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History of Psychiatry and Psychiatric Nursing. Learning Objectives. Describe the various phases in the evolution of psychiatry Discuss the factors shaping the practice of psychiatric nursing. Introduction. The history of psychiatry can be categorized under six time periods which are:
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History of Psychiatry and Psychiatric Nursing
Learning Objectives • Describe the various phases in the evolution of psychiatry • Discuss the factors shaping the practice of psychiatric nursing
Introduction • The history of psychiatry can be categorized under six time periods which are: • Pre-History • Ancient World • Dark Ages • Middle Ages and Renaissance • Modern Era • Age of Managed Care
1. Pre-History • It was believed that mental illness was due to supernatural forces of: i. Gods ii. Spirits iii. Demons • Primitive man could not differentiate between magic, religion or medicine. • Spirits spoke to man through shamans.
2. Ancient World • Hippocrates attributed mental illness to increased humidity of the brain. • In pre-Christianity years, the priests acted as magicians, physicians and psychologists. • Magical treatments were carried out in temples.
3. Dark Ages • It was believed that the cause of mental illness was due to possession by evil spirits. • By the time Christianity became an official religion, this demonic belief was an essential part of the faith. • Galen systematized all previous medical knowledge about mental illness.
4. Middle Ages & Renaissance • Witchcraft and pagan practices existed in the form of devil worship. • Johann Wyer and Reginald Scott pointed out that ‘witches’ were actually mentally ill persons. • St Vincent de Paul claimed that many ‘witches’ were mentally ill persons and founded the Mental Hospital of St Lazare.
5. Modern Era • Late 18th century Led to the advent of moral treatment which was characterized by: i. Kindness ii. Compassion iii. Humane treatment of mentally ill patients
5. Modern Era (cont.) • 20th century There were two opposing views regarding mental illness: i.Biological view stated that mental illness was due to biological causes and could be treated with physical treatments. ii. Psychological view stated that mental illness was due to factors such as social stresses.
6. Age of Managed Care • Mental health care is managed separately from general health care. • The emphasis is on reducing institutionalized care of patients with mental illnesses and treating them in community settings such as clinics, homes and schools. • Preventive and promotive psychiatry is also on the rise.
History of Psychiatric Nursing • Prior to 1860, psychiatric treatment was by custodial care whereby untrained persons controlled mentally ill patients. • There was no concept of psychiatric care.
Florence Nightingale • Her philosophy of treating a patient as a member of the family and part of the society laid the foundation of psychiatric nursing. • She emphasized on: • Holistic care • Therapeutic communication • Sensitivity to human emotions • Development of independence in patients
Moral Treatment Era • This was started by Dr Edward Cowles, who encouraged Linda Richards, US’ first trained nurse, to start training for mental health nursing. • The first mental health training school for nurses was set up in 1882 at the McLean Hospital. • Effie Taylor combined general and mental health nursing.
Moral Treatment Era (cont.) • Mary Adelaide Nutting emphasized the role of the psychiatric nurse and conceptualized nursing care in terms of: i. Diagnosis ii. Care iii. Treatment • Harriet Bailey described nursing in terms of procedures.
Hill-Burton Act 1946 • This Act facilitated the expansion of psychiatric units in general hospitals. • It also provided training grants for stipends and fellowships to train nurses in advanced care.
Hildegarde E. Peplau • She is known as the Mother of Psychiatric Nursing. • She developed the first graduate psychiatric nursing programme in 1954 at Rutgers University. • Her emphasis was on the nurse–patient relationship.
Hildegarde E. Peplau (cont.) • First to identify psychiatric nursing as an essential element of general nursing and as a specialty area. • First to describe the nurse–patient relationship as the foundation of nursing practice. • Her model represented a shift from traditional treatments to interpersonal relational model of practice.
Hildegarde E. Peplau (cont.) • Statement on Psychiatric Nursing Practice by ANA (1967) officially sanctioned the holistic approach to nursing care. • In 1963, two journals were published: i.Journal of Psychiatric Nursing(nowJournal of Psychosocial Nursing and Mental Health Services) ii.Perspectives in Psychiatric Care
