Preface

This book is an adaptation of Nursing Mental Health and Community Concepts by Chippewa Valley Technical College. The original Open RN project was supported by a $2.5 million grant from the Department of Education to create five free, open-source nursing textbooks. However, this content does not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the federal government. The first three textbooks of the Open RN textbook series, Nursing Pharmacology, Nursing Skills, and Nursing Fundamentals, received a Best OER Award from OE Global in 2020 and 2021.

This version was edited and adapted by Dr. Terri Farmer at the University of Arizona College of Nursing for classroom use in Bachelor of Science in Nursing programs. Mental health is discussed while emphasizing stress management techniques, healthy coping strategies, referrals to community resources, and other preventative interventions. Nursing care for individuals with specific mental health and substance use disorders is examined, and the nurse’s role in caring for vulnerable populations is introduced.

Original Editors

Kimberly Ernstmeyer, MSN, RN, CNE, CHSE, APNP-BC
Elizabeth Christman, DNP, RN, CNE

Original Graphics Editor

Nic Ashman, MLIS, Librarian, Chippewa Valley Technical College

Original Developing Authors

Developing authors remixed existing open educational resources and/or developed content based on evidence-based sources and experience in the mental health field:

Elizabeth Christman, DNP, RN, CNE
Dawn Barone, MSN, RN, Chippewa Valley Technical College
Sue Dzubay, MSN, RN, CHSE, RN-BC, Chippewa Valley Technical College
Kimberly Ernstmeyer, MSN, RN, CNE, CHSE, APNP-BC, Chippewa Valley Technical College
Jeanne Green, EdS, MSN, RN, CNE, CHEP, RN-BC, Chippewa Valley Technical College
Deb Johnson-Schuh, MSN, RN, CNE, Mid-State Technical College
Rorey Pritchard, EdS, MEd, MSN, RN-BC, CNOR(E), CNE, Senior RN Clinical Educator, Allevant Solutions, LLC
Miriam Sward, DNP, PMHNP, APNP, Psychiatric Mental Health Nurse Practitioner
Alicia Tays, MS, LPC, Counselor

Original Contributors

Contributors assisted in creating this textbook:

Jane Flesher, MST, Proofreader, Chippewa Valley Technical College
Shronda Green, MSN, RN, Gateway Technical College
Vince Mussehl, MLIS, Open RN Lead Librarian, Chippewa Valley Technical College
Joshua Myers, Web Developer, Chippewa Valley Technical College
Kelly Nelson, MSN, RN, Mid-State Technical College
Amanda Olson-Komisar, CSW, Social Worker; Pupil Services Teacher Assistant, Pepin Area Schools
Andrea Olson, MSN, RN, Trempealeau County Healthcare Center
Meredith Pomietlo, BA, Retail Design and Marketing, University of Wisconsin – Stout
Dominic Slauson, BA, Open RN Instructional Technologist
Jamie Zwicky, EdD, MSN, RN, Moraine Park Technical College

Original Advisory Committee

The Open RN Advisory Committee consisted of industry members and nursing deans who provided input for the Open RN textbooks and virtual reality scenarios:

Jenny Bauer, MSN, RN, NPD-BC, Mayo Clinic Health System Northwest Wisconsin, Eau Claire, WI
Lisa Cannestra, Eastern Wisconsin Healthcare Alliance
Travis Christman, MSN, RN, Chief Nursing Officer, HSHS Sacred Heart and St. Joseph’s Hospitals
Sheri Johnson, UW Population Health Institute
Vicki Hulback, DNP, RN, Dean of Nursing, Gateway Technical College
Jenna Julson, MSN, RN, NPD-BC, Nursing Education Specialist, Mayo Clinic Health System Northwest Wisconsin, Eau Claire, WI
Brian Krogh, MSN, RN, Associate Dean – Health Sciences, Northeast Wisconsin Technical College
Hugh Leasum, MBA, MSN, RN, Nurse Manager Cardiology/ICU, Marshfield Clinic Health System, Eau Claire, WI
Pam Maxwell, SSM Health
Mari Kay-Nobozny, NW Wisconsin Workforce Development Board
Amy Olson, DNP, RN, Nursing Education Specialist, Mayo Clinic Health System Northwest Wisconsin, Eau Claire, WI
Gina Petrie, MSN, RN, Dean of Nursing, Chippewa Valley Technical College
Rorey Pritchard, EdS, MEd, MSN, RN-BC, CNOR(E), CNE, Senior RN Clinical Educator, Allevant Solutions, LLC
Kelly Shafaie, MSN, RN, Associate Dean of Nursing, Moraine Park Technical College
Ernise Watson, PhD, RN, Associate Dean of Nursing, Madison Area Technical College
Sherry Willems, HSHS St. Vincent Hospital

