3. Roll number:1
BNS 2nd year
Aarati
Chaudhary
Prepared By::
HISTORY
OF PSYCHIATRIC &
PSYCHIATRIC NURSING
4. INTRODUCTION:
Psychiatric nursing is the result of combining knowledge from
psychiatry, psychology, pharmacology, and philosophy with
the basic concept of caring that is fundamental to nursing practice
There nursing approaches aim to help clients improve
communication skills and adapt more effectively to society
HISTORICAL PERSPECTIVES
OF PSYCHAITRY
AND PSYCHAITRIC NURSING:
5. The term history is deried from ROMAN
word historicus’ which means
knowledge
through enquiry.
Cave dwellers were believed that abnormal
behaviour was occuring due to the act of
devil’ or evil sprits’ or magical power or anger
of god or supernatural powers.
History
of Psychiatry
6. Historically, the mentally ill were
stigmatized as evil witches, with their
conditions manifesting as symptoms
like headaches and seizures, reflecting
a misunderstanding of mental health.
History of
Psychiatry Cont’d...
7. To relieve this problem or cure
the illness,
they used to do,TRIPHENING METHOD,
or by performing ritualistic exorism
to purge the body of these unwanted
forces or by starvation or torturous
means like brutual beating or burned
at stake
History of Psychiatry
Cont’d..
8. Historically, mental illness was attributed to sin
or taboo violations, leading to treatments centered
on spiritual rituals, counseling, or basic physical care
History
of psychiatric
cont’d..
9. Asclepiades (124BC): Has mentioned manifestations
of perception disorders like hallucinations, delusion
and illusions and also quoted acute and chronic
illness of mental disorders
He cited hygienic measures, diet and massage
therapy etc, were the remedial measure for mental
illness
History of psychiatric
cont’d..
10. King Ashoka established hospitals
for mentally ill individuals (BC273-232 BC).
Aristotle (384BC-322BC) theorized that body fluids
govern emotions, linking hot bile to desires,
talkativeness, and suicidal thoughts. His melancholi
treatment involved catharsis and music therapy.
History
of psychiatric
cont’d..
11. Hippocrates (460–375BC): Identified
melancholia, depression excitement, hysteria
and mania. He quoted the causes for mental
illnesses were; hereditary, brain tumours,
and disequilibrium in the body fluids.
History
of psychiatric cont’d..
12. He comprehended the relationship between body
mind &narrated the dreams roads for desire.
Plato(429–347BC):
Stated the organic,
moral and divine forces
will influence
the normative behaviour
of an individual.
According to him
the family has to
be punished,if insane
or mentally ill commited
any mistake,he doesnot
know what is doing?
History of psychiatric cont’d..
13. Pythorus (590.-510BC): Formulated the
conse pl that brain is the base of intellectual
activity
Indian Civilization (700BC): Enlisted the cause
for mental illness viz, demons, trans
migration of soul after death, karma
siddhanta
History
of psychiatric
cont’d..
14. Chinese Civilization (220–1750BC): Mentioned
the manifestations of mental illness like
disturbance in sleep pattern, grandiose ideas.
Ching Chung emphasized treating psychiatric
disorders with freedom, reassurance, and meeting
clients' needs at an appropriate level without
suppression
History
of psychiatric
cont’d..
15. Galan (120–200AD): Mental illness
was linked to factors like head injury,
alcoholism, emotional
shock,heartbreak, poverty, and life
transitions such as
adolescence and reproductive stages.
History
of psychiatric
cont’d..
16. In the middle ages (500–1500 AD):
Treatment of mental illness often
involved witchcraft
and supernatural beliefs, with some
patients sent to sea on boats in hopes
of regaining their lost
rationality.
History
of psychiatric
cont’d..
