Students are often blindsided when they get to mental health nursing and suddenly start struggling more than usual or doing poorly on exams. Now, I’m not saying that to scare you or make you more nervous about this class, but I do want to give you some advance warning. 

When you understand WHY a course might be challenging, you can come up with a plan to conquer the challenges AND you give yourself permission to feel slightly off balance for a bit. After all, I don’t want you wasting precious time wondering why you’re struggling with mental health. 

Chances are, you’ll find this to be a difficult class and that is absolutely okay. There are some really compelling reasons why this class is so hard for many students. By knowing what those reasons are, you won’t waste time or energy trying to figure it out and can hopefully approach it with more confidence and less stress. 

You’re starting from scratch

With Med-Surg nursing, peds and OB, you had background knowledge you could pull from your anatomy & physiology class. You could review the normal function to better understand the abnormal function and nursing interventions. With mental health nursing, on the other hand, you’re likely starting from scratch. This is the number one reason students find this course so difficult. 

For this reason, you may need to do MORE reading of the text than you are accustomed to. A great way to manage this workload is to divvy the chapters up amongst a group of 10-12 friends. Everyone takes a chapter and writes a comprehensive outline. You’ll save a significant amount of time reading and learn the chapters you’re responsible for really, really well. It’s a win-win!


Another key reason mental health nursing is so challenging is the sheer amount of medications and side effects you must know. Until you use these medications regularly and see how they work for a variety of conditions and patients, you’ll unfortunately have to rely on a lot of memorization. Group the drugs together into classes and focus on the key characteristics for each drug class. I even made a podcast episode where I share my unique way of remembering the side effects (complete with a downloadable study guide!). 

There are a lot of disorders with a lot of similarities

Next on the list is the simple fact that there are a lot of mental health disorders with multiple subtypes, making it a challenge to differentiate and remember them all. For example, there are multiple types of schizophrenia and several different personality disorders.

My best advice for learning content like this is to make tables or draw pictures. Visually differentiating the key elements may make it easier for you to recall that information on an exam.

The interventions are often just words

Many interventions in mental health nursing are “soft” interventions and not the sort of thing you learned extensively in Med Surg. For example, when your patient has a pneumothorax with dropping oxygen saturation levels, you KNOW what to do. You’re going to get oxygen on that patient, alert the MD and prepare for a chest tube insertion. The interventions are clear with very defined parameters and goals. 

In mental health nursing, a lot of your interventions will be based on what you say to patients. The whole concept of therapeutic communication is often difficult for students to master because, honestly, it’s not how we naturally communicate in our day-to-day life. A lot of students take this for granted and think, “I know how to speak to people. Of course I’ll say the right thing,” only to discover when doing practice questions that they are consistently saying the wrong things. Pay careful attention to the rationales for these questions, take notes and connect the dots between what the patient does, what the nurse says, and why the nurse says it. Every response in therapeutic communication has a therapeutic goal…remember that and this element of mental health nursing won’t be quite so difficult for you to adjust to. 

In addition to therapeutic communication, nursing interventions are often aimed at keeping the patient (and yourself) safe. If you can examine all your mental health nursing exam questions and care plans with safety as the overarching goal,  you’ll definitely be on the right track.

Now, before you think that you only need to learn mental health nursing for this one class and that you can forget all of it once you pass your NCLEX, I have a surprise for you. Patients with mental health disorders also have medical conditions that land them in the hospital or outpatient setting. I’ve never worked a single day in a psychiatric hospital or clinic, but I’ve cared for patients with borderline personality disorder, schizophrenia, depression, anxiety, suicidal ideation, homicidal ideation, substance abuse, substance abuse withdrawal, eating disorders, bipolar disorder, acute delirium and PTSD. So if you think you won’t be a mental health nurse just because you’re not working in a mental health facility, it’s time to rethink that notion and embrace this fascinating topic with enthusiasm and compassion. 

Interested in learning more about taking care of patients with mental illness? Check out my summary of caring for patients with schizophrenia here.

Listen to this on the go in episode 136 of the Straight A Nursing podcast here or wherever you get your podcast fix.


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