Treatment: Trephination (drilling holes in the skull to release evil spirits).
Greek Civilization:
Hippocrates (460–377 BC): Father of Medicine; proposed the Humoral Theory (imbalance of body fluids—blood, phlegm, yellow bile, black bile—causes disease including mental disorders).
Advocated for natural rather than supernatural causes.
Roman Period:
Galen expanded on Hippocrates’ theories.
Introduced concepts of personality based on humors (e.g., sanguine, choleric).
📚 Medieval Period
Mental illness viewed as a result of sin, witchcraft, and demonic possession.
Treatments included exorcisms, confinement, and harsh punishments.
Famous asylums:
Bethlehem Hospital (Bedlam), London (1247): First mental hospital, known for poor conditions.
Establishment of more asylums but still with poor care.
📅 Modern Era
18th Century (Age of Enlightenment):
Rise of moral treatment movement.
Philippe Pinel (France): Advocated for humane treatment, removed chains from mentally ill patients.
William Tuke (England): Founded York Retreat, promoting kindness and structured daily routines.
19th Century:
Emil Kraepelin: Classified mental disorders scientifically (laid groundwork for modern psychiatric diagnosis).
Sigmund Freud: Introduced Psychoanalysis, emphasizing unconscious mind and childhood experiences.
Establishment of specialized psychiatric hospitals.
20th Century:
Introduction of Electroconvulsive Therapy (ECT) (1938).
Discovery of Chlorpromazine (1952), first antipsychotic drug, beginning the Psychopharmacological Era.
Rise of Cognitive Behavioral Therapy (CBT) and other structured therapies.
Deinstitutionalization movement started, promoting community-based care.
21st Century:
Emphasis on Holistic Care, Mental Health Acts, and Human Rights.
Development of advanced psychotropic drugs and neuroimaging techniques.
Focus on destigmatizing mental health and integrating mental health into primary healthcare.
📚 One-Liner Revision on History of Psychiatry
Who is the Father of Medicine? ✅ Hippocrates – Proposed the Humoral Theory of mental illness.
What was the first known mental hospital? ✅ Bethlehem Hospital (Bedlam), London, established in 1247.
Who is known for initiating humane treatment of mentally ill patients in France? ✅ Philippe Pinel – Removed chains from patients.
Who started the moral treatment movement in England? ✅ William Tuke – Established the York Retreat.
Who developed the first scientific classification of mental disorders? ✅ Emil Kraepelin.
Who introduced Psychoanalysis and emphasized the unconscious mind? ✅ Sigmund Freud.
When was Electroconvulsive Therapy (ECT) introduced? ✅ In 1938.
Which was the first antipsychotic drug discovered? ✅ Chlorpromazine in 1952.
Which era is known for the rise of psychopharmacology? ✅ 20th Century.
What is the modern approach to mental health care? ✅ Community-based care and holistic mental health services.
🎯 Quick MCQs for Practice
Who proposed the Humoral Theory of mental illness? A) Galen B) Hippocrates C) Freud D) Paracelsus ✅ Correct Answer: B) Hippocrates
Which hospital is known as the first mental institution? A) York Retreat B) Bedlam C) NIMHANS D) Broadmoor Hospital ✅ Correct Answer: B) Bedlam
Who is considered the father of modern psychiatry? A) William Tuke B) Sigmund Freud C) Emil Kraepelin D) Philippe Pinel ✅ Correct Answer: C) Emil Kraepelin
The first antipsychotic drug introduced was: A) Lithium B) Imipramine C) Chlorpromazine D) Diazepam ✅ Correct Answer: C) Chlorpromazine
The psychoanalysis theory was developed by: A) Jung B) Freud C) Adler D) Skinner ✅ Correct Answer: B) Freud
📖 Ancient and Medieval Period
Mental illness was treated with superstition, exorcism, and inhumane methods.
No specialized nursing role existed; care was often custodial and provided by untrained persons.
Mentally ill individuals were often chained, isolated, or subjected to torture.
