Grob provides a historical account of a major social problem and society’s evolving responses to the mentally ill and how the "mad among us" be treated and managed. The book details the history of the treatment of the mentally ill starting in colonial America, when local families and communities were held responsible for mentally ill family and community members. The first mental hospitals were created when America grew in size, population and complexity. They were successful at treating the severely and persistently mentally ill compared to past solutions. In the past treatment varied from confinement, to a considerably wide measure of freedom. Hospitals deteriorated from providing humane treatment into custodial institutions because of a …show more content…
And while this new method has succeeded in recent decades, there is now a new group of homeless, mentally ill substance abusers who refuse treatment around the country. The author is a very qualified historian of the care of the mentally ill. Grob was a professor of the History of Medicine at Rutgers University and its Institute for Health, Health Care Policy and Aging Research. He received his B.S. from City College of New York, received a master’s degree from Columbia University and, his Ph.D. in history from Northwestern University. He was elected to what is now known as the National Academy of Medicine in 1991. In 1986, he received the William H. Welch Medal and the Fielding H. Garrison Lecturer from the American Association of the History of Medicine before receiving the Lifetime Achievement Award in 2006. He writes as an authority on one of the biggest social problems in American history. There are many historians who will apply today’s standards to the past but he does a great job of analyzing the past in the proper context. For example, in the book he does not condemn early Americans for confining the mentally ill under lock and key. While in modern times that would be considered cruel, he understands that they were not properly equipped to handle those …show more content…
Because there are so few general histories on this subject, larger libraries should invest and purchase this work. Grob has published scholarly works on the treatment of mentally ill in the past but this account is highly readable and meant to target everyday readers. The book tracks the changing approaches in the treatment of the mentally ill in the U.S. psychiatry has basically transformed from dealing with asylums to now being a private-office practice. In the early history of this field, ``lunatics'' were primarily seen as a family or community responsibility, and those who had no one to take care of them were seen not as a medical issue but an economic or social one. Widows, orphans, and people who generally needed public assistance were housed in public almshouses. The Enlightenment period is characterized by an increased focus on reason and science which gave rise to the idea of trying to treat and possibly cure the mentally ill. Starting in the 18th century, local insane asylums began to appear around the country. Dorothea Dix is one of those responsible for persuading state legislatures to set up mental hospitals, and almost all states had at
During the 1700’s the jails were not only used to confine criminals, but they confined people with mental illness as well. People with mental illness were subjected to inhumane treatment, even when the individual was admitted
Institutional care was condemned, as in many cases patients’ mental conditions deteriorated, and institutions were not able to treat the individual in a holistic manner. In many state institutions, patients numerously outnumbered the poorly trained staff. Many patients were boarded in these facilities for extensive periods of time without receiving any services. By 1963, the average stay for an individual with a diagnosis of schizophrenia was eleven years. As the media and newspapers publicized the inhumane conditions that existed in many psychiatric hospitals, awareness grew and there was much public pressure to create improved treatment options (Young Minds Advocacy, 2016). .
The shutdown of state mental hospitals and lack of available financial and institutional resources force mentally ill people to the United States Judicial System for mental health. Every year thousands of people are arrested for various crimes and they are sent to jail. Sixteen percent of these people have some type of mental health problem (Public Broadcasting System , 2001). When we consider that the United States has the largest incarcerated population in the world at 2.2 million, this number is staggering (Anasseril E. Daniel, 2007). This is about 1% of the entire population of the United States. There are many reasons as to why the situation has taken such a bad turn and when the history of the treatment of mental illness is examined one can see how the situation developed into the inhumane disaster it is today.
