Historical 20 Timeline 2
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Historical 20 Timeline 2

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mental health history

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  • Greek physician Hippocrates had concerns over how people with mental health problems were treated & so did Plato Following fall of Roman Empire in 476 AD Often treated brutally and tortured. Sometimes families would choose to hide relatives with mental health problems. ‘ Bedlam’ was the name to symbolise the treatment of the patients/ inmates who were put on public display for tuppence a look
  • William Battie was a pioneer in the care of people with mental health problems. From whose name the term ‘batty’ is derived. Part of the new school of thought that institutionalising patients in asylums was in itself therapeutic; their purpose was not only to protect the patients and society but was in itself curative. He recognised that mental health nurses needed special training and wrote that ‘madness is as manageable as many other distempers’ and that its victims ‘ought by no means to be abandoned, much less shut up in loathsome prisons as criminals or nuisances to the society’. The rich were expected to pay a donation of sixpence but the poor were ‘to be electrified for free’ Advances in general medical knowledge saw attention shift from pathology & bacteriology to a search for organic causes of mental health problems
  • The Lunacy Act required countries to provide asylums Dr Connoly was a doctor at the Hanwell Asylum where patients were cared for without chains - He introduced a system of no-restraint into practice. Read hanwell article from Edinburgh Magazine as highlighted
  • Followed by 1844 first English journal published in USA – The American Journal of insanity, 1855 the British journal of Mental Health Science was developed
  • Nightingale was the dominant nursing theorist until 1950
  • An Examination question in those days was ‘around the ability to detect abnormalities in specimen of urine as this was considered an important feature of the attendants work
  • Before these most treatments were of a physical nature and often involving the use of restraints such as straitjackets and being subjected to cold water baths or showers These were of varying efficacy and toxicity
  • This book emphasised the nurse patient relationship as the essence of nursing - Peplau’s model focused on a total view of the client from health promotion to health restoration whereby mental health nursing is seen as a therapeutic relationship between the nurse and the patient
  • Deinstitutionalisation resulted in an expansion of community based care and the relocation of inpatient psychiatric beds to general hospitals. Community based care involved the establishment of community mental health centres and supported accommodation with a greater emphasis on the MDT however several gaps in community based services was revealed and needed rectifying the MOH established a set of five strategic directions as part of an overall strategy for mental health. By 1996 there was recognition that more specific policy and targeting of funding was needed to achieve the objectives of the National Mental Health Strategy. - 1996 Mason Report identified continuing problems with the services and made numerous recommendations – Among these was the recommendation of creating a national monitoring body This sets more specific targets for service developments the benchmarks set in Moving Forward include the range of Mild, Moderate and severe mental disorders among the adult population It also looks at the infrastructure, mental health promotion and prevention
  • This is the principle document that guides the work of the MHC originally the commission expected their work to be completed by 2001 but such is the complexity of reform and the scope of issues to still to be addressed that the commission still exists Recovery is a philosophical orientation to mental health and mental health service and is promoted by the MHC as part of its mandate to promote better mental health services Recovery is a concept with a long history in Mental Health Care but the commissions work is linked to the consumer advocacy movement rather than having a medically orientated meaning of recovery as cure of illness.

