history of psychiatry for nursing students

2. History of Psychiatry and
Psychiatric Nursing
Mr. Mahesh. S. Wangi.
B.V.V’ S INSTITUTE OF NURSING SCIENCES
BAGALKOT.

3. Psychiatry
• It is a branch of medicine that deals with the
diagnosis, treatment and prevention mental illness.

4. Psychiatric Nursing
1. It is a specialized area of nursing practice
employing theories of human behavior, as a
science and the purposeful use of self as an art in
the diagnosis and response to actual or potential
mental health problems.
(American Nurses Association 1994)

5. • Psychiatric nursing deals with the promotion of
mental health, prevention of mental illness, care
and rehabilitation of mentally ill individuals both in
hospital and community .

6. History of Psychiatry
Primitive beliefs regarding mental illness:
• Individual had been dispossessed of his/her soul
Mgt: Returning the soul to the client
• Broken a taboo or sinned against another individual
or god
Mgt: Ritualistic purification

7. Evil spirits or super natural/magical powers entered
the body.
Mgt:
• Exorcism (prayer, noise making)
• Brutal beating, starvation, Burning, amputated and
tortured
• Oral preparation of a purgative made from sheep
dung and wine
• Trephining (A circular opening made on the skull
by means of crude stone instruments to let out evil
spirits)

8. Development of Psychiatry
• Pythagoras (580-510 BC) : developed the concept that the
brain is the seat of intellectual activity
• Hippocrates (460-370 BC) : described mental illness as
hysteria, mania and depression
• Plato (427-370 BC) identified the relationship between
mind and body.
• Asciepiades, who is referred to as the father of psychiatry,
made use of simple hygienic measures, diet bath, massage
in place of mechanical restraints.

9. • Aristotle, a Greek philosopher, emphasized on the
release of repressed emotions for the effective
treatment of mental illness. He suggested catharsis
and music therapy for the patient with melancholia.
• St. Augustine who believed that although God
acted directly in human affairs, people were
responsible for their own actions.

10. • Renaissance in Europe( 1300- 1600 AD): it was
believed that demons were the cause of hallucinations,
delusions and sexual activity.
Mgt: Torture and even death.

11. Important Milestones
1773: The first mental hospital in the US was built in
Williamsburg, Virginia.
1793: Philip Pinel removed the chains from mentally ill
patients confined in Bicetre, a hospital outside Paris
i.e. the first revolution in psychiatry.
1812:The first American text book in psychiatry was written
by Benjamin Rush, who is referred to as the father of
American Psychiatry.

12. 1812: Clifford Beers, an ex- patient of mental hospital wrote
the book, “The Mind That found Itself” based on his
bitter experiences in the hospital.
1912: Eugen Bleuler, a Swiss psychiatrist coined the term
‘Schizophrenia’.
The Indian Lunacy Act passed.
1927: Insulin shock treatment was introduced for
schizophrenia.
1936: Frontal lobotomy was advocated for the management
of psychiatric disorders .

13. • 1938:Electro Convulsive Therapy (ECT) was used for
the treatment of psychoses.
• 1939: Development of psychoanalytical theory by
Sigmund Freud led to new concepts in the
treatment of mental illness.
• 1946: The Bhore committee presented the situation
with regard to mental health services. Based on
the recommendations 5 hospitals were set up at
Amritsar, Hyderabad, Srinagar, Jamnagar and
New Delhi.

14. • 1949: Lithium was first used for the treatment of mania.
• 1952: Chlorpromazine was introduced which brought
about a revolution in psycho-pharmacology
• 1963:The ‘community Mental Health centers’ Act was
passed .
• 1978: The Alma –Ata declaration of ‘Health for all by
2000 AD’ posed a major challenge to Indian
mental health professionals.

15. • 1981:Community psychiatric centers were setup
experiment with primary mental health approach
at Raipur Rani, Chandigarh and Sakalwara,
Bangalore.
• 1982: The Central Council of India accepted the national
Mental Health Policy and brought out the National
Mental Health programme in India.
• 1987: The Indian Mental Health Act was passed.

16. • 1990: The Govt. of India formed an Action Group at
Delhi to pool the opinions of mental health
experts about the National Mental health
program
• NIMHANS Bangalore has taken up the leadership in
orienting heath care professionals about the mental
health programs of our country.

17. Development of Modern Psychiatric
Nursing
• 1872: First training school for nurses based on the
Nightingale system was established by the New
England Hospital for women and children,USA
• Linda Richards the first Nurse to graduate from the
one year course, developed 12 training schools in
the USA.

18. • 1882: First school to prepare nurses to care for the
mentally ill was opened at Mc Lean Hospital in
Waverly.
• Two year program was started but few psychological
skills were addressed and much importance was given
to custodial care such as personal hygiene, nutrition,
medication etc
• 1913: John Hopkins became the first school of nursing
to include a fully developed course for psy.nsg in
the curriculum

19. • 1943: Psychiatric Nursing course was started for male
nurses.
• 1946: Health survey committee’s report recommended
preparation of nursing personnel in Psychiatric
Nursing also. The existing institutions like mental
hospitals in Bangalore and Ranchi should start
training.

20. • 1952: Dr. Hildegard Peplau defined the therapeutic
roles that nurses might play in the mental
health setting.
• She described the skills and roles of the psychiatric
Nurse in her book “interpersonal relations in Nursing” .
It was the first systematic and theoretical frame work
developed for psychiatric Nursing.

21. • 1953: Maxwell Jones introduced therapeutic community.
• 1956: one year post certificate course in psychiatric
nursing was started at NIMHANS, Bangalore.
• 1960: The focus began to shift to primary prevention
and implementing care and consultation in the
community
• The name psychiatric nursing changed in to mental
health nursing. 1970’s when it was known as
psychosocial nursing.

22. • 1963: Journal of psychiatric Nursing and Mental Health
services was published.
• 1964: Mudaliar committee felt the need for preparing
large number of Psy. Nurses and recommended
inclusion of Psychiatry in the nursing curriculum.
• 1965: The INC included psychiatric Nursing as a
compulsory course in B.Sc Nursing program.
• 1973: Standards of psychiatric and mental health
nursing practice were enunciated to provide a
means of improving the quality care

23. • 1975: Psychiatric Nursing was offered as an elective
subject in M.Sc Nursing at the RAK College of
Nursing, New Delhi.
• 1980: Scientific advances in the area of psychobiology,
brain imaging techniques, knowledge about
neurotransmitters and neuronal receptors, molecular
genetics related psychiatry etc emerged.
These contributed to the shift from psychodynamic
models to more balanced psychobiological models
of psychiatric care.

24. • 1986: The Indian Nursing Council made psychiatric
nursing a component of General nursing and
Midwifery course.
• 1990: During these years integration of neuro sciences
into holistic biopsychosocial practice of
psychiatric nursing occurred.
• 1994: The above mentioned changes led to the revision
of standards of psychiatric and mental health
nursing.