SEJARAH JIWA
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Transcript of SEJARAH JIWA
HISTORY OF MENTAL
HEALTH CARE
Ns.BYBA MELDA SUHITA,S.Kep. M.Kes
BAGAIMANA PENDAPAT ANDA TTG GG JIWA ???
GANGGUAN JIWA ???
Bagaimana Masyarakat Memperlakukan ?
SETELAH DIRAWAT
PASIEN DIPASUNG 10 TAHUN
LOKASI PEMASUNGAN
SETELAH DIRAWAT
PASIEN DIPASUNG
PASIEN DIPASUNG
SETELAH DIRAWAT
Rumah pasien pasung
Unsur manusia yg non-materi, tetapi fungsi dan
manifestasinya terkait pada materi
Manifestasi Jiwa: Kesadaran, afek & emosi, psikomotor, proses berpikir, persepsi, & sifat-sifat kepribadian.
JIWA
KEPERAWATAN JIWA
Suatu bidang spesialisasi dari praktik keperawatan, yang menerapkan teori perilaku sebagai ilmunya, dan penggunan diri secara terapeutik sebagai kiatnya
KEPERAWATAN JIWA
Suatu proses interpersonal yang berupaya meningkatkan dan mempertahankan perilaku, yang mengkontribusi pada
fungsi yg terintegrasi
Contents: Introduction Development of mental health care
Early civilization Middle ages 18 & 19th centuries 20th centuries Indonesia
Introduction Mental Health Nursing is the diagnosis
and treatment of human responses to actual or potential mental health problems
Specialized area of nursing practice that uses theories of human behavior as its scientific frame work and requires the purposeful use of self as its art of expression
Its concerned with the promotion of optimum health for society
Comprehensive service focus on prevention of mental illness health maintenance management or referral of mental and physical
health problems diagnosis and treatment of mental disorders and
their sequel and rehabilitation (Haber & Billings, 1993)
Psychiatric nurses must be :
Able to make rapid comprehensive assessment Use effective problem solving skillsAct autonomously as well as collaboratively with other professionalBe sensitive issues as ethical dilemmas, cultural diversityBe comfortable working in decentralized settingsBe sophisticated about the costs and benefits of providing care
(ANA, 1994)
Development of mental health care
Early civilization Middle ages 18 & 19th centuries 20th centuries Indonesia
Early civilization 1770 - 1880 Movements concerning the treatment of persons with
mental illness The ancient Greeks, Romans and Arabs believed
emotional disorders were an organic dysfunction of the brain
They used a variety of treatment approaches, such as :
Sedation Good nutrition Good physical hygiene Music Recreational activities
Hipocrates : Described a variety of personalities or temperaments and proposed that mental illness was disturbance of four body fluids or “humors” heat, cold, dryness and moisture
Aristoteles :The mind was associated with heart
Gallen :The emotional or mental disorders were associated with brain
Early civilization … cont
The Greeks : Used temples as hospitals Provided an environment of fresh air,
sunshine and pure water Riding, walking and listening to the
sounds of waterfall were examples of therapeutic care
Early civilization … cont
Middle AgesAn era of alienation, social exclusion and confinementPersons who displayed abnormal behavior were considered to be lunatics, witches, or demons possessed by evil spiritsSuperstition, mysticism, magic and witchcraft prevailed as patients were starvedBeheading, hanging, and burning at the stake common occurrences
Patients suffering from a mental illnessPhysicians describes symptoms : depression, paranoid, delusions, hysteria and nightmaresThe first mental hospital : Bethlehem Royal Hospital in England
Middle Ages … cont
Bethlehem Royal Hospital
18th and 19th centuriesBenjamin Rush
”The Father of American Psychiatry” Wrote the first American textbook on psychiatry and encouraged more humane treatment of persons with mental illness In 1783 an era of moral treatment, he joined with Pennsylvania Hospital : talk to patients, share in their activities
Philippe Pinel (a French physician ) Began more humane treatment, removing chains
Benjamin Rush
Philippe Pinel
In 1843, Thomas Kirkbridge attempted to establish a training school for attendants at Pennsylvania Hospital to assist physician in the care of mentally ill patients
In 1872, New England Hospital of Philadelphia had established schools of nursing
Dorethea Lynde Dix (a Boston teacher) spent much of her time working for improved conditions for mentally ill persons building state mental hospitals to meet the needs of patients
18th and 19th centuries … cont
The nurse’s role was to oversee the care given and ensure the smooth operation of the ward housekeeping duties, dietary management and laundry care As Hospitals were established to provide long term custodial care In 1882, the first psychiatric training school was established at McLean Hospital in Belmont, Massachusetts
the first formally organized school for nurses in a hospital for mentally ill
18th and 19th centuries … cont
In 1890, trained nurses were employed on nursing staff of state mental hospitals develop their skills to provide therapeutic nursing care
There was a growing appreciation of the therapeutic role of the psychiatric nurseDuties included :1. Assisting the physician2. Administering sedative drugs3. Providing hydrotherapeutic measures
18th and 19th centuries … cont
Martin Charcot penyembuhan Nerosa Histeri dengan hipnosa
18th and 19th centuries … cont
Any Question?
