Academic journal article Nursing History Review

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

Academic journal article Nursing History Review

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

Article excerpt

The Rise of Mental Health Nursing: A History of Psychiatric Care in Dutch Asylums, 1890-1920 By Geertje Boschma (Amsterdam: Amsterdam University Press, 2003; distributed in the United States by University of Chicago Press) (324 pages; $30.00 paper)

Geertje Boschma's study traces the effort to reshape care and treatment in Dutch asylums at the turn of the 19th and 20th centuries. The focal point in this account is the emergence of mental health nursing as a respectable, secularized occupation for women. This is an area of sparse research that is addressed hete by taking a detailed look at the records of four psychiatric institutions, separated geogtaphically and ideologically.

In gleaning what she could from these records, Boschma attempts to distance herself from "a traditionalist, celebratory style of writing nursing history" (p. 23) and the tendency to collapse nursing's past into a process of professionalization. Instead, her aim is to present the findings within "the context of broader social, gender, and religious transformations" (p. 28). The full achievement of this aim is constrained, however, by a frequently cited problem in nursing history research. The study relies on records written not by nurses themselves but by doctors or administrators, which means that conclusions about asylum nursing tend to be speculative.

Yet the careful documentation in this book, including 52 pages of appendices and notes, enables the reader to make the final decision on whethet a specific conclusion is warranted. For instance, the director of one asylum is said to have instructed nurses to provide literal descriptions of what happened to patients rathet than offering diagnoses and decisions. This, according to Boschma, ultimately "instilled an anti-intellectualism in nurses" (p. 117). Whether one tends to view such a conclusion as reasonable or not, the evidence is laid out in a clear and direct manner.

This book excels both in linking changes in asylum care and treatment to larger regional and national developments, and in placing gender center stage in examining specific changes that occurred in mental health nursing. Asylum reform in the Netherlands, for example, is explained as a response to increasing poverty in the late eighteenth and early 19th centuries, a result of economic stagnation and foreign domination. The re-establishment of the Netherlands as a sovereign monarchy in 1815 brought to power a king who found great appeal in the new liberal and humanitatian insights of "moral treatment." Under his influence, the emphasis on improving asylum conditions with the aim of curing the "insane," attend elsewhere in Europe as well, took firm root in the Netherlands. Still, this emphasis eventually yielded to bold advancements in medical science and the resulting pressure to concentrate on more somatically focused treatment and care.

Each of these developments brought about a renewed emphasis on improving the skill and training of mental health nutses. …

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