In the late 1960s and early 1970s, the lack of dignity afforded to patients in some of the remaining large and overcrowded mental hospitals was publicised in several scathing public reports. Fashionable anti-psychiatric writing emerging out of the counter-culture added to the sense of unease.
Full Answer
What caused the deinstitutionalization of mentally ill patients in the 1960s?
In the 1960s, a social movement resulted in the widespread deinstitutionalization of mentally ill patients across America. In this lesson, we'll examine the causes and effects of deinstitutionalization, as well as the rights of mentally ill patients.
What is the history of mental health treatment?
Yet, the inhumane history of mental health treatment reminds us how far we have already come. While terrifying mental health remedies can be traced back to prehistoric times, it’s the dawn of the asylum era in the mid-1700s that marks a period of some of the most inhumane mental health treatments.
How were the mentally ill treated in the past?
TREATMENT IN THE PAST For much of history, the mentally ill have been treated very poorly. It was believed that mental illness was caused by demonic possession, witchcraft, or an angry god (Szasz, 1960). For example, in medieval times, abnormal behaviors were viewed as a sign that a person was possessed by demons.
What was the stigma of mental health in the 1950s?
In the 1950s, ignorance about mental health meant that there was extreme stigma and fear surrounding it. People with mental health problems were considered ‘lunatics’ and ‘defective’ and were sent off to asylums. ‘Insanity’ was thought to be incurable and there was no incentive to treat it.
How was mental health treated in the 60s?
In the 1960s, social revolution brought about major changes for mental health care including a reduction in hospital beds, the growth of community services, improved pharmacological and psychological interventions and the rise of patient activism.
What two main factors led to the community mental health movement and deinstitutionalization in the 1960s within the United States?
Two major causes of the deinstitutionalization movement were the introduction of antipsychotic drugs and the implementation of Medicaid and Medicare.
Why was there a movement toward community mental health centers in the early 1960s?
Why was there a movement toward community mental health centers in the early 1960s? Treatment in a community setting was viewed as a form of secondary prevention, in which the development of more serious mental breakdowns would be prevented.
Why were persons with serious mental illness Deinstitutionalized beginning in the 1960s?
Three forces drove the movement of people with severe mental illness from hospitals into the community: the belief that mental hospitals were cruel and inhumane; the hope that new antipsychotic medications offered a cure; and the desire to save money [8].
What situation led to the deinstitutionalization movement?
The most important factors that led to deinstitutionalisation were changing public attitudes to mental health and mental hospitals, the introduction of psychiatric drugs and individual states' desires to reduce costs from mental hospitals.
How did deinstitutionalization begin?
Deinstitutionalization began in 1955 with the widespread introduction of chlorpromazine, commonly known as Thorazine, the first effective antipsychotic medication, and received a major impetus 10 years later with the enactment of federal Medicaid and Medicare.
How was depression treated in the 1960s?
Exorcisms, drowning, and burning were popular treatments of the time. Many people were locked up in so-called "lunatic asylums." While some doctors continued to seek physical causes for depression and other mental illnesses, they were in the minority.
When did the mental health movement start?
19081908. Clifford Beers sparked the mental health reform movement with an insightful autobiography, A Mind That Found Itself, which chronicled his struggle with mental illness and the shameful conditions he and millions of others endured in mental institutions throughout the country.
What was the major impact of the community mental health Centers Act of 1963?
On the one hand, the CMHA completely changed the system and mental health care and counseling in the United States. The act offered support to construct mental health centers that provided community-based care as an alternative to institutionalization.
What was the main problem with deinstitutionalization of the mentally ill?
Deinstitutionalization has progressed since the mid-1950's. Although it has been successful for many individuals, it has been a failure for others. Evidence of system failure is apparent in the increase in homelessness (1), suicide (2), and acts of violence among those with severe mental illness (3).
What was one of the causes of the deinstitutionalization movement in the 1950's?
The deinstitutionalization movement began in the 1950s when antipsychotic medications became available to treat severe mental illnesses. This movement led to the emptying of the asylums that had previously housed individuals with mental illness.
How was mental health treated in the 1970s?
In the treatment of mental disorders, the 1970s was a decade of increasing refinement and specificity of existing treatments. There was increasing focus on the negative effects of various treatments, such as deinstitutionalization, and a stronger scientific basis for some treatments emerged.
When did mental health parity change?
This changed with the Mental Health Parity and Addiction Equity Act of 2008, which requires group health plans and insurers to make sure there is parity of mental health services (U.S. Department of Labor, n.d.).
What did Dix discover about the mental health system?
