The treatment of mental illness has gone through many reforms over the years. Stemming from some of the earliest documented cases of treatment such as trephination in 5000 B.C. to the opening of “mental” asylums starting in the late 1300s to the development of the modern healthcare system. Through the 1800s until now, major developments in mental health treatment include the evolution of the “mental” asylum, widespread psychopharmacology, and psychotherapy treatments. Primarily focusing on the treatment methods of the past two hundred or so years, the United States of America has made leaps and bounds to provide humane treatment to aid those in need. The most famous “mental” asylum, which is now known as a psychiatric or mental hospital, would most likely be the Bethlem Royal Hospital in England. Opening its doors to mentally ill patients back in the late 1300s, it’s famous for its …show more content…
The conditions of psychiatric hospitals were poorly maintained yet again. From the late 1800s until the mid-1900s, the conditions of these institutions were hit or miss. Despite the rising population of those in need of mental health treatment, conditions were deteriorating across the board. This pushed in the deinstitutionalization movement (Nevid, Rathus, & Green, 2014). This was a push to remove patients from state-run hospitals into a more community-based treatment center. In most cases today, there are treatment plans in place depending upon the severity of the disorder an individual may be suffering from. It’s more about treating an individual with any variety of modern techniques or therapies and trying to reintegrate them into society rather than a lifelong stay in an institution. Deinstitutionalization didn’t work the way it was intended. After it was put into place there was a rise in the homeless population and different programs that were supposed to be put into place didn’t live up to
Institutional care was condemned, as in many cases patients’ mental conditions deteriorated, and institutions were not able to treat the individual in a holistic manner. In many state institutions, patients numerously outnumbered the poorly trained staff. Many patients were boarded in these facilities for extensive periods of time without receiving any services. By 1963, the average stay for an individual with a diagnosis of schizophrenia was eleven years. As the media and newspapers publicized the inhumane conditions that existed in many psychiatric hospitals, awareness grew and there was much public pressure to create improved treatment options (Young Minds Advocacy, 2016). .
The evolution of mental health treatment in America has been a long and arduous road with many ups and downs. In many ways, attitudes towards the disease towards mental illness help shape the evolution of treatment. In addition, trends in treatment and cultural understanding of mental illness influence national policy. In Mad in American author Robert Whitaker discusses the mental health care system its history, evolution, and the current state of mental health care in America. Whitaker explores the ethnicity of practices and questions the safety and efficacy of psychiatric
In the video, “The New Asylums”, it demonstrated how deinstitutionalization has left thousands of mentally ill patients in the hands of the prison system. As the mental health hospitals closed down, the police department and prison system has become responsible for the mentally ill people that are on the streets. There was a firm point made about the release of mentally ill patients- “When hundreds of thousands of mentally ill are released, they do not magically become healthy. They went to the streets, became homeless, and turned to a system that cannot say no.” The video also stated that today, there are nearly 500,000 mentally ill people being held in jails and prisons throughout the country. Furthermore, there was no safety net for those
With states closing many of its mental facilities in the communities, there were a lot of people in need of outpatient care who fell through the cracks of the system and ended up in prison. Prison is where many of them died from inadequate treatment. Prisons were suddenly receiving inmates with the following types of mental illnesses: Schizophrenia, bipolar, and deep depressions. These prisons just did not provide these inmates with any medication during their incarceration. Because the community based health services is lacking, and patients aren’t receiving sufficient outpatient care, it makes the effectiveness of deinstitutionalization a serious problem. Without the availability of 24/7 psychiatric services that are well structured, I believe that deinstitutionalization is what is accounting for the increase of the mentally ill inmates in the correctional facility.
Many years ago, mental illness was viewed as a demonic possession or a religious punishment. In the 18th century, the attitudes towards mental illness were negative and persistent. This negativity leads to the stigmatization and confinement of those who were mentally ill. The mentally ill were sent to mental hospitals that were unhealthy and dangerous. A push in the mid 1950s for deinstitutionalization began because of activists lobbying for change. Dorothea Dix was one of these activists that helped push for change. The change called for more community oriented care rather than asylum based care. The Community Mental Health Centers Act of 1963 closed state psychiatric hospitals throughout the United States. "Only individuals who posed an imminent danger to themselves or someone else could be committed to state psychiatric hospitals" (A Brief History of Mental Illness and the U.S. Mental Health Care System). Deinstitutionalization meant to improve quality of life and treatment for those who are mentally ill. This would hopefully result in the mentally ill receiving treatment so they could live more independently. The hope was that community mental health programs would provide this treatment but sadly there was not sufficient or ongoing funding to meet the growing demand for these programs. Budgets for mental hospitals were reduced but there was no increase for the community based programs. Many mentally ill individuals have been moved to nursing homes or other residential
The introduction of new psychotic drugs can provide better or more thorough care for the mentally ill. Creating options rather than one solution may have been believed to do greater good for the mentally ill community. Furthermore, the economic incentives involved as long term care was and continues to be at such a high cost. Community resources cost little to nothing for the federal Government to support. As well as releasing the mentally ill to their families, in any case those with minor illnesses. Additionally, a shift from treating chronic patients to treating acute ones would generate basic sense into the minds of many. This modification states through actions that
During the 1800s, treating individuals with psychological issues was a problematic and disturbing issue. Society didn’t understand mental illness very well, so the mentally ill individuals were sent to asylums primarily to get them off the streets. Patients in asylums were usually subjected to conditions that today we would consider horrific and inhumane due to the lack of knowledge on mental illnesses.
In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the
The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus
The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.
The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and
In 1965, there was a histrionic change in the method that mental health care was delivered in the United States. The focus went from State Mental Hospitals to outpatient settings for the treatment of mental health issues. With the passing of Medicaid, States were encouraged to move patients out of the hospital setting (Pan, 2013). This process failed miserably due to under funding and understaffing for the amout of patients that were released from the State Mental Hospitals. This resulted in patients, as well as their families, who were in dire need of mental health services. This population turned to either incarceration (jails and/or prisons) or emergency departments as a primary source of care for their loved ones.
What comes to mind when you hear the words “insane asylum”? Do such terms as lunatic, crazy, scary, or even haunted come to mind? More than likely these are the terminology that most of us would use to describe our perception of insane asylums. However, those in history that had a heart’s desire to treat the mentally ill compassionately and humanely had a different viewpoint. Insane asylums were known for their horrendous treatment of the mentally ill, but the ultimate purpose in the reformation of insane asylums in the nineteenth century was to improve the treatment for the mentally ill by providing a humane and caring environment for them to reside.
The first of the largest asylums was built in Mulgrave Street Limerick, The Limerick District Lunatic Asylum, better known today as St. Joseph's Hospital opened its doors in 1827. This asylum served Limerick City, County as well as Clare and Kerry under the legislative Lunacy Act of 1821. Originally it was to house one hundred and fifty 'lunatics', however within twenty years it was overcrowded, housing close to five hundred patients within its walls. According to Dr. Brendan Kelly in an article in the Irish Examiner, overcrowding was due to change in legislation in the nineteenth century where 'it became a lot easier to commit somebody to an asylum as a criminal lunatic, even if they hadn't committed a crime'. He goes onto say the laws of
During the mid-1800’s the mentally ill were either homeless or locked in a cell under deplorable conditions. Introduction of asylums was a way to get the mentally ill better care and better- living conditions. Over a period of years, the admissions grew, but staff to take care of their needs did not. Asylums became overcrowded and treatments that were thought to cure, were basically medieval and unethical