17. a) Ancient time to B.C
In ancient times it is believed that any
sickness indicated displeasure of gods
and it is the outcome of sins and wrong
doings
Mental disorders were seen as either divine
or demonic; divine individuals were
worshipped, while those deemed demonic
were ostracized, punished, or burned at the
stake
Historical Development
of Psychiatry
18. b) Greek & Roman Era
The first study was made by Greek
physician Hippocrates
Hippocrates (460–357BC) described
a variety of personalities or
temperaments and proposed that
mental illness was a disturbance
of four body fluid or humors
Historical Development
of Psychiatry Cont’d..
19. These four substances or humors
corresponded with happiness calmness,
anger and sadness
Imbalances of four humors were believed
to cause mental disorders so treatment
was aimed at restoring balance through
bloodletting, starving and purging
Historical
Development
of Psychiatry Cont’d..
20. c). Era of Christianity
Demonic possession is the
main & only cause of mental
illness
When that failed, they used
more severe measures such
as incarceration in dungeons,
flogging and starving
Historical Development
oF Psychiatry Cont’d..
21. d). In European (Renaissance period)
Those considered harmless were
allowed to wander the country side
or live in the rural communities but the
more "dangerous lunatics" were thrown
in prison, chained and starved
Historical Development
oF Psychiatry Cont’d..
22. In 1547, the Hospital of St.
Maryof Bethlehem became the first hospital
for the insane. Meanwhile, in the colonies,
the mentally ill were seen as evil
or possessed, leading to witch hunts
and executions by burning
Historical Development
oF Psychiatry Cont’d..
23. Mentally sick were tortured and left their own
Nobody was allowed to develop a relationship with clients
Insane were thrown out of the society and beaten up by the people.
Treatment of mentally sick was based on superstitious beliefs
People believed that sounds black spirit or black magic etc can
predispose the mental illness
The period of persecution (1552–1440AD)
Period in psychiatry
24. 2. The period of segregation (1545–1800AD)
Middle Eastern Islamic countries believed anger
of god and witch craff etc were the causes
for mental illness
In England mentally ill were kept in "bethlem
asylums"
The aim of this period is to segregating the clients
from the general public
Period in psychiatry
cont’d..
25. 3. The humanitarian period (1745–1826AD
More number of asylums was set up and
physicians were interested to work
on mentally ill and moral treatment
Phillipe pinel in france & William tuke
in England were innovated
the humanitarian reform of mental
hospital
Period in psychiatry
cont’d..
26. There was a shift from evil to ill. Dorothea
Dix Stated pre disposing conditions,
chronicity personality defects etc
Mentally ill were called as insane or mad
4. Beginning of scientific attitude (1796–1878
AD)
Period in psychiatry
cont’d..
27. She believed that mentally ill individuals,
being innocent, should be treated humanely
through friendly interactions, purposeful
activities, and a moral approach.
Period in psychiatry
cont’d..
28. 5. Period of prevention (1885–1960AD)
Emil Krapelin in 1883 wrote a book
on descriptive psychiatry. The history
of psychiatry has witnessed 3 major
revolutions:
1" revolution occurred when it was believed
that sin and witch craft are responsible
for mental illness and mentally ill were
chained in jail and asylums
Period in psychiatry
cont’d..
29. 3" revolution was the
development of community
psychiatry that result
the integration of mental health
care in the community
2'd revolution was the advent
of psycho analysis which
explained atiology of mental
disorders
Period in psychiatry
cont’d..
30. Chlorpromazine, lithium an anti-psychotic
and antimanic drug developed. Later
anti-depressant and anti-anxiety agents
(Benzodiazepines) developed
Period in psychiatry
cont’d..
6. Period of psychotropic drugs
31. Phase 1- The emergence of psychiatric menta
health nursing:
This era covers the colonial period
(1700–1790) and the mental
treatment period (1790–1900).
It encompasses
both historical phases
PHASES OF PSYCHIATRIC
MENTAL HEALTH NURSING
32. In the 1770s, specialized institutions for psychiatric
patients "lunatics") were deemed necessary.
The Eastern Lunatic Hospital was established in 1773;
by 1880, approximately 30 psychiatric hospitals existed.
