NCM 105:Psychiatric Nursing

Looking back at the Historical Development of

Psychiatric Mental Nursing…
PRIMITIVE sickness indicated
ERA displeasure of God and
punishment for sins and wrong doing

BEFORE Greeks, Romans & Arab

CHRIST (BC) organic dysfunction of the brain

excluded from the society

MIDDLE Bethlehem Royal Hospital
AGES became a sanctuary for the
destitute and afflicted
Phase 1: The Emergence of Psychiatric-Mental Health
Nursing (1773-1881)
Phase 2: Development of the Work Role of the Nurse
in Psychiatric-Mental Health Facilities (1882-1914)
Phase 3: Development of Undergraduate Psychiatric-
Mental Health Nursing Education (1915-1935)
Phase 4: Development of Graduate Psychiatric-Mental
health Nursing Education (1936-1945)
Phase 5: Development of Consultation and Research in
Psychaitric-Mental Health Practice (1946-1956)
 Phase 1: The Emergence of Psychiatric-Mental
Health Nursing (1773-1881)
• identification of special institutions for individuals
with psychiatric disorders – Eastern Lunatic
Hospital, Williamsburg, Virginia.
• Benjamin Rush: the father of American Psychiatry,
wrote the 1st textbook on psychiatry.
• Johann Weyer: first psychiatrist.
• Dorothea Lynde Dix: devoted her life to the cause
of building state mental hospitals and helped
improved the humane treatment of mentally ill
people.
• Emil Kraepelin (1856 to 1929) differentiated
manic-depression psychosis from schizophrenia and
stated that schizophrenia was incurable.
• Sigmund Freud (1856 to 1939) introduced
psychoanalytic theory and therapy.
• Eugene Bleuler (1857 to 1939) described the psychotic
disorder of schizophrenia.
• Alfred Adler (1870 to 1937) focused on the area of
psychosomatic medicine, referring to organ inferiority
as the causative factor.
• Carl Jung (1875 to 1961) described the human psyche
as consisting of a social mask (persona), hidden
personal characteristics (shadow), feminine
identification in men (anima), masculine identification
in women (animus), and the innermost center of the
personality (self).
•
 Phase 2: Development of the Work Role of the
Nurse in Psychiatric-Mental Health Facilities
(1882-1914)
• McLean Hospital, Belmont Massachusetts (1882) –
established the first training school for nurses in the psychiatric
setting.
• (1890) trained nurses were employed on nursing staff of
state mental hospitals.
• Annie Payson Call (1891) wrote the first psychiatric
literature by a psychiatric nurse.
• Mary E. May (1899) wrote the first paper about the
work of a nurse in a psychiatric facility: The Work of
Nursing the Insane.
• Effie Jayne Taylor: first professor of psychiatric nursing
and outlined the curriculum of the undergraduate
psychiatric nursing program at Johns Hopkin’s Phipps
Psychiatric Clinic.
 Phase 3: Development of Undergraduate
Psychiatric-Mental Health Nursing Education
(1915-1935)
• Linda Richards (1915) first graduate nurse in the
US – “first American psychiatric nurse”.
• Journals published and textbooks focusing on
psychiatric nursing were written.
• Harriet Bailey (1920) – wrote the first
textbook of psychiatric nursing: Nursing Mental
Diseases.
• electroconvulsive therapy (ECT) introduced.
 Phase 4: Development of Graduate Psychiatric-
Mental Health Nursing Education (1936-1945)
• (1937) clinical experiences in psychiatric hospitals
were standardized:
students were given the opportunity to care for
patients with varying degrees of mental disorders
including organic origin.
• (1955) psychiatric nursing became a requirement
for licensure.
• National League of Nursing Education developed
curriculum guidelines for graduate education:
– 60 to 80 hours of theoretical instruction, and
– 12 to 16 weeks of clinical experience.
 Phase 5: Development of Consultation and
Research in Psychiatric-Mental Health Practice
(1946-1956)
• passage of Mental Health Act of 1946.
• Helen Render (1947) wrote Nurse-Patient
Relationships in Psychiatry.
• (1956) National League of Nursing Education
formed a committee to review and revised a
proposed guide for the development of an
advanced clinical course in psychiatric nursing.
• Brown Report: stressed that the interest in the
field of psychiatry should be stimulated to facilitate
research focusing on the prevention and cure of
mental illness.
 1956 and beyond…..
• Phenothiazines and other major tranquilizers were
developed and used to treat the major symptoms
of pyschoses.
• (1963) the Community Mental Health
Act authorized funding for the establishment of
community health centers to provide services to
the public.
• 20th Century – Psychiatric nursing began to
evolve as a clinical specialty.
• Diagnostic Bible of Psychiatry refers to the
Diagnostic and Statistical Manual for Mental Disorders
(DSM) outlines the signs and symptoms to
assign a specific diagnosis of a patient.
• Published in 6 editions
 In the Philippines
National Center for Mental Health
• NCMH was established in 1925
through Public Works Act 3258. It
was formally opened on
December 17, 1928 and was
originally called the INSULAR
PSYCHOPATIC HOSPITAL. It was
later called the National Mental
Hospital. On November 12, 1986,
it was renamed NATIONAL
4200 bed capacity CENTER FOR MENTAL HEALTH
56,000 outpatients per (NCMH) through Memorandum
year Circular No. 48 issued by the
Special Research Office of the President.
Training Center
 Mental Ilness in the 21 st Century
Deinstitutionalization
Shift from hospital
to community
facilities
Shorter stay of
patients
Reduced by 80%,
increased by 90%
Revolving Door Effect
 Student Concerns….
What if I say a
wrong thing?
What will I do?
What if no one
will talk to me?
How will I handle
inappropriate
behavior?
 Points to consider when
working SELF AWARENESS
1. Keep a Diary
2. Talk to someone about your experience
whom you trust
3. Empathy
4. Do not be critical of yourself. Accept
your own values and beliefs
 Is the process by which the nurse gains
recognition of his/her own feelings, beliefs and
attitudes.
The nurse can accomplish self-awareness through
reflection, spending time consciously
focusing on how one feels and what one
values or believes.The nurse
needsto discover himself or
herself and what he or she
believes before trying to help others with different
views.