History and evolution of mental-health, psychiatry, and mental health nursing.

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.

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.

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.

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.

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.

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.

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

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

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)

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.