PHASES
OF PSYCHIATRIC
MENTAL HEALTH
NURSING
33. In 1783, Benjamin Rush
inaugurated the first course
of study in mental illness
Known as "the father of American psychiatry,"
Rush wrote the first American textbook
on psychiatry and advocated for more
humane treatment of the mentally ill.
Phases Cont’d..
34. In 1792, Philippe Pinel, a French physician, was placed
in charge of La Bicetre, a hospital for mentally ill persons
in paris
He joined the staff of Pennsylvaniahospital and insisted that
intelligent, kind attendants be hired to read to the patients, talk
to them, and share in their activities
Phases Cont’d..
35. Johan Weyer, a German physician, is considered
the first psychiatrist for describing diagnostic
categories
Pinel classified patients based on observable
behaviors, created case histories, and recorded
conversations
Advocated for humane treatment of the mentally
ill by removing chains and promoting compassion
Phases Cont’d..
36. In 1843, Thomas Kirkbridge attempted
to establish a training school for attendants
at Pennsylvania Hospital to aid in patient care
In 1843, Thomas Kirkbridge attempted
to establish a training school for attendants
at Pennsylvania Hospital to aid in patient care
Phases Cont’d..
37. The nurse's role was
to oversee the care
given and ensure
to smooth operation
of the ward
Housekeeping duties,
dietary management
and laundry care
were considered
nursing responsibilities
Phases Cont’d..
38. Phase2- Development of the work role of the nurse in psychiatric
mental health facilities (1882–1914)
In 1882, the first training school for nurses in the psychiatric setting
was established at Mc Lean Hospital in Belmont, Massachusetts. A simila
school was established at Buffalo state Hospital in1883
Clifford Beers' 1908 book, “A Mind That Found Itself”, influenced
the mental health movement by sharing his personal experiences
in mental institutions
Phases
Cont’d..
39. Phase3- Development of undergraduate
psychiatric mental health nursing education
(1915–1935)
In 1915 LINDA RICHARDS the first graduate nurse in the
united states the often referred to as "the first American
psychiatric nurse", suggested that mentally ill patients text
book focusing on psychiatric nursing practice were written
and national league for nursing conventions from 1915
through 1935 discussed under graduate psychiatric nursing
education. Objectives include:
Phases Cont’d..
40. Educating the student nurse about the cause of mental
disease or illness and modern methods of treatment.
Teaching the student nursing relationship between physical
and mental illness. The application of nursing
principles to psychiatric nursing.
Phases Cont’d..
41. Teaching the student nurse to
be resourceful,
versatile and adaptable while giving
Instructing the student nurse about
relationship between environmental
condition and mental disorders
Training the student nurse how to assess
behaviours of patient who are mentally ill
so that they may recognize early signs
of symptoms
Phases Cont’d..
42. Interest in under graduate psychiatric
nursing education and supplementary post graduate
course paved the way for graduate
education as it evolved in this era
Phase4- Development of graduate
psychiatric mental health nursing
education (1936–1945)
Phases Cont’d..
43. By 1937, clinical experience in psychiatric hospitals
became standardized, allowing nursing students
to work with patients experiencing a range
of mental disorders
Their training included therapies such
as hydrotherapy, physical, occupational,
recreational, and educational activities to support
Phases Cont’d..
44. Nursing interventions included emphasizing
cleanliness, proper elimination, and adequate
nutrition, as well as supervising continuous baths
to promote relaxation
Phases
Cont’d..
45. This acts setup funding of graduate nursins
programmes to prepare psychiatric clinical
nurse specialists
This era began with the passage of mental
health act of 1946
Phase5- Development of consultation
and research in psychiatric mental health
nursing practice (1946–1945)
Phases Cont’d..
46. The National League for Nursing received
annual grants to stimulate psychiatric
research, focusing on preventing and curing
mental illness
Phases
Cont’d..