Twentieth centuryThe mental health movement was strongly
Publication of a book written by Clifford Beers “A Mind That Found Itself”(1908) Influence to organize the National Association for Mental Health public awareness
Large state mental hospitals were built in rural areas
“A Mind That Found Itself”
by Clifford Beers
In 1915 Linda Richards (the first graduate nurse in US The First American Psychiatric Nurse) :
Mentally ill patients receive the same quality care as physically ill patients
The average students : Caring for mental ill Clinical experience in mental hospital
With ANA promoted study of mental ill & publishing journal articles
Twentieth century … cont
Linda Richards
Emil Kraepelin Psikosa manik-depresif VS Dementia Praecox
Kretschmer and Sheldon Typical body VS personality, temperament and emotional disorders
Sigmund Freud Teori libido, struktur kepribadian, topografi jiwa
Carl Gustav Jung Teori alam bawah sadar kolektif, individualisasi, introversi dan extroversi
Alfred Adler Motivasi manusia pada kekuasaan, perfeksi dan totalitas
Eugen Bleuler Skizofrenia
Adolf Meyer Teori psikobiologi
Harry Stack Sullivan and Erich Fromm Penerapan konsep psikoanalisa ke masalah sosiobudaya
Twentieth century … cont
Sigmund Freud
Textbooks focusing on psychiatric nursing practice
The National League for Nursing educational objectives included :- Relationship between physical and mental illness- The application of nursing principles to MHN- Assessment behaviors of patients – recognize early
signs or symptoms- Relationship of environmental conditions and mental disorders- To be resourceful, versatile and adaptable
(Smoyak, 1982)
Twentieth century … cont
Students were given the opportunity to care for patients with varying degrees of mental disorders
Experiences Focused :- physical- hydrotherapy- occupational- recreational- diversion therapy- patients education
Twentieth century … cont
Nursing interventions : Emphasizing Cleanliness Proper elimination Adequate nutrition Supervising continuous bath to promote
relaxation
Twentieth century … cont
In 1963, The Community Mental Act : establish community health centers to provide:1. Emergency mental health care 2. Inpatient care /hospitalization3. Partial hospitalization4. After care 5. Consultation services
Twentieth century … cont
The deinstitutionalization of patients from hospitals to community
At the present psychiatric nursing began to evolve as clinical specialize
Nurse involved as managers and coordinators of activities that provided therapeutic care
Advanced study and clinical practice experienced in a master’s program in psychiatric nursing, clinical specialists to gain expert knowledge in care and prevention of mental disorders
Twentieth century … cont
Indonesia
Jaman Kolonial Sebelum ada RSJ ditampung di RSU Sipil
atau RS Militer di Jakarta, Semarang dan Surabaya
1862 Pemerintah Hindia Belanda Sensus Banyak yang gangguan jiwa dibangun RSJ: RSJ Bogor (1 Juli 1882) RSJ Lawang (23 Juni 1902) RSJ Magelang (1923) RSJ Sabang (1927)
Pembagian tempat penderita psikiatrik: Rumah Sakit Jiwa
Bogor, Magelang, Lawang, Sabang Rumah Sakit Sementara
Tempat penampugan pertama pasien psikotik akut Bisa pulang atau dikirim ke RSJ Jakarta, Semarang, Surabaya, Ujung Pandang,
Palembang, Bangli (Bali), Padang, Lubuk Pakam (Padang), Banjarmasin, Manado, Glugur (Medan)
Rumah Perawatan Fungsi sama dgn rumah sakit sementara, tetapi
dikepalai oleh perawat berijazah dan di bawah pengawasan dokter umum
Koloni Penampungan pasien yang sudah tenang, bekerja di
bidang pertanian, tinggal di rumah penduduk, masih di bawah pengawasan
Jaman Kolonial … cont
Pengobatan: Isolasi dan penjagaan “dibungkus” Suntikan obat penenang Terapi mandi Jemur di panas matahari Terapi kerja
1910 gerakan “No Restraint”
Jaman Kolonial … cont
Perang dunia ke-2 dan pendudukan Jepang Tidak dapat berkembang RSJ Sabang hancur karena bom
Kemerdekaan Oktober 1947 terbentuk Jawatan Urusan
Penyakit Jiwa (di bawah Departemen Kesehatan) penyelenggaraan dan pembinaan kesehatan jiwa di Indonesia
1958 dirubah menjadi Urusan Penyakit Jiwa
1959 dirubah menjadi Bagian Penyakit Jiwa
1960 dirubah menjadi Bagian Kesehatan Jiwa
1966 – sekarang Direktorat Kesehatan Jiwa
Selesai …