A Brief History of Mental Health Care Mental Health In Early Civilizations to Renaissance Historical records indicate that many
early civilizations viewed mental illness with disgust. Instead of caring for the mentally ill, those with mental illness were often cast away and shunned. In the early years, it was believed that the mentally ill were possessed, evil, and possibly even witches. Many were afraid of the mentally ill and as a result, mentally ill persons were often sent to live out their lives in institutions. Mental Health In The 18th & 19th Centuries During the 18th and 19th centuries, the mentally ill were usually sent to live in asylums. Asylums in this time period were staffed by untrained personnel who often had no professional experience in working with the mentally ill. Mentally ill that were living in these asylums were often referred to as inmates and many were kept after treatment to continue to work in the asylums. Standards of care for the mentally ill did not exist, as a result, the mentally ill were often neglected and mis-treated. Asylums became overcrowded and the mentally ill were often ill treated and restrained to make control of their behaviors easier and manageable. The the treatment of the mentally ill in the 1800's did not go unnoticed and many began to call for reform. Private citizen Dorothea Dix was one of the first advocates for the mentally ill asking for humane and safe treatment for those will mental illness. In the late 1800's, schools of nursing were created to allow for trained personnel to care for the mentally ill. At this time, those committed to asylums were called patients instead of inmates and their care givers were called nurses. In the middle 1800's, the term psychiatry came about to define mental health care and treatment. Psychiatry was deemed a medical specialty with the help of The Journal of Mental Science. Mental Health In The 20th Century The year 1907 brought about standards of care for nurses when working with the mentally ill. The year 1913 marked the beginning of the Johns Hopkins Hospital School training for psychiatric nurses. Doctors were now in control of the care over mental health and mental health nurses instead of untrained personnel.
The 1930's produced changes in the treatment and care of the mentally ill. New treatments being explored used insulin and electroshock therapy as a treatments process for mental health. 1946 marked the passing of the National Mental health Act which established Mental Health treatment Institutions across the USA. Federal funds for mental health care, mental health research, and mental health education were becoming available across the nation. The 1940's & 1950's brought about the development of tranquilizers for use in the mental health field. During this time Psychiatric journals were being published that included new information regarding mental health practices and care guidelines for the mentally ill. The 1990's marked an expanse in the use of pharmacological interventions in the use of treating mental illness. Mental Health In The 21st Century Today, insurance issues and the need to contain costs has been said to lead to under treatment and under diagnosis. On the other hand, many people who are mentally ill are able to lead near normal lives with treatment and medication. With more than 5.7 million Americans being diagnosed with diseases like bipolar disease alone, the future of mental health will continue to drastically change over the years. to come. Source: Varcarolis, E (2005). Foundations of psychiatric mental health nursing. W.B. Saunders.
Example: care of a new born.
Example: Nurse guides a mother how to breastfeed her baby. families.
Exploitation – the nurse uses communication tools to offer services to the patient. Identified 3 related concepts: Self-care – activities an Individual performs independently throughout life to promote and maintain personal well-being. This is the problem identification phase. Therapeutic relationship is terminated and the links are dissolved. Nurse can bring a meal tray for client who can feed himself Supportive-educative – nurse’s actions are to help the client develop/learn their own self-care abilities through knowledge. sensation and emotion Hildegard Peplau’s Interpersonal Relations Theory Defined Nursing: “An interpersonal process of therapeutic interactions between an Individual who is sick or in need of health services and a nurse especially educated to recognize. as patient drifts away from identifying with the nurse as the helping person. and Principles of Homeodynamics Nursing is an art and science that is humanistic and humanitarian. groups. Identification – where the patient begins to have feelings of belongingness and a capacity for dealing with the problem. The life processes of human beings evolve irreversibly and unidirectionally along a space-time continuum 4. care of client recovering from surgery in a post-anesthesia care unit Partial compensatory – nurse and client perform care. 1. Nursing is a “maturing force and an educative instrument” Identified 4 phases of the Nurse – Patient relationship: Orientation – individual/family has a “felt need” and seeks professional assistance from a nurse (who is a stranger). Nursing interventions seek to promote harmonious interaction between persons and their environment. Self-care deficit – results when self-care agency (Individual’s ability) is not adequate to meet the known selfcare needs.