Historical 20 Timeline 2 Historical 20 Timeline 2 Presentation Transcript

  • Mental Health Nursing Historical Foundations
    • At the completion of this session students will:
    • Be able to discern the different ways in which mental
    • illness has been constructed in the past
    • Appreciate the different ways that have been used to
    • treat mental disorders in the past
    • Critique the theory that treatment has improved over
    • time
    • Be aware of some of the key historical, social and
    • political developments of mental health services in New
    • Zealand
  • Timeline...........
    • Ancient Civilisation : Ancient Romans, Greeks and Arabs treated people with mental health problems humanely
    • Middle ages (AD 500-1450 : The age of
    • Witchcraft, superstition and mysticism.
    • People were locked away with no professionals
    • to take care of them.
    • 1403 The first Mental hospital, Bethlehem Royal Hospital, opened in the UK
    • The Renaissance (14 th -17 th centuries) :
    • Mental illness thought to be reversible
  • Timeline...........
    • Eighteenth Century : Move towards humane kindness and the emergence of Psychiatric Mental Health Nursing
    • William Battie (1703-1776)
    • 1757 - Benjamin Franklin introduced a form of Electroconvulsive therapy
    • 19 – 20 th century : Definition of madness
    • shifts from ‘spirit possession theory’
  • Timeline...........
    • 1845 Lunacy Act
    • Asylums were established in New Zealand as part of the process of colonisation
    • 1846 The first premises were provided for the care of ‘lunatics’ in New Zealand
    • Six provincial asylums were built on the British model between 1854 and 1872
    • Staffed by ‘attendants who were more akin to warders than nurses’ (O’Brien, 2001)
  • Timeline...........
    • Punishment was replaced by the development of care
    • 1818 – First medical Journal published: ‘The Journal of Psychological Doctors’ (Germany)
    • 1855 – Training for doctors developed ‘Certificate in psychological medicine’
    • 1870 Education Act - education was provided for all attendants of asylum
  • Timeline...........
    • Nursing rises in status but the status of the asylum worker in New Zealand shared the stigmatised status of those they were looking after
    • 1882 First nursing school (USA) for mental health nursing based on Nightingales teaching
    • 1885 Handbook for the instruction of attendants of the insane was published
    • 1902 15,000 had been sold and mental health nursing became a written instead of oral tradition
  • Timeline...........
    • 1890: A Training Scheme was developed for nurses
    • 1892: 15 Asylums were participating in the training scheme
    • New Zealand now followed UK in developments
    • 1907 First training programme for psychiatric nurses and registration commenced in Auckland
    • 1923 ‘The handbook for mental Nurses’ was published
  • Timeline...........
    • Following World War II pharmacological treatments emerged
    • Antidepressant’s then Antipsychotic’s
    • So successful that many institutionalised clients were able to leave hospital for the first time in decades
  • Timeline...........
    • 1950 -1954 Hildegarde Peplau initiates, first speciality training and text book :
    • ‘ Interpersonal relations in nursing’
    • Conceptualisation of mental health
    • nursing as a therapeutic relationship was
    • an international trend
  • Timeline...........
    • Nursing Theorists Render, Orlando and Barker developed further on Peplau’s theory
    • 1970 Education from mental institutions to polytechnics and universities
    • 1995 development of postgraduates certificate /program of mental health nursing
    • 2000 Professionalism of speciality of mental health nursing: postgraduate diploma's , masters
  • Timeline
    • 1980’s De-institutionalisation
    • 1994 New Zealand Ministry of Health establish a set of five strategic directions ‘Looking Forward: Strategic Directions for the Mental Health Services’. ( www.moh.govt.nz )
    • 1996 Mason Report (Mason, Johnston & Crowe, 1996)
    • 1996 The Mental Health Commission established to oversee implementation of the National Mental health Strategy ( www.mhc.govt.nz )
    • 1997 ‘Moving Forward: The National Plan for More and Better Mental Health Services (MOH, 1997a)
  • Timeline...........
    • 1998 Blueprint for Mental Health Services ( http://www.mhc.govt.nz/publications/1998/Blueprint1998.pdf )
    • Treaty of Waitangi (1840) is accorded a central place in policy development and service provision by both MHC and MOH bodies
    • 1990’s Recovery principles developed and consumers became involved
    • Mental Health Nursing has blossomed into a skilled profession but there are still many challenges facing mental health nurses with ongoing policy developments in the provision of services and the need to balance the caring and controlling functions of mental health nursing practice.
    (Elder et al, 2005)
  • Challenge yourself with these questions
    • What skills do you consider consumers would bring to mental health services?
    • What may be some of the barriers to involving consumers in mental health services?
    • How do you explain how mental health care appears to have come full circle with regard to the humane approach used in Roman Times?
    • What do you see as the costs or benefits of a recovery philosophy being established within mental health nursing ?