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MENTAL HEALTH

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Title: MENTAL HEALTH


1
MENTAL ILLNESS
2
MENTAL ILLNESS
  • Brief History and Statistics
  • Labeling of people
  • Key People
  • Legal Actions and Movements
  • Treatments

3
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4
A BRIEF HISTORY OF MENTAL ILLNESS
  • During the 1700s people were locked away by
    their families
  • The first mental asylum was built in 1769 and was
    headed by Benjamin Rush
  • In the 18th and 19th century asylums and
    hospitals were built
  • After World War II, people began to realize that
    soldiers were having abnormal behavior

5
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6
More History
  • In 1940s and 1950s medication was actually
    prescribed to some patients
  • Many laws were passed to help with regulations of
    institutions
  • In the 1960s around 500,000 people were
    institutionalized and by 1986 the number had
    reduced to 100,000

7
STATISTICS
  • From 1880 to 1920 the number of insane patients
    had increased from 40,942 to 232,680!! And as
    mentioned before 500,000 by 1960
  • Some statistics from 1923

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9
Mental Illness Statistics Today
  • Panic Disorders 6 million Americans
  • Obsessive-Compulsive Disorder (OCD) 2.2 million
    Americans
  • Schizophrenia 2.4 million Americans
  • Bipolar Disorder 5.7 million Americans
  • Mood Disorders 20.9 million Americans
  • Post-Traumatic Stress Disorder 7.7 million
    Americans

10
MENTAL ILLNESS
  • Labels
  • Mythical causes
  • Types of people who were in mental hospitals
  • Places

11
LABELS GIVEN TO MENTALLY ILL
  • Lunatics
  • Crazy
  • Insane
  • Idiots
  • Feeble-minded
  • Brain-sickness
  • Beast
  • Animals
  • Witches
  • Sorcerers
  • Werewolves
  • Madness
  • Possessed
  • Disturbed
  • Maniac
  • Unbalanced

12
Mythical causes of Mental Illness
  • Post-partum depression
  • Old-age
  • Evil spirits
  • blessed by God
  • Masturbation

13
Who were in Mental Hospitals?
  • Wives daughters who disobeyed their husbands
    fathers
  • Depressed
  • Menopausal women
  • Those caught masturbating
  • Those who didnt fit the status quo
  • Alcoholics

14
Places
  • All people with brain sickness were placed here
    for peoples amusement.
  • Cages
  • Cellars
  • Closets
  • Stalls
  • Pens

15
Important People In Mental Health
  • Benjamin Rush
  • Dorthea Dix

16
Benjamin Rush (1745-1826)
  • He was one of the
  • founding fathers of
  • the United States
  • He was a staff member
  • at the Pennsylvania
  • hospital
  • He was also a professor of
  • medical theory and clinical
  • practice at the university of
  • Pennsylvania
  • After he began to practice
  • medicine he realized that his
  • primary interest was the
  • treatment of mentally ill

17
Father of American Psychiatry
  • He advocated bleeding for almost any illness long
    after its practice had declined
  • His favorite method was to tie patients to a
    board and spin them until all the blood went to
    their head
  • Rush was far ahead of his time in the treatment
    of mental illness
  • He invented the tranquilizing chair and the
    gyrator

18
Father of American Psychiatry
  • Rush was an advocate for the insane asylums,
    believing that with proper treatment mental
    disease can be cured
  • He worked toward a more human housing for
    psychiatric patients. He encouraged hygiene for
    patients and forms of occupational therapy
  • Rush disapproved completely of restraints of any
    kind, for long periods of time
  • He outlawed the use of whips, chains, and
    straitjackets and developed his own method for
    keeping control
  • Some of his methods we feel he was quite harsh,
    but in his day his methods were considered
    exceedingly humane

19
Dorthea Dix (1802-1887)
  • In 1841, began her moral
  • treatment crusade
  • She was a teacher and ended
  • up working herself to exhaustion
  • Took a break and traveled
  • to Europe. While there she met
  • Dr. Samuel Tuke, he was
  • concerned about problems of all
  • people, the sick, poor, and insane
  • She learned from him that
  • in an environment of compassion
  • and genuine care, mental
  • disease could be more effectively
  • treated

