History of Mental Health Treatment

• Mental Health - Psychiatric Nursing Practice discussed

Prehistoric Times

• Mental health conditions were attributed to unknown causes during prehistoric times.
• Tribal rites were performed to address illnesses, due to the lack of understanding of their origins

Early Greek and Roman Era

• Individuals with mental health issues were placed in temples

Middle Ages

• Treatment was entrusted to priests, who believed mental illness was caused by demon possession

16th Century

• Individuals with mental illness were confined in jails, dungeons, and lunatic asylums
• Treatment was barbaric and inhumane, and those afflicted were not regarded as human beings

King Henry VIII

• Known as a "mad king", considered influential but known to have psychiatric disorder
• Dedicated Bethlehem Hospital as a mental institution
• Historically known for having 6 wives, 2 of whom were beheaded

17th Century

• Anatomy of Melancholy by Robert Burton

18th Century

Philippe Pinel

• Freed mentally ill patients from jails
• Known as the liberator of the insane
• Promoted humane treatment for mentally ill patients
• Known as the Father of Modern Psychiatry
• Advocated moral treatment of psychiatric patients
• Science of psychiatry began during this period

Esquirol

• Jean-Étienne-Dominique Esquirol continued his professor's advocacy for humane treatment
• A student of Philippe Pinel, Esquirol succeeded his distinguished teacher as physician in chief at the Salpêtrière Hospital in Paris in 1811

Benjamin Franklin

• Co-founded Pennsylvania Hospital with Dr. Thomas Bond
• Pennsylvania Hospital was dedicated to caring for the sick, poor, and insane
• To care for the indigent and mentally ill who were wandering the streets of Philadelphia.

Benjamin Rush

• Founder of modern medicine
• Believed mental illness was a disease of the mind rather than a "possession of demons"
• Known as the Father of American Psychiatry

Dr. Edward B. Cowles

• An American psychiatrist
• Medical superintendent of McLean Hospital in Massachusetts
• Advocated for hospital functions encompassing patient treatment, research, and teaching

19th Century

• The first authentic textbook of psychiatric disorders was published in 1845

Dorothea Lynde Dix

• Was a social reformer and a nurse
• Campaigned and raised funds for hospitals, asylums, and buildings for mentally ill

Jean Martin Charcot

• Discussed morbid or pathogenic ideas
• Hypothesized hysterical manifestations occurred
• Introduced the idea that morbid thoughts could manifest as hysterical symptoms
• Believed constant morbid thoughts could lead to hysterical manifestations

Emil Kraepelin (1856-1926) of Germany

• Classified mental disorders
• Coined the term "dementia praecox" to describe symptoms of what is now called schizophrenia

Sigmund Freud (1856-1939)

• Developed Psychoanalytic Theory
• Known as the Father of Psychoanalysis
• Exponent of the unconscious mind, and psychosocial development of man
• Known for Psychosexual Theory

20th Century

Dr. Adolf Meyer

• Developed Psychobiological Theory

Clifford Beers

• Known for A Mind That Found Itself
• Founded Mental Hygiene Association
• Former mentally ill patient
• After he recovered, he wrote a mind that found itself: reference to his book

Dr. Harry Stack Sullivan (1892-1949)

• Developed Interpersonal Theory

Historical Background

• The first world-wide Mental Health Year was in 1960, with consideration of needs of children and family, teaching/principles of mental health, sociological aspects of change and psychological problems relating to migration

Dr. Franz Kallmann

• Known for study of identical twins
• If one twin has schizophrenia, the other has an 86% chance of developing it
• If one twin has bipolar disorder, the other has a 96% chance of developing it

Eugene Bleuler

• (1857-1939) was Swiss
• Coined the term "schizophrenia" in 1911

Dr. Manfred Sakel

• (1900-1957)
• Introduced Insulin Shock Therapy

Ladislas J. Meduna

• Lived from 1896-1964
• Developed Pentylenetetrazole (Metrazol)
• Metrazol induced convulsions

Cerletti and Bini

• Discovered in 1938
• Developed Electroconvulsive Therapy (ECT)

Other Significant Persons in Psychiatric Nursing

St. Dymphna

• Patron Saint of the Insane
• Victim of her father who became insane after the death of her mother (likely due to depression)
• Her father sought a woman resembling his deceased wife but found none until seeing Dymphna
• Dymphna attempted to flee but was found and killed by her father
• The location of Dymphna's death is now considered sacred, with some miracles believed to occur
• The patron saint of hospitals and nursing is St. Elizabeth of Hungary

Rank

• Otto Rank
• Authored Birth Trauma and Separation Anxiety Theory

Simon and Binet

• Founder of IQ Testing

Alfred Adler

• Will Power Theory
• Striving for superiority compensated for feelings of inferiority

John Watson

• Known as the Father of behaviorism

Viktor Frankl

• Man's Search for Meaning
• Spiritual Therapy

Carl Rogers

• Person-Centered Therapy; known as client-centered therapy

Carl Jung

• Collective Unconscious: Extrovert, Introvert, Ambivert
• Typology of the Mind

Asclepiades

• Father of Psychiatry
• Sigmund Freud was believed to be inspired by his work

Sisa

• Considered epitome of Filipino woman's suffering
• A statue was erected in her honor at the entrance of the NCMH compound
• Some believed that Sisa is a real person
• Others think that she is fictional, made by Rizal to depict the Spaniards' treatment to woman during the Spanish colonialism
• Behind Sisa's statue is a bridge with a fountain on its both sides- Bridge of Hope

