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LTSG ERIC F PAZZIUAGAN PCGA
 Complimentary     therapies- unconventional therapies
  that encompasses a spectrum of practices and
  beliefs, including herbs, visual imagery,
  acupunctures, and massage therapy.
 Decade of brain- proclamation by the state
  Congress that explains mental illness as a disease
  of the brain. It underscores the significance of
  technological advances in neurobiology and
  genetics and their impact on understanding mental
  illness.
 Deinstitutionalization- caring for people outside
  the hospital who have been previously hospitalized
  for an extended period, caring for people in the
  community rather than in a state facility.
 Mental  Health Movement- a movement that begun
  more than 25 years ago that focuses on humane
  treatment of the mentally ill, initially advocating
  their release from state institutions to community
  mental health centers.
 Moral treatment- humane treatment of the
  mentally ill; for example, releasing clients from
  mechanical restraints and improving physical care.
 Psychotropics- various pharmacologic agents, such
  as antidepressants and antipsychotic, antimanic
  and antianxiety agents used to affect
  behavior, mood and feelings.
 Neurobiology- biology of the nervous
  system, particularly the brain.
 Neuroscience- the science and study of the central
  nervous system.
Insanity was associated with demonic
 possession.
Healers extract unseen spirits through
 rituals using herbs, ointments and
 precious stones.
Mental illness was perceived as
 incurable, and treatment of the insane
 was sometimes inhumane and brutal.
 Mentally ill people:
  Often imprisoned or forced to live
   in streets and beg for food.
  For more humane treatment, they
   depend on charity of religious
   groups, who dispenses alms or
   food or other donations to the
   needy or poor and ran almshouses
   and general hospitals.
First mental asylum: St. Mary
 of Bethlehem
 Built in London, England
  during the 14th Century.
 Conceived as a sanctuary or
  refuge for the destitute and
  afflicted.
 Model for similar institutions
  elsewhere.
 Continued skepticism about the curability of
  mental illness.
 Asylums became the repositories for
  prolonged enclosure of the mentally ill.
 Insane people were treated more like
  animals than humans.
 Inhabitants were poorly clothed and fed;
  often chained and caged, and deprived of
  heat and sunlight.
The insane was no longer
 treated as less than human.
The concept of asylum
 developed from the humane
 efforts of Pinel and Tuke.
Emphasized the need for pleasant
 surroundings and diversional and
 moral treatment of the mentally
 ill.
Treatment include (considered
 controversial): bloodletting and
 the administration of cold and hot
 baths, harsh purgatives, and
 emetics.
Considers inducement of fright or
 shock would cause the mentally ill
 to regain their insanity.
Invented the tranquilizer chair and the
 Gyrator.
 Tranquilizer chair- the mentally ill’s
  extremities is strapped down and this reduces
  motor and pulse rates; thought to produce
  calming effect.
 Gyrator- a form of shock therapy consisting of
  a rotating, swinging platform onto which the
  person was strapped and moved at high speed;
  Thought to increase cerebral circulation.
Author of the first American treatise on
 Psychiatry: Medical Inquiries and
 Observations upon the Disease of the
 Mind.
Advocated kindness and
 moral treatment.
Greatest impact came
 after he was placed in
 charge of Bicerte Hospital.
Proved that releasing the
 insane from chains and
 providing moral treatment
 improved their prospect.
 William Tuke (1732-1822)
   Began a 4-yaer dynasty that
    advocated humane treatment
    of the mentally ill.


 Franz Anton Mesmer (1734-
  1815)
   Renewed the art of suggestive
    healing that stemmed form the
    ancient use of trances, which
    became the basis of hypnosis.
US and other European Countries
 began a movement that championed
 reformation of ideas in establishing
 state hospitals.

1772- First psychiatric hospital in
 America in Williamsburg, Virginia.
 1817- Mclean Asylum in Massachusetts
  became the first US institution to provide
  humane treatment for the mentally ill.
   Humane treatment- emphasized an
    environment of understanding and
    promoted a sense of contentment and
    mental and physical health.

 Increased concerns and sensitivity to the
  needs of the mentally ill generated a need
  for better-educated attendants to care for
  severely disturbed clients.
 A retired school teacher
  from Massachusetts.
 Led crusade that brought
  attention of these
  conditions to the public
  and legislature.
 The result is an
  improvement in standards
  of care for the mentally ill
  which led to proliferation
  of state hospitals.
 The first American Psychiatric
  Nurse
 Graduate of New England
  Hospital for Women
 Developed nursing care in state
  hospitals and also directed a
  school of psychiatric Nursing in
  Mclean Psychiatric Asylum in
  1880.
 Her efforts resulted to the
  development of school for
  nurses in more than 30
  asylums
   Exploration of the reasons for mental
    disease accelerated with contributions
    from numerous theorists and
    researchers who laid the foundation
    for understanding and demystifying
    mental illness.
