This document outlines the timeline of major developments in the historical foundations of mental health nursing from ancient civilizations through to modern times. It traces the evolution from viewing mental illness as spiritual possession and locking people away without care, to the establishment of asylums and early attempts at humane treatment. Key developments included the emergence of psychiatric nursing as a profession, pharmacological treatments, deinstitutionalization, and integration of mental health services. The timeline shows how attitudes and approaches to mental illness and its treatment have changed significantly over centuries.

1. Mental Health Nursing
Historical Foundations
At the completion of this session students will:
Be able to discern the different ways in which mental
illness has been constructed in the past
Appreciate the different ways that have been used to
treat mental disorders in the past
Critique the theory that treatment has improved over
time
Be aware of some of the key historical, social and
political developments of mental health services in New
Zealand
Have critically challenged, through discussion, some of the key
points of this session
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2. Timeline...........
Ancient Civilisation: Ancient Romans, Greeks and Arabs
treated people with mental health problems humanely
Middle ages (AD 500-1450: The age of
Witchcraft, superstition and mysticism.
People were locked away with no professionals
to take care of them.
1403 The first Mental hospital, Bethlehem Royal Hospital,
opened in the UK
The Renaissance (14th-17th centuries):
centuries)
Mental illness thought to be reversible
2

3. Timeline...........
Eighteenth Century: Move towards
humane kindness and the emergence of
Psychiatric Mental Health Nursing
William Battie (1703-1776)
1757 - Benjamin Franklin introduced a
form of Electroconvulsive therapy
19 – 20th century: Definition of madness
shifts from ‘spirit possession theory’
3

4. Timeline...........
1845 Lunacy Act
Asylums were established in New Zealand as part of the
process of colonisation
1846 The first premises were provided for the care of
‘lunatics’ in New Zealand
Six provincial asylums were built on the British model
between 1854 and 1872
Staffed by ‘attendants who were more akin to warders
than nurses’ (O’Brien, 2001)
4

5. Timeline...........
Punishment was replaced by the development of
care
1818 – First medical Journal published: ‘The
Journal of Psychological Doctors’ (Germany)
1855 – Training for doctors developed
‘Certificate in psychological medicine’
1870 Education Act - education was provided
for all attendants of asylum
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6. Timeline...........
Nursing rises in status but the status of the asylum
worker in New Zealand shared the stigmatised status of
their ‘charges’
1882 First nursing school (USA) for mental health
nursing based on Nightingales teaching
1885 Handbook for the instruction of attendants of the
insane was published
1902 15000 had been sold and mental health nursing
became a written instead of oral tradition 6

7. Timeline...........
1890: A Training Scheme was developed for
nurses
1892: 15 Asylums were participating in the
training scheme
New Zealand now followed UK in developments
1907 First training programme for psychiatric
nurses and registration commenced in Auckland
1923 ‘The handbook for mental Nurses’ was
published
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8. Timeline...........
Following World War II pharmacological
treatments emerged
Antidepressant’s then Antipsychotic’s
So successful that many institutionalised
clients were able to leave hospital for the
first time in decades
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9. Timeline...........
1950 -1954 Hildegarde Peplau initiates,
first speciality training and text book :
‘Interpersonal relations in nursing’
Conceptualisation of mental health
nursing as a therapeutic relationship was
an international trend
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10. Timeline...........
Nursing Theorists Render, Orlando and Barker
developed further on Peplau’s theory
1970 Education from mental institutions to
polytechnics and universities
1995 development of postgraduates certificate
/program of mental health nursing
2000 Professionalism of speciality of mental health
nursing: postgraduate diploma's , masters
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11. Timeline...........
1980’s De-institutionalisation
1994 New Zealand Ministry of Health establish a set of
five strategic directions ‘Looking Forward: Strategic
Directions for the Mental Health Services’.
(www.moh.govt.nz)
1996 Mason Report (Mason, Johnston & Crowe, 1996)
1996 The Mental Health Commission established to
oversee implementation of the National Mental health
Strategy (www.mhc.govt.nz)
1997 ‘Moving Forward: The National Plan for More and
Better Mental Health Services (MOH, 1997a)
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12. Timeline...........
1998 Blueprint for Mental Health Services
(http://www.mhc.govt.nz/publications/1998/Blueprint1998.pdf)
Treaty of Waitangi (1840) is accorded a central place in
policy development and service provision by both MHC
and MOH bodies
1990’s Recovery principles developed and consumers
became involved
Mental Health Nursing has blossomed into a skilled
profession but there are still many challenges facing
mental health nurses with ongoing policy developments
in the provision of services and the need to balance the
caring and controlling functions of mental health nursing
practice.
(Elder et al, 2005) 12