📅 17th to 18th Century (Pre-Modern Era)
Care was mostly custodial, provided by attendants known as “keepers” or “warders” in asylums.
Conditions in mental institutions like Bedlam Hospital were harsh and unhygienic.
🧠 19th Century – Birth of Psychiatric Nursing as a Profession
Moral Treatment Movement initiated humane and compassionate care.
Florence Nightingale (1859):
Though not directly involved in mental health nursing, she emphasized therapeutic environments and compassionate care, influencing psychiatric nursing indirectly.
Linda Richards (1873):
Recognized as the First American Psychiatric Nurse.
Opened the first school of psychiatric nursing at McLean Hospital, Massachusetts, USA.
📚 20th Century – Formal Development of Psychiatric Nursing
Psychiatric nursing became a recognized specialty.
1920s-1940s: Psychiatric nursing education was introduced in nursing schools.
Hildegard Peplau (1952):
Known as the “Mother of Psychiatric Nursing”.
Developed the Interpersonal Relations Theory, emphasizing nurse-patient therapeutic relationships.
Introduced the concept of Advanced Psychiatric Nursing Practice.
1960s-1980s:
Expansion of mental health services into community settings (Deinstitutionalization Movement).
Rise of Community Mental Health Nursing and introduction of Mental Health Acts for patient rights.
📅 21st Century – Modern Psychiatric Nursing
Emphasis on evidence-based practice, holistic care, and rehabilitation.
Nurses play vital roles in crisis intervention, community psychiatry, psychotherapy, and psychoeducation.
Introduction of Advanced Practice Psychiatric Mental Health Nurses (PMHNPs) who can provide psychotherapy and prescribe medications in some countries.
🎯 Key Contributors in Psychiatric Nursing
Contributor
Contribution
Florence Nightingale
Humanitarian approach, therapeutic environment.
Linda Richards
First trained psychiatric nurse, started formal training.
Hildegard Peplau
Mother of Psychiatric Nursing, Interpersonal Relations Theory.
📚 One-Liner Revision on History of Psychiatric Nursing
Who is considered the Mother of Psychiatric Nursing? ✅ Hildegard Peplau.
Who was the first trained psychiatric nurse? ✅ Linda Richards.
Where was the first school of psychiatric nursing established? ✅ McLean Hospital, Massachusetts, USA.
Who introduced the Interpersonal Relations Theory in psychiatric nursing? ✅ Hildegard Peplau (1952).
Which famous nurse indirectly influenced psychiatric nursing through her focus on the therapeutic environment? ✅ Florence Nightingale.
What was the main focus of the Moral Treatment Movement? ✅ Humane and compassionate care for the mentally ill.
When did psychiatric nursing start being formally included in nursing education? ✅ Early 20th Century (1920s-1940s).
What significant movement in the 1960s led to the growth of community mental health nursing? ✅ Deinstitutionalization Movement.
Which advanced role allows psychiatric nurses to prescribe medications in some countries? ✅ Psychiatric Mental Health Nurse Practitioner (PMHNP).
🎯 MCQs for Practice
Who is known as the Mother of Psychiatric Nursing? A) Florence Nightingale B) Linda Richards C) Hildegard Peplau D) Dorothea Dix ✅ Correct Answer: C) Hildegard Peplau
The first school of psychiatric nursing was started at: A) Johns Hopkins Hospital B) McLean Hospital C) Bellevue Hospital D) Massachusetts General Hospital ✅ Correct Answer: B) McLean Hospital
Who was the first American trained psychiatric nurse? A) Linda Richards B) Hildegard Peplau C) Dorothea Dix D) Mary Mahoney ✅ Correct Answer: A) Linda Richards
Which nursing theorist developed the Interpersonal Relations Theory? A) Betty Neuman B) Florence Nightingale C) Hildegard Peplau D) Virginia Henderson ✅ Correct Answer: C) Hildegard Peplau
The deinstitutionalization movement emphasized: A) Building more mental hospitals B) Isolating mentally ill patients C) Community-based mental health care D) Using restraints for safety ✅ Correct Answer: C) Community-based mental health care
📖 1. Holistic and Patient-Centered Care
Focus on treating the patient as a whole: biological, psychological, social, and spiritual aspects.
