Introduction
Two words come to mind as I review how I came to be immersed in this venture of writing a history of the University of Utah Graduate Psychiatric Nursing Program: deserve and preserve. As to the latter, I recognized that there was no written history of the Graduate Psychiatric Nursing Program at the University of Utah. In 1976, my friend and colleague, Bonnie Clayton wrote a history of the development of graduate psychiatric nursing programs in the United States for her dissertation. That was a long time ago. Nothing definitive had been written about the program since, aside from a few paragraphs in a few histories of the College of Nursing.
I had taught in the program for 36 years and met wonderful people along the way: students, faculty colleagues, patients and their families, university administrators, philanthropists, and others. Some were local and some from around the country. While I wouldn’t be able to mention by name every person who may deserve recognition, I could preserve a history of the program that was important and valuable to them.
The COVID-19 pandemic with its restrictions on gathering, became an opportunity to engage in a writing exercise to preserve the history of the program. I believed that history was about people and what they had done. The history of psychiatric nursing is built on knowledge, compassion, interpersonal skills, and so much more. The names and efforts of so many people that established the foundation of advanced psychiatric nursing in Utah would be lost if there were no record of their work.
In outlining the project, it became apparent that a brief history of mental illness needed to form the background for the field of psychiatric mental health nursing in Utah. Mental illness didn’t arrive in the nineteenth century. Mental illness existed where there were people eons ago. Even a brief review of historical records of the ancient Greeks and others shows the presence of this form of human experience. Individuals with the symptoms and behaviors of these illnesses were confusing to people around them. While some may have received compassionate care, others met with brutal and degrading responses. As knowledge and understanding of mental illness evolved, treatment strategies became more humane and more curative.
The next building block was a brief history of the profession of nursing and nursing education in the United States. Late in my professional career, I read in depth about Florence Nightingale, and was deeply impressed with her courage, intelligence, and social connections. Through her own vision of nursing, and her experiences and her writings, she created the foundation of modern nursing. Nightingale’s influence in the United States of America was profound and the nursing profession is in debt and rightfully grateful to this remarkable woman.
The early history of the nursing profession in the United States is relatively well documented, including some early mentions of nurses caring for those with mental illness. However, only a few of nurses associated with caring for the mentally ill are named. Yet, there were nurses in mental asylums and hospitals across the nation that offered care for people with behaviors and symptoms of mental illness. In Part II I tried to give an overview of the most influential efforts of key nurses in the evolution of care for people with mental illnesses as well as outlining advances in nursing education in the United States.
Starting in the late 19th century and continuing through the 20th century, education for nurses became more organized and prescribed. Education for nurses treating patients with mental illness was more formalized by mid-twentieth century. While there were suggestions that hospital-based nursing education programs should affiliate with formal educational institutions (colleges and universities), it wasn’t until Esther Lucile Brown’s publication of Nursing as a Profession in 1936 that nursing education moved to colleges or institutes of higher education.
In Part III I shifted my focus to theory and treatment strategies that were emerging in these early years, and then to various reforms in psychiatric care in the United States, often impelled by the trauma of war and its impact on veterans. Activists, many of them psychiatric nurses and nurse educators, led the way forward on the national stage to the creation of NIMH (National Institute of Mental Health), which has been of such vital importance to the evolution of psychiatric nursing as a profession. In Part IV, I turned my attention to the University of Utah College of Nursing, its pioneer heritage, and the advent of nurse training schools in various hospitals around the state, before the need for a more academic grounding become apparent and support was forthcoming for the University to organize a Department of Nursing and then the College.
All this, though interesting and essential as framework, was preliminary to a deep dive into the history of the University of Utah’s Graduate Program in Psychiatric/Mental Health Nursing, the fascinating subject I have researched and present herein. I chose to describe the evolution of the University of Utah Graduate Program by decades to keep the discussion in historical perspective. There were many ways to present information, but I chose five areas of focus that I thought would describe and clarify why changes were made in the curriculum. First, what were the current psychiatric theories of a particular decade? Second, what were the national issues relative to mental illness? Third, what were the leadership and curriculum issues for the Graduate Psychiatric-Mental Health Nursing Program at the University of Utah? Fourth, how did the Utah Nurse Practice Act influence the educational program and vice versa? Fifth, what was happening in Utah that affected the practice of psychiatric nursing?
There is no way to capture in a brief historical review all those who have made significant contributions to this program. Nor could I find one specific text or review article that drew together all the foundation pieces for a comprehensive history of the University’s graduate psychiatric nursing program. I hope my efforts here will begin to redress this omission and gather some scattered references and names for the use of future historians. I know for certain that I have missed some significant people, events, and contributions and for that I apologize.. However, when you include some names, you will inevitably leave some names out that others feel are equally important. Historians often revisit events, offering new insights and perspectives, and perhaps others will write histories and articles about the University of Utah’s graduate psychiatric nursing program that will include other important people and their contributions to the field. I welcome and look forward to such endeavors.