She investigated how those who are mentally ill and poor were cared for, and she discovered an underfunded and unregulated system that perpetuated abuse of this population (Tiffany, 1891). Horrified by her findings, Dix began lobbying various state legislatures and the U.S. Congress for change (Tiffany, 1891).
What was the purpose of asylums in the 1960s?
It was once believed that people with psychological disorders, or those exhibiting strange behavior, were possessed by demons. These people were forced to take part in exorcisms, were imprisoned, or executed. Later, asylums were built to house the mentally ill, but the patients received little to no treatment, and many of the methods used were cruel. Philippe Pinel and Dorothea Dix argued for more humane treatment of people with psychological disorders. In the mid-1960s, the deinstitutionalization movement gained support and asylums were closed, enabling people with mental illness to return home and receive treatment in their own communities. Some did go to their family homes, but many became homeless due to a lack of resources and support mechanisms.
Why did people become homeless in the 1960s?
Some did go to their family homes, but many became homeless due to a lack of resources and support mechanisms.
What are the funding sources for mental health?
A range of funding sources pay for mental health treatment: health insurance, government, and private pay.
How much did the Department of Agriculture invest in mental health?
At the end of 2013, the U.S. Department of Agriculture announced an investment of $50 million to help improve access and treatment for mental health problems as part of the Obama administration’s effort to strengthen rural communities.
How long does a psychiatric hospital stay?
In all types of hospitals, the emphasis is on short-term stays, with the average length of stay being less than two weeks and often only several days.
When did mental health facilities close?
By 1994, that number decreased to just over 70,000. Starting in the 1960s, institutions were gradually closed and the care of mental illness was transferred largely to independent community centers as treatments became both more sophisticated and humane.
What is the most infamous treatment for mental illness?
One of the most infamous treatments for mental illness includes electroconvulsive shock therapy. Types of non-convulsive electric shock therapy can be traced back as early as the 1st century A.D., when, according to de Young, “the malaise and headaches of the Roman emperor Claudius were treated by the application of a torpedo fish — better known as an electric ray — on his forehead.” But their heydey in treating mental illness began in 1938.
When did metrazol shock therapy stop?
Beyond its terrifying experience, metrazol shock therapy also produced retrograde amnesia. Luckily, the Federal Drug Administration revoked metrazol’s approval in 1982, and this method of treatment for schizophrenia and depression disappeared in the 1950s, thanks to electroconvulsive shock therapy.
What were the mechanical restraints used in asylums?
Asylums also relied heavily on mechanical restraints, using straight jackets, manacles, waistcoats, and leather wristlets, sometimes for hours or days at a time. Doctors claimed restraints kept patients safe, but as asylums filled up, the use of physical restraint was more a means of controlling overcrowded institutions.
When did asylums become notorious warehouses?
While terrifying mental health remedies can be traced back to prehistoric times, it’s the dawn of the asylum era in the mid-1700s that marks a period of some of the most inhumane mental health treatments. This is when asylums themselves became notorious warehouses for the mentally ill.
When was the first antipsychotic drug introduced?
In 1955, the year the first effective antipsychotic drug was introduced, there were more than 500,000 patients in asylums.
Who was the journalist who went undercover at the Blackwell Island Insane Asylum?
Journalist Nellie Bly captured the asylum atmosphere firsthand when she went undercover at the Blackwell Island Insane Asylum in New York in 1887. Not only was Bly committed without much of an examination to determine her sanity, but the conditions were harsh, cruel, and inhumane.
Where did the first mental health reform take place?
But it was in Paris, in 1792, where one of the most important reforms in the treatment of mental health took place. Science Museum calls Pinel “the founder of moral treatment,” which it describes as “the cornerstone of mental health care in the 1800s.” 9,10 Pinel developed a hypothesis that mentally unhealthy patients needed care and kindness in order for their conditions to improve; to that effect, he took ownership of the famous Hospice de Bicêtre, located in the southern suburbs of Paris. He ordered that the facility be cleaned, patients be unchained and put in rooms with sunlight, allowed to exercise freely within hospital grounds, and that their quality of care be improved.
Who had the most progressive ideas in how they treated the people among them who had mental health concerns?
Two papyri, dated as far back as the 6th century BCE, have been called “the oldest medical books in the world.”. It was the ancient Egyptians who had the most progressive ideas (of the time) in how they treated the people among them who had mental health concerns.
What did Freud do to help people with mental health problems?