Dorothea Orem’s Self-Care Theory Defined Nursing: “The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness. health and well-being. creating an optimistic attitude from which inner strength ensues. Counseling a psychiatric client on more adaptive coping strategies. Nursing interventions are aimed at promoting physiologic. 5 basic assumptions: The human being is a unified whole. support and encouragement. It is directed toward the unitary human and is concerned with the nature and direction of human development. Patterns identify human being and reflect their innovative wholeness 5. respond to the need for help. The goal of nurses is to participate in the process of change. who is expected to take advantage of all services. The individual and the environment are continuously exchanging matter and energy with each other 3.Nursing Theories Callista Roy’s Adaptation Theory Viewed humans as Biopsychosocial beings constantly interacting with a changing environment and who cope with their environment through Biopsychosocial adaptation mechanisms. Has a strong health promotion and maintenance focus.” Focuses on activities that adult individuals perform on their own behalf to maintain life. and social functioning or adaptation. Focuses on the ability of Individuals. Here happens the selection of appropriate professional assistance. language and thought. or societies to adapt to change. but also accepts care done by the nurse for needs the client cannot meet independently.. Example: Nurse can assist post operative client to ambulate. The degree of internal or external environmental change and the person’s ability to cope with that change is likely to determine the person’s health status. The individual is characterized by the capacity for abstraction and imagery. possessing individual integrity and manifesting characteristics that are more than and different from the sum of parts.. Resolution – where patient’s needs have already been met by the collaborative efforts between the patient and the nurse. strengthen the wholeness of the Individual and redirect human and environmental patterns or organization to achieve maximum health. client can perform selected self-care activities. communities. psychologic. Nursing System – nursing interventions needed when Individual is unable to perform the necessary self-care activities: Wholly compensatory – nurse provides entire self-care for the client. Martha Roger’s Concept of Science of Unitary Human Beings. 2.
This served as prototype for other nursing education programs. They were successful in promoting the integration of mental health concepts into general nursing educational programs facilitating a national public awareness of the inter-relationship of mental and physical health in achieving patient outcomes. specialized bodies of knowledge and securing the didactic and clinical experiences necessary for students to develop to achieve competence as menta lhealth nurses. Adelaide Nutting. Psychiatric mental health nursing leaders played a critical role in identifying and developing relevant. Early nursing leaders such as Harriet Bailey.Under nursing leadership. 1982). 1982). but in prevention of mental illness through the educative aspects of nursing care (Nutting.HISTORY AND EVOLUTION OF THE SPECIALTY Psychiatric Mental Health Nursing as a specialty has its roots in 19th century reform movements to reorganize mental asylums into hospitalized settings and develop care and treatment for the mentally ill. (Church. Through their efforts. psychiatric mental health nursing practice moved far beyond the walls of state hospital institutions in meeting the mental health needs of the broader community (Church. Euphemia Jane Taylor and Lillian Wald supported the Mental Hygiene Movement and advocated for the acceptance of the emerging specialty of psychiatric nursing into the larger community of general nursing. psychiatric mental health nursing evolved from the narrow focus of medical models and mind-body dichotomy towards a biopsychosocial approach to mental illness including the concept of mind as expressed in behavior and adaptation to experience (Church. The first organized efforts to develop psychiatric nursing started at McLean Asylum in Massachusetts in 1882. 1982). a well-known nursing educator at Teachers College at Columbia. addressing a conference at the new Psychopathic Hospital in Boston emphasized the role that nursing could play. 1926). not only in promoting recovery from mental illness. The first nurse organized training program for psychiatric nursing within a general nursing education program was established at Phipps Clinic at Johns Hopkins Hospital in 1913. 1979). This position and visibility became extremely important when the next wave of reform occurred in the 1940’s with the passage of the Mental Health Act. (Buckwalter & Church. As early as 1914.