INTRODUCTORY MENTAL HEALTH NURSING

Chapter 1: Mental Health Nursing: A Historical Perspective

Advancement of Mental Health Care Beginning of Change Twentieth Century Progress Community-Based Care Present Issues

Early Civilizations First institutions Early approach to abnormal behaviors Fragmented care situations Asylums to house the insane, prisoners, orphans Cruel and inhumane treatment

Beginning of Change Benjamin Rush –Environmental influence on care Dorothea Dix –Legislation and training programs aimed at improvement Linda Richards –Education integral to treatment practices 1913 – First psychiatric content added to curriculum of nursing school –Beginning of psychiatric nursing as a specialty

Twentieth Century Progress –National Mental Health Act –Funds for research, nursing programs, and community support –Trend toward community-based treatment –NLN endorsement of psychiatric nursing in all nursing programs –First psychotherapeutic drugs introduced

Community-Based Care Federal legislation –Create funding for diversified treatment methods –Inpatient stays shortened –Follow-up outpatient care Omnibus Budget Reform Act (OBRA) –Restrictions on nursing home placement of clients Mental Health Act of 1983 –Patient rights National Mental Health Parity Act –Improved insurance benefits for mental health care

Hildegard Peplau Systematic and scientific approach to psychiatric nursing –Nursing process –Nurse-client interpersonal relationship –Interactive processes –Nursing roles

Present Issues Managed-care delivery system Closing of inpatient units Growing demand for services Lack of access to treatment –Impact on client –Impact on family –Impact on society as a whole