Past to Present: The History of Mental Health
Treatment in America
Mental health and illness have always been slight shortcomings in people’s understanding. The invisible nature of the mental wounds that trauma leaves on the brains of survivors renders many quirks and behaviors of mentally ill people to be simplified into the realm of obscurity or eccentricity, where the reality is much deeper and often more severe.
Advances in science and medicine have uncovered many mysteries of the mind and of mental health. The same breakthroughs that have allowed people to complete nursing programs online fast have led to the ability to assess, diagnose, and treat a wide variety of mental illnesses that people can be saddled with throughout their lives.
But how did we get here? What was the sequence of events that led to our modern understanding of mental illness and maintaining good mental health? And where are we going from here?
Read on to find out.
Again, the Greeks Invented It
There is a common saying that the Ancient Greeks invented everything. From philosophy to plumbing, there are many inventions that can be attributed to the Ancient Greek empire, and they were also the forerunners in the study of mental health.
The earliest written records displaying an intentional study of mental illness come from 400 BC when the Greek physician Hippocrates (of the Hippocratic Oath) began to treat mental illnesses as physiological conditions. Prior to this, the mentally ill were considered victims of demonic possession, evil curses, or the targets of one God or another’s wrath.
The first facility specifically to house and treat the mentally ill was established in Baghdad in 705 BC. Islam established that the mentally ill were incapable of caring for themselves but still deserved care and protection
Unfortunately, the progressive attitude is not one of the ones that took root, and in the Middle Ages, there are records showing that non-dangerous people with mental illness were freed from the asylums they were previously interned at, while violent or dangerous patients were treated extremely poorly and said to be witches.
The Age of Asylums
Although “asylum” is the commonly used term, the Baghdadian facilities were actually far more akin to hospitals where the mentally ill could receive care and protection. So-called “Insane Asylums” became extremely prevalent in Europe during the 1600s but were far from their namesake.
From the Greek “a-” to mean “without” and “style” meaning “right of seizure” (as in a sudden attack or act of theft), the word “asylum” developed to essentially translate to “refuge.” Unfortunately, the asylums of the 1600s were anything but a refuge. Mental illness patients were isolated, chained to walls, housed with criminals, and suffered numerous human rights violations.
By the 1800s, much of this activity was still relatively common, though there had been some more positive reforms. Shackling mentally ill people was forbidden in the 1700s, and many places allowed their inmates into so-called “sunny rooms,” where they could exercise. However, the mistreatment of the mentally ill was still rife.
The major reforms in mental health treatment came in the 1800s when U.S. reformer Dorothea Dix established 32 state hospitals for patients with mental illness. However, the new humane treatment methods at the hospitals did not cure the patients as expected, leading to overcrowding and prolonged custodial care. This was largely due to a lack of information, and the first major scientific studies into mental illness would not occur until the 1880s when Emil Kraepelin, a German psychiatrist, began to study mental illness.
Early 20th Century Treatments
In June 1900, Clifford Whittingham Beers was admitted to three separate medical facilities: Stamford Hall, The Hartford Retreat, and the Connecticut State Hospital at Middletown. His family admitted him, as during his University studies, he suffered from frequent depressive episodes and, after graduating, became increasingly anxious and distressed, which culminated in a suicide attempt. Though he survived, during his recovery, he experienced hallucinations and paranoia and even went as far as to stop speaking due to the delusion that his family were in danger. It was at this point that Beers was hospitalized.
During his period of facility care, Beers was repeatedly physically abused and experienced degrading treatment at the hands of hospital staff. After coming out of his hospitalization, he wrote a book called “A Mind That Found Itself” in which he detailed his experiences. The book was released in 1908 and immediately launched a mental illness reform movement in the U.S.
This led to the founding of the National Mental Health Association in 1909, which would later be called Mental Health America, and is today still the largest umbrella organization for mental health and illness in the U.S today.
Further advances included the development of psychological treatments in the 1930s, though these were often barbaric and sometimes worsened patient’s conditions, such as electroshock therapy and lobotomies, which saw extended use in the 1930s and 40s. However, possibly the most significant mental health breakthrough came when Harry Truman signed the National Mental Health Act in 1946. The act called for the scientific research of the mind, brain, and behavior. This allowed the formation of the National Institute of Mental Health in 1949, and in that same year, lithium was discovered to be a hugely effective drug for bipolar disorder.
Although throughout the 50s, these breakout treatments allowed many mentally ill patients to leave their hospital beds, the lack of follow-up care and attention resulted in a glut of homeless mentally ill people. Additionally, the '60s saw a rash of critics; however, in the 1980s, many advocacy groups were able to secure funding and support for mentally ill people.
Mental Illness Today
Today the conversation around mental illness is louder and more open than ever. People take to social media to share their experiences, interact with global support communities, and distribute information useful to certain mental illness demographics. The ability of the internet to hastily communicate issues and information has been something of a double-edged sword with mental illness, as erroneous information is just as rapidly spread as what is useful and true.
However, there is no doubt that despite the shortcomings in mental healthcare today, the situation is globally much improved than it was several hundred years ago, and as research and updates to our understanding of mental health and the brain continue, things will only continue to get better from here on in.