Mainstream psychology may not have thought much of psychoanalysis, but the attention Freud’s work received opened other doors of mental health treatment, such as psychosurgery, electroconvulsive therapy, and psychopharmacology. These treatments originated from the biological model of mental illness, which put forward that mental health problems were caused by biochemical imbalances in the body (an evolution of the “four humors” theory) and needed to be treated like physical diseases; hence, for example, psychosurgery (surgery on the brain) to treat the symptoms of a mental health imbalance.
Why is having a mentally ill person in the family bad?
Having a mentally ill person in the family suggests an inherited, disqualifying defect in the bloodline and casts doubt on the social standing and viability of the entire family. For that reason, mentally unhealthy family members were (and still are) brutally and mercilessly ostracized.
What is the most common medication for depression?
As lithium became the standard for mental health treatment, other drugs like chlorpromazine (better known as Thorazine), Valium and Prozac became household names during the middle and latter decades of the 20th century, becoming some of the most prescribed drugs for depression across the world.
What is the oldest medical book?
Two papyri, dated as far back as the 6th century BCE, have been called “the oldest medical books in the world,” for being among the first such documents to have identified the brain as the source of mental functioning (as well as covering other topics like how to treat wounds and perform basic surgery). 4.
What were the causes of mental illness in ancient times?
Ancient theories about mental illness were often the result of beliefs that supernatural causes, such as demonic possession, curses, sorcery, or a vengeful god, were behind the strange symptoms. Remedies, therefore, ran the gamut from the mystical to the brutal.
Trephination
Trephination dates back to the earliest days in the history of mental illness treatments. It is the process of removing a small part of the skull using an auger, bore, or saw. This practice began around 7,000 years ago, likely to relieve headaches, mental illness, and even the belief of demonic possession.
Bloodletting and Purging
Though this treatment gained prominence in the Western world beginning in the 1600s, it has roots in ancient Greek medicine. Claudius Galen believed that disease and illness stemmed from imbalanced humors in the body. English physician Thomas Willis used Galen’s writings as a basis for this approach to treating mentally ill patients.
Isolation and Asylums
Isolation was the preferred treatment for mental illness beginning in medieval times, which may explain why mental asylums became widespread by the 17th century.
Insulin Coma Therapy
This treatment was introduced in 1927 and continued until the 1960s. In insulin coma therapy, physicians deliberately put the patient into a low blood sugar coma because they believed large fluctuations in insulin levels could alter how the brain functioned. Insulin comas could last one to four hours.
Metrazol Therapy
In metrazol therapy, physicians introduced seizures using a stimulant medication. Seizures began roughly a minute after the patient received the injection and could result in fractured bones, torn muscles, and other adverse effects. The therapy was usually administered several times a week. Metrazol was withdrawn from use by the FDA in 1982.
Lobotomy
This now-obsolete treatment won the Nobel Prize in Physiology and Medicine in 1949. It was designed to disrupt the circuits of the brain but came with serious risks. Popular during the 1940s and 1950s, lobotomies were always controversial and prescribed in psychiatric cases deemed severe.
What was the mental health crisis of the 1950s?
1950s. In the 1950s, ignorance about mental health meant that there was extreme stigma and fear surrounding it. People with mental health problems were considered ‘lunatics’ and ‘defective’ and were sent off to asylums. ‘Insanity’ was thought to be incurable and there was no incentive to treat it.
When did the Mental Health Research Fund merge with the Mental Health Trust?
1972 saw the merging of the Mental Health Research Fund with the Mental Health Trust and in 1973 a renaming of the newly formed organisation to the Mental Health Foundation.
What was the purpose of the MHRF in the 1960s?
In the 1960s MHRF also began to influence policy to turn research into practice. Henderson described the motive behind their policy involvement as ‘ ‘not only to add to the total sum of research, but also to serve as an advisory body concerned with developing the field on a much wider scale.’’.
What is the inequality between mental health and physical health?
Current NHS waiting times for mental health services in the UK are often too long, compared with waiting times for physical illnesses.
What is the goal of the Mental Health Foundation?
In the coming years, our goal is to drive change towards a mentally healthy society and support communities, families and individuals to live mentally healthier lives, with a focus on inequalities and those at greatest risk. We will keep making the case for prevention and ensure that there is even greater public understanding of mental health and its causes, so that more people practice effective self-management techniques to stop their mental health deteriorating.
What was the most neglected area of public health in the 1980s?
Mental illness remained the most neglected area of public health in the 1980s, despite being the most widely suffered of the disease groups. Incidents of mental ill health were still high. There had been no decline, despite the progress that had been in helping people to better cope with their mental health .
When was the MHRF founded?
