Community psychiatric nursing—a literature review

Abstract

In the last 25 years, the management of psychiatric patients has changed from a hospitalbased to a community-centred policy. The availability of psychotropic drugs, the overcrowding of hospitals, and the recommendations in the 1959 Mental Health Act to promote community care were some of the important factors influencing change in attitude towards psychiatric illness. One of the recent innovations in the area of mental health is Community Psychiatric Nursing. As with any new approach, the early development of community psychiatric nursing was slow and limited but increased in momentum over the last 5 years. As a consequence, an increasing volume of literature has started to appear. Much of it comprises descriptions of services, of goals, patterns of care and special aspects. There have been few evaluative studies. One hundred and twenty-nine articles covering aspects of community psychiatric nursing were extracted from the Nursing Times, Nursing Mirror, The International Journal of Nursing, Health and Social Service Journal and other journal sources which dealt with mental health. Very few attempts have been made at a comprehensive review of the literature published in this area; therefore, the purpose of this article is to bring them together. One such attempt was made by Hunter (1974) who published an historical review of community psychiatric nursing in Britain up to 1974. Community psychiatric nursing originated in Britain at Warlingham Park Hospital in the early 1950s. This was recognised by Hunter, who saw this and the development of subsequent psychiatric nursing services as being concerned with “after care or continuing care stage” and, more generally, with the enormous diversification of skills acquired by the psychiatric nurse within the developing services. At that time, the nursing staff of 42 hospitals in Britain were involved in community care. By 1979, this number had not only increased, but there had been significant developments in community based services.