History of Psychiatry and
Psychiatric Nursing
Sr.Poojitha MSJ
Psychiatry
• It is a branch of medicine that deals with the
diagnosis, treatment and prevention mental
illness.
Psychiatric Nursing
• 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)
• 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 .
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
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)
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.
• 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
• 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
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
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: Eugene 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
• 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 Amirtsar, Hyderabad, Srinagar,
Jamnagar and New Delhi
• 1949: Lithium was first used for the treatment of
mania
• 1952: Chlorpromazine was introduced which
brought about a revolution in psychopharmacology
• 1963:The community Mental Health centres Act
was passed
• 1978: The Alma –Ata declaration of ‘Health for
all by 2000 AD’ posed a major challenge to
Indian mental health professionals.
• 1981:Community psychiatric centres 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
• 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
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
• 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
• 1943: Psy. Nsg course was started for male
nurses
• 1946: Health survey committee’s report
recommended preparation of nursing
personnel in Psy. Nsg also. The existing
institutions like mental hospitals in Bangalore
and Ranchi should start training
• 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 psy.
Nurse in her book “interpersonal relations in
Nursing” . It was the first systematic and
theoretical frame work developed for Psy. Nsg.
• 1953: Maxwell Jones introduced therapeutic
community.
• 1956: one year post certificate course in psy.
nsg 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.
• 1963: Journal of Psy. Nsg 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 Indian Nursing Council included psy. Nsg
as a compulsory course in B.Sc Nsg program
• 1973: Standards of psychiatric and mental health
nursing practice were enunciated to provide a means
of improving the quality care
• 1975: Psy. Nsg was offered as an elective
subject in M.Sc Nursing at the RAK College of
Nsg, 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.
• 1986: The Indian Nursing Council made psy.
nsg 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 nsg