Original Reviewers

Caryn Aleo, PhD, RN, CCRN, CEN, CNE, CNEcl, Pasco-Hernando State College
Dawn Barone, MSN, RN, Chippewa Valley Technical College
Lisa Bechard, MSN, RN, Mid-State Technical College
Shanleigh Bechard, MS, LPC, Beloit Area Community Health Center
Ginger Becker, Nursing Student, Portland Community College
Nancy Bonard, MSN, RN-BC, St. Joseph’s College of Maine
Joan Buckley, PhD, RN, Nassau Community College
Kathleen Capone, MS, RN, CNE, EdD, Utica College
Lorraine Chiappetta, MSN, RN, CNE, Emeritus Washtenaw Community College
Travis Christman, MSN, RN, Hospital Sister’s Health System
Maria Darris, MSN, RN, St. Louis Community College
Tamara Davis, MSN, RN, Chippewa Valley Technical College
Andrea Dobogai, DNP, RN, Moraine Park Technical College
Judith Dornbach, DNP, MSN, RN, NEA-BC, Southwestern Oregon Community College
Jessica Dwork, MSN-Ed, RN, Maricopa Community Colleges-Phoenix Collège
Terri J. Farmer, PhD, PMHNP-BC, University of Arizona College of Nursing
Rachael Farrell, EdD, MSN, CNE Howard Community College, Columbia, MD
Vivienne Friday, EdD, MSN, RN, CNE, MSOL Goodwin University
Jocelyn E. Goodwin, MSN, RN, Paradise Valley Community College
Kerry L. Hamm, MSN, RN, Lakeland University
Julia Harelstad, MSN, RN, Mayo Clinic Health System, Eau Claire WI
Deborah Harmon, BSN, RN, AdventHealth Zephyrhills/Dade City
Melissa Hauge, MSN, RN, Madison College
Camille Hernandez, MSN, APRN-Rx, ACNP/FNP, Hawaii Community College – Palamanui
Katherine Howard, MS, RN-BC, CNE, Middlesex College New Jersey
Susan Jepsen, MSN, RN, CNE, Lansing Community College
Eric Johnson, MSN, RN, Chippewa Valley Technical College
Kathi L. Johnson, DNP, MS, RN-BC, CNE, Howard Community College
Jenna Julson, MSN, RN, NPD-RN, Mayo Clinic Health System
Andrew D. Kehl, DNP, MSN, MPH, APRN, RN, Vermont Technical College
Kathryn Kieran, MSN, PMHNP-BC, MGH Institute of Health Professions
Lindsay Kuhlman, BSN, RN, HSHS Sacred Heart
Kathy L. Loppnow, MSN, RN, WTCS Health Science Education Director (retired)
Dawn M. Lyon, MSN, RN, Saint Clair County Community College
Erin Micale-Sexton, DNP, MSN-RN, CNL, Lansing Community College, Madonna University, Arizona College
Sara K. Mitchell, MSN, RN, Fox Valley Technical College
Jamie Murphy, PhD, RN, SUNY Delhi
Kelly Nelson, MSN, RN, Mid-State Technical College
Tram Nguyen, Nursing Student, Portland Community College
Tennille O’Connor, DNP, RN, CNE, College of Central Florida
Andrea Olson, MSN, RN, Trempealeau County Health Care Center
Amanda Olson-Komisar, CSW, Social Worker; Pupil Services Teacher Assistant, Pepin Area Schools
Grace Paul, DNP, MPhil, RN, CNE, Glendale Community College
Krista Polomis, MSN, RN, CNE, Nicolet College
Mary A. Pomietlo, MSN, RN, CNE, University of Wisconsin – Eau Claire
Cassandra Porter, MSN, RN, Lake Land College
Rachel Potaczek, BSN, RN, Chippewa County Department of Public Health
Rorey Pritchard, EdS, MSN, RN-BC, NPD, CNOR(E), CNE, Allevant Solutions, LLC
Debbie Rickeard, DNP, MSN, BScN, BA, RN, CNE, CCRN, University of Windsor
Argie Rivera, DNP, MAN, PMHNP-BC, Polara Health, Grand Canyon University, Cara Behavioral Health
Kathleen S. Rizzo, MSN, RN, St Louis Community College at Forest Park
Ann K. Rosemeyer, MSN, RN, Chippewa Valley Technical College
Brenda Scheurer, MS, PMP, Eau Claire City-County Health Department
Cynthia Schroder, MSN, RN, FNP, Yavapai College
Katherine A. Sell, MSN, RN, IBCLC, CNE, University of Wisconsin – Eau Claire
Alexis Smith, MScN, RN, Western University
Justine Sparrgrove, MSN, RN, Southwest Wisconsin Technical College
Morgan Stock, MSN-Ed, RN, CNE, University of Arizona
Miriam A. Sward, DNP, PMHNP, APNP, Northlakes Community Clinic
Maria E. Thomas, MSN, MS, RN, CNE, Yavapai College
Jane Trainis, MS, PMHCNS-BC, CNE, Community College of Baltimore County
Jennie E. Ver Steeg, MLIS, AHIP, Mercy College of Health Sciences
Emily Vergenz, MSN, RN, Lakeshore Technical College
Devon Rice Weaver, MSN, RN, Clatsop Community College
Nancy Whitehead, PhD, APNP, RN, Milwaukee Area Technical College

