nurse: direct patient care, behavioral
management, crisis intervention, psycho education, detoxification,
medication etc.
 Forensic Psychiatric Nurse: works with individuals who have
entered the legal system.
 Psychiatric Consultation –
 Liaison Nurse PCLN: Psychiatric nurse who work in non- psychiatric
setting and provide necessary support, guidance and counseling for
those affected with anxiety, depression and other psychological
problems.

39.  Case Manager: Nurse manager acts as advocates by
coordinating care and linking patient with physician and
other members of health care team. Works in community
and helping in daily living of a mentally ill person such as
transportation, managing money, buying things etc.
 Gero Psychiatric Nurse;
 Parish Nurse: An RN with spiritual mature. Supports
health education, social services, and carry out non-invasive
nursing care. Common in US.
 Tele health / Tele nurse: Nurses engaged in tele-nursing
practice use technologies such as internet, computers,
telephones, digital assessment tools & tele-monitoring
equipment to deliver nursing care. In India around 10
hospitals are having telemedicine departments. Eg. Apollo
hospitals, Narayana Hrudayalaya.

40.  Nurse Researcher: Nurse researchers design, conduct
& disseminate findings of research at professional
meets & in peer reviewed journals. They are doctorally
or post-doctorally prepared persons who initiate or
participate in all phases of the research process.
 Psychiatric Nurse Educator:
 Nurse Administrator/Manager
 Nurse Pharmacologist: The psychiatric clinical nurse
specialist with prescriptive authority.
 Holistic Nurse: Integrates complementary and
alternative modalities such as relaxation,

41. INPATIENT PSYCHIATRIC WARD…
 Provide for environment safety including protecting the patient & others
from injury.
 Perform psychosocial, high risk & physical assessment.
 Promotion of self care activities.
 Medication management.
 Assisting for somatic therapies.
 Accurately observing & documenting the patient’s behavior.
 Providing opportunities for the patient to make his own decisions & to
assume
 Provide safe environment and protect from injury.
 Perform psychosocial, high risk & physical assessment.
 Promotion of self care activities.
 Medication management.
 Documentation of behaviour.
 Providing opportunities for the patient to make his own decisions & to
assume responsibility for his life.

42.  Participation in various therapies, individual
interactions, formal & informal group situations, role
play, advocating on behalf of the patient & so forth.
 Delivering psycho-education, social skill and stress
management strategies.
 Counseling the patient & family members.
Interdisciplinary approach to care.
 Discharge planning & community referral & follow up
care.

43. PSYCHIATRIC OUTPATIENT DEPARTMENT
 Performing clinical assessment.
 Assisting for psychometric assessment.
 Assisting or providing psychotherapy or behavior
therapy.
 Counseling the patient & family members.
 Conducting group therapy.
 Delivering psycho education.
ECT TREATMENT SETTING
 Preparing the patient for ECT.
 Providing care during the procedure.
 Assisting with post treatment.
 Providing reassurance to reduce anxiety.
 Delivering psycho education regarding ECT.

44. PSYCHO THERAPY UNIT
 Establishing a therapeutic relationship with the patient.
 Providing an opportunity for the patient to release tension as
problem are discussed.
 Assisting the patient in gaining insight about the problem.
 Providing opportunity to practice new skills.
 Reinforcing appropriate behavior as it occurs.
 Providing consistent emotional support.
DAY CARE CENTERS OR DAY HOSPITALS
 Performing clinical assessment /observation/ documentation.
 Medication management.
 Teaching social skills.
 Counseling patient & family members.
 Delivering psycho education.
 Providing occupational or recreational therapy & vocational
assistance.

45.  CHILD PSYCHIATRIC WARD
 Assessing the child and understand his strengths and
abilities.
 Monitor the child’s developmental levels & initiate
supportive interventions such as speech, language or
occupational skills as needed.
 Provide a safe therapeutic environment.
 Interdisciplinary approach to care.
 Teach the child adaptive skills such as eating, dressing,
grooming & toileting.
 Deliver psycho education and Medication
management, participate in therapies.

46. HOME SETTING
 Assessment of symptoms.
 Teaching the patient & family regarding nutrition,
exercise, hygiene & the relationship between physical
& emotional health.
 Stress management and Daily living kills (bank
accounts, rent, utility bills, use of the telephone,
grocery shopping).
 Medication management Oral/IV– monitoring blood
levels, toxicity, side effects & purposes.
 Acts as a case manager & coordinate an array of
services such as therapies.

47. COMMUNITY MENTAL HEALTH CENTERS
 Identification and referral of patients to appropriate
hospitals.
 Home visiting & providing direct care to the patients
in the community.
 Follow up care with special emphasis on medication
regimen, & side effects, patient’s occupational
function.
 Conducting public awareness programs to remove
misconceptions regarding mental disorders.
 Training of other care giving professionals in the
community.

48. HOSPICE CARE CENTERS
 Helping cancer patients or terminally ill individuals
through the grieving process.
 Provide supportive psychotherapy and support their
families.
EMERGENCY DEPARTMENTS
 Crisis intervention during natural disasters, accidents,
unexpected illnesses causing increased anxiety.
 Helping the mother in labor & to cope with stress.
 Providing support to bereaved patients in the event of
fetal demise, abortion, birth of an infant with congenital
abnormalities.