47. 4 Types of personality
(choleric, melancholic,
sanguine, phlegmatic)
defined
by Hippocrates BC
French physician
Philippe Pinel
introduced human
treatment approaches
to those suffering from
1792
IMPORTANT
MILESTONE
IN PSYCHIATRY:
48. 1843- Victoria's Lunacy
Act
1838-France enacted a law to regulate both
the admission in to asylums and asylum
services across the country
In the early 1800s, England and France had only
a few hundred people in asylums, but by the late
1890s and early 1900s, that number had risen
to hundreds to thousands.
IMPORTANT MILESTONE
IN PSYCHIATRY:
49. 1863-Kalhlbaum and Hecker were among the first
to describe and categorize syndromes of the
mentally ill. They used descriptive terms such
as dysthymia, cyclothymia, catatonia, paranoia
and hebephrenia in their analyses
Milestone in psychiatry
cont’d..
50. 1874- Kallbaum publishes his book
on catatonia
1890- Asylums worldwide had become
overcrowded, partly due to transferof care
from families and poor houses, and the
optimism of treating the mental ill waited
as asylums increasingly became custodial
institutions which adversely impacted the
reputation of psychiatry
Milestone in psychiatry
cont’d..
51. 1890-Burckhardt performs 1" frontal lobe
lobotomies
1893- Krapelin divided psychosis in to manic
depression (now seen as comprising a range
of moos disorders such as major depression
and bipolar disorder), and dementia praecox (what
we now call Schizophrenia)
Milestone
in psychiatry cont’d..
52. 1900–02- Sigmund Freud publishes his books
which spurred the psychoanalytic approach
1903- Barbital (veronal) is the 1" barbiturate
1906- Alzheimer publishes pathology
of Alzheimer's disease
1908- Bleuler coins the Schizophrenia "split
or shattered" mind)
1912- Phenobarbital (Luminal, Phenobarbitone
introduced
Milestone in psychiatry
cont’d..
53. 1912- Phenobarbital
(Luminal,
Phenobarbitone)
introduced
1908- Bleuler coins
the Schizophrenia
"split or shattered"
mind)
1906- Alzheimer
publishes pathology
of Alzheimer's
disease
1903- Barbital
(veronal) is the 1"
barbiturate to find
clinical use
Milestone in psychiatry
cont’d..
54. 1920-Sigmund Freud in his essay
Beyond the Pleasure Principle
proposes the psyche cab be divided in
to ego, super-ego and id and that
humans are driven by two central
conflicting desires-life drives (libido)
and death drive (Thanatos)
1924- Development of behavioural
therapies starting with 'Mary Cover
Jones' work on the unlearning
Milestone in psychiatry cont’d..
55. 1950's after Moniz successfully performed
prefrontal leucotomies in 1935
1930's — Lobotomies and ECT treatment
introduced & gained widespread use in the
1940's and
1927-Pavlov's experiments 1 translated in
to English and inspired behaviourist learning
theory
Milestone in psychiatry
cont’d..
56. 1947-Eysenck proposed E-N model personality
1946-Freeman first performed a transorbital lobot
1943- Maslow's hierarchy of need
1936- Anna Freud stresses .the importance of the
ego and
proposes the concept of defense
Psychiatry milestone
continues. Further
developments are underway
57. 1952- Chlorpromazine (Largactil)
revolutionises the treatment
of Schizophrenia
1950- Anna Freud instrumental
in development of child psychoanalysis
and child development
1948-Melbourne psychiatrist Dr. Cade's
discovery of lithium as treatment of bipolar
disorders
Milestone in psychiatry
cont’d..
58. 1960-the 1* of the Benzodiazepines,
chlordizepoxide (Librium) marketed
Late 1950's tricyclic anti-depressants
1" discovered (imipramine)
1955-Meprobamate marketed &
became popular in the later 1950's as
"Happy pills"
Milestone
in psychiatry cont’d..
59. 1960's- the development of cognitive
therapy
1960’s-Janov creates Primal Threapy to
re-live and express threapy.
