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The History of Mental Illness in America: A Journey From Despair to Hope & Recovery Ms. Manzo.

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Presentation on theme: "The History of Mental Illness in America: A Journey From Despair to Hope & Recovery Ms. Manzo."— Presentation transcript:

1 The History of Mental Illness in America: A Journey From Despair to Hope & Recovery
Ms. Manzo

2 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

3 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

4 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.”

5 Care????? Family Parish Church Those without family-
placed in prisons- chained to walls, unclothed poorhouses

6 1770s First hospitals 1773- Williamsburg, Virginia
Designed to keep those with mental illness away from society- not treat them.

7 The Public Hospital, Va. When it first opened, a “keeper,” or jailor with no medical training, ran the hospital. Patients were kept isolated, usually alone in a room or cell with just a mattress and shackles. Treatments included use of leeches (called “bloodletting,” a common medical practice) and use of a restraining chair prescribed by the visiting physician. The hospital had only eight beds. Patients stayed for a few weeks or sometimes months and then were released back to their families, depending upon when the doctor and board of directors determined they were ready to return to society. “The idea was that they could be cured, that [their condition] wasn’t a lifetime illness,” says Gilliam. At the time, it was believed that patients chose to behave irrationally, and doctors tried to help them adopt a more normal manner.

8 17th-18th Centuries Demon-possessed Senseless animals

9 Dorothea Dix

10 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. 14 men freezing- no clothing- asked warden and found out they had a mental illness

11 1840 US Census Includes its 1st question on “insanity”

12 Thomas Kirkbride Designer of Asylums
Dix and Horace Mann – believed that mental illness could be treated by removing the person to an asylum to receive a mix of somatic and psychosocial treatments in a controlled environment.

13 Athens Asylum for the Insane-1874
Restraints returned when patient population grew from 200 to 1800 Limited staffing Community realized these institutions were a great place for unwanted people in the community 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…..

14 An Asylum For Every State
Buffalo, New York 1871

15 The Civil War Many servicemen- postwar trauma
State hospitals and asylums overcrowded Restraints, shock therapy, opium

16 Soldier’s Heart- or “PTSD”

17 Post Civil War Asylums – now underfunded – overcrowded
Quality of care deteriorates Newspapers expose inhumane conditions

18 1900- Clifford Beers Yale graduate
Young Businessman- suffers acute breakdown brought on by the illness & death of his brother Hospitalized in a private Connecticut mental institution after suicide attempt His attendants- untrained, incompetent- suffer mental & physical abuses Writes his autobiography- A Mind That Found Itself- which changed the way people viewed those with mental illness

19 “A Mind That Found Itself”
1908- changed mental health care Beers’ autobiography –chronicles his struggle with mental illness and healthcare

20 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.”

21 The National Committee For Mental Hygiene
Founded in 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

22 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

23 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…….

24 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).

25 1st community based health treatment for patients in state institutions

26 1949- Lithium New hope

27 1954 Antipsychotic drugs introduced
Thorazine- improves hallucinations and delusions Other medications now become available

28 1956 Congress allocates- $12 million for psychopharmacology
Number of consumers decline in mental institutions

29 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?”

30 1960s Community health movement Outpatient services More research
Less state mental hospitals More general hospitals with psychiatric wings More community health centers

31 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

32 1981-1985 Carter’s work halted Mental Health Systems Act repealed
Funding drops

33 Behavioral Health Managed Care
1988 States now “carved out” mental care from physical care Purpose: increase efficiency Results: led to erosion of health care

34 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."

35 1994 Behavioral Brain Imaging
Helps scientists learn more about the development of major mental illnesses.

36 1996 HIPPA-regulation of forms, privacy and security
Significant impact on caregivers of those with mental illness

37 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

38 The Clinton Administration
Bans the use of restraints in federally funded hospitals Report on co-occurring disorders ordered Between 1995 and 2001, the proportion of substance abuse treatment admissions with co-occurring substance abuse and psychiatric disorders increased from 12 to 16 percent In 2001, admissions with co-occurring disorders were more likely to report alcohol as a primary substance of abuse (45 vs. 38 percent) compared with all other admissions Females constituted a larger proportion of admissions with co-occurring disorders (44 percent) than of all other admissions (30 percent)

39 The Bush Administration
Increased funding for community health centers New Freedom Commission on Mental Health

40 The Obama Administration
Mental health parity states that psychological conditions must be treated equivalently to physical illnesses.

41 So why does the suffering continue?

42 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

43 And…..STIGMA

44 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.

45 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

46 And America is changing because we are “saying what we need to say”!


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