Encouraging active patient participation in care decisions.
📅 2. Community-Based Mental Health Services
Shift from institutional care to community-based rehabilitation and outpatient services.
Development of Halfway Homes, Day Care Centers, and Rehabilitation Centers.
Example: National Mental Health Programme (NMHP) in India promotes community psychiatry.
🧠 3. Integration of Mental Health into Primary Health Care (PHC)
Mental health services are now integrated into primary health centers and district hospitals.
Training of PHC staff under programs like District Mental Health Programme (DMHP).
💊 4. Advances in Psychopharmacology
Introduction of Second and Third Generation Antipsychotics with fewer side effects.
Personalized medication management based on genetic testing (Pharmacogenomics).
💡 5. Use of Telepsychiatry and E-Mental Health
Remote mental health services using telemedicine platforms.
E-mental health apps offering counseling and crisis support (e.g., Tele MANAS in India).
📚 6. Cognitive Behavioral Therapies and Evidence-Based Practice
Increasing use of CBT, DBT (Dialectical Behavior Therapy), and Mindfulness-Based Therapies.
Practice based on clinical guidelines and research evidence.
📖 7. Recovery-Oriented Approach
Focus on helping individuals lead meaningful lives despite mental illness.
Emphasis on empowerment, hope, and self-determination.
👩⚕️ 8. Expanded Role of Psychiatric Nurses
Nurses involved in counseling, crisis intervention, psychotherapy, and psychoeducation.
Rise of Advanced Practice Roles like Psychiatric Mental Health Nurse Practitioners (PMHNPs).
🧩 9. Mental Health Legislation and Policy Reforms
Implementation of laws like the Mental Healthcare Act 2017 (India) ensuring patient rights and decriminalizing suicide.
Emphasis on confidentiality, informed consent, and humane treatment.
📝 10. Focus on Mental Health Promotion and Prevention
Programs for stress management, suicide prevention, and school mental health.
Early identification of mental illnesses through screening programs.
📚 One-Liner Revision on Recent Trends in Mental Health Nursing
What is the current focus of mental health care? ✅ Holistic and patient-centered care addressing biological, psychological, social, and spiritual needs.
Which program in India integrates mental health services into primary care? ✅ District Mental Health Programme (DMHP).
Name the mobile mental health service initiative launched in India. ✅ Tele MANAS.
Which approach focuses on empowering patients to lead meaningful lives despite illness? ✅ Recovery-Oriented Approach.
Which therapy focuses on modifying negative thoughts and behaviors? ✅ Cognitive Behavioral Therapy (CBT).
Which recent legislation ensures the rights of mental health patients in India? ✅ Mental Healthcare Act, 2017.
Which advanced nursing role allows mental health nurses to prescribe medications? ✅ Psychiatric Mental Health Nurse Practitioner (PMHNP).
Which new technologies are widely used for remote mental health services? ✅ Telepsychiatry and E-Mental Health Platforms.
What is the focus of pharmacogenomics in psychiatry? ✅ Personalizing psychiatric medications based on genetic profiles.
What is the emphasis of the deinstitutionalization movement? ✅ Community-based mental health care.
