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In the colonial era of the United States, some settlers adapted community health nursing practices. Individuals with mental defects that were deemed as dangerous were incarcerated or kept in cages, maintained and paid fully by community attendants. Wealthier colonists kept their insane relatives either in their attics or cellars and hired attendants, or nurses, to care for them. In other communities, the mentally ill were sold at auctions as slave labor. Others were forced to leave town.<ref>Levine, M. (1981). The History and Politics of Community Mental Health. United States: Oxford Press.</ref> As the population in the colonies expanded, informal care for the community failed and small institutions were established. In 1752 the first “lunatics ward” was opened at the [[Pennsylvania Hospital]] which attempted to treat the mentally ill. Attendants used the most modern treatments of the time: purging, bleeding, blistering, and shock techniques. Overall, the attendants caring for the patients believed in treating the institutionalized with respect. They believed if the patients were treated as reasonable people, then they would act as such; if they gave them confidence, then patients would rarely abuse it.<ref>Levine, M. (1981). The History and Politics of Community Mental Health. United States: Oxford Press.</ref>
The 1790’s in Europe is considered a time of enlightenment for the moral treatment of the mentally ill. <ref>Videbeck, S. L. (2008). Psychiatric- Mental Health Nursing. Philadelphia: Lippincott Williams & Wilkes.</ref> The concept of a safe asylum, proposed by [[Phillipe Pinel]] and William Tukes, offered protection and care at institutions for patients who had been previously abused or enslaved. <ref>Videbeck, S. L. (2008). Psychiatric- Mental Health Nursing. Philadelphia: Lippincott Williams & Wilkes.</ref>In the United States, [[Dorothea Dix]] was instrumental in opening 32 state asylums to provide quality care for the ill. Dix also was in charge of the Union Army Nurses during the [[American Civil War]], caring for both Union and Confederate soldiers. Although it was a promising movement, attendants and nurses were often accused of abusing or neglecting the residents and isolating them from their families.<ref>Videbeck, S. L. (2008). Psychiatric- Mental Health Nursing. Philadelphia: Lippincott Williams & Wilkes.</ref>
The formal recognition of [[psychiatry]] as a modern and legitimate profession occurred in 1808.<ref>Alexander, F. & Selesnick, S. T. (1967). The History of Psychiatry: An Evaluation of Psychiatric Thought and Practice from Prehistoric Times to the Present. Michigan: Allen and Unwin.</ref> In Europe, one of the major advocates for mental health nursing to help psychiatrists was Dr. William Ellis. He proposed giving the “keepers of the insane” better pay and training so more respectable, intelligent people would be attracted to the profession. In his 1836 publication of ''Treatise on Insanity'', he openly stated that an established nursing practice calmed depressed patients and gave hope to the hopeless.<ref>Nolan, P. (1993). A History of Mental Health Nursing. United Kingdom: Stanley Thornes Ltd.</ref> However, psychiatric nursing was not formalized in the United States until 1882 when [[Linda Richards]] opened Boston City College. This was the first school specifically designed to train nurses in psychiatric care. <ref>Boyd, M. & Nihart, M. (1998). Psychiatric Nursing - Contemporary Practice. Philadelphia: Lippincott.</ref> The discrepancy between the founding of [[psychiatry]] and the recognition of trained nurses in the field is largely attributed to the attitudes in the 19th century which opposed training women to work in the medical field. <ref>Alfredo, D. (2009). The History of Psychiatric Nursing. Retrieved 24, November 2009.</ref>
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