Mental health care and the politics of inclusion: a social systems account of psychiatric deinstitutionalization. Theor Med Bioeth , The impact of living arrangements and deinstitutionalisation in the health status of persons with intellectual disability in Europe.
J Intellect Disabil Res , 55 9 : The New York Times. The shift of psychiatric inpatient care from hospitals to jails and prisons. J Am Acad Psychiatry Law , Community Ment Health J, All Rights Reserved Worldwide. Privacy Policy Information Disclaimer.
Unite For Sight. Mental Health Care System The history of mental illness in the United States is a good representation of the ways in which trends in psychiatry and cultural understanding of mental illness influence national policy and attitudes towards mental health. Early History of Mental Illness 1 Many cultures have viewed mental illness as a form of religious punishment or demonic possession.
Mental Health Hospitals and Deinstitutionalization In the s, activist Dorothea Dix lobbied for better living conditions for the mentally ill after witnessing the dangerous and unhealthy conditions in which many patients lived.
Instead, doctors force diagnoses upon Black children that are some of the most stigmatized in the United States, often conflated with violent criminality. In this way, Black children are routinely viewed as being defiant and out of control; rather than receiving adequate disability care and services in schools, school resource officers arrest and the courts incarcerate Black children in juvenile detention facilities. We still live in a world that institutionalizes mentally ill people - but instead of in asylums, they are behind bars in prisons and jails and psychiatric hospitals.
Therefore, our fight against modern institutionalization is a protest movement that fights against all carceral responses to mental health crises and builds alternatives to incarceration. July 29, Image description: grey and black stock photo of bars on a window. BIPOC mental health.
Figure 1. This painting by Francisco Goya, called The Madhouse, depicts a mental asylum and its inhabitants in the early s.
It portrays those with psychological disorders as victims. 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, For example, in medieval times, abnormal behaviors were viewed as a sign that a person was possessed by demons.
If someone was considered to be possessed, there were several forms of treatment to release spirits from the individual. Most people treated in this manner died. In addition to exorcism and trephining, other practices involved execution or imprisonment of people with psychological disorders. Still others were left to be homeless beggars. Generally speaking, most people who exhibited strange behaviors were greatly misunderstood and treated cruelly. The prevailing theory of psychopathology in earlier history was the idea that mental illness was the result of demonic possession by either an evil spirit or an evil god because early beliefs incorrectly attributed all unexplainable phenomena to deities deemed either good or evil.
From the late s to the late s, a common belief perpetuated by some religious organizations was that some people made pacts with the devil and committed horrible acts, such as eating babies Blumberg, These people were considered to be witches and were tried and condemned by courts—they were often burned at the stake.
Worldwide, it is estimated that tens of thousands of mentally ill people were killed after being accused of being witches or under the influence of witchcraft Hemphill, By the 18th century, people who were considered odd and unusual were placed in asylums.
Asylums were the first institutions created for the specific purpose of housing people with psychological disorders, but the focus was ostracizing them from society rather than treating their disorders. Often these people were kept in windowless dungeons, beaten, chained to their beds, and had little to no contact with caregivers.
In the late s, a French physician, Philippe Pinel, argued for more humane treatment of the mentally ill. Patients benefited from this more humane treatment, and many were able to leave the hospital.
Figure 2. This painting by Tony Robert-Fleury depicts Dr. In the 19th century, Dorothea Dix led reform efforts for mental health care in the United States. 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, Horrified by her findings, Dix began lobbying various state legislatures and the U.
Congress for change Tiffany, Her efforts led to the creation of the first mental asylums in the United States. Figure 3. Dorothea Dix was a social reformer who became an advocate for the indigent insane and was instrumental in creating the first American mental asylum. She did this by relentlessly lobbying state legislatures and Congress to set up and fund such institutions.
At Willard Psychiatric Center in upstate New York, for example, one treatment was to submerge patients in cold baths for long periods of time. Electroshock is now called electroconvulsive treatment, and the therapy is still used, but with safeguards and under anesthesia.
A brief application of electric stimulus is used to produce a generalized seizure. Controversy continues over its effectiveness versus the side effects. Many of the wards and rooms were so cold that a glass of water would be frozen by morning Willard Psychiatric Center, Conditions like these remained commonplace until well into the 20th century.
Starting in and gaining popularity in the s, antipsychotic medications were introduced. These proved a tremendous help in controlling the symptoms of certain psychological disorders, such as psychosis. Psychosis was a common diagnosis of individuals in mental hospitals, and it was often evidenced by symptoms like hallucinations and delusions, indicating a loss of contact with reality. Then in , Congress passed and John F. Kennedy signed the Mental Retardation Facilities and Community Mental Health Centers Construction Act, which provided federal support and funding for community mental health centers National Institutes of Health, This legislation changed how mental health services were delivered in the United States.
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