Transcript The History of Mental Illness in America

The History of Mental Illness
in America: A Journey From
Despair to Hope & Recovery
Ms. Manzo
Former First Lady Rosalynn
Carter

“We have been given many gifts as a nation; we are
rich beyond measure. We Americans think of
ourselves as decent, generous, and compassionate
people, & for the most part we are; yet we treat a large
proportion of our own population as though they are
second class citizens undeserving of our help, our
resources, & our understanding.”
2010
Colonial America
Society believed insanity was caused by
a full moon at the time of a baby’s birth
 These “lunatics”- (lunar) were thought to
be possessed by the devil
 Treatments: ice baths, bloodletting

Colonial Treatment

Barbaric
 Demon-possessed
 Senseless animals
 “It was believed that patients chose to
behave irrationally, and doctors tried to help
them adopt a more normal manner.”
Care?????
Family
 Parish Church
 Those without family
– placed in prisons- chained to walls,
unclothed
– poorhouses
1770s
First hospitals
 1773- Williamsburg, Virginia
 Designed to keep those with mental
illness away from society- not treat
them.

The Public Hospital, Va.
17th-18th Centuries
Dorothea Dix
Dorothea Dix
Schoolteacher
 Discovered many people with mental
illness were in jails.
 Crusaded for the establishment or
enlargement of 32 mental hospitals, &
transfer of those with mental illness from
almshouses and jails.

1840

US Census
– Includes its 1st
question on “insanity”
Thomas Kirkbride
Designer of Asylums
Athens Asylum for the Insane-1874
• 544 rooms- self-sufficient with dairy barns,
greenhouses, transportation system, recreational
activities
• But others soon went there for food & shelter
• Populations skyrocketed – patient care suffered.
• Now old ways returned…ice baths- shock machines…..
An Asylum For Every State
The Civil War
Many servicemen- postwar trauma
 State hospitals and asylums
overcrowded
 Restraints, shock therapy, opium

Soldier’s Heart- or “PTSD”
Post Civil War
Asylums – now underfunded –
overcrowded
 Quality of care deteriorates
 Newspapers expose inhumane
conditions

1900- Clifford Beers
“A Mind That Found Itself”
1908- changed mental health care
 Beers’ autobiography –chronicles his
struggle with mental illness and
healthcare

Mental Health Screening Begins

Ellis Island
Dr. Thomas Salmon in 1905: “Justice to the immigrant requires a
carefully considered diagnosis; while on the other hand, the
interests of this country demand an unremitting search for the
insane persons among the hundreds of thousands of immigrants
who present themselves annually at our ports of entry.”
The National Committee For
Mental Hygiene

Founded in 1909- in NY by psychiatrists and
Beers
 Goals
– To improve attitudes toward mental illness and
those with mental illness
– To improve services
– To work for the prevention of
mental illness & promote mental
health
1930s- The Lobotomy
Mental Health’s Darkest Hour
Surgically separated the neural
passages from the back of the brain
 Over 20,000 performed
 Abuse and neglect soared

Asylums Renamed Mental
Hospitals
Psychiatric units opened in general hospitals
 Treatments ineffective
 Hospitals provided humane custodial care at
best

– At worst- neglect or abuse

Great Depression=overcrowding…….
1946- National Mental Health Act

President Truman - National Mental Health
Act
 Creates for the first time in US history a
significant amount of funding for
psychiatric education and research
 Led to the creation in 1949 of the National
Institute of Mental Health (NIMH).
1947-1951

1st community based health treatment
for patients in state institutions
1949- Lithium

New hope
1954
Antipsychotic drugs introduced
 Thorazine- improves hallucinations and
delusions
 Other medications now become
available

1956
Congress allocates- $12 million for
psychopharmacology
 Number of consumers decline in mental
institutions

1961- Action for Mental Health

Report to Congress based on 5 years of
research
– Task- arrive at a national program to meet the
needs of those with mental illness
– Recommends improved research, training and
treatment in the field of mental health.
– Attempts to answer:


“Why has care of the mentally ill lagged?”
“How can we catch up?”
1960s

Community health movement
– Outpatient services
– More research
– Less state mental hospitals
– More general hospitals with psychiatric
wings
– More community health centers
1980s
President Jimmy Carter
 Mental Health Systems Act

– Grant program
– Involves consumer input
– Offers education and support
– Strengthens the links between
 Federal and state services
1981-1985
Carter’s work halted
 Mental Health Systems Act repealed
 Funding drops

Behavioral Health Managed
Care
1988
 States now “carved out” mental care
from physical care
 Purpose: increase efficiency
 Results: led to erosion of health care

1990s- The Decade of the Brain

President George Bush designates the
1990s as the Decade of the Brain: "to
enhance public awareness of the benefits
to be derived from brain research" through
"appropriate programs, ceremonies, and
activities."
1994

Behavioral Brain Imaging
– Helps scientists learn more about the
development of major mental illnesses.
1996
HIPPA-regulation of forms, privacy and
security
 Significant impact on caregivers of
those with mental illness

1999- The Voice of the Supreme
Court

Olmstead v. LC
– It is a violation to keep a patient in a
restricted setting when outpatient services
are available
The Clinton
Administration
Bans the use of restraints in
federally funded hospitals
 Report on co-occurring disorders ordered

The Bush Administration
Increased funding for community health
centers
 New Freedom Commission on Mental
Health

The Obama Administration

Mental health parity states that
psychological conditions must be
treated equivalently to physical
illnesses.
So why does the suffering
continue?
Funding for research & services is
scarce
 Screening for childhood disorders
does not exist in most schools
 Veterans are returning with few
services
 Few jobs and places to live

And…..STIGMA
But…… We have come so far…
Mental Health is our last Civil Rights
Movement….
 New advances in science are leading to
better lives
 Recovery is possible.

The Value of Hope & Hard Work
“Having
some hope is
crucial to recovery;
none of us would strive
if we believed it a futile
effort.”
Leete ‘89
And America is changing
because we are “saying what
we need to say”!