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The Rise of Mental Health Nursing

The Rise of Mental Health Nursing: A History of Psychiatric Care in Dutch Asylums, 1890-1920

Geertje Boschma
Copyright Date: 2003
Pages: 328
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  • Book Info
    The Rise of Mental Health Nursing
    Book Description:

    Examining the relations between the rise of scientific psychiatry and the emergence of mental health nursing in Dutch asylums, this study analyses the social relationships of class, gender and religion that structured asylum care in the Netherlands around 1900. Drawing on archival collections of four Dutch asylums, the book highlights the gendered nature of mental health nursing politics. Seeking to model the asylum after the forceful example of the general hospital, psychiatrists introduced new somatic treatments and designed mental nurse training which aimed at creating a nursing staff skilled in somatic care. The training system, based on the projected image of the civilized, middle-class female nurse, bringing competence and compassion to the care of the mentally ill, created new opportunities for women, while at the same time restricting the role of men in nursing. Capturing the contradictory realities of hospital-oriented asylum care, the book illustrates the social complexity of the care of the mentally ill and forms an important addition to the historiography on European psychiatry. This title is available in the OAPEN Library -

    eISBN: 978-90-485-0507-4
    Subjects: Health Sciences, History, Psychology, Sociology

Table of Contents

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  1. Front Matter
    (pp. 1-4)
  2. Table of Contents
    (pp. 5-10)
  3. Acknowledgments
    (pp. 11-14)
  4. Introduction
    (pp. 15-30)

    Mental health nursing emerged as a new occupational field in the late nineteenth century in the context of the rise of scientific psychiatry. Based on new understandings of mental illness and new forms of psychiatric treatment, asylum physicians legitimized and initiated the introduction of mental nursing in asylums, which restructured a field of work that had hitherto been the domain of lay attendants. In light of the new significance that skilled nursing care had acquired in the context of general hospital reform, psychiatrists, themselves a rising professional group, argued that more refined and better trained personnel would greatly improve psychiatric...

  5. CHAPTER I Asylum Reform Ideals: Personnel Matters
    (pp. 31-58)

    Until the nineteenth century, institutional care for the mentally ill had only existed on a small scale in the Netherlands. Most of the mentally afflicted either remained with their families or were boarded out by their legal guardians with relatives or other families for a fee. For profoundly disturbed lunatics who threatened themselves, their relatives, or their fellow citizens, most towns maintained a facility in which to lock them. Usually this was a prison or a separate wing of the local charitable guest- or poor-house. Only a few towns had an asylum or madhouse for this purpose, and these often...

  6. CHAPTER II The Ideal of a Mental Hospital
    (pp. 59-80)

    The rhetoric about the poor quality of asylum personnel took on a new dimension in the late nineteenth century. The traditional complaints about the low social standing of personnel did not disappear but acquired new import. As of the late 1880s asylum doctors argued that asylum personnel should be better trained in medical matters. The class-based complaint that attendants lacked a philanthropic attitude became intertwined with the class- and gender-based argument that they lacked the skill and expertise of nurses experienced in taking care of the sick. The shift in thinking and the new demand for nursing expertise emerged in...

  7. CHAPTER III Female Compassion: Mental Nurse Training Gendered Female
    (pp. 81-112)

    The innovative idea to attract nurses, preferably middle-class women experienced in the care of the sick, to the asylums built on a new gendered image of nursing that had evolved during the nineteenth century. From the beginning of that century nursing gradually became acceptable work for middle-class women. However, psychiatrists chose to institute the new training concept within the asylum structure as a system of hospital-based mental nurse training similar to the nurse training system within general hospitals. This differed drastically to the way nursing had originally evolved as a field of charitable work early in the nineteenth century. At...

  8. CHAPTER IV The Burdensome Task of Nurses
    (pp. 113-140)

    Henriëtte Koffijberg, head nurse at the Veldwijk asylum, used these poetic words of her colleague Maria Beets to explain to her female pupils the behavior that was expected of them on the ward. She quoted the poem in an instruction booklet on mental nursing, which she had written for the purpose of training at Veldwijk. The booklet strongly emphasized the importance of female character traits and a respectable morality.² It reflected the idea that disciplinary nurse training enhanced the female qualities that would bring about the cleanliness, rest, and order expected on the wards. It was most likely the first...

  9. CHAPTER V Negotiating Class and Culture
    (pp. 141-174)

    An analysis of the introduction of mental nursing in asylums reveals the inherent class and gender contradictions of the training ideals. Training provided a metaphor for negotiating a new hierarchical structure, which facilitated the creation of a disciplined, respectable lower middle- and working-class nursing workforce, a process quite similar to changes simultaneously occurring in industry, such as the adherence to regular work routines and stricter time schedules. The process forged new gendered work relationships and new understandings of care shaped according to the cultural and religious context of the various groups involved. Female compassion and a civilized attitude were the...

  10. CHAPTER VI The Marginalization of Male Nurses
    (pp. 175-196)

    The conceptualization of nursing as women’s work generated a gendered system of training and favored career opportunities for female nurses. This gendered ideology of nursing functioned as a selective mechanism that excluded male nurses. The process, however, was not only an ideological matter but also a result of the way the labor market developed. Men apparently had more options in the expanding labor market. In all asylums filling the positions for male nurses turned out to be more complex than hiring female nurses. Both Meerenberg and Franeker had to advertise the vacancies for male nurses, whereas they usually had enough...

  11. CHAPTER VII Controversy and Conflict over the Social Position of Nurses
    (pp. 197-224)

    Despite the promise of training, the social position of student nurses remained unstable and ambiguous. Although ideologically nursing had been reformulated as a respectable occupation, the actual working conditions rendered student nurses quite unprotected and prone to exploitation. Many nurses suffered from physical exhaustion as a result of the long working hours and strenuous working conditions. In Meerenberg, for example, the high turnover and continuous demand for personnel often prevented nurses from benefitting from a preparatory period in the nurses home. They were in a very vulnerable position as they usually came to work on the wards whilst young and...

  12. Conclusion: The Politics of Mental Health Nursing
    (pp. 225-234)

    As was also true of hospital nursing, mental nursing emerged within a broader context of social and medical changes in the late nineteenth century. The mental nurse training system that psychiatrists established within the asylums reflected the ideal of raising the level of asylum personnel and oriented asylum care towards the achievements in hospital medicine. The promise of science, the improving image of the hospital, and the apparent success of organic explanations of diseases were so forceful that such explanations also gained strong social support in psychiatry. Psychiatrists, socialized in the cultural and scientific values of the time, were strongly...

  13. Appendix
    (pp. 235-240)
  14. Notes
    (pp. 241-288)
  15. List of Illustrations
    (pp. 289-290)
  16. List of Abbreviations
    (pp. 291-292)
  17. List of Archives
    (pp. 293-296)
  18. Bibliography
    (pp. 297-312)
  19. Index
    (pp. 313-324)