Introduction to Modern Psychiatry

Psychiatry is a type of science that involves mental illnesses and diagnosing the patient's’ mental, and sometimes physical, health. Psychiatrists are doctors that are trained to diagnose mental illnesses, and spot mental, emotional and behavioral symptoms. They work with their patients, listening to their stories, and performing tests in order to find out what, if any, mental illnesses or cognitive disorders. The median annual salary for a psychiatrist is around $200,000.

“Timeline: Treatments for Mental Illness” notes the history of mental illness; before the 1840s, being mentally ill was considered to be a form of religious punishment and demonic punishment by many cultures. In 1407 the first European establishment for mentally ill was established in Valencia, Spain. As time progressed it was shown that Europeans began to increasingly isolate the mentally ill; treated inhumanly, often kept chained to walls in dungeons. In the late 1700s some changes were made as concerns for the mentally ill people’s well being grew. After the French revolution Phillippe Pinel, a French physician, took over the Bicêtre insane asylum, forbidding the use of chains and shackles. He provided the mentally ill with better living conditions, sunny rooms and the ability to roam around the grounds. Though some things have improved, mistreatment in other asylums persisted. In

31 y/o AA male patient seen today for psychiatric-mental health assessment. He is awake, alert and oriented x4. He is calm, cooperative and follows commands during assessment. The patient reports he is depressed, difficulty sleeping and nightmares at night. The patient explained his depression is as a result of deep thinking from a news he received two days ago from his elder brother that his mother is ill. Stressors identified by the patient include losing his job a week ago before the news about his mother; his wife is 6-months pregnant with their first child, who currently works part-time at her present job; patient relates difficulty paying monthly bills and inability to provide adequately for his family as a man. The patient denies mood swings, suicidal/homicidal thoughts and ideation. Patient reports his spouse is at work at the moment and he does not want to put stress on his wife due to her current condition. Patient denies been hospitalized for depression or psychiatric illness; and denies family history of mental illness. Patient reports he is seeking help because he does not like feeling this way using terms of “helpless and loss of worth from his spouse”. Patient reports he needs help with his depression and nightmares before his current condition get out of hands and ruined his marriage.

In early American history, individuals with mental illnesses have been neglected and suffered inhuman treatments. Some were beaten, lobotomized, sterilized, restrained, in addition to other kinds of abuse. Mental illness was thought to be the cause of supernatural dreadful curse from the Gods or a demonic possession. Trepanning (the opening of the skull) is the earliest known treatment for individuals with mental illness. This practice was believed to release evil spirits (Kemp, 2007). Laws were passed giving power to take custody over the mentally ill including selling their possessions and properties and be imprisoned (Kofman, 2012). The first psychiatric hospital in the U.S. was the Pennsylvania Hospital where mentally ill patients were left in cold basements because they were considered not affected by cold or hot environments and restraint with iron shackles. They were put on display like zoo animals to the public for sell by the doctors (Kofmen, 2012). These individuals were punished and isolated and kept far out of the eyes of society, hidden as if they did not exist. They were either maintained by living with their families and considered a source of embarrassment or institutionalized

Hippocrates was the first to recognize that mental illness was due to ‘disturbed physiology’ as opposed to ‘displeasure of the gods or evidence of demonic possession’. It was not until about one thousand years later that the first place designated for the mentally ill came to be in 15th century Spain. Before the 15th century, it was largely up to individual’s families to care for them. By the 17th century, society was ‘often housing them with handicapped people, vagrants, and delinquents. Those considered insane are increasingly treated inhumanely, often chained to walls and kept in dungeons’. There are great strides for the medical treatments for the mentally

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.

The first official mental asylum was built in the 1800’s for the treatment of the mentally ill. Illnesses such as depression, anxiety, schizophrenia, and insanity were treated here. American asylums helped to provide a home for those whose minds differ from normal. In the institutions, patients could seek treatments. The invention of the asylums helped shape the world in early urbanization.

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

One of the earliest reforms occurred at an asylum in Devon, England. This facility had employed opium, leeches, and purges as cures for mental illness, but in the mid-1800s emphasized non-restraint methods to affect patients’ health (Stigma 64).

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.

Unfortunately, asylum founders could only guess at the causes of insanity. Patient after patient was admitted into the state hospitals, but the cause of their disturbance was often a mystery. Many were inflicted with various organic diseases, like dementia, Huntington’s disease, brain tumors, and many were in the third stage of syphilis. With no treatments available, providing humane care was all that could be done. In the years following the civil war American cities boomed and the asylum began struggling to keep up. Soldiers, freed slaves, and immigrants were stranded in a strange land. The asylum became organized more like a factory or small town. There were upper and lower classman, bosses and workers, patients with nothing, and patients with privileges. Sarah Burrows, a schizophrenic and daughter of a wealthy doctor had a ten bedroom house that was built for her on the hospital grounds. Burrows home was just a stone’s throw away from the hospital’s west wing, where over sixty black women slept side by side. (Asylum: A History of the Mental Institution in America). The hospital began to rely on the free labor the patients provided. However, isolating the hospital from the community meant there was no way of knowing what was happening inside the asylum. The asylum became a world apart. In the 1870’s, Elizabeth Packard, a former patient of St. Elizabeth’s, wrote about her mistreatment and abuse

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

In this assignment I shall be defining the topic surrounding crisis throughout the field of mental health. I will be attempting to do this by using a various range of literature and theories of that can help us create a greater understanding and knowledge base of what a crisis is, why it occurs and how we can potentially prevent a crisis from occurring. I shall then be discussing how I would engage those individuals that are in crisis, exploring the engagement process and showing the skills that are necessary to provide support to the person in crisis. I will then be discussing what challenges we meet as both professionals and the individual that is in crisis and what tools and strategies are placed in order to conquer these

If we reach that far back in psychiatric history it would appear as though mainstream psychiatry has actually come a long way. To gain insight in to all disciplines of study it’s critical to venture back in time to get a glimpse of its history. It’s necessary to study the roots in an effort to accurately extrapolate where things have been, where things are, and where the vision is directed for the future. Advancements in health care have unfolded through trial and error. These progressive improvements in patient care are profoundly swayed by public attitudes and medical theories. Since we have had such difficulty in finding our way out of the stigma mental illness maintains on today’s society, it is not surprising that psychiatry continues to lag behind other fields of medicine in terms of advancements.