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The following information was prepared by former CAPT Editor and Consultant Keith Hearn.
Much of the earlier historical material comes from the research of Norm Cone,
former president of the CAPT Chapter at Atascadero State Hospital. (Revised February 2006)

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In California, Psychiatric Technician is a state-licensed nursing discipline focusing on the care of people with mental illnesses and/or developmental disabilities (such as mental retardation, autism, epilepsy and cerebral palsy). The license category is parallel to Licensed Vocational Nurse, which is California's term for what other states call Licensed Practical Nurse. The distinction is Psychiatric Technicians have more education and training in mental and developmental disabilities while LVNs have additional training in ob-gyn and pediatrics.

The profession of Psychiatric Technician has its roots in the unskilled occupation of "attendant" or "aide" in the first state hospitals for the mentally ill. At the time they were opened in the late 19th Century, the names of these institutions clearly reflected the way contemporary society viewed the mentally ill.

For example, what was until recently Agnews Developmental Center in San Jose was first called "The Great Asylum for the Insane" when it opened in 1885. When Patton State Hospital opened in 1893, it was named the "Southern California State Hospital for the Insane and Inebriates." And when Sonoma Developmental Center was built in 1895, it was named the "California Home for the Care and Training of Feeble-minded Children."

Sometime after World War II, the ward-level nursing staff in "mental hygiene," as it was called then, began being referred to as Psychiatric Technicians rather than attendants or aides. In large part, this came with the advent of so-called "modern" scientific treatment such as lobotomies and other neurosurgery, as well as electroconvulsive treatment or "shock therapy." The name "technician" seemed more fitting for the care of patients in this more scientific, technological environment.

Of course, the change in title did not necessary translate into a more educated and qualified workforce. It wasn't until the formation of the California Society of Psychiatric Technicians in 1950 that a cohesive vision for the future emerged. Although the road to expanded professionalism was long and difficult, CSPT's efforts set a positive course to the eventual establishment of the Psychiatric Technician as a key component in the modern interdisciplinary treatment team.

State job class created

The next milestone was in 1951 with creation of the state civil service job classification of Psychiatric Technician, along with specific entry requirements. At the same time, Psychiatric Technicians started being utilized more frequently outside state institutions.

As a result, in 1959 the state established a system for "certification" of Psychiatric Technicians working in both government facilities and in the private sector. This provided a state-administered testing process to assure competence in practice, no matter where the individual was employed.

In 1970, this process was elevated to full state licensure like that required for other healthcare disciplines. Today, California is one of only four states that license Psychiatric Technicians, the others being Colorado, Arkansas and Kansas. (Arkansas stopped licensing new Psychiatric Technicians in 1994 due to closure of its Psychiatric Technician education programs, but existing Psychiatric Technicians in that state can still renew their licenses.)

In the 1970s, the country was going through significant changes in the treatment of the mentally ill and mentally retarded, and Psychiatric Technicians understandably were affected by this. One train of thought was that Psychiatric Technicians should focus on the "behavioral model" and align themselves more closely with psychologists and psychiatric social workers.

Another faction believed Psychiatric Technicians should stay within the "medical model" and build closer ties with psychiatrists, registered nurses and licensed vocational nurses. Ultimately, one could say the behaviorists came out ahead, as the current Psychiatric Technician training is about two-thirds behavioral science and one-third nursing science.

In its effort to reach out to a wider array of individuals, the California Society of Psychiatric Technicians reorganized itself into the California Association of Human Services Technologists (CAHST). Largely through its efforts, bachelor's degrees and even a graduate degree in Psychiatric Technology were offered at San Jose State University. However, the name of Psychiatric Technologist never caught on.

In state employment, CAHST promoted the concept of having Psychiatric Technicians voluntarily secure additional education in their chosen career field to enhance their skills. This eventually led state facilities to establish higher salary ranges for state-employed Psychiatric Technicians who complete additional college-level education.

