History of Psychiatry

a) History of Psychiatric Nursing – India and at

international level

b) Trends in Psychiatric Nursing

c) National mental health programme

UNIT :- 2 HISTORY OF PSYCHIATRY

EXPLAIN THE HISTORY :-

History is a meaningful record of human achievements. It is not just events over time, but a truth relationship with person, event, time, and space.

The word history is derived from the Roman words ‘historic’ means ‘knowledge through enquiry’

The history of development of secretarial and secretarial nursing over different periods is discussed below:-

QUE :- (A) Explain History of Psychiatric Nursing in India and at international level :-

✓ HISTORY OF PSYCHIATRIC NURSING IN INDIA :-

1912– Indian Lunacy act was passed as law

1918- The ruling British government built the European Hospital in Ranchi.

1925- Indian Mental Hospital was built in Ranchi.

1930 – Principles and Practice of Psychiatric Nursing

Taken from the experience of caring for psychiatric patients.

1937-Madras Government organizes 3 months psychiatric nursing course at Mental Hospital Madras.

1950s- The role of the psychiatric nurse became more defined.

1954 – Noor Manzil Mental Health Centre, Lucknow started offering psychiatric nursing orientation course of 4-6 weeks duration.

1956- One year Post Certificate Course in Psychiatric Nursing started at Nimhans Bangalore.

1962- Mysore Government started a 9-month course in psychiatric nursing for men.

1965– Indian Nursing Council included psychiatry nursing as a compulsory course in B.Sc nursing curriculum.

1967– Trained Nurses Association of India formed a separate committee. To improve the perception of psychiatric nursing.

1975- Psychiatric Nursing was offered as an optional subject, P.G. R.A.K. program at

College of Nursing, Delhi Later P.G.I. Chandigarh (1978), SNDT Mumbai (1980),

CMC Vellore and Ludhiana (1987), NIMHANS (1988).

1980- Psychiatric nursing was included in the Diploma in Nursing Education.

1986- Indian Nursing Council included psychiatric nursing as a common nursing curriculum.

1987– The Indian mental health act was passed

1991- Indian Society of Psychiatric Nurses (ISPN) was formed at NIMHANS, Bangalore.

✓ HISTORY OF PSYCHIATRIC NURSING AT INTERNATIONAL LEVEL

1873-Linda Richards develops better nursing care in mental hospitals, and organizes nursing services and educational programs in state mental hospitals.

1882 – First school to train nurses to care for the mentally ill at McLean Hospital in Waverley.

1913– John Hopkins, first school of nursing to implement fully developed psychiatric nursing curriculum.

1920– Harriet Bailey publishes the first psychiatric nursing textbook. “Nursing mental illness”

1935- Insulin shock treatment is introduced.

1936– Psychosurgery was introduced to treat mentally ill patients.

1938- Electroconvulsive therapy was introduced as a treatment approach for psychiatric patients.

1943- Psychiatric nursing course for male nurses was started.

A 1946-Health Survey Committee report recommended training nursing personnel in psychiatric nursing as well.

1952 – Heidegger Phelps, one of the nurse theorists, published a book on interpersonal relationships in nursing and presented the first systematic theoretical framework for psychiatric nursing.

1953- Maxwell Jones wrote a book on ‘Therapeutic Community’.

1955 – Psychiatric nursing experience included in general nursing curriculum in all schools.

1956—Master’s program extended to two academic years.

1960- The first doctoral program in psychiatric nursing begins in Boston. Psychiatric Nursing changed to ‘Psychiatric Mental Health Nursing’.

1963- Journal of Psychiatric Nursing and Mental Health Services is published.

1970s—again, psychiatric mental health nursing was replaced by ‘psychosocial nursing’.

1972- The American Nursing Association published the Standards of Psychiatric Nursing Practice.

which was amended in 1982.

1979 – Issues in Mental Health Nursing is published.

1980-Concept of decentralization brought changes in the organization.

1985-Psychiatric Mental Health and Standards of Clinical Nursing Practice were published. By the American Nurses Association.

1990- Integration of neuroscience into the holistic bio-psycho-social practice of psychiatric nursing.

1991-Community participation is a major concern in the rehabilitation of the mentally ill.

(B) Briefly explain Trends in Psychiatric Nursing :-

Trends in psychiatric nursing

A number of graduate and certification programs for psychiatric mental health nurses were launched in Psychiatric Nursing, many of which led to improvements in the nursing literature.

• Shift from institutional to community-based care:

There is a greater trend toward providing mental health care in community settings such as primary care clinics, schools, and workplaces. This is consistent with the trend towards institutionalization and the belief that people with mental illness can live and thrive in the community with appropriate support.

