Community Mental Health Nursing in Alberta, Canada: An Oral History

Community Mental Health Nursing creating new professional roles in the community and transgressing traditional institutional boundaries, community mental health nurses had a central role in the construction of new rehabilitative practices and community mental health services in the 1960s and 1970s.

We have only scant historical knowledge of nurses’ work in this transformative process; however; historiography on the history of community mental health nursing is limited, and existing work on
mental health nursing history concentrates on the history of nursing and nursing education in the mental hospital.

In Canada, a first historical study of community mental health nursing was conducted in the 1980s by Dorothy Sillars.

As both Church and Sillars observe, the (public) mental health movement was an important context for the early development of (community) mental health nursing. In the United States in the 1940s, this process stimulated the integration of psychiatric and mental health nursing in nursing curricula at hospital training schools and emerging university programs. The emerging body of Canadian historiography on psychiatric mental health nursing reveals that in Canada, the response was more divided.

General and mental hospital nurse training was also integrated in the eastern Canadian provinces, bridging the traditional gap between them. Historiography on mental health care in Quebec indicates early and increasing strategic interaction between institutional staff and families, showing the fluidity of boundaries between institutions and community.

In the western provinces, mental hospitals did not establish schools for psychiatric nursing until the 1930s. Professionalization of these nurses was met with resistance from existing professional nursing organizations; as a result, graduates from these mental hospital schools formed their own professional organization and licensing bodies in the 1950s.

These graduates contributed in important ways to the expanding scope of psychiatric mental health nursing practice during the 1960s and 1970s. In the 1960s, a trend toward community-based mental health care and rehabilitation occurred in Canada, as throughout North America and Western
Europe.
The changing therapeutic climate within mental hospitals affected the roles of nurses, and as I will show, their involvement with community care expanded. The ways the movement toward rehabilitation generated a new professional identity and practice in the Alberta mental hospitals, similar to the change in professional orientation Ann Sheridan described for Ireland and Peter Nolan for Britain.

The implementation of a National Health Service in 1948 and a new mental health act in 1959 changed the course of mental health care in Britain toward more outpatient and community care, and transfer of long-term hospitalized patients into the community increased. Not until the mid-1970s, however, was specialized training in community care 106 Geertje Boschma implemented for psychiatric nurses, with the introduction of new programs for community psychiatric nurses, expanding their scope of practice and professional recognition.

Sheridan’s analysis of psychiatric nursing in Ireland points out that the field profoundly changed during the 1970s because of the formation of the European Union, which brought new directives on professional and academic education, and an emerging philosophy of rehabilitation and community
care.

During the 1980s, the Irish psychiatric nursing education curriculum was reoriented toward community-based service and education in rehabilitation, and therapeutic techniques were expanded. However, the question of how nurses constructed their work in the community as the emphasis shifted toward community-based mental health care in the 1960s is only recently
receiving more detailed historical analysis.

The changing circumstances of work and mental health care shaped their new role and professional identity.