learning Objectives - Narrate the historical development of Psychiatry and psychiatric nursing.
Hours - 4
Teaching and Learning Activities - Lecture cum discussion
Assessment Methods - Short answer Objective type
Content of the chapter
a) History of Psychiatric Nursing – India and at
international level
b) Trends in Psychiatric Nursing
c) National mental health programme.
Psychiatry has evolved from superstitious beliefs to a scientific, humane, and community-based discipline. Psychiatric nursing has played a key role in promoting care, rehabilitation, and mental health awareness.
a) History of Psychiatric Nursing
International Level
- Ancient Period
- Mental illness was believed to be caused by evil spirits, witchcraft, or divine punishment
- Treatment included exorcism, trephination, and religious rituals
- Middle Ages
- Mentally ill were kept in asylums, prisons, or poorhouses
- Care was custodial, inhumane, and neglectful
- 18th Century – Humanitarian Era
- Philippe Pinel (France) removed chains from mentally ill patients
- William Tuke (England) introduced moral treatment
- Focus on kindness, dignity, and structured environment
- 19th Century
- Development of large mental hospitals
- Nursing role mainly custodial
- Dorothea Dix advocated humane treatment
- 20th Century – Scientific Era
- Introduction of psychotropic drugs
- Growth of psychiatric nursing education
- Development of psychotherapy and psychoanalysis (Freud)
- Modern Era
- Shift from institutional care to community mental health
- Emphasis on rehabilitation, prevention, and holistic care
- Advanced psychiatric nursing roles developed
History of Psychiatric Nursing in India
- Ancient India
- Mental illness described in Ayurveda
- Treatments included herbs, yoga, meditation, and counseling
- Colonial Period
- First mental hospital established in 1745 at Bombay
- Care was mainly custodial under British rule
- Post-Independence Period
- Expansion of mental hospitals
- Introduction of psychiatric nursing education
- Modern Developments
- 1950s: Psychiatric nursing included in nursing curriculum
- 1962: Establishment of All India Institute of Mental Health (now NIMHANS)
- Growth of community mental health services
- Psychiatric nurses involved in prevention, treatment, and rehabilitation
b) Trends in Psychiatric Nursing
Modern psychiatric nursing has shifted focus to patient-centered, community-based, and holistic care.
Major Trends:
- Community Mental Health Nursing
- Care provided at home and community level
- Reduced hospitalization
- Deinstitutionalization
- Shorter hospital stays
- Emphasis on outpatient and day care services
- Preventive Psychiatry
- Primary, secondary, and tertiary prevention
- Mental health promotion
- Use of Psychopharmacology
- Safe administration and monitoring of psychiatric drugs
- Multidisciplinary Team Approach
- Collaboration with psychiatrists, psychologists, and social workers
- Rehabilitation and Recovery Model
- Skill training, vocational rehabilitation
- Focus on quality of life
- Advanced Psychiatric Nursing Roles
- Nurse therapists, counselors, nurse educators
- Use of Technology
- Tele-psychiatry
- Online counseling services
c) National Mental Health Programme (NMHP)
Introduction
The National Mental Health Programme was launched in 1982 by the Government of India to ensure accessible, affordable, and equitable mental health care.
Objectives of NMHP
- To ensure availability of mental health care to all
- To integrate mental health services with general health care
- To promote community participation
- To prevent mental illness and promote mental health
- To reduce stigma and discrimination
Key Components of NMHP
- District Mental Health Programme (DMHP)
- Mental health services at district level
- Training of general health staff
- Community awareness programs
- Manpower Development
- Training psychiatrists, psychiatric nurses, psychologists
- Strengthening nursing education
- Modernization of Mental Hospitals
- Improving infrastructure and quality of care
- Information, Education, and Communication (IEC)
- Public awareness
- Mental health education
- Research and Monitoring
- Data collection and evaluation of services
Role of Nurse in NMHP
- Early identification of mental illness
- Health education and counseling
- Medication supervision
- Follow-up and rehabilitation
- Community awareness programs
Conclusion
The history of psychiatry shows a transformation from inhumane care to compassionate, scientific, and community-based mental health services. Psychiatric nursing has evolved significantly, playing a vital role in prevention, treatment, and rehabilitation under national programs like NMHP.