history of mental illness

Mystical views dominate this period
No division between health care, magic,
and religion - no understanding of why
diseases occur
- Abnormal behavior attributed to the
supernatural
- Treatment included spells cast by
Shamans, exorcisms

Between 500 BCE – 500 CE numerous
mental disorders were identified
- Melancholia-
Mania
-Dementia
=Hysteria
--Delusions
- Hallucinations

thoughts on the mentally ill
- Arguments for the existence of witches
- ‘Proof’ that witches are mostly women
- How to identify a witch (deviant
behavior, i.e. sexual)
- Insanity was caused by possession by
the devil
how they treated they witches
- ƒ Salvation of the immortal soul was more
important than the comforts of the
possessed body
- ƒ Physical punishments were used to make
the body an intolerable refuge for the devil

• People with psychological disorders were seen as dangerous so they were locked up to protect society and there was an increase in mortality rate.
• In the 16th and 17th centuries, people were obsessed with the concept of mental illness. This is evident throughout Shakespeare's plays, but is especially evident throughout his play "Hamlet.

General belief: If mad people behaved like
animals, they should be treated like animals
- Thomas Willis (neuroanatomist and doctor)
advocated the following treatments:
- Curative discipline
- Fetters
- Blows
- Medical treatments
- In the eyes of the law, mentally ill people lacked the capacity to reason, so a Court of Wards would hand the responsibility for their affairs to someone else. King James I (1603-1625) instructed the court that 'lunatics be freely committed to their best and nearest friends that can receive no benefit by their death.' The care of the mentally ill was essentially a domestic matter and on the whole, it seems that people were not exploited by the system.
In the 17th century people with mental
health problems were often cared for
privately
- This evolved into a business where people
housed numerous patients – “private
madhouse”
- Treatment varied according to ability to pay

Development of new asylums
- Built to house people with mental health
problems separately from houses of
correction and poor houses
- Prisons with neglectful conditions?
at this time mental illness was considered or moral of weakness.
Hospitalization
Mentally ill referred to as “Lunatics”

Colonists declared these lunatics
possessed by the devil, and usually
they were removed from society and
locked away

Moral Management
- The environment plays a vital role in the
treatment of the mentally ill
- Recovery would more likely occur if
conditions and surroundings resembled the
comfort of home
- Beds, pictures and decorations replaced
shackles, chains and cement cells
Moral management included:
- Mentally ill to be to be treated in special
facilities
- Structured daily schedule (work therapy)
z Inappropriate behaviors were to be confronted
with the goal of eliminating the behavior
- Ultimate goal - restore sanity and to return the
patient to society as a fully functioning,
productive member of society
- Punitive treatments were abolished
-Due to public demand, asylums began
to appear all over the country

medical treatment of the 1930's
Few mental health specialists
- Numerous theories were proposed about the
cause of mental illness and its treatment
-Treatments included:Removal of a person’s teeth and large intestines
- Induction of fevers
- Sleep therapy
- Hypothermia
- Bath treatmen
De-institutionalization
- Changes in mental health institutions
- Emphasis on protecting the human
rights of the mental patients
- Individualized treatments instead of
group cure-alls
-Movement toward de-institutionalization
- 500,000 patients in 1960
- Development of outpatient services
-Deinstitutionalization was really transinstitutionalization. Changes in regulations in Medicaid allowed the shifting of mentally ill people who were older than age 65 to nursing homes
- Community mental health centers never developed programs to serve people who were seriously mentally ill. Rather than serving clients who were psychotic, the community mental health centers marketed their treatment programs to people with anxieties, who were undergoing divorce, or who had mildly troubled children.