CONCEPTIONS OF MENTAL ILLNESS HOW VIEWS OF MENTAL ILLNESS HAVE CHANGED OVER TIME CURRENT CONCEPTIONS OF MENTAL ILLNESS WHERE DRAW THE LINE BETWEEN MENTAL ILLNESS AND NORMALITY?

PRE-20TH CENTURY MENTAL ILLNESS IS UNIVERSAL MENTAL ILLNESS LIMITED TO SMALL NUMBER OF MOST SERIOUS CONDITIONS MENTALLY ILL HIGHLY STIGMATIZED

CAUSES NOT MUCH KNOWN SUPERNATURAL BRAIN DISEASE

EARLY TREATMENT PRE-19TH CENTURY - LEFT TO FEND FOR SELVES NO OUTPATIENT TREATMENT 19TH CENTURY - SHUT AWAY IN INSTITUTIONS

PRE-20TH CENTURY LIMITED TO SMALL NUMBER OF SEVERE CONDITIONS MENTALLY ILL BIZARRE AND DIFFERENT CAUSES UNKNOWN INSTITUTIONALIZED

20th CENTURY VIEWS FIRST PSYCHIATRIC MANUAL AT BEGINNING OF 20 TH CENTURY – 19 OF 20 CONDITIONS PSYCHOTIC DSM NOW - NEARLY 400 DIFFERENT MENTAL ILLNESSES TREMENDOUS BROADENING OF CONDITIONS VIEWED AS MENTAL ILLNESSES

EXPANSION OF M.I. SIGMUND FREUD EVERYONE TO SOME EXTENT IS M.I. IDEAS BEGAN TO EXPAND THROUGH THE CULTURE - MOVIES, BOOKS, PROFESSIONS

RESPONSE OUTPATIENT TREATMENT IN COMMUNITY PSYCHOTHERAPY FOR MOST PART, LIMITED TO ELITE

CURRENT CONCEPTIONS BEGAN WITH DSM-III (1980) NOT JUST MOST SEVERE CONDITIONS BUT MANY DIFFERENT CONDITIONS

M.I. WIDESPREAD NO LONGER SEEN AS UNUSUAL BUT MANY PEOPLE AFFECTED BY THEM 50 PERCENT OF POPULATION OVER LIFETIME; 20 PERCENT IN ANY GIVEN YEAR

NORMALIZATION MENTALLY ILL NOT SEEN AS DIFFERENT FROM NORMAL MENTALLY ILL NOT CERTAIN KIND OF PERSON BUT NORMAL PERSON WITH PARTICULAR DISEASE

MEDICALIZATION NORMAL PEOPLE HAVE MEDICAL CONDITION TREATED BY PROFESSIONALS

BIOLOGICAL CAUSES MENTAL ILLNESSES VIEWED AS BRAIN DISEASES GENETICS AND BRAIN CHEMISTRY AT FAULT

TREATMENT SSRI - SELECTIVE SEROTONIN REUPTAKE INHIBITORS - “ANTI- DEPRESSANTS” HUGE INCREASE IN DRUG TREATMENT - 60 MILLION SCRIPTS 3 OF 7 MOST PRESCRIBED DRUGS

THERAPEUTIC CULTURE MANY BEHAVIORS MEDICALIZED MENTAL ILLNESS IS COMMON MENTALLY ILL NOT DIFFERENT RISING NUMBERS OF PEOPLE IN TREATMENT AND OF MENTAL HEALTH PROFESSIONALS

RATES OF TREATMENT

M.H. PROFS

SUMMARY OF TRENDS FROM ONLY SERIOUS TO MANY CONDITIONS FROM RARE TO WIDESPREAD FROM STIGMATIZED TO MEDICALIZED FROM UNKNOWN CAUSES TO PRESUMED BIOLOGICAL

SUMMARY OF TRENDS FROM INSTITUTIONS TO OUTPATIENT THERAPY TO DRUGS FROM SEGREGATION TO PART OF CULTURE

WHERE DRAW THE LINE? ARE TOO MANY CONDITIONS MEDICALIZED NOW? HOW CAN WE SEPARATE WHAT’S M.I. FROM WHAT’S NORMAL?

SOPRANOS BEHAVIORS VIEWED AS DISEASES CHANGE OVER TIME FROM ROWDY TO SICK CONFLICT WITH MUCH LAY CULTURE RISE OF M.H. PROFESSIONALS TREATMENT NOT PUNISHMENT