20
Dorothea Dix
  • Her second job started when she was 39. In 1842
    she entered the East Cambridge Jail. She
    volunteered to teach the inmates Sunday school.
    When she got there she witnessed horrible images
    of prostitution, drunks, criminals, mentally ill.
    The people were chained to the wall in the
    basement they were under fed and filthy. They
    were all housed together in a unheated,
    unfurnished, and foul smelling quarters
  • When she asked the jailer why they lived in such
    conditions they said the insane cant feel heat
    or cold.
  • After seeing these conditions she took matters to
    the court

21
Dorothea Dix
  • Dorthea was devoted to the right of the sick and
    insane. She traveled all over the U.S to visit
    hospitals
  • She would visit these hospitals repeatedly over
    time to document the current conditions and the
    treatment of the patients

22
Dorothea Dix
  • Because of her status as a female, she was not
    powerful enough to promote action to help the
    people in these institutions
  • In 1848, she attacked the federal government. She
    made an appeal for 5 million acres to be used for
    and by the insane, deaf, and the dumb
  • In 1854, the bill was sent to the senate and
    house and was passed by a large majority, but was
    vetoed by president Franklin Pierce

23
Dorothea Dix
  • As an educator, Dorthea educated the nurses
    because most of them were often uneducated,
    crude, and cruel. She taught them ethics and
    every aspect of hospital care, including
    exercises
  • Dorthea believed that the mentally ill would
    never be cured living in those dreadful
    conditions by betting the conditions of the
    inmates, sowed people that mental illness wasnt
    all incurable
  • She played a major role in founding 32 mental
    hospitals, 15 schools for the feeble minded, a
    school for the blind, and numerous training
    facilities for nurses
  • She also established libraries in prisons, mental
    hospitals and other institutions

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25
Dorothea Dix
  • Many believed that she was the most useful and
    distinguished women American has yet produced
  • She was also known as the most effective
    advocate of humanitarian reform in American
    Mental Institutions during the 19th century

26
Mental Illness
  • Asylum Movement
  • Eugenics
  • Mental Hygiene Movement
  • Deinstitutionalization
  • Psychiatric Survivor Movement
  • Today

27
Asylum Movement
  • 1843 Memorial to Massachusetts legislature asking
    for better conditions and treatment for the
    mentally ill
  • 1894 State Care Act
  • Placed financial responsibility on state
    government instead of local government
  • By mid 19th century the asylums had deteriorated
    to horrible conditions like that originally found
    in the jails

28
Eugenics
  • The study of improving human genetic qualities
  • 1865 Sir Francis Galton developed the idea of
    eugenics for social control of the weak. It would
    help control the natural selection process
  • 20th centurylaws written to prohibit marriage
    and force sterilization of the mentally ill

29
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30
Eugenics
  • Laws were abolished in 1967
  • By 194545,000 mentally ill patients had been
    forcibly sterilized
  • Many people were told they were having other
    surgical procedures and then were sterilied
  • Nazis were most famous for the use of eugenics
    for racial cleansing

31
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32
Mental Hygiene Movement
  • Clifford Beers
  • Yale educated
  • Went mad
  • Wrote A Mind that Found Itself 1908
  • His journey through many asylums
  • Created the National Committee for Mental Hygiene
  • Today it is called the National Mental Health
    Association, NMHA

33
Mental Health Movement
  • Goals
  • To improve attitudes toward mental illness and
    the mentally ill
  • Improve treatment, services and care
  • Prevention of mental illness and promote mental
    health
  • 1920 created model laws for states
  • Conducted many studies and research

34
Mental Hygiene Movement
  • Didnt like asylums, renamed them mental
    hospitals
  • Began psychiatric care of patients with drugs and
    patient centered care
  • Wanted early treatment and preventative measures
  • Believed in outpatient care for discharged
    patients

35
Deinstitutionalization Movement
  • Called a social experiment
  • Removing patients from hospitals and placing them
    within the community
  • Problems
  • Forgotten relatives returned to family members
    homes
  • Community not receptive
  • Psychotropic drugs failed

36
Deinstitutionalization Movement
  • Pressure to make changes from
  • Civil Rights Movement
  • Professionals in the asylums
  • Discovery of psychotropic drugs
  • Cheaper care alternatives were available
  • The number of psychiatric hospitals decreased
  • 277 hospitals in 1977
  • 231 hospitals in 1996

37
Deinstitutionalization Movement
  • The shift in care was placed on community
    organizations
  • 92 of people living in psychiatric hospitals in
    1955 were not there in 1994

38
Who was deinstitutionalized?
  • 50-60 schizophrenic
  • 10-15 manic depressive or severe depressive
  • 10-15 brain disease
  • Alzheimers, TBI
  • The restpsychosis, mental retardation and brain
    damage from alcohol and/or drug use

