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

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

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

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


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.

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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 that time, nursing had not yet been linked to the modern hospital as a system of training, nor with the concept of an independent paid professional occupation for middle-class women. The modern hospital did not yet exist at that time and only emerged during the late nineteenth century. Furthermore, a paid career for middle- class women was hardly conceivable or acceptable at the beginning of the nineteenth century; this only became possible during the latter part of the century. Asylum work was not yet considered to be women's work, since male and female patients were cared for by attendants of their own sex. When, psychiatrists incorporated the “nursing idea” into their professional aspirations during the 1890s as a means to create the mental hospital, nursing had already undergone a profound change.

Religious Roots

The socially respected image of nursing — a seemingly natural blending of a refined morality, female compassion, and professional skill — that was so attractive to nineteenth-century doctors was carefully constructed within the context of religious communities of men and women actively involved in charitable work since the seventeenth century. Roman Catholic orders that undertook charitable work re-emerged in seventeenth-century France during the Counter Reformation. Prime examples were the influential male order of the Congregation of Lazarists and the female congregation of the Sisters of Mercy (or Daughters of Charity), founded by Vincent de Paul in 1625 and 1633, respectively, and which spread throughout Europe far into the nine-

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