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Mental Health Awareness Month: Communication with Mental Health Patients

May is Mental Health Awareness Month. The National Alliance for the Mentally Ill (NAMI) hopes to both raise awareness of various mental health issues faced by individuals and to help remove the stigma associated with mental illness. A staggering 26.2% of adult Americans deal with a variety of mental disorders, including manic depression, anxiety, eating disorder, borderline personality disorder, schizophrenia, and many others.

Very often, there is an unfair stigma attached to these disorders. For this reason, those who deal with mental health issues are less inclined to seek help for their disorders and suffer in silence. Suicide rates among persons with a mental disorder are alarmingly high: more than 90% of all individuals who commit suicide had at least one mental health disorder.

With this in mind, Mental Health Awareness month shines a spotlight on various disorders and opens the floor to discussing these problems and helping those who live with mental health issues.

When mental health professionals communicate with the intent of forming therapeutic alliances it teaches patients how to cope with their mental disorders and helps them to feel more in control -- in a situation where they have very little control over their lives. With this in mind, we'd like to discuss some reminders for psychiatric nurses about verbal and non-verbal mental health communication techniques that foster therapeutic interactions between nurses and patients.

Non-Verbal Communication

"It's not just what you say, it's also how you say it." This mantra makes perfect sense within the field of mental health communication, where one needs to be adept at reading between the lines to understand how one's tone and non-verbal cues augment verbal communications.

Another non-verbal aspect of processing is tone of voice. For instance, a patient might verbalize that they are feeling fine, whereas their gesturing could indicate some kind of upsetting emotion that might lead to an outburst. Much in the same way lab screenings are performed to check on a patient's physical health, being aware of a patient's body language can help nurses sense a potential problem immediately, identify the problem accurately, and intervene promptly before unwanted behavior becomes disruptive.

Nurses must master the ability to alter their tone of voice and volume of speaking to suit the objective of eliciting calm, nonviolent reactions from their patients. In some instances this might require them to speak in a soothing tone, where as other situations might necessitate a more authoritative tone.

Verbal Communication

In addition to practicing mindful non-verbal communication, psychiatric nurses must also be skilled at choosing the right words to use with a patient—words that inform but do not overwhelm, and are honest but not harsh. In the same way that it is important to organize a patients medical needs, it is also important for a nurse to utilize structured verbal communications that provide patient's with a sense of consistency and esteem.

One productive way to do so is by verbalizing observations of what the patient has said, and then seeking clarification. As a sort of formula this might look like: "I heard you say you felt _________ when _________. Is that right?" By listening to the patient and acting as a reflector in which a patient can explore his or her feelings and make sense of current or past experiences, the nurse is inviting the patient to participate in his or her own treatment.

Other helpful verbal prompts include words of acceptance, recognition, encouragement, and at times utilizing silence as a time for reflection or affirmation that one is listening.

As with most things in life, when it comes to interpersonal communication skills, one size does not fit all. Learning to communicate in the most effective way requires trial and error where the best way to intervene is dependent on each unique situation.

Alas, when it comes to communication in mental health, there is no "right" or "wrong" set of communication skills nor is there a universal verbal formula to solve every problem. There are instead useful and non-useful interventions, and nurses who possess the skills, devotion and enthusiasm to determine which are which.

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