A dirty business: caring for people who are a nuisance or a danger

This paper argues that developments in chemical, administrative and legal methods of control, once confined to the asylum, now operate over mental patients in the community. Differences between the hospital and the community have thus been eroded. This paper therefore seeks to understand how mid-twentieth century sociology, that informed an understanding of the asylum prior to its demise, can be usefully revisited to inform an understanding of the contemporary practice of community mental health nursing. It is argued that in their development, community mental health nurses (CMHNs) have endeavoured to associate themselves with the clean work of caring, rather than with the dirty work of coercive control. However, CMHNs now find themselves representing societal and psychiatric demands for the greater control of mental patients in the community to their clients. Issues of control and care (coercion and persuasion) in community mental health care nursing practice are thus considered in relation to theory regarding the imposition of power.