The professionalisation of mental nursing in Great Britain, 1850-1950
This thesis takes the form of an investigation into the lack of progress towards the professionalisation of mental nurses during the period 1850 to 1950 and concentrates on their failure to become a professional sub-group within nursing. The proposal is put forward that their relative failure to advance was due to the fact that mental nurses were controlled and dominated by other more powerful health care groups with their own agendas. These were the asylum doctors in the (Royal) Medico-Psychological Association ((R)MPA), and the doctors and general trained nurses in the General Nursing Council (GNC). During the 1850s the (R)MPA's main concern was to raise the status of asylum doctors. The association aimed to achieve this by developing the care and treatment of the insane into another recognised speciality of medicine. To do this they needed to hospitalise the asylums, a process which would include transforming asylum attendants into qualified mental nurses. To this end a mental nursing textbook was published by the (R)MPA in 1885. This was followed by the inauguration of a national training scheme with certification for successful candidates. In order to advance the goal of hospitalisation, female nurses were introduced into male wards in many asylums. It was also asserted that the care of insane male patients was improved, a claim which led to conflicts with the trade unions, which were totally opposed to female nurses on male wards. The impact of unionisation of mental nurses will also be discussed in relationship to the struggle for professionalisation. Even when the Nurses' Registration Act 1919 was passed, mental nurses were caught in the middle of an internecine conflict over who controlled them: on one side was the GNC with its new supplementary register for mental nurses; on the other stood the (R)MPA, reluctant to give up their training and examination scheme under the conditions offered by the GNC. So a dual system of registration continued to exist until the introduction of the National Health Service in 1948. Even then mental nursing was still controlled by the general trained dominated GNC.