Mental Health in Canada Historical Perspectives

Defining Words Mental Health Movement Mental HygienePatient Rights ExclusionWork Therapy MarginalizationShock Therapy InstitutionalizationJailing MisunderstandingPharmacotherapy StigmaPsychotherapy AdvocacyProtection Social PolicyCommunity Support

Mental Disorder  any illness with significant psychological or behavioral manifestations that is associated with either a painful or distressing symptom or an impairment in one or more important areas of functioning.

Mental Hygiene  The science of maintaining mental health and preventing the development of psychosis, neurosis, or other mental disorders.

Mental Health  a condition of mental well-being, balance, and resilience in which the individual can successfully work and function and in which the individual can both withstand and learn to cope with the conflicts and stresses encountered in life.

The ancient past…  918 (AD) Earliest known mental hospital establised in Baghdad.  The treatment of the mentally ill reflects society’s ideas, and what’s culturally acceptable.

Mental Illness as Deviance  Mental illness was often thought of as deviant to “regular” behaviour.  Those who did not conform to society’s expectations were marginalized and as the care for mental health patients rose so did the number of people placed in institutions.

Patients or Prisoners?  Those with mental disorders were admitted to mental hospitals and asylums but so too were those who didn’t fit society’s picture of a productive citizen.  People with Special Needs  Criminals  Women  Homosexuals

18 th Century  Bedlam (London 1247) and Bicetre (Paris) Known as mad houses or asylums. Inmates were often thought to be devoid of human feeling and treatment was brutal. Many sufferers were routinely shackled.

Change…  Dorothy Dix was a reformer and in 1840 led a personal crusade to change treatment of the mentally ill in Canada, the US, and Britain.  Her outrage was based in American experiences. She discovered that criminals and the mentally ill were detained and treated the same way.

Continued Issues…  Still for many generations the mentally ill were marginalized in society and largely misunderstood.  Institutionalization took the ill from their families and did not allow them to interact with the public and their community.

1899 British Columbia  Population of people suffering mental illnesses surpasses 300.  In the absence of social services, the hospital became a housing facility. Those who were there included: unwanted children, physically handicapped children along with psychiatric patients. Complaints are heard of serious overcrowding, poor hygiene and living conditions, and inadequate care.

Change in BC…  New site for Mental Institution are sought and a large hospital is built to accommodate patients.  Work therapy continues to be a major part of treatment.

Modern Mental Health Treatment  1908 Clifford Wittingham Beers wrote A Mind That Found Itself  Organized the Connecticut Society for Mental Hygiene  Continues to influence people  Sought improvements for care of the unwell and distribution of reliable information.

1918: In Canada…  Canadian National Committee for Mental Hygiene (CNCMH), founded by Dr. Clarence M. Hincks and Clifford W. Beers in January 26,  This organization has evolved and is now the Canadian Mental Health Association (with chapters all across Canada)

The World Wars  After WWII in Canada doctors were concerned with rehabilitation of their soldiers.  Post traumatic stress disorder and other illnesses continue to be a concern for soldiers serving overseas.

Continued Momentum  1946 Rise is Pharmacotherapy.  Founding of the United Nations and in 1946 constitution of the World Health Organization (WHO) pushed health and mental health into the world’s view.

Ideas about Mental Health  1901 The psychiatric literature lists the principal causes of insanity as heredity, intemperance, syphilis and masturbation.  2009 Causes include Organic Causes (within the brain), Hereditary Factors, Drug and Alcohol Abuse, Stress, etc.

Be careful…  Very often the cause of a particular type of mental disorder is unknown or is understood only to a very limited extent.

Current Ideas for Treatment Include  Psychotherapy  Community Supports  Pharmacotherapy  Patient Rights  Creation of Mental Health Courts  1980’s saw the National Decline in Institutionalization

New language for patients  The term “consumer” refers to a person who has used or is using services provided by the mental health system.  There is some debate within our community about the most appropriate term. While some organizations prefer the term “client”, CMHA has listened to and heard individuals who have used or are using the mental health system and many of them prefer the term “consumer”.

Where is this information coming from? (sources)  Encyclopaedia Britannica (online database)  Health Canada Website  Canadian Mental Health Association  BC Mental Health and Addiction Services