Mental health nurse offering care in the community

Mental Health Nursing: Bridging the Gap Between Theory and Practice

Nico Varela in Health & Wellness August 2025 • 4 min read.

"Explore how mental health nurses can overcome challenges in care through practical strategies and team collaboration."

In Brazil, mental healthcare has undergone significant transformation, driven by the Movimento de Reforma Sanitária and Movimento de Reforma Psiquiátrica. This shift emphasizes deinstitutionalization, aiming to reduce reliance on psychiatric hospitals and foster specialized care networks. The goal is to champion the rights of individuals with mental health conditions, ensuring they receive comprehensive support within their communities.

A critical component of this evolved system is the Rede de Atenção Psicossocial (RAPS), established in 2011. RAPS seeks to integrate various points of care to provide holistic support to those experiencing psychological distress. Its guiding principles include respecting individual autonomy, fighting stigma, and promoting psychosocial rehabilitation, all while ensuring care is delivered in a humanized and accessible manner.

Central to the success of RAPS is the Unique Therapeutic Project (Projeto Terapêutico Singular or PTS). This collaborative effort involves a multidisciplinary team working alongside the individual and their family to create a tailored care plan. The PTS process includes comprehensive assessment, collaborative goal setting, clear division of responsibilities, and continuous reassessment to ensure the plan remains responsive to the individual's evolving needs.

Why Do Mental Health Nurses Feel Unprepared?

Mental health nurse offering care in the community

A recent study explored the experiences of nurses within the RAPS network, focusing on their role in providing Nursing Appointments (NA) in mental health settings. The findings revealed a significant gap: many nurses feel inadequately prepared for the specific demands of mental health care. This lack of preparedness stems from several factors, including:

Many nurses expressed a sense of disconnect between their initial nursing education and the realities of mental health practice. Traditional nursing curricula may not adequately cover the nuances of psychosocial care, therapeutic communication, and collaborative practice.

Limited Mental Health Training: General nursing education often lacks in-depth training in mental health, leaving nurses feeling ill-equipped to handle complex cases.
Stigma and Misconceptions: Negative attitudes towards mental illness can hinder effective care. Proper training can help dispel myths and foster empathy.
Rapidly Evolving Field: Mental health care is constantly evolving, with new approaches and research emerging regularly. Continuous professional development is essential.

Many nurses also struggle to define their role within the multidisciplinary team, particularly in the context of the CAPS (Centros de Atenção Psicossocial) model. Some perceive their responsibilities as overlapping with those of other professionals, leading to confusion and a sense of diminished value. Traditional models often emphasize clinical and biological aspects of care, potentially overshadowing the psychosocial components that are central to mental health nursing.

What's Next for Mental Health Nursing?

To bridge the gap between theory and practice, several key steps are essential. Nursing education must integrate comprehensive mental health training, emphasizing psychosocial rehabilitation, therapeutic communication, and collaborative practice. Continuing education programs should keep nurses abreast of the latest advancements in mental health care, fostering a commitment to lifelong learning. Healthcare organizations need to foster supportive environments where nurses feel valued, empowered, and equipped to contribute meaningfully to the multidisciplinary team.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/0034-7167-2017-0678, Alternate LINK

Title: Nursing Appointment In Mental Health: Experience Of Nurses Of The Network

Subject: General Nursing

Journal: Revista Brasileira de Enfermagem

Publisher: FapUNIFESP (SciELO)

Authors: Patrícia Aline De Almeida, Maria Cristina Mazzaia

Published: 2018-01-01

Everything You Need To Know

What role did the Movimento de Reforma Sanitária and Movimento de Reforma Psiquiátrica play in shaping mental healthcare in Brazil?

The Movimento de Reforma Sanitária and Movimento de Reforma Psiquiátrica were crucial in transforming mental healthcare in Brazil by championing deinstitutionalization and fostering specialized care networks. They aimed to reduce reliance on psychiatric hospitals, ensuring individuals with mental health conditions receive comprehensive support within their communities. These movements underscore a shift towards humanized, rights-based mental healthcare.

What is the significance of the Rede de Atenção Psicossocial (RAPS) within the Brazilian mental healthcare system?

The Rede de Atenção Psicossocial (RAPS) is a critical component of Brazil's evolved mental healthcare system. Established in 2011, RAPS integrates various points of care to provide holistic support to individuals experiencing psychological distress. Its core principles include respecting individual autonomy, fighting stigma, and promoting psychosocial rehabilitation, ensuring care is delivered in an accessible and humanized manner.

How does the Projeto Terapêutico Singular (PTS) function, and what key elements are involved in creating a tailored care plan?

The Projeto Terapêutico Singular (PTS), or Unique Therapeutic Project, is central to the success of RAPS. It involves a multidisciplinary team working with the individual and their family to create a tailored care plan. The PTS process includes comprehensive assessment, collaborative goal setting, clear division of responsibilities, and continuous reassessment to ensure the plan remains responsive to the individual's evolving needs. Missing is the process of how teams handle conflicting goals or lack of participation from different roles, or individuals and their families.

What are some reasons that mental health nurses report feeling unprepared for the demands of mental health care?

Mental health nurses sometimes feel unprepared due to a disconnect between their initial nursing education and the realities of mental health practice. Traditional nursing curricula may not adequately cover the nuances of psychosocial care, therapeutic communication, and collaborative practice, as well as a lack of in-depth training, negative attitudes towards mental illness, and a rapidly evolving field which all contribute to this lack of preparedness.

What are the essential steps needed to bridge the gap between theory and practice in mental health nursing?

To improve mental health nursing, nursing education must integrate comprehensive mental health training, emphasizing psychosocial rehabilitation, therapeutic communication, and collaborative practice. Continuing education programs should keep nurses informed of the latest advancements, and healthcare organizations need to foster supportive environments where nurses feel valued and empowered within the multidisciplinary team. Missing from this is how organizations can help the mental well-being of the nurses.