The introduction of new psychotic drugs can provide better or more thorough care for the mentally ill. Creating options rather than one solution may have been believed to do greater good for the mentally ill community. Furthermore, the economic incentives involved as long term care was and continues to be at such a high cost. Community resources cost little to nothing for the federal Government to support. As well as releasing the mentally ill to their families, in any case those with minor illnesses. Additionally, a shift from treating chronic patients to treating acute ones would generate basic sense into the minds of many. This modification states through actions that
Today, it seems almost incomprehensible that so many people with serious mental illnesses reside in prisons instead of receiving treatment. Over a century and a half ago, reform advocates like Dorothea Dix campaigned for prison reform, urging lawmakers to house the mentally ill in hospitals rather than in prisons. The efforts undertaken by Dix and other like-minded reformers were successful: from around 1870 to 1970, most of the United States’ mentally ill population was housed in hospitals rather than in prisons. Considering reformers made great strides in improving this situation over a century and a half ago. Granted, mental hospitals in the late 19th and early 20th century were often badly run and critically flawed, but rather than pushing for reform of these hospitals, many politicians lobbied for them to close their doors, switching instead to a community-based system for treating the mentally ill. Although deinstitutionalization was originally understood as a humane way to offer more suitable services to the mentally ill in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives. This callousness has created a one-way road to prison for massive numbers of impaired individuals and the inhumane warehousing of thousands of mentally ill people. Nevertheless, there are things that can be done to lower the rate mentally ill persons are being incarcerated. Such
During the 1800s, treating individuals with psychological issues was a problematic and disturbing issue. Society didn’t understand mental illness very well, so the mentally ill individuals were sent to asylums primarily to get them off the streets. Patients in asylums were usually subjected to conditions that today we would consider horrific and inhumane due to the lack of knowledge on mental illnesses.
In the book, Crazy, by Pete Earley, provides a detailed overview of the mental health system in the United States, as it presents a first hand narrative of Earley’s family journey through the system. The author’s major premise and arguments, in the book, is to highlight the history of mental health, navigation through the judicial system with mental illness, the bureaucracy and policies of hospitals, society views on human rights and client safety, and the impact on the individual, family, and community. The content suggests that human service workers and public health workers should extend their professional lens to advocate for change in the mental health system in the United States.
Over the past thirty years, there has been a 500% increase in the U.S incarceration rate. (The Sentencing project, 2014) Advances in medicine, such as the discovery of psychoactive drugs, led to the deinstitutionalization of mentally ill patients from psychiatric hospitals. With a long record of horrific abuse,
Throughout the ages, the idea of involuntary hospitalization has always had its supporters and its detractors. Many people have long debated the ethics of forcing treatment on patients that cannot always make the best decisions for themselves. Involuntary commitment is now a very hot topic, especially in a state like Florida, where their Baker Act and Marchman Act laws are greatly debated on their usefulness versus their harmfulness. The Baker Act, enacted in 1971, is Florida’s main mental health law, which allows for the voluntary and involuntary commitment of mentally ill patients who are believed to be a threat to themselves or others. Many have highlighted key issues
Mental health services in St. Louis have undergone a multitude of changes as stigmas towards mental health issues have begun to change. Traditionally, mentally ill individuals were thought to be lacking religion or in trouble in the eyes of God, and this thought process was believed until after the Middle Ages. These beliefs may have changed, but the attitudes towards the mentally ill were continued into the 18th century and beyond, which caused an increase in the stigmatization of mental illness, and thus subjected these individuals to humiliating and unhealthy conditions found in the original confinement of mentally ill patients, asylums. The government created mental health asylums, which separated these individuals from their societies,
The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus
Wright, D. (1997). Getting out of the asylum: understanding the confinement of the insane in the nineteenth century. Social History of Medicine, 10, 13
The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and
What comes to mind when you hear the words “insane asylum”? Do such terms as lunatic, crazy, scary, or even haunted come to mind? More than likely these are the terminology that most of us would use to describe our perception of insane asylums. However, those in history that had a heart’s desire to treat the mentally ill compassionately and humanely had a different viewpoint. Insane asylums were known for their horrendous treatment of the mentally ill, but the ultimate purpose in the reformation of insane asylums in the nineteenth century was to improve the treatment for the mentally ill by providing a humane and caring environment for them to reside.
During the mid-1800’s the mentally ill were either homeless or locked in a cell under deplorable conditions. Introduction of asylums was a way to get the mentally ill better care and better- living conditions. Over a period of years, the admissions grew, but staff to take care of their needs did not. Asylums became overcrowded and treatments that were thought to cure, were basically medieval and unethical