1963-Diazepam (Valium) " marketed
1962-Kesey's novel one flew
over the cuckoo's nest published
1961-the popular MAOI,
iproniazid withdrawn as cases
of fatal hepatotoxicity
Psychiatry milestone
continues. Further
developments are underway
60. (2029 BS), ten-bedded neuro-
psychiatric unit established
in Royal Army Hospital, Kathmandu
1992
AD (B.S. 2020), psychiatric
OPD service started in Bir Hospital
1961
Psychiatry
in Nepal
61. In 1984 AD (2041/42 BS) 12 bedded
psychiatric department separated from
Bir Hospital and shified in Lagankhel, Patan
which is separate Mental hospital in Nepal
1986(2044BS) February TU Teaching hospital
started psychiatric OPD services
Psychiatry
in Nepal Cont’d...
62. 1995(205 IBS) department of psychiatric
made in BP Koirala Institute of Health
Sciences, Dharan
Since 1997 Ten beded drug detoxification
unit started in TUTH
1987(2045BS) December 12 bedded
psychiatric inpatient unit was established in
TU Teaching hospital
Psychiatry in Nepal
63. 1984(2041BS) United Mission to Nepal's
Mental Program was started
Dr. Bishnu Prad Sharma First psychiatric
doctor in Nepal, after completing his DPM
from Great Britain
(2045BS), psychiatric services
started at western regional hospital
outside Kathmandu valley
1988
Psychiatry in Nepal
Cont’d..
64. In 1994, Maryknol Nepal opened Aasha Deep
Rehabilitation and treatment center for women
Father Thomas Gafney started a rehabilitation center
for Nepali drug abusers in 1976
The department of psychiatric of TU Teaching Hospital
started the Mental Health Project by launching
A Community Mental Health Program in Morang in
1989(2046BS)
Psychiatry in Nepal
Cont’d..
65. In 1997 April, three years full time
residential MD psychiatry training program
was started in the TU Teaching Hospital,
Institute of Medicine
In 1991–1995 Mental Health Project
activities extended to Morang,
1991(2047BS) Kaski, 1992(2048BS) Banke
and syanja
In 1995 Aasha Deep extended in services
to men
Psychiatry in Nepal
Cont’d..
66. program was started in the TU Teaching Hospital,
Institute of Medicine
April, three years full time residential
MD psychiatry training
In 2000, IOM’s Maharajgunj Nursing Campus
and Lalitpur Nursing College began offering
a Bachelor’s in Nursing with a major
in Psychiatry, enrolling four students per year
Psychiatry in Nepal
Cont’d..
67. In 2000, IOM, started Bachelors In Nursing (Major
in Psychiatry) in Maharajgunj Nursing Campus,
4 get enrolled every year. In the same year Lalitpur
Nursing College also started major psychiatric
nursing in same programme
In 1999: BPKIHS started master in psychiatric course
Psychiatry
in Nepal Cont’d..
68. In 1998 November: First National conference
of psychiatrists Association of Neapl was held on Dharan.
It was hosted by the Department of Health Sciences,
Dharan
In 1997: National Mental Health policy was adopted
by Government of Nepal
In 1990: The psychiatrists Association of Nepal
has been established
Psychiatry in Nepal
Cont’d..
69. 2000: In 2000, IOM, started
Bachelors in Nursing (major
in psychiatry) in Maharajgunj
Nursing Campus, 4 get enrolled
every year
In 1999: Nepal Mental Health
legislation drafted
Psychiatry in Nepal
Cont’d..
70. 2008: Master
in psychiatric nursing
was started in, BPKIHS
Dharan in 2008
2007: Lalitpur Nursing
campus has also started
to Bachelors in Nursing
(major in psychiatry)
from this year (2064 BS /
2007)
2013: Bachelor
psychiatric nursing major
was started
by Purbanchal University
in 2013
Psychiatry in Nepal Cont’d..
71. 2024: Psychiatric Nursing Foundation
was established
2023: Master in psychiatric nursing
was started in,NAMS,Bir Hospital Nursing
campus
2016: Master in psychiatric nursing
was started in TU,IOM, Maharajgunj
Nursing Campus with the intake of three
students in 2016
Psychiatry in Nepal
Cont’d..
