The development of community psychiatric nursing: a professional project?

In this paper the author argues that the development of community psychiatric nursing can be understood as a professional project. However, the case of community psychiatric nursing cannot be adequately understood from mainstream literature on the subject of professionalization within the health care division of labour. The inadequacy of such literature is that it either concentrates upon the pre-eminent case of medicine or regards nursing's professionalization as being unitary. The author posits that the professional projects of general nursing and community psychiatric nursing have different and even opposing interests. To contextualize community psychiatric nurses' (CPNs') professional project the author examines: the history of mental nursing, from which community psychiatric nursing evolved; the development of community mental health care, which allowed for the inception of community psychiatric nursing; CPNs' relationships with both psychiatrists, whose patronage assisted CPNs' initial growth as para-professionals, and general practitioners, who later assisted a more functionally autonomous role for CPNs in primary care; and social policy towards community care that enhanced CPNs' growth. In conclusion the author argues that recent government-led changes in the management of community mental health care now impel CPNs to change the direction of their strategy for occupational survival and advancement.