🎯 MCQs for Practice
Which act decriminalized suicide and ensured patient rights in India? A) Mental Health Act 1987 B) Mental Healthcare Act 2017 C) Disability Act 1995 D) Consumer Protection Act 2019 ✅ Correct Answer: B) Mental Healthcare Act 2017
Which program focuses on integrating mental health into primary health care? A) NHM B) RNTCP C) DMHP D) NACP ✅ Correct Answer: C) DMHP (District Mental Health Programme)
What is the purpose of the Recovery-Oriented Approach in mental health care? A) Complete cure of mental illness B) Empowerment and meaningful life despite illness C) Institutionalized care D) Use of only medications ✅ Correct Answer: B) Empowerment and meaningful life despite illness
Which advanced psychiatric therapy is commonly used for Borderline Personality Disorder? A) CBT B) DBT C) ECT D) IPT ✅ Correct Answer: B) DBT (Dialectical Behavior Therapy)
Tele MANAS provides which of the following services? A) In-person therapy only B) Tele-mental health counseling and crisis support C) Home visits by psychiatrists D) Only medication supply ✅ Correct Answer: B) Tele-mental health counseling and crisis support
History of Psychiatric Nursing – India
Here’s a concise and exam-oriented note on the History of Psychiatric Nursing in India:
📚 Ancient Period
Mental illness in ancient India was primarily viewed through religious and supernatural beliefs.
Treatment was based on Ayurveda, yoga, meditation, and spiritual healing.
The ancient texts like Charaka Samhita and Sushruta Samhita mentioned mental disorders (e.g., Unmada for insanity, Apasmara for epilepsy).
🏥 Colonial Period (British Era)
Establishment of mental asylums began under British rule.
The first mental asylum in India was established at Bombay (Mumbai) in 1745.
Other major asylums:
Calcutta (Kolkata) – 1784
Madras (Chennai) – 1794
Care was largely custodial and lacked professional nursing standards.
📅 Post-Independence Era (1947 Onwards)
1946: Bhore Committee recommended the integration of mental health into general health services.
1954: Establishment of National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore, now a premier mental health institute.
1955: Launch of the First Diploma Course in Psychiatric Nursing at NIMHANS.
Psychiatric nursing began to be formally included in nursing curricula under the Indian Nursing Council (INC) guidelines.
1982: Launch of the National Mental Health Programme (NMHP) – Aimed to make mental health care accessible at all health levels.
1996: Introduction of the District Mental Health Programme (DMHP) for delivering community mental health services.
2017: Mental Healthcare Act, 2017 passed, decriminalizing suicide and ensuring rights-based care for the mentally ill.
🎯 Key Developments in Psychiatric Nursing Education in India
Year
Event/Development
1946
Bhore Committee Recommendation
1954
NIMHANS Established
1955
First Psychiatric Nursing Diploma Course at NIMHANS
1982
National Mental Health Programme (NMHP) Launched
1996
District Mental Health Programme (DMHP) Started
2017
Mental Healthcare Act Implemented
Would you like me to provide MCQs and One-Liner Revision on this topic for practice? 😊
📚 One-Liner Revision on History of Psychiatric Nursing in India
When was the first mental asylum established in India? ✅In 1745 at Bombay (Mumbai).
Which ancient texts mention mental disorders like Unmada and Apasmara? ✅Charaka Samhita and Sushruta Samhita.
When was NIMHANS established? ✅In 1954 at Bangalore.
Where was the first diploma course in psychiatric nursing started? ✅At NIMHANS in 1955.
Which committee recommended integrating mental health with general health services? ✅Bhore Committee (1946).
When was the National Mental Health Programme (NMHP) launched? ✅In 1982.
When was the District Mental Health Programme (DMHP) introduced? ✅In 1996.
Which act decriminalized suicide and ensured rights-based care for mental health patients? ✅Mental Healthcare Act, 2017.
