Out of the Asylum: The History of Mental Health Nursing
Exhibition
Exhibition
5 October 2015 - 4 March 2016
RCN Library and Heritage Centre, London,
From institutional confinement to care in the community, mental health nursing has seen many significant changes throughout its history, with the profession following a very different path from that of general nursing.
From institutional confinement to care in the community, mental health nursing has seen many significant changes throughout its history, with the profession following a very different path from that of general nursing.
The exhibition on display (5 October - 4 March) at the RCN Library and Heritage Centre, London, explores the role of the largely untrained but often hardworking attendants in Victorian asylums to the breadth of nursing roles across hospitals and community care today.
Environment
The setting within which mental health nurses work has changed dramatically throughout history. Increasing demand on the smaller 'madhouses' of the eighteenth century prompted the building of much larger asylums in the Victorian and Edwardian era. The move to community care from the 1960s has led to many mental health nurses now being based out hospital walls. Nursing roles and responsibilities have changed within those different environments. Few mental health nurses how wear uniforms, making their identity badges one of the only visible distinctions between staff and patient.
The setting within which mental health nurses work has changed dramatically throughout history. Increasing demand on the smaller 'madhouses' of the eighteenth century prompted the building of much larger asylums in the Victorian and Edwardian era. The move to community care from the 1960s has led to many mental health nurses now being based out hospital walls. Nursing roles and responsibilities have changed within those different environments. Few mental health nurses how wear uniforms, making their identity badges one of the only visible distinctions between staff and patient.
Legislation
Laws and regulations have always shaped mental health nursing practice. Earlier laws were often supplemented by long rules books, which were gradually replaced by codes of practice. Statutes such as the 1845 Lunacy Act and the 1983 Mental Health Act in England and Wales, and the Mental Health (Care and Treatment) Act 2003 in Scotland, have all defined nurses' working lives. Now, the Nursing and Midwifery Council (NMC) Code of Conduct guides nurses in how to carry out their responsibilities to deliver high quality care.
Treatment
In nineteenth century asylums, treatment was largely focused on the setting and surroundings. As well as maintaining order, nursing staff worked alongside patients at facilities such as the laundry and on-site farms. They also provided entertainment with concerts and dances. As physical treatments became popular in the twentieth century, nursing staff administered medication and assisted with new practices, like electro-convulsive therapy. Whilst asylum nurses were expected to communicate with patients as much as possible, 'talking treatments' such as counselling and Cognitive Behavioural Therapy came much later. Now mental health nurses trained in a range of psychotherapeutic techniques.
Laws and regulations have always shaped mental health nursing practice. Earlier laws were often supplemented by long rules books, which were gradually replaced by codes of practice. Statutes such as the 1845 Lunacy Act and the 1983 Mental Health Act in England and Wales, and the Mental Health (Care and Treatment) Act 2003 in Scotland, have all defined nurses' working lives. Now, the Nursing and Midwifery Council (NMC) Code of Conduct guides nurses in how to carry out their responsibilities to deliver high quality care.
Treatment
In nineteenth century asylums, treatment was largely focused on the setting and surroundings. As well as maintaining order, nursing staff worked alongside patients at facilities such as the laundry and on-site farms. They also provided entertainment with concerts and dances. As physical treatments became popular in the twentieth century, nursing staff administered medication and assisted with new practices, like electro-convulsive therapy. Whilst asylum nurses were expected to communicate with patients as much as possible, 'talking treatments' such as counselling and Cognitive Behavioural Therapy came much later. Now mental health nurses trained in a range of psychotherapeutic techniques.
Education
Early mental health nurses learned on the job, guided by colleagues and lengthy rule books. In 1885 doctors responded to the need for more guidance for staff and published 'The Handbook for the Instruction of Attendants on the Insane', known famously as the 'Red Handbook.' By 1891, the Medico-Psychological Association - now the Royal College of Psychiatrists - had established the first national training scheme for nurses, introducing formal lectures and examinations.
At the turn of the Century, the movement towards state registration for nurses was gathering momentum. Mental health nurses were included in the 1919 Nurses Registration Act, but on a supplementary part of the register. Today, mental health nurses are recognised amongst other fields of nursing and are required to complete a NMC approved degree in nursing.
Early mental health nurses learned on the job, guided by colleagues and lengthy rule books. In 1885 doctors responded to the need for more guidance for staff and published 'The Handbook for the Instruction of Attendants on the Insane', known famously as the 'Red Handbook.' By 1891, the Medico-Psychological Association - now the Royal College of Psychiatrists - had established the first national training scheme for nurses, introducing formal lectures and examinations.
At the turn of the Century, the movement towards state registration for nurses was gathering momentum. Mental health nurses were included in the 1919 Nurses Registration Act, but on a supplementary part of the register. Today, mental health nurses are recognised amongst other fields of nursing and are required to complete a NMC approved degree in nursing.
Now
Nurses today work as part of a multi-disciplinary team, alongside other professionals such as psychiatrists, social workers and occupational therapists. These nurses and the wider team play a pivotal role with patients and their families, helping to restore people's mental well-being and supporting their recovery.
Nurses today work as part of a multi-disciplinary team, alongside other professionals such as psychiatrists, social workers and occupational therapists. These nurses and the wider team play a pivotal role with patients and their families, helping to restore people's mental well-being and supporting their recovery.
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