Hans Berger

• Discovered Electroencephalography (EEG)

Egas Moniz

• Developed Lobotomy or psychosurgery and cerebral angiography

Franz Anton Mesmer

• Associated with hypnotism, called Mesmerism

Dorothy M. Smith

• Developed Remotivation Technique which used rhythm and poetry to engage mute clients

M. Jones

• Therapeutic Community or Therapeutic Milieu

Joseph Pratt

• Developed Group Psychotherapy

Joseph Wolpe

• Desensitization, a type of Behavior Therapy for phobic patients, was his main contribution

Fritz Perls

• Was known for Gestalt Therapy, from a technique-oriented psychotherapy

Ivan Pavlov

• Associated with Classical Conditioning

Linda Richards

• Was the first American Psychiatric Nurse, graduated from the New England Hospital for Women
• Directed a school of Psychiatric Nursing at the McLean Psychiatric Asylum in Waverly, Massachusetts in 1880

Harriet Bailey

• Authored the first psychiatric nursing textbook, "Nursing Mental Diseases" (1920)

Skinner

• Known for Operant Conditioning

Bettelheim

• Was known for the theory Infantile autism to be due to parental rejection

Asherman

• Known for the theory Family Therapy

History of the National Center for Mental Health (NCMH)

19th Century

• A sailor of the Spanish Navy became mentally ill
• Most patients were Spanish Sailors
• Treatment provided in Hospicio de San Jose, in Manila by medical doctors and nuns
• Hospicio de San Jose was owned by nuns
• Originally for orphans, was later used to treat mentally ill Spanish Sailors

1904

• "Insane Department" opened at San Lazaro Hospital
  • San Lazaro Hospital originally for infectious disease, there's only an insane department.
• Dr. Elias Domingo: 1st trained doctor in psychiatry, and 1st director of the mental hospital
• 1918: Constructed for manila residents

1917

• Government patients transferred to San Lazaro Hospital

1918

• The City of Manila erected its own hospital, the City Sanitorium

1925

• 64-hectare site acquired: Barrio San Felipe Neri, Mandaluyong, Rizal

DECEMBER 17, 1928

• Insular Psychopathic Hospital
• Later renamed the National Psychopathic Hospital, a 400-bed facility for treating the mentally ill

1935

• City Sanitorium closed
• Patients were transferred to the National Psychopathic Hospital
• The war stopped the expansion program in 1941

Start of World War II

• 3,156 patients
• 2,062 admitted during the war
• 5,228 total
• Some portions used as emergency wards during Japanese concentration camp occupation

After World War II

• Patient population reached 2,030 in 1950
• Increased to 8,700 in 1975
• Renamed to the NATIONAL MENTAL HOSPITAL, and later NATIONAL CENTER FOR MENTAL HEALTH

Objectives of the National Center for Mental Health

• Care, treatment, and rehabilitation
• Prevention and promotion of mental health consciousness
• Training of personnel
• Research in related disciplines

Methods of Treatment in NCMH

• Somatic Therapy, primarily ECT
• Chemotherapy
• Ergo therapy, use of occupational and recreational therapy
• Logotherapy
• Psychotherapy

Historical Development of Psychiatry in the Philippines

• Belief in native healers performing healing process
• Can be spiritual, magical, and interpersonal

Pre-Spanish Regime

• Believed material and spiritual are equal
• Healers or Babaylan are considered abomination to God
• If they disobeyed the spiritual world they would be punished materially

Spanish Rule

• Mental illness cause by acts of sorcery, mangkukulam, and manggagaway
• Treatment done by herbolarios, usage of bamboo sticks and herbs
• Hysteric patient are thrown in the river

Japanese Time

• National Psychopathic Hospital
• Electroshock

Liberation Period and Era of the Republic

• National Psychopathic Hospital renamed to NATIONAL MENTAL HOSPITAL
• 1946: V. Luna General Hospital established psychiatric service
• ECT mode of treatment, with hypnosis and group therapy the available modalities
• 1947: UST opened Neuropsychiatry Section
• 1949: Philippine Mental Health Association was founded
• 1956: University of the East Ramon Magsaysay Memorial Medical Cent established psychiatry dept.
• 1958: Phil opened neuropsychiatry section
• 1973: An Outline of Psychiatric Nursing by Jesusa Bagan Lara, first textbook
• Nenita Yasay Davadilla was the 1st local nurse sent abroad to obtain masters degree
• Magda Carolina Go Vera Llamanzares was the 1st nurse specializing in Child Psychiatry
• UP COLLEGE OF NURSING 1968-1st Graduate program
• Sotera Capella was the 1st Chief Nurse
• 4,200 bed capacity

Systemic Changes in Mental Health Care

• Shift from symptom stabilization toward recovery and reintegration
• Shift from professional dominance to consumer and family involvement
• Shift from medication management toward holistic thinking
• Community-based care to prevent issues and treat disorders
• Development of coordinated treatment sources and facilities

A review of mental health treatment through history, starting in prehistoric times and moving to the 18th century including barbaric treatments and the first mental institutions.