MHRF was set up in 1949 to fill a much-needed void in mental health research. Now, in 2019, the Mental Health Foundation is celebrating its 70th anniversary. In 70 years, we have transformed knowledge of mental health, how it’s caused, treated and prevented.
Asylums
Early Psychiatric Treatments
Shock Therapies
- By then, however, the professional community was ready to move on to the next fad — insulin shock therapy. Brought to the United States by Manfred Sakel, a German neurologist, insulin shock therapy injected high levels of insulin into patients to cause convulsions and a coma. After several hours, the living dead would be revived from the coma, and thought cured of their madne…
Electroconvulsive Shock Therapy
- Buzz box, shock factory, power cocktail, stun shop, the penicillin of psychiatry. One of the most infamous treatments for mental illness includes electroconvulsive shock therapy. Types of non-convulsive electric shock therapy can be traced back as early as the 1st century A.D., when, according to de Young, “the malaise and headaches of the Roman emperor Claudius were treate…
Lobotomies
- Around the same time, doctors overseas performed the first lobotomies. The practice was brought to the United States thanks to Walter Freeman, who began experimenting with lobotomies in the mid-1940s, which required damaging neural connections in the prefrontal cortex area of the brain thought to cause mental illness. “The behaviors [doctors] were ...
Psychiatric Medications
- Drugs had been used in treating the mentally ill as far back as the mid-1800s. Their purpose then was to sedate patients to keep overcrowded asylums more manageable, a kind of chemical restraint to replace the physical restraints of earlier years. Doctors administered drugs such as opium and morphine, both of which carried side effects and the risk of addiction. Toxic mercury …
Mental Health Treatment in Ancient Times
The Oldest Medical Books in The World
- When violence wasn’t used, priest-doctors (like those in ancient Mesopotamia) would use rituals based on religion and superstition since they believed that demonic possession was the reason behind mental disturbances. Such rituals would include prayer, atonement, exorcisms, incantations, and other forms of tribalistic expressions of spirituality. However, shamans would …
The Four Humors
- Astandard belief across many of those ancient cultures was that mental illness was seen as a supernatural in origin, usually the result of an angry god (or goddess). In an attempt to attribute this to an understandable cause, people of those civilizations believed that a victim or a group of people had somehow trespassed against their deity and were being punished as a result. It took …
Caring For The Mentally Ill
- Typically, the patient’s family was responsible for custody and care of the patient. Outside interventions and facilities for residential treatment were rare; it wasn’t until 792 CE in Baghdad that the first mental hospital was founded.7 In Europe, however, family having custody of mentally ill patients was for a long time seen as a source of shame and humiliation; many families resort…
from Workhouses to Asylums
- However, there were some options for treatment beyond the limitations of family care (or custody). These including putting up the mentally unhealthy in workhouses, a public institution where the poorest people in a church parish were given basic room and board in return for work. Others were checked into general hospitals, but they were often abandoned and ignored. Clergy i…
The Roots of Reform
- While bloodletting and inducing vomiting were still the preferred form of treatment (when staff actually deigned to help their wards), additional forms of “therapy” included dousing the patients in extremely hot or cold water, the idea being that the shock would force their minds back into a healthy state. The belief that mental disturbance was still a choice prevailed, so staff used physi…
Moral Treatment
- But it was in Paris, in 1792, where one of the most important reforms in the treatment of mental health took place. Science Museum calls Pinel “the founder of moral treatment,” which it describes as “the cornerstone of mental health care in the 1800s.”9,10 Pinel developed a hypothesis that mentally unhealthy patients needed care and kindness in order for their conditio…
Moving Away from Moral Treatment
- The radical nature of moral treatment made waves on the other side of the Atlantic Ocean. When the moral method reached the shores of the United States, doctors understood it to be a comprehensive way of treating mentally ill people by working on their social, individual, and occupational needs. This was the first time that the idea of rehabilitating mentally ill people bac…
Sigmund Freud
- Notwithstanding the end of the moral treatment movement, the conversation about mental health treatment was ready to take a big step forward. A major figure in that progression was Sigmund Freud. The famous Austrian neurologist and psychiatrist developed his theory of psychoanalysis, which gave rise to the practice of “talking cures” and free association, encouraging patients to ta…
The Rise and Fall of Electroconvulsive Therapy
- Mainstream psychology may not have thought much of psychoanalysis, but the attention Freud’s work received opened other doors of mental health treatment, such as psychosurgery, electroconvulsive therapy, and psychopharmacology. These treatments originated from the biological model of mental illness, which put forward that mental health problems were caused …