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Mental Illness

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Mental Illness A brief history Source: www.pbs.org/wgbh/amex/nash/timeline/index.html Ancient Views of Mental Illness Affected person is possessed by a demon or has ... – PowerPoint PPT presentation

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Title: Mental Illness


1
Mental Illness
  • A brief history
  • Source www.pbs.org/wgbh/amex/nash/timeline/index
    .html

2
Ancient Views of Mental Illness
  • Affected person is possessed by a demon or has
    become subject to displeasure of the gods
  • Shunned by society
  • Greek medical writers began to prescribe
    treatments quiet, use of drugs to purge mental
    illness
  • Family members responsible for care

3
400 B.C. Hippocrates
  • Mental illness is result of disturbed physiology
    and should be treated as a medical illness.

4
Middle Ages
  • In Europe, mentally ill mostly allowed freedom,
    as long as not dangerous
  • In some places, however, treated as witches, as
    inhabited by demons
  • Some religious orders care for mentally ill
  • Muslim Arabs establish asylums in 8th Century,
    attempt scientific study
  • First European facility specifically for people
    with mental illness, established in Valencia,
    Spain, in 1407

5
1600s
  • Europeans begin to isolate mentally ill, putting
    them with vagrants and delinquents
  • Persons seen as insane begin to be treated
    inhumanely, chained to walls or kept in dungeons

6
Late 1700s
  • Concern about treatment of mentally ill grows,
    leads to occasional reforms
  • Phillippe Pinel takes over the Bicêtre insane
    asylum and removes patients from dungeons

7
1840s
  • Dorothea Dix discovers that mentally ill people
    in Massachusetts are jailed with criminals,
    denied clothing, left in unlit, unheated,
    windowless rooms
  • Over a 40-year period, she crusades on behalf of
    the mentally ill and succeeds in establishing 32
    state hospitals as asylums for the mentally ill

8
1883
  • German psychiatrist Emil Kraepelin develops
    distinctions among mental disorders, particularly
    between manic-depressive psychosis and
    schizophrenia

9
Late 1800s
  • State mental hospitals become very popular, then
    very crowded
  • Original conditions of low staff-patient ratio
    and humane treatment are replaced by overwhelmed
    staff and warehouse conditions
  • NYT reporter, Nelly Bly, gets self admitted to
    Blackwells Island and writes exposé on
    conditions there, resulting in more funding

10
Early 1900s
  • Era of psychoanalysisthe talking cure
  • Freud treated wide variety of patients, but most
    people with psychosis still given custodial care
    in institutions

11
1908
  • Clifford Beers publishes his autobiography, A
    Mind that Found Itself, describing his
    dehumanizing experiences in a Connecticut mental
    institution
  • Calls for reform, founds National Committee for
    Mental Hygienean education and advocacy group
  • This group later becomes the National Mental
    Health Association

12
1930s
  • Drugs, electro-convulsive therapy,
    insulin-induced comas, and surgery (lobotomy)
    used to treat people with schizophrenia

13
Scenes from typical state hospitals in the
mid-1940s
Philadelphia State Hospital
14
More scenes from Philadelphia State Hospital
15
Philadelphia State Hospital 1942-1946
16
Philadelphia State Hospital, 1940s
17
Publicity on patient conditions helped bring
about reform
Conscientious objectors during World War II
serving as attendants in state hospitals helped
publicize the plight of the mentally ill and
fought to improve conditions for the patients.
18
1940s
  • In 1946, President Harry Truman signs National
    Mental Health Act, establishing National
    Institute of Mental Health (1949)
  • In 1949, Australian psychiatrist, J. F. J. Cade
    introduces use of lithium to treat psychosis.
    Later this becomes a very useful drug in treating
    bi-polar disorder.

19
1950s
  • Anti-psychotic drugs introduced for treatment of
    psychosis. First anti-psychotic drug,
    chlorpromazine (Thorazine).
  • In 1955, there were 560,000 patients in state
    psychiatric hospitals. The advent of
    anti-psychotic drugs makes it possible for a
    dramatic reduction in state hospital populations.
  • Anti-psychotic drugs introduce new problem
    sometimes serious side effects

20
1961
  • Psychiatrist Thomas Szasz publishes The Myth of
    Mental Illness, which argues that schizophrenia
    is not a disease but a reasonable adaptation to a
    mad world
  • Sociologist Erving Goffmans book, Asylums,
    argues that many, if not most, symptoms in
    patients who have been in psychiatric hospitals
    for long periods are induced by the institution
    itself (institutionalization).

21
1962
  • Ken Keseys novel, One Flew Over the Cuckoos
    Nest, based on his experiences working in a VA
    Hospital psychiatric ward, is made into an
    influential movie starring Jack Nicholson as a
    rebellious patient who appears to be saner than
    the staff.

22
Mid-1960s
  • Deinstitutionalization number of
    institutionalized mentally ill people in the US
    drops from 560,000 to 130,000 by 1980.
  • Deinstitutionalization possible because
    anti-psychotic drugs control symptoms, but
    long-term institutionalized people need ongoing
    mental health treatment and an array of social
    services that are not uniformly available.
  • Results homelessness, revolving door
    syndrome, concern in the community about
    discharged patients

23
1963
  • Community Mental Health Centers Construction Act
    passes, providing federal money to develop a
    network of community mental health centers.
  • Note that this occurs after deinstitutionalization
    was well underway.

24
1979
  • National Alliance for the Mentally Ill
    foundedprovides support, advocacy, research for
    people with serious psychiatric illness.

25
1990
  • New generation of anti-psychotic drugs
    introducedclozapine, etc.
  • Drugs appear to be more effective and have fewer
    side effects

26
1992
  • Survey of American jails finds that 7 of inmates
    (100,000) are seriously mentally ill
  • Most of these individuals receive little, if any,
    treatment
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