72. Psychiatric service remained virtually unknown in Nepal
till 1961 AD. Psychiatric out patient department service
was first started in 1961 AD (B.S. 2020) in Bir Hospital
by first psychiatric Dr.Bishnu Prasad Sharma after
completing his DPM form Great Britain
Hospital based
mental health service
73. At that time, Bir Hospital was 100
bedded of which 5 bedded
inpatient unit was established
in the same hospital in 1965 AD,
which was further strengthened to
12 beds in 1971 AD
Established in 1973, the Royal
Army Hospital’s neuro-psychiatric
unit in Kathmandu has grown to
25 beds, serving army personnel,
retirees, and their families
Hospital based mental health service
74. In 1984 AD (2041/42) 12 bedded psychiatry
department Bir Hospital was separated and
a separate Mental Hospital was created, which
was then shifted in 1985 AD to the current site
at Lagankhel, Patan
It then has 25 beds which were increased later to 39
beds. New building construction was started in BS
2055 (1997 AD) and the building was completed in
BS 2060 (2003 AD). At present Mental Hospital
(Patan) has expanded to 45 beds
Hospital based mental
health service cont’d..
75. TU Teaching Hospital, established in 1983, began
psychiatric OPD services in 1986, added a 12-bed inpatient
unit in 1987, and a 10-bed drug detoxification unit in 1997,
along with the introduction of clinical psychological
services
Hospital based
mental health
service cont’d..
76. BP Koirala Institute of Health Sciences, established in 1993
through a collaboration between Nepal and India, began
its psychiatry department in 1995 with outpatient services
and 22 psychiatric beds. In 1988, psychiatric services were
also introduced at the Western Regional Hospital outside
the Kathmandu Valley
Hospital based
mental health
service cont’d..
77. In 2008 AD 25 beds
tranquility hospital
and research center
established
in Khumaltar,
Hattiban,Lalitpur
(2041): United Mission
to Nepal's Mental
Health Program
started in South
Lalitpur
1984
Hospital based
mental health
service cont’d..
78. In 1989, the Department of Psychiatry at TU Teaching
Hospital launched a successful Community Mental Health
Program in Morang, which attracted professional interest
and led to expansion into the western region and Banke
district with additional staff
Community base
Mental Health
Service
79. In 1976, Father Thomas Gafney started
a rehabilitation center for Nepali drug
abusers of mental retardation and drug abuse
-In 1994, Maryknoll Nepal opened Aasha
Deep Rehabilitation and treatment center
for women
In 1995 Aasha Deep extended in services
to men
1991–1995 Mental Health Project activities
extended to Morang [1991 (2047)]. Kaski [1992
(2048)], Banke and Sangja
Community base Mental
Health Service cont’d.
82. Khadka,A.Comprehensive Texbook of Psychatric Nursing.(1st ed
2074).Samisksha publication
Sharma,C. and Bhattrai,j.Textbook for behavioural and mental
heath nursing.(1st 2018).Tara book and stationary
Prasai,D. Mental health and Psychratic nursing.(4th ed 2018).
Makalu publication house
Dhami,j.Essential textbook of Behavioural science and Mental
health Nursing.(2nd ed 2018).Samiksha Books Pvt.Ltd
https//www.psychatricnursing.org
References
![In 1976, Father Thomas Gafney started
a rehabilitation center for Nepali drug
abusers of mental retardation and drug abuse
-In 1994, Maryknoll Nepal opened Aasha
Deep Rehabilitation and treatment center
for women
In 1995 Aasha Deep extended in services
to men
1991–1995 Mental Health Project activities
extended to Morang [1991 (2047)]. Kaski [1992
(2048)], Banke and Sangja
Community base Mental
Health Service cont’d.](https://image.slidesharecdn.com/hop-250820020511-eefa8b44/85/HOP-RELATED-TO-NURSING-EDUCATION-FOR-BSC-79-320.jpg)
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