• Increased focus on early intervention and prevention:

Psychiatric nurse play key role in intervention and other programs. This includes working with children and adolescents at risk of developing mental health problems, as well as supporting families and carers.

• Greater emphasis on holistic care:

Psychiatric nurses are taking a more holistic approach to holistic care, which considers aspects of physical, social and spiritual well-being. This includes helping patients manage their physical health as well as providing support for their social and emotional needs.

• Utilization of technology:

Psychiatric nurses are increasingly using technology to provide care for the mentally ill. These include telehealth and telepsychiatry, which allow nurses to provide care to patients in remote or underserved areas.

• Collaboration with other healthcare professionals:

Working more closely with other healthcare professionals such as psychiatric nurses, doctors, social health workers and psychologists. This recognizes the complex needs of people with mental disorders and the importance of a team approach to care.

• Mental health care and general health care are provided as community services.
• Adequate trained staff available in mental health area.
• Qualified mental health care provider available and focus on holistic care.
• Awareness about mental health has increased among people.
• comprehensive approach
• Nurses have an important contribution to improve mental health care.
• Nurses play an important role in primary psychiatric care and cure of mental health problems, providing mental and physical support to patients.
• A lot of research has also been done for the treatment of mentally ill patients. The training of which is given to the nurse for effective care.

QUE :- (C) EXPLAIN THE NATIONAL MENTAL HEALTH PROGRAM:-National Mental Health Programme:-

(NMHP) :-

Mental Health :-

Mental health is a state of well-being in which a person knows his abilities and can cope with normal stressors and can work productively and interact with the community.

(WHO)

Mental Illness :-

Mental illness is a medical condition that disrupts a person’s thinking, feeling, mood, abilities, and daily functioning. Mental illness is a medical condition that often impairs the ability to cope with the normal demands of life.

The National Mental Health Program was implemented by the Government of India to provide mental health services at the rural level. (1982)

Because mental illness was becoming a heavy burden in the community, this program was launched so that people can get its services.

The first was implemented in 1982 in Maharashtra which was the first state to implement a National Mental Health Programme.

Under this program district mental health program (DMHP) was implemented.

In which Bellary District of Karnataka was the first district which was modeled by NIMHANS.

In which 27 districts were implemented in 1996

Under which,

• DMHP expanded to 100 districts all over the country.
• Mental Hospitals were modernized
• IEC Activity (Information, Education, Communication)
• Conducted research and training to improve metal health services

Currently, 123 districts come under DMHP.

AIM OF NMHP :-

• To prevent and treat mental neurological disorders and related disabilities.
• Using mental health technology to improve general health services.
• Application of mental health principles in total national development to improve quality of life.

OBJECTIVES OF NMHP :-

• To provide mental health care to every class and especially to those who need it.
• Applying mental health knowledge to care for general health and social development.
• To involve community people in the implementation of mental health services and to educate themselves.
• To select essential elements for mental health care.
• Allocate all available resources to improve mental health.

COMPONENT :-

• Providing mental health related training to the health team of the state.
• To increase awareness about mental health among people.
• To provide early detection and treatment of mentally un-healthy person.

LEVEL OF NMHP :-

treatment at

a) Village level

b) Primary health level

c) At district level

d) Tertiary care institution

e) Mental Hospital

f) Supportive Organization

THE TEAM OF WORKERS AT THE DISTRICT UNDER THE PROGRAM :-

Psychiatrist

Clinical psychologist

Psychiatric social worker

• Community nurse
• Program manager
• Case registry assistant
• Record keeper

HEALTH CARE UNDER NMHP :-

1. The mental morbidity requires priority in mental health treatment :-

A number of causes are responsible for acute mental disorders that directly affect the cerebral function of the brain, such as malaria, typhoid, meningitis, alcohol psychosis and epileptic psychosis, which can treat temporary disability.

2. Primary health care at village and sub center level :-

Training of multi-purpose health workers and health supervisors for psychiatric emergencies, behavioral changes in children, mental retardation,

Assessing and getting treated by a doctor and referring to a higher centre.

3. At primary health center level :-

Medical officers should be trained to provide the following services,

• Supervision of MPHW and Health Worker
• Diagnosis and Treatment Chart Neurological Examination
• Treatment of mental disorders at PHC
• Survey of mental disorders in the area and implementation of various programs.

1. At the district hospital level :-

• Have a DISTRICT health service of 30 to 50 beds with clinical psychiatric presence. which provides treatment, ECT, or referral services for mental disorders.

1. Mental hospital :-

There is a higher center for psychiatric care where proper care and treatment of patients are done in a planned manner.