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Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care.

In this paper, the author argues that, despite the self-image of the mental health nursing profession as innovative, radical and progressive, this is a 'false consciousness'. Mental health nursing is deeply immersed in a crisis of legitimacy which dates from, at least, the publication of Russell Barton's Institutional Neurosis in 1959. However, although mental health nurses responded positively to the insights of Russell Barton, they failed to respond directly to the dissenting voices of the anti-psychiatrists or the damning criticisms of various official inquiries into care in various individual psychiatric hospitals during the 1970s. Instead mental health nursing has uncritically embraced humanistic psychology and vaingloriously promoted a false image of mental health nursing which suggests that it has wholeheartedly embraced sensitive user-centred approaches to care. However, the author suggests that, despite superficial similarities between person-centred psychology and the theories of the anti-psychiatrists, mental health nursing can never develop truly liberating approaches to care unless it widens its focus from purely inter-personal relationships and addresses historical, structural and ideological influences on both mental health services and the causation of mental distress.

This paper begins with an exploration of current attitudes towards the use of physical restraint in psychiatric nursing, and the contributions which the 1985 Ritchie Report and the 1991 Report of the Committee Of Inquiry Into Ashworth Hospital have made to the debate on the use of control and restraint within psychiatric institutions. The main focus of the paper, though, is an evaluation of the ethical justifications for and the ethical and political objections to the use of physical restraint techniques as a response to aggressive and self-injurious behaviour in contemporary mental health nursing practice. The author concludes that the number of situations where control and restraint techniques are used might be reduced by the development of new therapeutic approaches. Such approaches should allow for more negotiation regarding care between clients and nurses, and acknowledge the potential benefits of clients resisting supposedly therapeutic interventions which they find unhelpful.

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The aim of this paper is to outline an agenda for critiques of psychiatry and other mainstream ideologies of mental health for the 21st century. While the heyday of anti-psychiatry was the period from the 1960s to the 1970s, new critiques of psychiatry, clinical psychology and psychotherapy continued to emerge throughout the last two decades of the 20th century. Some of these – not least those that emerged from the mental health service users’ movement – echoed the themes of earlier critics such as R. D. Laing and Thomas Szasz by questioning the legitimacy of diagnoses and therapeutic interventions. Others focused on anti-racist and/or feminist perspectives. This paper suggests that, in the wake of developments in biological psychiatry and socio-biology as well as clinical advances in psychopharmacology and the rise of Evidence Based Psychiatry, critical psychiatry has a new role. This role is less adversarial than that of the so-called anti-psychiatry of the 1960s and 1970s and less concerned with challenging basic assumptions about the causes of mental distress. The critical psychiatry of the 21st century can best serve the interests of service users by ensuring that service users’ rights to autonomy, fairness and freedom of choice are not overlooked due to a preoccupation with the science of Evidence Based Psychiatry.

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Working in Partnership, the Department of Health's report on the 1994 review of mental health nursing, implies that mental health nurses should develop anti-oppressive approaches to nursing practice. There is a notable absence of articles within the nursing literature which specifically address this issue. This is possibly because the historical and ideological issues which have informed the development of mental health nursing are complex and difficult to unravel. However, an integration of the theories of David Cooper and Frantz Fanon may provide an appropriate starting point for the development of a theory of anti-oppressive practice which addresses some of the issues specific to mental health nursing.