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Social Change and Mental Health. Chapter 1. Social Change and Mental Health Treatment. Depends on community’s views and fears See Table 1.1 Periods of social stability Less fear, more tolerance for diverse behavior Easier and safer for people with mental illness Periods of rapid change

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social change and mental health treatment
Social Change and Mental Health Treatment
  • Depends on community’s views and fears
    • See Table 1.1
  • Periods of social stability
    • Less fear, more tolerance for diverse behavior
    • Easier and safer for people with mental illness
  • Periods of rapid change
    • Anxiety and fear towards mental illness
    • Often treated inhumanely
moral treatment
Moral Treatment
  • Definition:
    • Moral, compassionate and pleasant environment
  • 18th century
    • Philippe Pinel: removed chains at Bicetre (France)
    • William Tuke: established The York Retreat (England)
  • 19th century
    • Quaker Friends Asylum: Kind towards patients
    • Care of the mentally ill became a public responsibility in the United States and Canada (Horace Mann’s plea)
dorothea dix 1802 1887
Dorothea Dix1802-1887
  • Was responsible for mental health care system reform in the U.S., Canada and Great Britain
  • Introduced the idea of state hospitals
  • Twenty states established or enlarged state hospitals.
  • Appointed as Superintendent of Women Nurses during Civil War
early institutional life its reality
Early Institutional Life: Its Reality
  • Major concern was management of a large number of people who were forced to live together.
  • Women could be institutionalized at whim of husband or father.
  • Men and women were often abused.
  • It eventually evolved into self-contained communities.
clifford beers 1876 1943
Clifford Beers(1876-1943)
  • Wrote of his abusive experience in several mental hospitals - A Mind That Found Itself
  • Founded the National Committee for Mental Hygiene
  • Led committee’s efforts in the development of child guidance clinics, prison clinics and industrial mental health approaches.
psychiatric nursing thought early views
Psychiatric Nursing Thought:Early Views
  • Traced to Florence Nightingale’s holistic view of patients
  • Need for specialized psychiatric-mental health nursing recognized during Moral Treatment Era
  • First training school for PMHN was The Boston City Hospital Training School for Nurses (1882) at McClean Hospital.
  • First training school organized by nurses for psychiatric training was Johns Hopkins’ Phipps Clinic
  • Nursing Mental Disease by Harriet Bailey in 1920: First psychiatric nursing text
modern thinking evolution of scientific thought
Modern Thinking: Evolution of Scientific Thought
  • Psychosocial vs. biologic theory
  • Psychiatric pluralism (Adolf Meyer)
  • Freud and psychoanalytic theory
  • Integration of biological theories in psychosocial treatment
government involvement in mental health care
Government Involvement in Mental Health Care
  • National Mental Health Act - 1946
    • National Mental Health Advisory Council, which established the National Institute of Mental Health (NIMH)
    • Provided grants to states for construction of clinics
  • Hill-Burton Act - 1946
    • Federal support for hospital construction
  • Community Mental Health Centers Construction Act - 1963
    • Funded community mental health centers
    • Led to deinstitutionalization
continued evolution of psychiatric mental health nursing
Continued Evolution of Psychiatric-Mental Health Nursing
  • Development of master’s degree programs in psychiatric nursing
  • Interpersonal Relations in Nursing published in 1952.
  • Mainstreaming of psychiatric nursing into nursing education
late 20 th century
Late 20th Century
  • Community Mental Health Movement
    • 1961 Action for Mental Health
    • 1963 Mental Retardation and CMHC Construction Act
  • Deinstitutionalization
    • Decrease in inpatient population
  • Sanctioning of Holistic Nursing Care
    • Two psychiatric nursing journals by 1963
    • First development of common standards: Statement on Psychiatric Nursing Practice
contemporary issues
Contemporary Issues
  • Changing demographics
  • Age of managed care
  • National mental health objectives
    • Mental Health: A Report of the Surgeon General
    • Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda
    • Healthy People 2010: National Health Promotion and Disease Prevention Objectives
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