Mental Health In The 18th Century

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.

In 1965, there was a histrionic change in the method that mental health care was delivered in the United States. The focus went from State Mental Hospitals to outpatient settings for the treatment of mental health issues. With the passing of Medicaid, States were encouraged to move patients out of the hospital setting (Pan, 2013). This process failed miserably due to under funding and understaffing for the amout of patients that were released from the State Mental Hospitals. This resulted in patients, as well as their families, who were in dire need of mental health services. This population turned to either incarceration (jails and/or prisons) or emergency departments as a primary source of care for their loved ones.

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

Many years ago, mental illness was viewed as a demonic possession or a religious punishment. In the 18th century, the attitudes towards mental illness were negative and persistent. This negativity leads to the stigmatization and confinement of those who were mentally ill. The mentally ill were sent to mental hospitals that were unhealthy and dangerous. A push in the mid 1950s for deinstitutionalization began because of activists lobbying for change. Dorothea Dix was one of these activists that helped push for change. The change called for more community oriented care rather than asylum based care. The Community Mental Health Centers Act of 1963 closed state psychiatric hospitals throughout the United States. "Only individuals who posed an imminent danger to themselves or someone else could be committed to state psychiatric hospitals" (A Brief History of Mental Illness and the U.S. Mental Health Care System). Deinstitutionalization meant to improve quality of life and treatment for those who are mentally ill. This would hopefully result in the mentally ill receiving treatment so they could live more independently. The hope was that community mental health programs would provide this treatment but sadly there was not sufficient or ongoing funding to meet the growing demand for these programs. Budgets for mental hospitals were reduced but there was no increase for the community based programs. Many mentally ill individuals have been moved to nursing homes or other residential

As you will see in this paper, mental illness has been a serious situation for many years. Over the years, there have been different thoughts relating to the causes of mental illness including what the actual situation is and observance of how to treat the mentally ill. This paper will inform you of three different historical periods: Colonial America, Depression & the New Deal and War & Prosperity in which an important aspect of mental health happened in each. I will include some religious and economic information for each period due to the relationship that religion and economy had to the way mental illness was viewed and treated in those periods.

Overall, Conditions in asylums today are drastically different than asylums in the 1800s due to the better understanding of mental illnesses. As time goes on and technology advances, society will continue to advance in it’s knowledge of mental

brain, or sending patients to institutions, doctor prescribed pills to try and treat mental conditions. In addition mental health patients were no longer being institutionalized due to the poor conditions in mental institutions (History of Mental Illness”)

The mood shifted from hiding the mentally ill to curing the mentally ill. The definition of mentally ill was expanded to include anyone in the family that was unable to help the family in terms of survival and drained their family of money and resources: the aged, the epileptic, and the imbecilic. This caused massive overcrowding. The mentally ill were hidden from the public view along with the elderly and others suffering from debilitating disorders resulting in massive overcrowding of asylums which meant illnesses were not being treated in lieu of managing the ever expanding population.

The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.

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

Mental health services and resources in League City, Texas seem to be available for those individuals who are in need of help and qualify for any assistance offered by the facilities. For example, “Devereux Advanced Behavioral Health is one of the largest and most advanced behavioral healthcare organizations in the country. We have a unique model that connects the latest scientific and medical advancements to practical, effective interventions in the treatment of behavioral health. We were founded in 1912 by one of the first pioneers in the field, Helena Devereux. Today, we are a national nonprofit partner for individuals, families, schools and communities, serving many of the most vulnerable members of our society in areas of autism,

Through the course of time, mental illnesses have always been in existence due to varying factors and causes. However, as time has passed, the perceptions and available treatments for mental illnesses have also changed as new technology was developed. By looking at the treatments and perceptions of mental illnesses in the early 20th century, we can learn how to properly treat and diagnose not only mental disorders but also other conditions as well as show us the importance of review boards and controlled clinical trials.

The Kelly Center presentation provided useful information on mental health. The Kelly Center is located in the basement of Picken Hall and all their services are free to students. These services include personal counseling, drug and alcohol counseling, testing services, and academic support and tutoring.

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

It found that there was no significant change in the mortality rates and effectiveness of the treatments when observed in the long term; thus, outpatient clinics were a viable alternative (from the health perspective) to inpatient centers. Aside from severe cases, outpatient centers even provided better care in the psychiatric unit as well as some others.