State Psych Techs get their bargaining unit

During the late 1970s and early 1980s, the majority of California's Psychiatric Technicians still worked in state institutions. During this time, the Legislature enacted collective bargaining for state employees. To implement this system, employees were divided into separate bargaining units that grouped employees with generally similar duties. In this process, state-employed Psychiatric Technicians were fortunate to get their own bargaining unit, instead of being in a unit that included other categories of healthcare workers.

In 1981, state employees in each bargaining unit elected a single organization to represent the unit in job-related issues. The state-employed Psychiatric Technicians elected the AFL-CIO Communications Workers of America, rejecting the independent (not AFL-CIO) California State Employees Association which had served Psychiatric Technicians before the collective bargaining era.

During the next 15 years, this union focused primarily on salaries and working conditions in state government. As a result, little progress if any was made on "professional issues" for the overall ranks of Psychiatric Technicians. Many began to sense Psychiatric Technicians drifting into a lower status as compared to RNs, LVNs and other healthcare disciplines.

This dissatisfaction led state-employed Psychiatric Technicians to form their own independent organization in 1985, the California Association of Psychiatric Technicians (CAPT). In 1986, Psychiatric Technicians voted CWA out in favor of CAPT, which today remains the union representing state-employed Psychiatric Technicians.

CAPT's "two hats"

Because of varying needs of Psychiatric Technicians, CAPT "wears two hats," so to speak. The association serves as the elected representative of the 7,000 Psychiatric Technicians and related care-givers in state service. And it also serves as the statewide professional association for all 14,000 licensed Psychiatric Technicians in California.

CAPT's work on behalf of Psychiatric Technicians is carried out with the Legislature, with the Governor's Office, with state agencies that employ Psychiatric Technicians and with the licensing board -- the Board of Vocational Nursing and Psychiatric Technicians (BVNPT).

In terms of Psychiatric Technician professionalism, CAPT drafted and sponsored the 1989 legislation that led to a Continuing Education requirement for Psychiatric Technician license renewal. This brought the profession in line with RNs, LVNs and other healthcare disciplines.

CAPT later drafted and sponsored legislation allowing Psychiatric Technicians to draw blood after completing special training and being certified by the BVNPT. Although this legislation became law in January 1998, approval of regulations to implement the law was delayed until January 1999 due to technical problems.

The legislation also allows Psychiatric Technicians to administer immunizations and perform tuberculosis skin tests after completing training and demonstrating competency. Finally, the same legislation put into law the fact that Psychiatric Technicians may administer medications by hypodermic injection. This has long been within their scope of practice, but it's never been spelled out in law.

CAPT continues its work not only to enhance the Psychiatric Technician scope of practice, but also to ward off any efforts to reduce the scope.

Wide variety of practice settings

A century of evolution has led to today's environment where California has Psychiatric Technicians in hundreds of practice settings operated by private providers, hospitals, counties, cities and the state. Following are some of the main settings in which Psychiatric Technicians work:

• Residential treatment programs
• Psychiatric treatment facilities
• Acute psychiatric units
• Institutes for mental disease
• Psychiatric emergency teams
• State developmental centers
• Long-term care facilities
• Substance abuse programs
• Home health care
• State hospitals
• State adult and juvenile prisons
• Intermediate care facilities
• Psychiatric crisis units
• County jails
• Social rehabilitation facilities
• Adult residential facilities
• Secured geriatric facilities
• Day treatment programs
• Outpatient mental health clinics
• Psychiatric assessment centers
• Special school programs
• Mobile psychiatric emergency teams
• Partial hospitalization programs
• Residential care homes

Psychiatric Technician students are educated and trained at more than a dozen community colleges and adult schools throughout the state. The curriculum is regularly updated to ensure that they are well prepared to provide the most current care and treatment. This training -- along with post-licensure continuing education, in-service training and other education -- means Psychiatric Technicians are well-positioned to move into new practice settings as they develop in the changing world of health care.