The often silent and complex world of mental health nursing has gained new clarity thanks to a groundbreaking qualitative study published in BMC Psychiatry in 2025. By delving deep into the lived experiences of mental health nurses (MHNs) in Iran, this research illuminates the intricate and demanding nature of caring for inpatients with severe mental disorders (SMDs). With mental illnesses representing a growing global burden, understanding the realities of frontline care providers has never been more crucial. This study not only sheds light on their challenges and therapeutic approaches but also underscores the need for systemic improvements in psychiatric care.
Severe mental disorders, encompassing conditions such as schizophrenia, bipolar disorder, and severe depression, impose multidimensional challenges on both patients and healthcare workers. The management of these illnesses is notoriously complex, often necessitating a blend of medical, psychological, and social interventions. Mental health nurses often serve as the primary caregivers within psychiatric wards, acting as the crucial link between patients, families, physicians, and the broader healthcare system. Yet, their voices and perspectives remain underrepresented in scientific literature. This study steps into that gap with qualitative rigor, offering an intimate look at their day-to-day experiences through in-depth interviews with 20 MHNs.
Using a conventional content analysis framework, the research distilled the narratives into three salient themes that together map the contours of psychiatric nursing in acute inpatient settings. The first theme, termed “care based on the nature of the disease,” highlights how nurses tailor interventions considering the unique symptomatology and behavioral manifestations of each disorder. This involves vigilant care strategies aimed at preventing self-harm and injury to others, alongside pharmaceutical management as a cornerstone of therapeutic regimes. Moreover, effective communication forms a therapeutic bridge, demanding nuanced interpersonal skills to navigate the complexities of patient interactions.
The second thematic cluster, “patient- and family-based care,” reveals a more holistic and relational dimension of nursing practice. Mental health nurses described efforts to personalize care by building trust and respect, recognizing patients not merely as diagnoses but as individuals deserving empathy and dignity. Equally critical is the role mental health nurses play in educating families, who often shoulder the burden of care outside hospital walls. Family engagement emerges as a pivotal element in treatment adherence, recovery trajectories, and social reintegration, further complicating the nurse’s role as both caregiver and educator.
Perhaps the most revealing and sobering theme is the “complex and burdensome care” dimension. Nurses candidly described the multifaceted challenges they confront, ranging from gender-specific care issues to the psychological and physical toll exacted by relentless caregiving demands. Psychiatric wards, particularly in socio-cultural contexts like Iran, present unique gender dynamics that shape care delivery and interpersonal interactions. Additionally, the emotional labor involved in managing aggressive or profoundly disoriented patients compounds burnout risk, highlighting the pressing need for institutional support and mental health resources for healthcare workers themselves.
The study’s methodological choices, anchored in purposive sampling and semi-structured interviews averaging 45 minutes, allowed for rich, nuanced insights that quantitative methods might overlook. The use of MAXQDA software facilitated a rigorous and transparent content analysis process, ensuring that emergent themes reflected authentic patterns in the data rather than researcher biases. This analytic approach underscores the importance of qualitative research in psychiatric nursing, where context, culture, and human experience resist simple quantification.
The implications of these findings reverberate across multiple domains. For healthcare administrators and policymakers, the research offers a roadmap to enhance psychiatric ward environments, prioritize the wellbeing of mental health nurses, and foster family-inclusive care models. Training programs may benefit from integrating modules that underscore therapeutic communication and gender-sensitive care practices. Furthermore, highlighting the physical and psychological challenges faced by MHNs argues for proactive measures such as stress management interventions, workload adjustments, and ongoing professional support.
Importantly, this research situates Iranian psychiatric nursing within a global dialogue on mental health care, revealing both universal themes and culturally specific challenges. The intersection of traditional beliefs, gender norms, and healthcare infrastructure shapes the contours of psychiatric nursing in ways that may both resonate with and differ from experiences elsewhere. Cross-cultural comparative studies building on this foundational work could identify best practices and innovation opportunities that transcend borders.
Beyond immediate clinical implications, the study invites a broader reflection on the social meaning of mental health nursing. The profession, often overshadowed by medicine in psychiatric settings, is illuminated here as a critical therapeutic force. By centering nurses’ experiences, the research challenges hierarchical views of care and advocates for recognizing nursing knowledge as invaluable in shaping patient outcomes and systemic reforms. The complex interplay between disease characteristics, patient and family dynamics, and institutional demands foregrounds the multifaceted expertise nurses bring to psychiatric care.
The study also emphasizes the indispensable role of effective communication in managing SMDs. Establishing therapeutic rapport not only facilitates medication adherence but also mitigates patients’ anxiety and distress. Mental health nurses navigate a delicate balance between authority and empathy, harnessing relationship-building skills to foster trust. This interpersonal dimension is foundational yet often underappreciated, demanding more research and training focus to optimize psychiatric care delivery.
Given that severe mental disorders frequently involve long-term treatment trajectories with periodic acute exacerbations, the study’s insights bear on the continuity and integration of care beyond inpatient settings. Mental health nursing extends into community domains, where education and support for families can profoundly influence patient recovery and quality of life. Recognizing the burdens placed on families foregrounds the need for systemic policies that provide resources and respite, ultimately benefitting both patients and healthcare providers.
In summary, this qualitative inquiry into mental health nurses’ experiences encapsulates the profound complexity inherent in psychiatric inpatient care for severe mental disorders. It merges technical detail and humanistic understanding to chart a comprehensive view of nursing roles, challenges, and coping strategies. As mental health systems globally confront escalating demands, elevating such frontline voices is vital for shaping equitable, effective, and empathetic care landscapes. This study stands as a landmark contribution towards that imperative, poised to influence clinical practice, policy-making, and future research trajectories.
Subject of Research: Experiences of mental health nurses providing care for inpatients with severe mental disorders in psychiatric wards in Iran.
Article Title: Mental health nurses’ experiences of caring for inpatients with severe mental disorders: a qualitative study.
Article References:
Keykha, R., Seyedfatemi, N., Mousavizadeh, S.N. et al. Mental health nurses’ experiences of caring for inpatients with severe mental disorders: a qualitative study. BMC Psychiatry 25, 621 (2025). https://doi.org/10.1186/s12888-025-07024-7
Image Credits: AI Generated
