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began in the late 19th century when there was a societal shift in the perception
The field of psychiatric-mental health
of the purpose of mental asylums from custodial care to medical and social
nursing
treatment for mental illness.
awarded the first graduate degree in psychiatric-mental health nursing. The
In the 1950s, Rutgers University psychiatric mental health clinical nurse specialist was the first master's prepared
advanced practice nursing role.
The role of the psychiatric and mental was introduced in the 1990s and has evolved over time to incorporate a person-
health nurse practitioner (PMHNP) centered, biopsychosocial model of care.
In the late 19th century, reform movements led to changes in beliefs about the
role of mental asylums in the treatment of mental illness. Focus shifted from
Late 19th Century
restrictive custodial care to treatment. Dr. Edward Cowles created the first
organized training school within a hospital for the insane in 1882.
Early psychiatric nurses were trained by physicians; however, in 1913, Effie Jane
Early 20th Century Taylor developed the first nurse-organized training course for psychiatric nursing
at Johns Hopkins Hospital.
The World Wars expanded awareness of mental health disorders and the need for
WWI specialized nursing care. Following WWI, the National League for Nursing
Education added "nursing in nervous and mental diseases" to curriculum guides.
many potential military recruits deemed unfit for service due to psychiatric
concerns, while many veterans experienced combat-related neuropsychiatric
WWII,
conditions. Laura Fitzsimmons recommended standards of training for psychiatric
nurses, which led to improved education and standards of care.
With the passage of the National Mental Health Act (NMHA) of 1946, psychiatric
nursing was recognized as one of the four core disciplines in psychiatric care and
1946 treatment (American Nursing Association [ANA], 2014). The act increased funding
for psychiatric nursing education programs and contributed to a growth in
university-based nursing education.
, the first graduate program in psychiatric nursing was established at Rutgers
University by Hildegarde Peplau to prepare nurse therapists. The first advanced
1954
practice nursing role was the psychiatric-mental health clinical nurse specialist
(PMHCNS) role.
The 1950s brought a transition towards deinstitutionalization in care for those with
mental illnesses, which led to an increase in the number of psychiatric patients
receiving care in the community rather than hospitals. The Community Mental
1963
Health Centers Act of 1963 allowed for the expansion of the PMHCNS role into
community and ambulatory settings as they helped those who had been
deinstitutionalized adapt (ANA, 2014).
1965 Loretta Ford, RN and Henry Silver MD introduce the nurse practitioner role.
ANA first published Standards of Psychiatric-Mental Health Nursing Practice in
1973
1973.
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