PubMed · 16170414
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Yves Lecomte, Jean-François Saucier. 2005. [Foreword].. https://pubmed.ncbi.nlm.nih.gov/16170414/
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TOPIC: Emotional upheaval is rampant in society, affecting mental and physical health. Yet the focus, in the "Era of the Brain," lacks direction on how to address these issues. However, psychiatric-mental health nursing possesses the know-how to provide solutions. PURPOSE: To explore the history of psychiatric nursing and its impact on the nursing profession and society and how its legacy can support and facilitate change. SOURCES: Primary and secondary CONCLUSIONS: Therapeutic interpersonal interactions are quintessential competencies for advanced practice psychiatric-mental health nurses and should be upheld, promoted, and implemented to improve outcomes.
In the last half of the 20th century, the community mental health movement, based on a public health model, came to dominate patterns of care for mental patients. In the process, brutal deinstitutionalization of very ill patients took place, at least in the United States. These events were not inevitable. In 1949, the Menningers of Topeka, Kansas, began administering Topeka State Hospital, which was in deplorable condition. By concentrating expenditures on clinical personnel, the Menningers humanely deinstitutionalized many patients before chlorpromazine, before the entitlement programs of the U.S. federal government such as Medicaid (1965), and before the community psychiatry movement got under way. Topeka State Hospital furnished a model of mental health care that centered a whole system on a last-resort, large, specialized state mental hospital. This inadvertent social experiment suggests that a clinical approach to mental health care offers a hard-headed alternative to present arrangements.
Despite more than 30 years of deinstitutionalization, a significant number of individuals continue to experience prolonged stays in state psychiatric hospitals. Many of these individuals appear to develop an ambivalence or resistance to discharge. This can itself contribute to further delay in discharge planning and implementation. We will describe a group intervention for persons with long stays labeled as "resistant." This effort was guided by the premise that each individual could benefit from personally exploring those aspects of his or her experience that may be contributing to continued hospitalization. The group utilized standard methods of rehabilitation and training with strong emphasis on validating individual needs and feelings, peer support and practical results. After 1 1/2 years of group intervention, 5 of the 7 group members had achieved discharge and initial community success.