49. HOSPITALS FOR CRIMINAL INSANE, JAILS &
PRISONS
 Forensic psychiatric nurses assist patients with self
care, administration of medications & monitor the
effectiveness of the treatment.
 Provide psychotherapy & act as consultants.
 Assessment of potential for violence.
 Parole / probation considerations.
 Assessment of racial / cultural factors during crime.
 Formal written reports to court.

50.  Nurse Practice acts.
 Professional Practice Standards
 Nurse’s Qualification.
 Philosophy of health Care Organization.
 The person competence and initiatives of the
individual nurse.

51.  Behaviour is the manner in which a person behaves,
whether they can conform to the standards, or not.
Types Of Behaviour
 1.NORMAL BEHAVIOUR:- Normal is seen as a good
thing, something that is natural, regular, or routine.
 2. ABNORMAL BEHAVIOUR:- Abnormal is any kind
of activity that a person sees as bad behaviour or
something that is not common, it can be defined as a
birth defect to a mental illness.

52. NORMAL BEHAVIOUR:-
 Word normal derived from latin word norma means rule .
means followed the rule or pattern or standards.
 Definition:- when the individual is able to function adquately
and performs his daily living activities efficiently and feel
satisfied with his life style called as normal behaviour .
ABNORMAL BEHAVIOUR :-
 The word abnormal with prefix ,’ab’(away from) means away
from normal.
 Abnormality is negetive concept it means deviation from norm
or standard or rules .
 Definition :-disturbances seen in behaviour which menifests in
cognitive domain(thinking,knowing,memory)affecti ve domain
(emotion and feeling ) and conative domain (psychomotor
activity) individual express his mental distress through thought,
feeling and action .

56.  Jahoda(1958) attempted to establish what is abnormal
by identifying the characteristics of people who are
normal.
 She identified six characteristics of mental health.
 Efficient self-perception
 Realistic self-esteem and acceptance
 Voluntary control of behavior
 True perception of the world
 Sustaining relationships and giving affection
 Self-direction and productivity

62. Characteristics Of Abnormal Behaviour
The 4 "D's" of Abnormality:-
 D – dysfunction ,
 D – distress,
 D – deviance ,
 D – dangerousness
 1. Dysfunctional: Behaviors and feelings are dysfunctional when they
interfere with person's ability to function in daily life, to hold a job,
or form relationships.
 2. Distress: Behaviors and feelings that cause distress to the individual
or to others around him or her are considered abnormal.
 3. Deviant: Highly deviant behaviors like chronic lying or stealing
lead to judgements of abnormality.
 4. Dangerous: Behaviors and feelings that are potentially harmful to
an individual or the individuals around them are seen as abnormal.

63.  Physiological or Biological Model
 Behavioural Models
 Psychodynamic Models
 Cognitive Model

64.  The biological model of abnormality (the only model not
based on psychological principles) is based on the assumptions
that if the brain, neuro-anatomy and related biochemicals
are all physical entities and work together to mediate
psychological processes, then treating any mental
abnormality must be physical/biological.
 Part of this theory stems from much research into the major
neurotransmitter, serotonin, which seems to show that major
psychological illnesses such as bipolar disorder and anorexia
nervosa are caused by abnormally
 The model also suggests that psychological illness could and
should be treated like any physical illness (being caused by
chemical imbalance, microbes or physical stress) and hence
can be treated with surgery or drugs.

65.  The behavioural model to abnormality assumes that all
maladaptive behaviour is essentially acquired through
one's environment.
 Therefore, psychiatrists practising the beliefs of this
model would be to prioritise changing the behaviour
over identifying the cause of the dysfunctional
behaviour.
 The main solution to psychological illness under this
model is aversion therapy, where the stimulus that
provokes the dysfunctional behaviour is coupled with a
second stimulus, with aims to produce a new reaction
to the first stimulus based on the experiences of the
second.

66.  The psychodynamic model is the fourth psychological
model of abnormality, and is based on the work of
Sigmund Freud.
 It is based on the principles that psychological
illnesses come about from repressed emotions and
thoughts from experiences in the past (usually
childhood), and as a result of this repression,
 The patient is believed to be cured when they can
admit that which is currently being repressed

67.  The cognitive model of abnormality focuses on the cognitive
distortions or the dysfunctions in the thought processes and
the cognitive deficiencies, particularly the absence of sufficient
thinking and planning.
 This model holds that these variables are the cause of many
psychological disorders and that psychologists following this
outlook explain abnormality in terms of irrational and negative
thinking with the main position
The cognitive model of abnormality is one of the dominant
forces in academic psychology beginning in the 1970s and its
appeal is partly attributed to the way it emphasizes the evaluation
of internal mental processes such as perception, attention,
memory, and problem- solving.
The process allows psychologists to explain the development of
mental disorders and the link between cognition and brain
function especially to develop

68.  Medical model considers organic pathology as the
definite cause for mental disorder.
 According to this model abnormal people are the ones
who have disturbances in thought, perception and
psychomotor activities.
 The normal are the ones who are free from these
disturbances.

69.  It involves the analysis of responses on a test or a
questionnaire or observations of some particular
behavioral variables.
 The degree of deviation from the standard norms
arrived at statistically, characterizes the degree of
abnormality.
 Statistically normal mental health falls within two
standard deviations (SDs) of the normal distribution
curve.

70.  The beliefs, norms, taboos and values of a society
have to be accepted and adopted by individuals.
Breaking any of these would be considered as
abnormal.
 Normalcy is defined in context with social norms
prescribed by the culture.
 Thus cultural background has to be taken into account
when distinguishing between normal and abnormal
behavior.