The History of Mental Illness in America: A Journey From Despair to Hope

1
The History of Mental Illness in America A
Journey From Despair to Hope Recovery
Ms. Manzo
2
Former First Lady Rosalynn Carter

• We have been given many gifts as a nation we
  are rich beyond measure. We Americans think of
  ourselves as decent, generous, and compassionate
  people, for the most part we are yet we treat
  a large proportion of our own population as
  though they are second class citizens undeserving
  of our help, our resources, our understanding.
• 2010

3
Colonial America

• Society believed insanity was caused by a full
  moon at the time of a babys birth
• These lunatics- (lunar) were thought to be
  possessed by the devil
• Treatments ice baths, bloodletting

4
Colonial Treatment

• Barbaric
• Demon-possessed
• Senseless animals
• It was believed that patients chose to behave
  irrationally, and doctors tried to help them
  adopt a more normal manner.

5
Care?????

• Family
• Parish Church
• Those without family-
• placed in prisons- chained to walls, unclothed
• poorhouses

6
1770s

• First hospitals
• 1773- Williamsburg, Virginia
• Designed to keep those with mental illness away
  from society- not treat them.

7
The Public Hospital, Va.
8
17th-18th Centuries
9
Dorothea Dix
10
Dorothea Dix

• Schoolteacher
• Discovered many people with mental illness were
  in jails.
• Crusaded for the establishment or enlargement of
  32 mental hospitals, transfer of those with
  mental illness from almshouses and jails.

11
1840

• US Census
• Includes its 1st
• question on insanity

12
Thomas KirkbrideDesigner of Asylums
13
Athens Asylum for the Insane-1874

• 544 rooms- self-sufficient with dairy barns,
  greenhouses, transportation system,
  recreational activities
• But others soon went there for food shelter
• Populations skyrocketed patient care
  suffered.
• Now old ways returnedice baths- shock
  machines..

14
An Asylum For Every State
15
The Civil War

• Many servicemen- postwar trauma
• State hospitals and asylums overcrowded
• Restraints, shock therapy, opium

16
Soldiers Heart- or PTSD
17
Post Civil War

• Asylums now underfunded overcrowded
• Quality of care deteriorates
• Newspapers expose inhumane conditions

18
1900- Clifford Beers
19
A Mind That Found Itself

• 1908- changed mental health care
• Beers autobiography chronicles his struggle
  with mental illness and healthcare

20
Mental Health Screening Begins

• Ellis Island

Dr. Thomas Salmon in 1905 Justice to the
immigrant requires a carefully considered
diagnosis while on the other hand, the interests
of this country demand an unremitting search for
the insane persons among the hundreds of
thousands of immigrants who present themselves
annually at our ports of entry.
21
The National Committee For Mental Hygiene

• Founded in 1909- in NY by psychiatrists and Beers
• Goals
• To improve attitudes toward mental illness and
  those with mental illness
• To improve services
• To work for the prevention of
• mental illness promote mental
• health

22
1930s- The LobotomyMental Healths Darkest Hour

• Surgically separated the neural passages from the
  back of the brain
• Over 20,000 performed
• Abuse and neglect soared

23
Asylums Renamed Mental Hospitals

• Psychiatric units opened in general hospitals
• Treatments ineffective
• Hospitals provided humane custodial care at best
• At worst- neglect or abuse
• Great Depressionovercrowding.

24
1946- National Mental Health Act

• President Truman - National Mental Health Act
• Creates for the first time in US history a
  significant amount of funding for psychiatric
  education and research
• Led to the creation in 1949 of the National
  Institute of Mental Health (NIMH).

25
1947-1951

• 1st community based health treatment for patients
  in state institutions

26
1949- Lithium

• New hope

27
1954

• Antipsychotic drugs introduced
• Thorazine- improves hallucinations and delusions
• Other medications now become available

28
1956

• Congress allocates- 12 million for
  psychopharmacology
• Number of consumers decline in mental institutions

29
1961- Action for Mental Health

• Report to Congress based on 5 years of research
• Task- arrive at a national program to meet the
  needs of those with mental illness
• Recommends improved research, training and
  treatment in the field of mental health.
• Attempts to answer
• Why has care of the mentally ill lagged?
• How can we catch up?

30
1960s

• Community health movement
• Outpatient services
• More research
• Less state mental hospitals
• More general hospitals with psychiatric wings
• More community health centers

31
1980s

• President Jimmy Carter
• Mental Health Systems Act
• Grant program
• Involves consumer input
• Offers education and support
• Strengthens the links between
• Federal and state services

32
1981-1985

• Carters work halted
• Mental Health Systems Act repealed
• Funding drops

33
Behavioral Health Managed Care

• 1988
• States now carved out mental care from physical
  care
• Purpose increase efficiency
• Results led to erosion of health care

34
1990s- The Decade of the Brain

• President George Bush designates the 1990s as the
  Decade of the Brain "to enhance public awareness
  of the benefits to be derived from brain
  research" through "appropriate programs,
  ceremonies, and activities."

35
1994

• Behavioral Brain Imaging
• Helps scientists learn more about the development
  of major mental illnesses.

36
1996

• HIPPA-regulation of forms, privacy and security
• Significant impact on caregivers of those with
  mental illness

37
1999- The Voice of the Supreme Court

• Olmstead v. LC
• It is a violation to keep a patient in a
  restricted setting when outpatient services are
  available

38
The Clinton Administration

• Bans the use of restraints in
• federally funded hospitals
• Report on co-occurring disorders ordered

39
The Bush Administration

• Increased funding for community health centers
• New Freedom Commission on Mental Health

40
The Obama Administration

• Mental health parity states that psychological
  conditions must be treated equivalently to
  physical illnesses.

41
So why does the suffering continue?
42

• Funding for research services is scarce
• Screening for childhood disorders does not exist
  in most schools
• Veterans are returning with few services
• Few jobs and places to live

43
And..STIGMA
44
But We have come so far

• Mental Health is our last Civil Rights Movement.
• New advances in science are leading to better
  lives
• Recovery is possible.

45
The Value of Hope Hard Work

• Having some hope is crucial to recovery none of
  us would strive if we believed it a futile
  effort. Leete 89

46
And America is changing because we are saying
what we need to say!