Psychiatric Nursing and the Saskatchewan Psychiatric Nurses' Association, 1930 - 1972

B. A. (Honors) Essay
By Angela Y. Martin
March, 1999

In the July, 1951 edition of The Psychiatric Nurse, W. L. Pritchard wrote of the challenges to be faced by the relatively new profession of psychiatric nursing:
Psychiatric nursing as a profession of merit is not too well known; it replaces the archaic concept of custody in the midst of regimentation, neglect, and abuse of the less fortunate of our own ' the mentally ill. The psychiatric nurse is a professional person - not inferior to the registered nurse, but equally important and equally essential in a changing social structure; each with a definite place, and a definite function. An entirely new concept in an entirely neglected field of operation. In all of this we share credit and future responsibilities! The path will be thorny and strewn with obstacles.¹

This was the challenge that the Saskatchewan Psychiatric Nurses' Association (SPNA) presented to itself. It was also a message to outside parties that this new profession would not only share responsibility in the care of the mentally ill, but also that it would be an equal partner with other medical professionals in planning for the future. The message was clear and so was the mandate. But after reading the material which represents the history of the SPNA, two questions arise. Did the SPNA share the responsibility of planning and strategizing for a better mental health system in Saskatchewan? Secondly, what were the obstacles they faced from their inception until the early 1970s and was it apparent to themselves and others that they were equal partners with the other professionals in the medical field?

In the 25th anniversary history of the SPNA, A Different Drummer, one member reflected on what the SPNA had accomplished and what might be in store for the future. He answered the above questions with what might be perceived as a yes and a no.

Little things that you could call stepping stones along the way, where they got the Act through the Legislature, got recognition by the University and a representative on the Board of Examiners. All these things take long periods of time. The SPNA, over a long period of time, did an awful lot of work - getting people to be able to go to the University and take courses there, to give them extra training where their psychiatric nursing training was recognized as entrance qualifications. These are things that stand out as highlights, things that took an awful lot of years, of meetings, arguing, writing briefs. Regarding the identity of the RPN, people worried so much about the fact that the Saskatchewan Registered Nurses Association (SRNA) was going to take us over. It hasn't happened yet, and people have been worrying about it for 20 years. Keeping this hassle up is something we could have done without. We could have gone more for cooperation.²

This Honors Essay will review the history of psychiatric nursing and the SPNA from the 1930s to 1972, and will attempt to show that the SPNA did truly share the responsibility of building a better mental health care system in Saskatchewan. The obstacles it faced were many but in the final analysis it will be argued that given all that was done, this group's viability was constantly challenged by outside parties and decisions over which it had no control. This led to a constant questioning of its identity and its place in a continually changing mental health system.

A review of published and unpublished literature found that although mental health in Saskatchewan has been studied, no works have addressed the topic of psychiatric nurses as a profession in the same way this study has. F. Kahan and Foote, et. al. wrote 25th and 50th anniversary histories, respectively. The 50th anniversary review is formatted like a yearbook, providing a very brief history, but is mostly composed of commentary by long-time SPNA members.³ Kahan's 25th anniversary book, A Different Drummer, provides a chronological description of the history of the SPNA using SPNA archival records and interviews of psychiatric nurses conducted in 1973. The book, although useful and interesting, lacks analysis and, more importantly, footnote citations.⁴

Sandra Bassendowski's M.Ed. Thesis includes a history of the psychiatric nursing, nursing assistant and diploma nursing training programs, showing their evolution from 1929 to 1972. For the most part, her thesis details the origins and development of the 'core' concept of nursing education in Saskatchewan. In doing so she identifies the role of the Departments of Public Health and Education in integrating into one program, these three traditionally separate and distinct curriculums, in 1972.⁵

Paul Nishida's M.A. Thesis reviews the establishment of Saskatchewan mental hospitals between 1912 and 1940, ⁶ and Duane Mombourquette chronicles the steps taken by the CCF government as they related to health care in Saskatchewan between 1944 and 1964.⁷ Both of these works provide an overview of health and mental health in the province, but neither discusses psychiatric nursing in any detail.

Harley Dickinson's book, The Two Psychiatries, details the nature of psychiatry in Saskatchewan from 1905 to 1984. ⁸ He traces transitions in psychiatry from asylum to community-based models. Within this context, he argues that over time there was a de-medicalization of psychiatry with a discernible trend toward the de-skilling of psychiatric occupations.

Sharon Baldwin's M.A. Thesis studies the effect of government involvement on the professionalization of seven different groups in Saskatchewan.⁹ Although this is an important study in its review of the relationship between government and professional groups, it does not include information on inter-professional relationships which are an important part of the growth of a professional group.

As seen from this summary, much of the history of psychiatric nursing and the SPNA remains to be explained. This essay hopes to add to the literature by looking into the day to day work the Association performed, the struggles it faced, and how it influenced and was influenced by outside and internal forces.

This essay is divided into three chronological sections, each dealing with a different era in the history of psychiatric nursing in Saskatchewan. The first, 1930 to 1948, will review the early history and training of psychiatric nurses and their eventual gaining of professional status in 1948.

The next era extended from 1948 through to the end of the 1950s. During this period the Association dealt with issues of training, and established its own pledge, code of ethics and rules and regulations. It was also faced with a major shift in thinking in the mental health field. This culminated in what became known as the Saskatchewan Plan, which placed greater emphasis on community psychiatric treatment.