Talking Therapy

Historian Kylie Smith sets out to tell the story of nurses in the shaping of American psychiatry. Nurses are the largest workforce in mental health, Smith explains, yet their contribution to the shaping of the psychiatric profession has remained underrecognized and underexplored. Nurses helped to shape the care of the mentally ill, both participating in the frontlines as well as in developing theoretical underpinnings. Yet, as Smith explicitly states in the book’s introduction, nurses were also complicit in maintaining many of psychiatry’s racial, structural, and gendered hierarchies and power structures. Smith draws on published articles, papers of nurse leaders (all women), and institutional records to tell a story of the rise of specialized nursing in psychiatry, with attention to training and theorizing of nursing practice. The book, organized chronologically, begins with the pre-history, exploring the early recognition of the need for highly skilled nurses to bolster the professional status of psychiatry and mental institutions. Smith explains the power dynamics, noting that psychiatrists were “forced to work with nurses in order to improve the quality of psychiatric nursing” (p. 27), and as they did, they ceded their control over the profession as psychiatric nursing grew to an independent field. Chapter 2 examines the role of the mental hygiene model, the importance of the first mental health textbook written solo by a nurse, Harriet Bailey, and the rise of holistic models of psychiatric nursing. Yet as Smith notes, the psychiatric institution, which stood in contrast to holistic approaches and public health outreach, remained the primary site of practice for psychiatric nurses. These tensions helped shaped the acceptance for the need of advanced training in psychiatry in nursing schools, to ensure that “the general nurse could be adequately prepared for work in psychiatry,” (p. 63) the focus of Chapter 3.

Health care · Mental health · Outreach · Political science · Power (physics) · Psychiatry · Workforce · Historical Psychiatry and Medical Practices · Historical Studies on Reproduction, Gender, Health, and Societal Changes · Law · Medical History and Research · Medicine · Nursing · Psychology