 Initiated psychobiological
  theory and dynamic
  concept of psychiatric care.
 Theory centered on
  treatment rather than
  disease and integrated
  biochemical, genetic, psych
  osocial, and environmental
  stresses on mental illness.
 Had been treated for mental
  illness.
 Contributed to preventive care
  though his classic work, A Mind
  That Found Itself, published in
  1908.
 Played a major role in
  establishing Mental Health
  Movement in New Haven,
  Connecticut, in 1908 and
  promoting the early detection
  of mental illness.
 Devised a classification of
  mental disorders.
 Shifted from an emphasis
  on research in the
  pathobiological laboratory
  to the observation and
  research in conditions
  known as praecox
  dementia and mania.
 Coinedthe term
 schizophrenia and
 included its
 characteristics the four
 As: apathy, associative
 looseness, autism, and
 ambivalence.
 Development of
  psychoanalysis,
  psychosexual theories, and
  neurosis.
 Psychoanalysis- a method
  that serves as the basis for
  treatment and a theory for
  personality development.
 Founded analytic
  psychology.
 Proposed and originated
  the concepts extroverted
  and introverted personality.
 Integrated spiritual
  concepts, reasoning,
  ancestral emotional trends,
  and mysticism , and the
  creative notion of human
  beings.
 Objected to Freud’s
  notions that neurosis and
  personality development
  were based on biological
  drives.
 Her theory suggested that
  neuroses stem from
  cultural factors and
  impaired interpersonal
  relationships.
 Postulated the Hypothesis of
  interpersonal theory and the
  development of
  multidisciplinary approaches to
  psychiatric and milieu therapy.
 He surmised that anxiety could
  be reduced through a
  meaningful interpersonal
  relationship that stresses the
  process of effective
  communication.
A  deliberate shift from
  institutional care in state hospitals
  to community facilities.
 Community mental health centers:
  provides less restrictive treatment
  located closer to homes, families
  and friends.
   Declared by the US Congress as the Decade of
    the Brain
   Increase in brain research; increased interest
    in biologic explanations for mental disorders.
   Significant changes in public awareness which
    enabled clinicians to address relatively
    complex topics with patients and families.
   Nursing responed by significant augmentation
    of psychobiologic content in academic
    nursing programs and a torrent of continuing
    education programs.
 “Nursing Mental Diseases”
 Written by Harriet Bailey in 1920
 In 1937, psychiatric nursing became a
  part of the curriculum of general
  nursing programs.
   Hildegard Peplau
   Developed a model for psychiatric nursing
    practice
   Wrote the book “Interpersonal Relationship in
    Nursing” (1952), heavily influenced by Harry
    Stack Sullivan.
   Emphasizes the interpersonal dimension of
    practice.
   Wrote a history of psychiatric nursing
   Single most important figure in psychiatric
    nursing
 The Diagnostic and Statistical Manual
  of Mental Disorders (DSM): outlines
  the signs and symptoms required in
  order for clinicians to assign a specific
  diagnosis to a patient.
 Has been published in six editions
  since its inception in 1952
 DSM-I                       1952
 DSM-II                      1968
 DSM-III                     1980
 DSM- IIIR (REVISED)         1987
 DSM-IV                      1994
 DSM-IV-TR (TEXT REVISION)   2000
   Axis I: Clinical disorders (e.g., schizophrenia, major
    depression, bipolar disorder)
   Axis II: Personality or developmental disorders
    (e.g., paranoid and borderline personality
    disorders, mental retardation)
   Axis III: General medical conditions that relate to
    axis I or II or have bearing on treatment
    (e.g., neoplasms, endocrine disorders)
   Axis IV: Severity of psychosocial stressors
    (e.g., divorce, housing, educational issues)
   Axis V: Global assessment of functioning, on a scale
    of 0 to 100 (e.g., score of 30 means that the
    patient’s behavior is highly influenced by delusions
    and hallucinations)
   Was established thru Public Works Act 3258
   Was first known as Insular Psychopathic
    Hospital, situated on a hilly piece of land in
    Barrio Mauway, Mandaluyong, Rizal and was
    formally opened on December 17, 1928.
   Later known as National Mental Hospital
   November 12, 1986: was given its present
    name National Center for Mental Health thru
    Memorandum Circular No. 48 of the Office
    of the President
   January 30, 1987: categorized as Special
    Research Training Center and Hospital under
    the DOH
   Today:
    ◦   Bed capacity: 4,200
    ◦   Daily average in-patients: 3, 400
    ◦   46.7 hectares
    ◦   35 pavilions/ cottages
    ◦   52 wards
    ◦   Personnel: 1,993
    ◦   Doctors: 116
    ◦   Nurses: 375
    ◦   Administrative staff: 651
    ◦   Medical Ancillary Personnel: 196
 A special training and research hospital
  mandated to render a comprehensive
  (preventive, promotive, curative and
  rehabilitative) range of quality mental
  health services nationwide.
