First psychotropic drug
Thorazine
-became possible to control sx of mental illness, patients responsive to communication led to fewer restraints.
Linda Richards
1st American psychiatric nurse
-assessed both physical and emotional needs of the pt.
-improved nursing care in US state mental hospitals
Harriet Bailey
First psychiatric nursing textbook
Hildegarde Peplau
Expanded role of psych. nurse- first systematic theoretical framework for psych nursing
1st school for psychiatric nurses
McLean Asylum, MA
Evidence Based Practice
-problem solving approach, best practices
-Integrating patient preferences and values
-nursing expertise
Community Mental Health Act (Pres. Kennedy)
-Mental health care a "right for everyone"
-Opened doors of state institutions
-deinstitutionalization resulted - mass exodus into community
-1960's
Passage of Medicare and Medicaid legislation
-Federal subsidy to health care
-Greatly increased access to care
-led to people being able to get disability
-1960's
Developmental Disabilities Act
-Focused on rights and treatment of people with developmental disabilities
-provided a foundation for people with mental disorders
-1970's
President's Commission on Mental Health
-Supported community mental health centers
-Protection of human rights, insurance for mentally ill
-1970's
Mental Health Systems Act
-Signed by President Carter
-established federal government role in services for children, elderly, minority, and chronic mentally ill
-"comprehensive mental health care for all
Pre-Moral Treatment Era - B.C.
-Mental illness was of supernatural origin caused by gods - beyond control of mortals
-Hippocrates contradicted supernatural theory - believed persons afflicted like other illnesses - described epilepsy, "humors"
-Fear and superstition dominated attitudes
Pre-Moral Era
-Widespread interest in demonology and witchcraft
-Church recognized the body and soul - an arena for battle
-Bedlam Asylum in London-chains and dungeons-confinement from community
-13th century miracle cure in Gheel, Belgium - sent to seek cure from patr
Moral Treatment Era (1700's-1900's)
-Humanistic movement - scientific investigation of mental illness
-Humane treatment introduced by Philippe Pinel, a French medical director of a prison (removed chains, classified symptoms, involved in activities)
-Dr. Benjamin Rush - physician at PA Hosp
1900-1940s
-Somatic therapies
-Social security act
-WW2
Somatic Therapies
ECT, insulin shock, lobotomies
-expanded role of psych nurse
Depression Era - Social Security Act
-Federal aid to blind, children, elderly
-Shifted care of ill people from the state to the federal government
WW2
-1.7 million Americans excused from military service due to mental illness or related reasons (a HUGE number of ppl)
1940s-1950s
-National Mental Health Act of 1946
-Mental Health Study Act
-First psychotropic drug
National Mental Health Act of 1946
Established NIMH - 2 purposed
1. explore causes and treatment for mental disorders
2. Provide federal funds for training nurses and other professionals in mental health field
Mental Health Study Act
Created joint commission on mental illness and health that recommended shift of patient populations from state hospital systems to community health systems
Mental Health Systems Act
-Repealed by President Reagan
-Severely cut funding for psych and social services
-"fewer services, economic constraints
1990s (decade of the brain)
-brain imaging techniques to map the brain (CT, MRI, positron emission tomography, single photon emission computed tomography)
-Neurobiological theories of mental illness (dopamine, serotonin, norepinephrine, GABA, Ach - more than 100 different transmitte
Omnibus Budget Reconciliation Act
-Nursing home reform initiative
-particularly affected use of restraints and psychotropic drugs
Americans with Disabilities Act
-Promoted job opportunities and prohibited discrimination for the disabled including mental illness
Patient Self-Determination Act
Required to inquire about advanced directives
Mental Health Parity Act
Prohibited lifetime or annual limitations on mental health coverage for certain insured employees
Contemporary Mental Health Care
-Mental Health: a report of the surgeon general
-Report of the surgeon generals conference on children's mental health: a national action agenda
-President's new freedom commission of mental health
-Healthy people 2020: Mental Health and Mental Disorders
Healthy People 2020
-National health care agenda - focus on promoting health and preventing disease
-reducing suicide rates, especially in children and adolescents, mental disorders among adults and adverse effects from stress
-Increasing community supports for people with m
Mental Health
-Emotional and psychological balance in the pursuit of wellness and a meaningful quality of life
-important part of overall health
-impossible to be healthy without being "mentally healthy"
-possible to be mentally healthy and have a chronic mental disord
Mental Disorders
-Conditions involving altered thinking, mood, or behavior
-association w/ distress or impaired functioning
-diagnosis follows DSM-5 criteria
-no absolute boundaries between disorders
-different manifestations at different times
Recovery for the mentally ill
-Single most important goal
-Mental illness and emotional disturbances are treatable
-recovery is an expectation