'Mother role' tasks were carried out by mental health nurses. Both custodial companionship care and patient punishment were part of their duties. Treatment methods for mental patients included the introduction of insulin shock therapy in 1935, psychosurgery in 1936, and electroconvulsive therapy in 1937.

1. HISTORICAL PERSPECTIVE
Dr. Senthil Thirusangu
Department of Psychiatric
Senthilamma.t@gmail.com

2. INTRODUCTION:
 Although the concept of caring for the sick, ‘nurturing’
or ‘nursing’ existed since time immemorial, mentally ill
were tortured, persecuted, ridiculed, neglected and
shunned.
 Before 1860, the emphasis in psychiatric institutions
was on custodial care, untrained people controlled the
mentally ill, psychiatric care as such was non-existent.

4.  Early scripts of Chinese, Egyptians and Greek reveal that
cause of mental illness was attributed by demons
 Mentally ill were treated by exorcism (prayer, noise making) &
oral preparation of a purgative made from sheep dung and
wine as well as trephining.
 The first ray of light in this dark history of psychiatry came
with Hippocrates (460 B.C.), the great physician called as “
The Father of Modern Medicine”. He told brain pathology led
to mental illness.
 Hippocrates classified mental illness as Mania, Melancholia &
Phrenitis. He recommended marriage as a treatment for mental
illness.

6.  The Great Philosopher, Plato (429 B.C.) believed that
mental disorders could be due to a combination of
organic, moral and divine causes.
 Aristotle (384 B.C.) another Greek philosopher
emphasized on release of repressed emotions through
catharsis and music therapy as an effective mode of
treatment for mentally ill.

7. THE FOLLOWING PERIOD “IN THE YEAR OF THE
LORD (AD)” ARE IDENTIFIED:
1) Period of Persecution (1552BC-1400AD): Patient
with mental illness were avoided, thrown out of
society & beaten up by people & nobody was allowed
to interact with these people.
2) Period of Segregation (1545AD- 1800AD): Mentally
ill patient were segregated & kept separately in
asylums. These asylums were funded by government.

8. 3) Humanitarian Period (1745AD- 1826AD): Philippe Pinel in
France and William Tuke in England opened chains of the
mentally ill, total care was provided to the patients without
restraints or chains. 1773 in the U.S. mental patients were
admitted to Pennsylvania Hospital. General nurses took care
of mentally ill patients.
4) Beginning of Scientific Attitude (1796AD- 1878 AD):
Insanity was regarded as an illness, Sigmund freud (1856-
1939), founder of psychoanalysis, believed in hypnotism for
easing psychic tension. Emile Kraeplian (1856-1926)
classified mental illness.

9. First Florence nightingale nursing school was opened at the
St. Thomas Hospital in London (1860), in 1873, Linda
Richards the first American psychiatric nurse, was
graduated from the new England hospital for women and
children.
5) Period of Prevention (1885AD- 1960AD): Between
1920-72, there was little change in the role of a
psychiatric nurse because all procedure like insulin
shock therapy, metrazol shock therapy, psychosurgery
and electroconvulsive therapy required skilled medical
surgical nurses.

10. Harry stack Sullivan (1920) also felt that nurses have a
very important role to play in the mileu tharapy.
Tremendous progress in academically too. Various books
and journals were published such as Journal of psychiatry
nursing and mental health services, standards of
psychiatric- mental health nursing practice- ANA (1973).

11. SOME IMPORTANT MILESTONES:
1) 1773: the first mental hospital in the US was built in Williamsburg,
Virginia.
2) Asciepiades, is the Father of Psychiatry and in 1882 Benjamin Rush
become Father of American Psychiatry.
3) 1912: Eugen Bleuler coined the term “Schizophrenia”.
4) 1912: Indian Lunancy Act passed.
5) 1927: Insulin Shock Therapy was introduced for schizophrenia
6) 1938: Electroconvulsive therapy (ECT) was used for the treatment of
psychoses
7) 1946: Bhore committee presented the situation with regard to mental
health services. Based on this 5 mental hospital were set up at Amritsar,
Hyderabad, Srinagar, Jamnagar and Delhi. All India Institute of Mental
Health was also set up at Bengaluru, currently known as NIMHANS.

12. SOME IMPORTANT MILESTONES:
8) 1949: Lithium was first used for the treatment of Mania.
9) 1963: The ‘Community Mental Health Centers’ Act was passed.
10) 1987: The Indian Mental Health Act was passed.
11) 2001: On Aug 6th 27 more mentally ill people died as they were tied to
their beds when fire engulfed the roof of Moideen Badusha Mental Home
at Erwadi, Tamil Nadu.
12) 2002: National Survey of Mental Health Resources carried out by the
Directorate General of Health Services, ministry of health and family
welfare.
13) 2007: Under the Eleventh five year plan, centre of excellence in the field
of mental health were established.
14) 2013: World Health Organization launched the Mental Health Action Plan
2013-2020 on 7 October, 2013.

13. DEVELOPMENT OF MODERN
PSYCHIATRIC NSG.:
1) 1840: Florence Nightingale made an attempt to meet the needs of
psychiatric patients.
2) 1872: First training school for nurses was established in New England.
3) 1913: Johns Hopkins became the first school of nursing to include fully
course for psychiatric nursing in the curriculum.
4) 1921: Short training course of 3 to 6 months were conducted in Ranchi.
5) 1943: Psychiatric nursing course was started for male nurses.
6) 1948-50: Four nurses were sent to UK by the Government of India for
training in ‘mental nurses’ diploma.
7) 1952: Dr. Hildegard Peplau defined therapeutic roles for nurses
8) 1954: Nur Manzil Mental Health Centre, Lucknow started psychiatric
nursing.

14. DEVELOPMENT OF MODERN
PSYCHIATRIC NSG.:
9) 1956: One year post- certificate course in psychiatric nursing started.
10) 1958: All the wards at the Agra Mental Hospital were ordered to be kept
open and all wards locks were removed.
11) 1965: The Indian Nursing Council included psychiatric nursing as a
compulsory course in the B.Sc. Nursing Program.
12) 1967: TNAI, formed separate committee for psychiatric nursing.
13) 1973: Standards of Psychiatric and Mental Health Nursing practice were
introduced.
14) 1975: Psychiatric nursing was offered as an elective subject in M.Sc.
Nursing at Rajkumari Amrit Kaur CON, New Delhi.
15) 1986: The INC made psychiatric nursing a component in GNM. American
Psychiatric Nurses Association was established.
16) 1991: Indian Society of Psychiatric Nurses formed at NIMHANS.