2025 Reviewers

LaTonia Chalmers, DNP, APRN, PMHNP-BC, NC-BC, University of North Carolina at Chapel Hill
Liz Greene, DNP, APRN, PMHNP-BC, University of Utah
Cynthia Linkes, DNP, MSN-CNS, RN, CPHQ, CCM, University of Texas Health Science Center at San Antonio
JoEllen Schimmels, PhD, DNP, PMHNP-BC, ANP-BC, CNE, FAAN, Emory University

2025 Copyeditor

Julie Balsdon Henderson, MS, RN, ELS

Licensing/Terms of Use

This textbook is licensed under a Creative Commons Attribution 4.0 International (CC-BY) license unless otherwise indicated, which means that you are free to:

• SHARE – copy and redistribute the material in any medium or format
• ADAPT – remix, transform, and build upon the material for any purpose, even commercially

The licensor cannot revoke these freedoms as long as you follow the license terms.

• Attribution: You must give appropriate credit, provide a link to the license, and indicate if any changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• No Additional Restrictions: You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
• Notice: You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
• No Warranties Are Given: The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.

Attribution

Some of the content for this textbook was adapted from the following resources. For specific reference information about what was used and/or changed in this adaptation, please refer to the footnotes at the bottom of each page of the book.

• Nursing Fundamentals by Chippewa Valley Technical College is licensed under CC BY 4.0
• Nursing Management and Professional Concepts by Chippewa Valley Technical College is licensed under CC BY 4.0
• Nursing Pharmacology by Chippewa Valley Technical College is licensed under CC BY 4.0
• mhGAP Intervention Guide – Version 2.0 by World Health Organization is licensed under CC BY-NC-SA 3.0 IGO
• Culture and Psychology by Worthy, Lavigne, & Romero is licensed under CC BY-NC-SA 4.0
• Human Relations by LibreTexts is licensed under CC BY-NC-SA 4.0
• Anatomy and Physiology by OpenStax is licensed under CC BY 4.0. Access for free at https://openstax.org/books/anatomy-and-physiology/pages/1-introduction
• Nursing Care at the End of Life by Lowey is licensed under CC BY-NC-SA 4.0
• Doing What Matters in Times of Stress: An Illustrated Guide by World Health Organization is licensed under CC BY-NC-SA 3.0 IGO
• Psychology 2e by OpenStax is licensed under CC BY 4.0. Access for free at https://openstax.org/books/psychology-2e/pages/1-introduction
• Antipsychotic medications by Chokhawala & Stevens, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Antisocial personality disorder (nursing) by Fisher, Torrico, Hany, & Doerr, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Benzodiazepine toxicity by Kang, Galuska, & Ghassemzadeh, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Benztropine by Ahuja, Patel, & Abdijadid, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Bethanechol by Padda & Derian, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Buspirone by Wilson & Tripp, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Dystonic reactions by Lewis & O’Day, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Erikson’s stages of psychosocial development by Orenstein & Lewis, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Family dynamics by Jabbari, Schoo, & Rouster, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Physiology, neurotransmitters by Sheffler, Reddy, & Pillarisetty, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Physiology, opioid receptor by Dhaliwal & Gupta, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Prevention strategies by Kisling and Das, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Tardive dyskinesia by Vasan & Padhy, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Trazodone by Shin & Saadabadi, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Wernicke encephalopathy by Vasan & Kumar, in StatPearls [Internet], is licensed under CC BY-NC-ND 4.0*
• Foundations of Addiction Studies by Flori & Trytek is licensed under CC BY-NC-SA 4.0
• Action Steps Using ACEs and Trauma-Informed Care: A Resilience Model by Laurie Leitch is licensed under CC BY 4.0
• Community Tool Box by Center for Community Health and Development at the University of Kansas is licensed under CC BY NC SA 3.0
• Daily New Confirmed COVID-19 Deaths Per Million People by Our World in Data is licensed under CC BY 4.0
• The Emerging Neurobiology of Bipolar Disorder by Harrison, Geddes, & Tunbridge is licensed under CC BY 4.0
• The Scholarship of Writing in Nursing Education: 1st Canadian Edition by Lapum, St-Amant, Hughes, Tan, Bogdan, Dimaranan, Frantzke, & Savicevic is licensed under CC BY-SA 4.0

*At the time of original publication, StatPearls was published under a CC BY 4.0 license. As of 2025, the license has changed to CC BY-NC-ND 4.0.

Suggested attribution statement: Ernstmeyer, K., & Christman, E. (Eds.). (2025). Nursing Mental Health Concepts by Chippewa Valley Technical College and University of Arizona is licensed under CC BY 4.0.