1.
PSYCHIATRIC NURSING

2.
PSYCHIATRIC HISTORY
18TH Century – mentally ill regarded as wild
animals
Community Response:
1. Assistance
2. Banishment – “Ship of fools”
3. Confinement – chained; mixed with criminals;
thought to be immune to normal biologic
stressors; displayed for amusement
St Mary of Bethlem Hospital in England (1770)
- charge visitors; bleeding, bathing, vomiting,

3.
PSYCHIATRIC HISTORY
Bicetre (France)
- attendants whips pts to perform; warehouses
Benchmark I: - 1790s Period of Enlightenment
Pinel and Tuke – superintendent of the French
Institution (Bicetre)
- dev’t of asylum
Dorothea Dix – visited Tuke’s York Retreat
- established asylum in US

4.
PSYCHIATRIC HISTORY
Benchmark II: late 1800s Period of Scientific
Study
Sigmund Freud (1856-1939) – describe human
behavior (Psychoanalytic
Theory)
Emil Kraepelin (1856-1926) – describe
schizophrenia
Eugene Bleuler (1857-1939) –coined the term
schizophrenia
Benchmark III: - 1950s Period of Psychotropic Drugs

5.
PSYCHIATRIC HISTORY
Benchmarck IV: 1960s Period of Community
Mental Health
*Legislative Act – National Mental Health Act
- funding for hospitals including
psychiatric units
*Increasing support and improvement of
treatment
* Community Mental Health Programs/ Centers
Act of 1963

6.
PSYCHIATRIC HISTORY
Benchmark V: 1990s Decade of the Brain
* increase in brain research
* diagnostic manual published
* psychobiologic content in academic nursing
programs
* significant public awareness
DIAGNOSTIC AND STATISTICAL MANUAL OF
MENTAL DISORDERS (DSM); ICD

7.
PSYCHIATRIC HISTORY
First Psychiatric Nurse
- Linda Richards
First Psychiatric Nursing Textbook
- “Nursing Mental Diseases” by Harriet Bailey
First Psychiatric Nursing Theorist
- Hildegard Peplau “Interpersonal Relations in
Nursing” (1952); “Interpersonal Techniques: the
Crux of Psychiatric Nursing” (1962);
“significant, therapeutic process”, counselor
(psychotherapist); mother of psychiatric nsg;

8.
PSYCHIATRIC HISTORY
McLean Hospital in Waverly, Massachusettes (1882)
- first school for nurses to prepare for mentally ill
- emphasizes assessment of both physical and
emotional needs of the patient
John Hopkins Hospital 1913
- 1st school of nsg to include psychiatric nsg in the
curriculum
Emergence of Somatic Therapies:
1935 – Insulin Shock Therapy
1936 – Psychosurgery
1937 – ECT

9.
PSYCHIATRIC HISTORY
WW II – Psychiatric nurses with advanced
preparation were in demand
Weiss (1947) – “attitude therapy”; observe for
changes; acceptance, respect & understanding;
promotes pts interest in reality
Psychiatrist (1951) – starts to acknowledge nurse’s
role in psychiatry
Mellow (1951) – “nursing therapy”
Tudor (1952) – NP rel; unconditional care, few
demand and anticipation of pts. needs

10.
PSYCHIATRIC HISTORY
Jone’s Publication (1953) – The Therapeutic Community: A
New Treatment Method in Psychiatry - using the pts
social envi to provide therapeutic experience; the
premise of the therapeutic com
1958 Functions of PN: (Psychiatric Nursing)
- Deals with pts problems of attitude, mood and
interpretation of reality
- Explores disturbing and conflicting thoughts and feelings
- Uses pts positive feelings toward the therapist to bring
about psychological stasis
- Counseling patients in emergencies, including panic and
fear
- Strengthening the well part of patients

11.
PSYCHIATRIC HISTORY
1960s – Primary prevention; Care and
consultation in the Com; “Psychiatric and
Mental Health Nursing”
1970s – Develop standards and scope of
practice; establish generalist and specialist
certification; “Psychosocial Nursing”
- reorganization of nsg curriculum; integration of
clinical rotation to psychosocial aspects to MS
pts

12.
PSYCHIATRIC HISTORY
1980s – Brain Imaging; Neurotransmitters and
neuronal receptors; Psychobiology; Understanding
the Brain; Genetics
- lack of integration resulting to slow of shifting
care
1990s – challenged in integrating neuroscience to
holistic biopsychosocial nsg care
2000s – knowledge integration of the biological,
psychological, spiritual, social and environmental
realms of the human experience

13.
PSYCHIATRIC HISTORY
PN – is an interpersonal process that promotes
and maintains pt behavior that contributes to
integrated functioning.
- a specialized area of nsg practice, employing
the wide range of explanatory theories of
human behavior as its science and purposeful
use of self as its art (ANA 2000)
- from “NP rel” to “NP partnership”; clinical
competence, pt-family advocacy, fiscal
responsibility, interdisciplinary collaboration,
social accountability and ethical-legal
parameters

14.
PSYCHIATRIC HISTORY
Continuum of Mental Health Care Settings:
Home, Outpatient, Inpatient, Partial,
Residential
Three Domains of Nsg Practice:
Direct Care; Communication; Management
- Make culturally sensitive biopsychosocial
health assessments
- Design and implement treatment plans for pts
and families with complex hlth problems and

15.
PSYCHIATRIC HISTORY
- Engage in case mngt act e.g organizing, accessing,
negotiating, coordinating and integrating services
and benefits for indivi. and families
- Provide a “health care map” for indiv, families and
groups to guide them to community resources for
mental health, including the most appropriate
providers, agencies, technologies and social
systems
- Promote and maintain mental health and manage
the effects of mental illness through teaching and
counseling
- Manage and coordinate systems of care integrating
the needs of pt , families, staff and regulators