39
Where did they go?
  • Jailapproximately 10 are mentally ill
  • Streets
  • Family
  • Community based programs
  • Many were untreated in any capacity

40
"Cast from shackles which bound them, this bell
shall ring out hope for the mentally ill and
victory over mental illness."
41
Psychiatric Survivor Movement
  • Initiated by patients
  • Two types of involvement
  • Consumersindividuals working to change mental
    health system from withinreform
  • Survivorsindividuals have fought and survived
    and overcame oppressive situations with mental
    health care and fight to be completely free of
    mental health services

42
Psychiatric Survivor Movement
  • Goals
  • They want real change in the mental health system
  • Partnership with professionals
  • Employ ex-patients
  • Expose imbalance of power within the mental
    health system
  • Individual change
  • October 1974 People First Convention
  • We are tired of being seen first as handicapped
    or retarded or disabled. We want to be seen as
    people first

43
Today
  • President Bush created the commission on Mental
    Health in 2002
  • Purpose
  • To project mental health services for the next 25
    years
  • Criticism
  • The past commissions, 1960 and 1977, failed to
    reach their goals
  • Project for the future
  • Only provided simple solutions
  • Lack of implementation system has changed but not
    the care

44
What does the commission need to do different?
  • Serve various populations
  • Focus on people and not on the system
  • 1993 approximately 15 of the adult population
    use mental health services

45
Treatments Techniques
  • Cleansing the body
  • Hydrotherapy
  • Motion and Spinning
  • Terrorizing and Scaring
  • Restraints
  • Institutions in North Dakota

46
Cleansing The Body
  • Bloodletting
  • Usually by applying leaches to the skin or by
    incision.
  • So much blood was taken from the patient that
    they would become anemic, depleted, exhausted and
    their blood pressure would drop significantly
  • Purging
  • Induced vomiting
  • Expelled toxic elements
  • Rational Calm mentally ill and rid the toxins
    from the body

Leeches? Dont Worry Mate. The little bit of
Blood they do take wont hurt you.
47
Hydrotherapy
  • Needle Cabinets
  • Steele boxes, designed for patients to stand
    upright high pressure water was then sprayed
    directing onto the skin
  • Hermann Boerhaave (1668-1738)
  • Renowned medical teacher
  • The greatest Remedy for it mental illness is
    to throw the Patient unwarily into the Sea, and
    to keep him under Water as long as he can
    possibly bear without being quite stifled.
  • Running cool water over patients wrists and
    ankles to reduce metabolic rate
  • Restraining them in cold baths

48
Motion and Spinning
  • Hollow Wheel
  • Would create goal-directed behavior
  • Hoped that would bring patient out of
    hallucination and back to relaity
  • Generally patients spent 36-48 hrs in the wheel
  • Came out obedient or so fatigued by the constant
    pace that there was no problems with managing
    patient
  • Gyrator (Rush)
  • OHallorans Swing
  • Immobile Patients were strapped down and rotated
    about 100XMinThought to
  • Stimulate blood circulation of the nervous system
  • Separate the humors of the brain

49

Terrorizing or Scaring
  • One of the earliest psychiatric treatment
    approaches was terrorizing patients back to
    sanity
  • Reils Immersion Method
  • Dunking patients underwater while firing cannons

50
Restraints
  • Chains
  • Straight Jackets
  • Waist Restraints
  • Utica crib
  • Tranquilizer Chair
  • Calm Patient by restricting High sensory input

51
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52
Institution Of North Dakota
  • Authorized by legislation in 1883
  • Opened its doors May 1, 1885
  • North Dakota 163/100,000 of the population was
    institutionalized National average 58/100,000
  • National Average spent per person was 68 per day
    North Dakota was only 24.42 dollars a day

53
Grafton Developmental Center
  • Originally known as the Institution for the
    Feeble-Minded, then name change in the 1930s to
    Grafton State School
  • In 1904, 12 people from the North Dakota State
    Hospital were transferred to the new facility in
    Grafton, N.D.
  • In recent years, the Developmental Center's
    population has ranged from 140 to 160 people with
    developmental disabilities
  • Lawsuit in 1982
  • ARC vs. State of ND

54
Social Welfare and Mental Illness
  • In the late 1950s social workers helped clients
    get and maintain food, clothing and housing
  • Continuing Day Treatment Programs were created,
    led and staffed with social workers
  • Create quality of life for mentally ill
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