History of Psychiatry and

Psychiatric Nursing
Asst. Prof. Hassam-M
Psychiatric–Mental Health
Nursing (2019-2020) . Lec/ 1
Psychiatry: is the branch of medicine focused on the diagnosis,
treatment and prevention of mental, emotional and behavioral
disorders.
Psychiatric Nursing : It focuses on the care and rehabilitation of
people with mental illnesses or disorders.
‫ھﻮ‬
Psychiatric nursing deals with
‫ع ﻃﺒﻲ‬the
‫ ھﻮ ﻓﺮ‬promotion of mental health,

prevention of mental illness, care and rehabilitation of mentally

ill individuals both in hospital and community.
Psychiatric mental health nursing :is a specialty within nursing.
Psychiatric mental health registered nurses work with
individuals, families, groups, and communities, assessing their
mental health needs. The PMH nurse develops a nursing
diagnosis and plan of care, implements the nursing process,
and evaluates it for effectiveness.
2
 Historical Overview of Psychiatric Care

1. Primitive beliefs regarding mental disturbances took several

views:
• Some cultures thought that an individual with mental illness
had been dispossessed of his or her soul and wellness.
• Others believed that evil spirits or supernatural or magical
powers had entered the body.

• Broken a taboo or sinned against another individual or God.

3/22/2020 3
 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.

3/22/2020 4
 Important Milestones
• Late 18th century .Led to the advent of moral
treatment which was characterized by:
• Kindness
• Compassion
• Humane treatment of mentally ill patients

3/22/2020 5
 Important Milestones
• 2911- 1912: Paul Eugen Bleuler , a Swiss psychiatrist . He coined
many psychiatric terms, such as schizophrenia,schizoid,autism.
• 1927 .Insulin shock treatment was introduced for schizophrenia
• 1936 .frontal lobotomy was advocated for the management of
psychiatric disorder
• 1937 .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.
• 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 20th
3/22/2020 6
century
 History of Psychiatric Nursing:
Florence nightingale : was the founder of
modern nursing and author of the
first nursing text notes on nursing
published in 1859 .
She emphasized on:
• Holistic care
• Therapeutic communication
• Sensitivity to human emotions
• Development of independence in patients
3/22/2020 7
Hildegarde peplau : She is known as the Mother of
Psychiatric Nursing.
wrote interpersonal relations in nursing
published in 1952 that described a
framework for psychiatric nursing practice;
her emphasis on nurses- patient
relationships and theoretical constructs to
explain patient problems provided the
foundation for psychiatric nursing practice.

8
 History of Psychiatric Nursing:
In 1873, Linda Richards graduated from the New England
Hospital for Women and Children in Boston. She went
on to improve nursing care in psychiatric hospitals and
organized educational programs in state mental
hospitals in Illinois. Richards is called the first
American psychiatric nurse; she believed that “the
mentally sick should be at least as well cared for as the
physically sick”.
• Dr. Edward Cowles, who encouraged Linda Richards,
US’ first trained nurse, to start training for mental
health nursing.

3/22/2020 9
 History of Psychiatric Nursing:
Maxwell Jones introduced therapeutic community.
• 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.

3/22/2020 Dr.Fadhal Alfadhal,Agri.College/Pl.Prot.Dept. 10

11
12
Diagnostic and Statistical Manual of Mental
Disorders: The Diagnostic and statistical manual of
mental disorders , 4th edition, Text Revision( DSM-
IV-TR) is a taxonomy published by the APA. The
DSM-IV-TR describes all mental disorders, outlining
specific diagnostic criteria for each based on clinical
experience and research .

13
  The purpose and use of the DSM-IV-TR 
1. To provide a standardized nomenclature
and language for all mental health
professionals.
2. To present defining characteristics or
symptoms that differentiate specific
diagnosis.

14
 The five diagnostic axes specific by DSM-IV-TR (2007) include:
Axis I : is for identifying all major
psychiatric disorders except mental
retardation and personality disorders.
Examples include depression,
schizophrenia, anxiety, and substance –
related disorders.

Axis II : is for reporting mental

retardation and personality disorders as
well as prominent maladaptive personality
features and defense mechanisms.

15
 The five diagnostic axes specific by DSM-IV-TR (2007) include:

Axis III: general medical conditional .

Examples include endocrine D, Metabolic D ,
blood. D.
Axis IV : is for reporting psychosocial and
environment problems. . Examples include
. family problems, social problems,
educational problems, occupational
problems, housing problems. Economic
problems, other problems (war, disasters).
Axis V : presents a Global Assessment of
Functioning, which rates the person's overall
psychological functioning on a scale of o to 100.
16
 Roles, Activities, of the Register Nursing in
Mental Health
1. Care provider ( direct car activities)
:Behavioral treatment; Medication
management; Medication management;
Psychotherapy; Case assessment and
management . Physical assessment.
2. Researcher
3. Counselor teacher : Individual counseling;;
Discharge planning Community education
and Social skill training.
4. Technical expert: Treatments modalities
;Special procedures (ECT).

17
3/22/2020 18
 Thank you

3/22/2020 hossam-M , Lecturer Mental Health Nursing 19

 Townsend,M. and Morgan ,K: of Psychiatric Mental Health Nursing, 93th ed, Philadelphia:

Lippincott Company William and Wilkins,2018.

 Videbeck, S.: Psychiatric Mental Health Nursing,6th edition, Lippincott Company William

and Wilkins,2014.

  Isaacs, A.: Mental Health and Psychiatric Nursing,4th edition, Lippincott Company

William and Wilkins,2005.

hossam-M , Lecturer Mental Health Nursing. 20