🎯 MCQs for Practice
The first mental hospital in India was established in: A) Calcutta, 1784 B) Madras, 1794 C) Bombay, 1745 D) Delhi, 1800 ✅ Correct Answer: C) Bombay, 1745
The National Institute of Mental Health and Neurosciences (NIMHANS) was established in: A) 1946 B) 1954 C) 1955 D) 1982 ✅ Correct Answer: B) 1954
The first formal psychiatric nursing education program in India began at: A) AIIMS, New Delhi B) NIMHANS, Bangalore C) RML Hospital, New Delhi D) JIPMER, Pondicherry ✅ Correct Answer: B) NIMHANS, Bangalore
Which committee laid the foundation for integrating mental health services into primary care in India? A) Bhore Committee B) Mudaliar Committee C) Shrivastav Committee D) Kartar Singh Committee ✅ Correct Answer: A) Bhore Committee
The Mental Healthcare Act, which ensures patient rights and decriminalizes suicide, was enacted in: A) 1987 B) 1996 C) 2017 D) 2015 ✅ Correct Answer: C) 2017
📚 Introduction
The National Mental Health Programme (NMHP) was launched by the Government of India in 1982.
Aim: To make mental health care accessible, affordable, and integrated with general health services.
🎯 Objectives of NMHP
Ensure availability and accessibility of mental health care for all, especially vulnerable and underprivileged populations.
Promote mental well-being and prevent mental disorders through awareness and early intervention.
Integration of mental health services with primary health care (PHC).
Develop community-based mental health services.
Train general health care personnel in basic mental health care.
🏥 Three Major Components of NMHP
Treatment of Mentally Ill Patients.
Rehabilitation of Mentally Ill Persons.
Prevention and Promotion of Mental Health.
📅 Key Milestones in NMHP
Year
Development/Event
1982
NMHP Launched
1996
District Mental Health Programme (DMHP) Started as a pilot project.
2003
NMHP Revised under the 10th Five-Year Plan.
2014
Inclusion of NMHP in National Health Mission (NHM) for better implementation.
🧠 District Mental Health Programme (DMHP)
Launched in 1996 to provide mental health services at the district level.
Focuses on community mental health care, early detection, and referral services.
Involves training PHC doctors, health workers, and community volunteers.
📖 Key Strategies of NMHP
Establishment of Mental Health Units in District Hospitals.
Training of PHC doctors and paramedical staff.
Public awareness and stigma reduction programs.
Expansion of mental health infrastructure and manpower.
📜 Legal Support for NMHP
Mental Healthcare Act, 2017: Ensures mental health services as a right and decriminalizes suicide.
📚 One-Liner Revision on National Mental Health Programme (NMHP)
In which year was the NMHP launched? ✅1982.
What is the main goal of NMHP? ✅To make mental health care accessible, affordable, and integrated with general health services.
When was the District Mental Health Programme (DMHP) introduced? ✅In 1996.
Under which national mission is NMHP now included? ✅National Health Mission (NHM).
What are the three key components of NMHP? ✅Treatment, Rehabilitation, and Prevention & Promotion of mental health.
Which Act supports mental health rights and services in India? ✅Mental Healthcare Act, 2017.
What is the focus of the DMHP? ✅Providing mental health services at the district level and integrating them with PHC.
What is a major strategy of NMHP for reducing stigma? ✅Public awareness and mental health education campaigns.
🎯 MCQs for Practice
When was the National Mental Health Programme (NMHP) launched in India? A) 1987 B) 1982 C) 1996 D) 2003 ✅ Correct Answer: B) 1982
Which of the following is NOT an objective of NMHP? A) Promote mental well-being. B) Provide mental health services only in urban areas. C) Integrate mental health care with general health services. D) Train health personnel in mental health. ✅ Correct Answer: B) Provide mental health services only in urban areas.
The District Mental Health Programme (DMHP) was introduced under NMHP in which year? A) 1990 B) 1996 C) 2005 D) 2014 ✅ Correct Answer: B) 1996
Under which mission is NMHP currently functioning for wider implementation? A) National Rural Health Mission (NRHM) B) National Health Mission (NHM) C) National Urban Health Mission (NUHM) D) Ayushman Bharat ✅ Correct Answer: B) National Health Mission (NHM)
Which legislation provides legal support for mental health rights in India? A) Mental Health Act, 1987 B) Mental Healthcare Act, 2017 C) Human Rights Act, 2009 D) Medical Council Act, 2016 ✅ Correct Answer: B) Mental Healthcare Act, 2017