Chapter 1

History of Psychiatric Nursing

Evolution of Psychiatric-Mental Health Nursing

Early History
Insanity associated with sin Mental illness thought to be incurable Treatment of mentally ill was sometimes inhumane and brutal

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Evolution of Psychiatric-Mental Health Nursing

The Middle Ages
Mentally ill often imprisoned Depended on the charity of religious groups First mental hospital: Hospital of St. Mary of Bethlehem
Built in London, England during the 14th century term bedlam was coined

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Evolution of Psychiatric-Mental Health Nursing

The Fifteenth Through the Seventeenth Centuries
Skepticism was rampant Conditions of asylums were deplorable Insane were treated like animals
Thought not to have feelings Were believed to lack understanding Men and women not given separate quarters

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Evolution of Psychiatric-Mental Health Nursing

The Eighteenth Century
Benjamin Rush (1745-1813)
Forerunner in highlighting plight of mentally ill Emphasized moral treatment 1812: Published the first American treatise on Psychiatry: Medial Inquiries and Observations upon the Disease of the Mind

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Evolution of Psychiatric-Mental Health Nursing

Phillippe Pinel (1745-1826)
Advocate for humane patient treatment Emphasized atmosphere of kindness and understanding

William Tuke (1732-1822)

Humanitarian efforts led to the establishment of York Retreat

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Evolution of Psychiatric-Mental Health Nursing

The Nineteenth Century: The Evolution of the Psychiatric Nurse
Dorothea Lynde Dix (1802-1887)
Plight of mentally ill recognized by legislative community This led to establishment of state hospitals

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Evolution of Psychiatric-Mental Health Nursing

The Twentieth Century: The Era of Psychiatry
Adolph Meyer (1866-1950)
Initiated psychobiological theory Dynamic concept of psychiatric care

Sigmund Freud (1856-1939)

Psychoanalysis Psychosexual theories Neurosis

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Evolution of Psychiatric-Mental Health Nursing

The Mental Health Movement
Gave authority to United States Public Health Service National Mental Health Act of 1946 was passed Nations attitude towards mentally ill began to change President Eisenhowers Commission on Mental Illness and Health (1961) established

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Evolution of Psychiatric-Mental Health Nursing

The Twenty-First Century: Neuroscience & Genetics
Information Systems: The Internet and Cyberspace
Telemedicine

Complementary Therapies
Aromatherapy Acupuncture Massage Therapy

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Evolution of Psychiatric-Mental Health Nursing

Cultural Considerations
Cultural competency skills

The Future
Social changes abroad Societal demands Rising cost of health care

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Evolution of Psychiatric-Mental Health Nursing

Trends
Managed care Evidence-based health care Advanced technologies Client advocacy groups

Concepts of Practice
Revaluing biological knowledge Reacquaintance with care and caring
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Evolution of Psychiatric-Mental Health Nursing

Directions for Nursing Education
Reconceptualize core psychiatric nursing content Identify critical clinical competencies Standardize measurable clinical outcomes Establish a national research agenda

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Evolution of Psychiatric-Mental Health Nursing

Societal Changes
Deteriorating social structures Global AIDS epidemic Increased violence Inadequate access to health care Rising poverty levels

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Evolution of Psychiatric-Mental Health Nursing

Health Care Trends
Diverse practice settings Intensive community programs Home health Mobile crisis units Therapeutic foster care Respite care

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Evolution of Psychiatric-Mental Health Nursing

Collaboration of Nursing Organizations
Coalition of Psychiatric Nursing American Psychiatric Nurses Association The International Society of Psychiatric-Mental Health Nurses The Alliance of Psychiatric-Mental Health Nurses The Association of Child and Adolescent Psychiatric Nurses
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