 Gives and creates venues for quality
  mental health education, training and
  research geared towards hospital and
  community mental health services
  nationwide.

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Evolution of Mental Health Psychiatric Nursing Practice

  • 1. LTSG ERIC F PAZZIUAGAN PCGA
  • 2.  Complimentary therapies- unconventional therapies that encompasses a spectrum of practices and beliefs, including herbs, visual imagery, acupunctures, and massage therapy.  Decade of brain- proclamation by the state Congress that explains mental illness as a disease of the brain. It underscores the significance of technological advances in neurobiology and genetics and their impact on understanding mental illness.  Deinstitutionalization- caring for people outside the hospital who have been previously hospitalized for an extended period, caring for people in the community rather than in a state facility.
  • 3.  Mental Health Movement- a movement that begun more than 25 years ago that focuses on humane treatment of the mentally ill, initially advocating their release from state institutions to community mental health centers.  Moral treatment- humane treatment of the mentally ill; for example, releasing clients from mechanical restraints and improving physical care.  Psychotropics- various pharmacologic agents, such as antidepressants and antipsychotic, antimanic and antianxiety agents used to affect behavior, mood and feelings.  Neurobiology- biology of the nervous system, particularly the brain.  Neuroscience- the science and study of the central nervous system.
  • 4.
  • 5. Insanity was associated with demonic possession. Healers extract unseen spirits through rituals using herbs, ointments and precious stones. Mental illness was perceived as incurable, and treatment of the insane was sometimes inhumane and brutal.
  • 6.
  • 7.  Mentally ill people:  Often imprisoned or forced to live in streets and beg for food.  For more humane treatment, they depend on charity of religious groups, who dispenses alms or food or other donations to the needy or poor and ran almshouses and general hospitals.
  • 8. First mental asylum: St. Mary of Bethlehem Built in London, England during the 14th Century. Conceived as a sanctuary or refuge for the destitute and afflicted. Model for similar institutions elsewhere.
  • 9.
  • 10.  Continued skepticism about the curability of mental illness.  Asylums became the repositories for prolonged enclosure of the mentally ill.  Insane people were treated more like animals than humans.  Inhabitants were poorly clothed and fed; often chained and caged, and deprived of heat and sunlight.
  • 11. The insane was no longer treated as less than human. The concept of asylum developed from the humane efforts of Pinel and Tuke.
  • 12.
  • 13. Emphasized the need for pleasant surroundings and diversional and moral treatment of the mentally ill. Treatment include (considered controversial): bloodletting and the administration of cold and hot baths, harsh purgatives, and emetics. Considers inducement of fright or shock would cause the mentally ill to regain their insanity.
  • 14. Invented the tranquilizer chair and the Gyrator. Tranquilizer chair- the mentally ill’s extremities is strapped down and this reduces motor and pulse rates; thought to produce calming effect. Gyrator- a form of shock therapy consisting of a rotating, swinging platform onto which the person was strapped and moved at high speed; Thought to increase cerebral circulation. Author of the first American treatise on Psychiatry: Medical Inquiries and Observations upon the Disease of the Mind.
  • 15. Advocated kindness and moral treatment. Greatest impact came after he was placed in charge of Bicerte Hospital. Proved that releasing the insane from chains and providing moral treatment improved their prospect.
  • 16.  William Tuke (1732-1822)  Began a 4-yaer dynasty that advocated humane treatment of the mentally ill.  Franz Anton Mesmer (1734- 1815)  Renewed the art of suggestive healing that stemmed form the ancient use of trances, which became the basis of hypnosis.
  • 17.
  • 18. US and other European Countries began a movement that championed reformation of ideas in establishing state hospitals. 1772- First psychiatric hospital in America in Williamsburg, Virginia.
  • 19.  1817- Mclean Asylum in Massachusetts became the first US institution to provide humane treatment for the mentally ill.  Humane treatment- emphasized an environment of understanding and promoted a sense of contentment and mental and physical health.  Increased concerns and sensitivity to the needs of the mentally ill generated a need for better-educated attendants to care for severely disturbed clients.
  • 20.
  • 21.  A retired school teacher from Massachusetts.  Led crusade that brought attention of these conditions to the public and legislature.  The result is an improvement in standards of care for the mentally ill which led to proliferation of state hospitals.
  • 22.  The first American Psychiatric Nurse  Graduate of New England Hospital for Women  Developed nursing care in state hospitals and also directed a school of psychiatric Nursing in Mclean Psychiatric Asylum in 1880.  Her efforts resulted to the development of school for nurses in more than 30 asylums
  • 23.
