Psychiatric nursing and the context of care

Our ability to provide nursing care for persons with severe mental illness is contingent on awareness of contextual factors and our ability to adapt and influence them. Briefer inpatient stays and more partial hospitalization programs must lead to changes in our theoretical orientation and types of intervention. Awareness of the shift to community mental health and the threat of the remedicalization of psychiatry should encourage nurses to broaden their roles and add new skills. Case management and political and systems advocacy are particularly crucial responses to the needs of the severely mentally ill and their families. We must never lose sight of individual patients and their pain. The alleviation or prevention of this pain is our ultimate goal.