Different Places, Different Ideas: Reimagining Practice in American Psychiatric Nursing After World War II.

In 1952, Hildegard Peplau published her textbook Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. This was the same year the American Psychiatric Association (APA) published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (1st ed.; DSM-I; APA). These events occurred in the context of a rapidly changing policy and practice environment in the United States after World War II, where the passing of the National Mental Health Act in 1946 released vast amounts of funding for the establishment of the National Institute of Mental Health and the development of advanced educational programs for the mental health professions including nursing. This article explores the work of two nurse leaders, Hildegard Peplau and Dorothy Mereness, as they developed their respective graduate psychiatric nursing programs and sought to create new knowledge for psychiatric nursing that would facilitate the development of advanced nursing practice. Both nurses had strong ideas about what they felt this practice should look like and developed distinct and particular approaches to their respective programs. This reflected a common belief that it was only through nurse-led education that psychiatric nursing could shape its own practice and control its own future. At the same time, there are similarities in the thinking of Peplau and Mereness that demonstrate the link between the specific social context of mental health immediately after World War II and the development of modern psychiatric nursing. Psychiatric nurses were able to gain significant control of their own education and practice after the war, but this was not without a struggle and some limitations, which continue to impact on the profession today.

Asignaturas pendientes del DSM-5 / Unresolved issues in the DSM-5

el presente artículo analiza las críticas generadas a partir de la publicación del Manual diagnóstico y estadístico de los trastornos mentales, quinta edición (DSM-5), ya anunciadas parcialmente durante las últimas fases de su elaboración. Una parte de las críticas se ha centrado en los cambios de los criterios diagnósticos para determinados trastornos y en la incorporación al DSM de nuevas entidades. Sin embargo, otra vertiente crítica va dirigida a la falta de validez de los diagnósticos del DSM, por cuyo motivo se ha cuestionado su eficiencia en el campo de la investigación. El fallo básico del DSM se centra en la incoherencia de un modelo basado en un amplio repertorio de definiciones de entidades categóricas, todas ellas con un alto componente de comorbilidad. Como propuesta para superar el bloqueo generado en la investigación y la parquedad de avances terapéuticos, el Instituto Nacional de Salud Mental de Estados Unidos ha propuesto una estrategia de investigación cuyo punto de partida se sustenta en la identificación y el estudio de las dimensiones básicas de las disfunciones que se presentan de modo transversal en los trastornos mentales (AU)

This paper analyses the criticism prompted by the publication of the Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5), which was already foreseen to a certain extent during the final stages of its drafting. Part of the criticism has focused on the changes in the diagnostic criteria for certain disorders and the incorporation of new entities into the DSM. Another line of criticism, however, is aimed at the lack of diagnostic validity of the DSM, which has led to its efficiency in the research field being questioned. The basic underlying flaw in the DSM is the incoherence of a model based on a wide range of definitions of categorical entities, all of which have a high element of comorbidity. As a proposal to overcome the blockage generated in research and the scarcity of therapeutic advances, the US National Institute of Mental Health has put forward a research strategy based on identifying and studying the fundamental dimensions of the dysfunctions that present transversally in mental disorders (AU)

The Colorado Crisis Education and Response Network: an analysis of policy and practices.

The Federal government has recognized the importance of including behavioral health in disaster response plans and policies. Many states have responded to these directives with the development and implementation of disaster behavioral health response teams. The Colorado Crisis Education and Response Network (CoCERN) is a statewide asset that is based in community partnerships formed to deliver effective, efficient, and professional disaster behavioral health services to communities impacted by a disaster Using the K. McInnis-Dittrich model of policy analysis, this paper analyzes this approach to disaster behavioral health response. Strengths and weaknesses of the program, as well as implications for practice are discussed.

Intervention research with youths at elevated risk for suicide: meeting the ethical and regulatory challenges of informed consent and assent.

Intervention research with youths at elevated risk for suicidal behavior and suicide--a vulnerable and high risk population--presents investigators with numerous ethical challenges. This report specifically addresses those challenges involving the informed consent and assent process with parents/guardians and youths. The challenges are delineated in the context of pertinent laws and regulatory requirements, and guidelines are suggested for their practical resolution. These are illustrated with case examples from NIMH-funded intervention trials. Through the sharing of such methodological information, intervention researchers can support each other in conducting ethical research in a manner that does not unduly compromise scientific rigor.