  • 24. Exploration of the reasons for mental disease accelerated with contributions from numerous theorists and researchers who laid the foundation for understanding and demystifying mental illness.
  • 25.  Initiated psychobiological theory and dynamic concept of psychiatric care.  Theory centered on treatment rather than disease and integrated biochemical, genetic, psych osocial, and environmental stresses on mental illness.
  • 26.  Had been treated for mental illness.  Contributed to preventive care though his classic work, A Mind That Found Itself, published in 1908.  Played a major role in establishing Mental Health Movement in New Haven, Connecticut, in 1908 and promoting the early detection of mental illness.
  • 27.  Devised a classification of mental disorders.  Shifted from an emphasis on research in the pathobiological laboratory to the observation and research in conditions known as praecox dementia and mania.
  • 28.  Coinedthe term schizophrenia and included its characteristics the four As: apathy, associative looseness, autism, and ambivalence.
  • 29.  Development of psychoanalysis, psychosexual theories, and neurosis.  Psychoanalysis- a method that serves as the basis for treatment and a theory for personality development.
  • 30.  Founded analytic psychology.  Proposed and originated the concepts extroverted and introverted personality.  Integrated spiritual concepts, reasoning, ancestral emotional trends, and mysticism , and the creative notion of human beings.
  • 31.  Objected to Freud’s notions that neurosis and personality development were based on biological drives.  Her theory suggested that neuroses stem from cultural factors and impaired interpersonal relationships.
  • 32.  Postulated the Hypothesis of interpersonal theory and the development of multidisciplinary approaches to psychiatric and milieu therapy.  He surmised that anxiety could be reduced through a meaningful interpersonal relationship that stresses the process of effective communication.
  • 33. A deliberate shift from institutional care in state hospitals to community facilities.  Community mental health centers: provides less restrictive treatment located closer to homes, families and friends.
  • 34. Declared by the US Congress as the Decade of the Brain  Increase in brain research; increased interest in biologic explanations for mental disorders.  Significant changes in public awareness which enabled clinicians to address relatively complex topics with patients and families.  Nursing responed by significant augmentation of psychobiologic content in academic nursing programs and a torrent of continuing education programs.
  • 35.  “Nursing Mental Diseases”  Written by Harriet Bailey in 1920  In 1937, psychiatric nursing became a part of the curriculum of general nursing programs.
  • 36. Hildegard Peplau  Developed a model for psychiatric nursing practice  Wrote the book “Interpersonal Relationship in Nursing” (1952), heavily influenced by Harry Stack Sullivan.  Emphasizes the interpersonal dimension of practice.  Wrote a history of psychiatric nursing  Single most important figure in psychiatric nursing
  • 37.
  • 38.  The Diagnostic and Statistical Manual of Mental Disorders (DSM): outlines the signs and symptoms required in order for clinicians to assign a specific diagnosis to a patient.  Has been published in six editions since its inception in 1952
  • 39.  DSM-I 1952  DSM-II 1968  DSM-III 1980  DSM- IIIR (REVISED) 1987  DSM-IV 1994  DSM-IV-TR (TEXT REVISION) 2000
  • 40. Axis I: Clinical disorders (e.g., schizophrenia, major depression, bipolar disorder)  Axis II: Personality or developmental disorders (e.g., paranoid and borderline personality disorders, mental retardation)  Axis III: General medical conditions that relate to axis I or II or have bearing on treatment (e.g., neoplasms, endocrine disorders)  Axis IV: Severity of psychosocial stressors (e.g., divorce, housing, educational issues)  Axis V: Global assessment of functioning, on a scale of 0 to 100 (e.g., score of 30 means that the patient’s behavior is highly influenced by delusions and hallucinations)
  • 41.
  • 42. Was established thru Public Works Act 3258  Was first known as Insular Psychopathic Hospital, situated on a hilly piece of land in Barrio Mauway, Mandaluyong, Rizal and was formally opened on December 17, 1928.  Later known as National Mental Hospital  November 12, 1986: was given its present name National Center for Mental Health thru Memorandum Circular No. 48 of the Office of the President
  • 43. January 30, 1987: categorized as Special Research Training Center and Hospital under the DOH  Today: ◦ Bed capacity: 4,200 ◦ Daily average in-patients: 3, 400 ◦ 46.7 hectares ◦ 35 pavilions/ cottages ◦ 52 wards ◦ Personnel: 1,993 ◦ Doctors: 116 ◦ Nurses: 375 ◦ Administrative staff: 651 ◦ Medical Ancillary Personnel: 196
  • 44.  A special training and research hospital mandated to render a comprehensive (preventive, promotive, curative and rehabilitative) range of quality mental health services nationwide.  Gives and creates venues for quality mental health education, training and research geared towards hospital and community mental health services nationwide.