Pratt1

TynishaPratt
Mrs.Oakes
HSB4U1
January13,2015

TreatmentsoftheMentallyIll:LookHowFarWeveCome

MentalillnessindirectlyaffectsallCanadiansinsomeway,throughafamilymember,
friendorcolleague.20%ofCanadianswillpersonallyexperiencementalillnessatsomepoint
intheirlife(CanadianMentalHealthAssociation).MentalIllnessisnostrangertohumans,in
factitcanbefounddatingbacktoancientGreeceandRoman(AllisonFoerschner).Mental
illnesshasconsumedourfriends,familiesandlovesones.Andtogetherwehavegone
throughalongandtoughjourney,tohelpthemreceivethetreatmenttheydeserve.Our
progressisshownthroughatimelinefromancienttreatmentsofthementallyill,tomodern
treatmentsofthementallyill,tothevastcomprehensionandacceptablesocializationofthe
mentallyillwevedevelopedtoday.Andtogetherwehaveaccomplishedsomany
revolutionarythingsthattoday,NorthAmericantreatmentsofthementallyillarebetterthan
theyhaveeverbeen.
Theproofofsuchsuccessliesinthecomparisonofancienttreatmentsofthementally
ill,andmoderntreatmentsofthementallyill.Tocomparethetwoonemusthaveadeep
understandingbothtreatments,beginningwiththeancientremediesforthementally
disturbed.
Treatmentsofthementallyillbeforementalinstitutionswereestablishedwasbased
onGodfearingbeliefs,vaguephilosophicalreasoningandincorrectassumptionsaboutthe

Pratt2

humanbody.InNeolithictimespeoplebelievedthatmentalillnesswasasupernatural
phenomenon,thatyouwereinhabitedbyanevilspirit.Inthistimeamethodcalledtrephining
orskulldrillingwasused(AllisonFoerschner).Theywouldmakeaholeinapersonshead
allowingtheevilspirittoleave.Howeverthisonlyleftthepersondeadorlobotomized.
HebrewsandPersiansbelievedmentalillnesswasinflictedbyGodandthereforeprevention
ofitincludedgoodhealth,hygieneandpurityofmindandbody(AllisonFoerschner).Atthe
time,thisleadtothestereotypethatthementallyillwereflooziesandunGodly.TheGreeks
believedhysteriainwomenwasduetoawanderinguterus.Theuteruswasfumigatedto
luretheorganbackintoposition(AllisonFoerschner).Suchviolenttreatmentswereused
basedontheassumptionthatGodorsupernaturalforceswaspunishingthem.Butoneman
hadanothertheory.Greekphilosopher,Hippocratesdeniedthatmentalillnesswasdueto
supernaturalforcesandwasactuallyaphysicalsymptomofunbalancedEssentialFluids.
EssentialFluidsblood,phlegm,bile,andblackbilewassaidtobethesubstanceaperson's
personality.InordertobecuredofmentalillnessesyourEssentialFluidsmustbebalanced.
Frequentleeches,cupping,emetics,tobaccoandlaxativeswereallusedtorestorebalance
(AllisonFoerschner).Ofcoursethistoowasincorrectandledtothin,sicklypeople.Thisall
provesthattreatmentsofthementallyillbeforementalinstitutionswereestablishedwas
clearlybasedonnothingmorethansupernaturalfear,extremelyvaguephilosophiesand
incorrectassumptionsaboutthehumanbody.
Treatmentsofthementallyillinearlymentalinstitutionswereinhumane,poorly
equippedandaccomplishedtheoppositeoftheirintentions.Theearliestinstitutionswere
calledprivatemadhouses,foundedinmonasteriesandstaffedbyclergy.Theillwereforced
torepenttheirsinsandseekrefuge.Iftheydidnotcomplytheywerebeatenintosubmission
(AllisonFoerschner).Asylumswereestablishedworldwidebythe16century,howeverthey

Pratt3

werestaffedbyuntrained,unqualifiedpeople(AllisonFoerschner).St.MaryBethlemHospital
(aka

Bedlam)isthe
oldestinstitutiontospecialiseinmentalillnesses,foundedinthe1600s
(AllisonFoerschner)
.Hospitalsinthistimewereknownfortheirbrutaltortureofpatientsinthe
nameofscience,butBedlamwasbyfartheworst.
Curesinsuchasylumsincluded
bloodletting,hotcoldwatersubmersions,intimidation,straightjackets,andpowerfuldrugs
(AllisonFoerschner).Buttheworstmethodofallwasthegyratingchair.Thegyratingchair
wasusedtoshakeupapatientsbloodandtissuestorestoreequilibrium(AllisonFoerschner).
Thisleftpatientsunconscious,incomas,withbrokennecks,braindeadandsometimeseven
completelydead.Treatmentsofthementallyillinearlymentalinstitutionswereinhumane,
poorlyequippedandaccomplishedtheoppositeoftheirintentions,makingthepatients
conditionsworstorsometimeskillingthem,insteadofcuringthemasahospitalshoulddo.
Butthen,arevolutionoffairandjusttreatmentaroseandachangebegan.
Philippe
PinelwasthesuperintendentatlAsylumdeBictre.In1793heintroducedhumanemethods
eliminatingchains,givingpatientsbedandroomswithwindowsandbeginningtotreateach
individualpatientsillnessindividually
(AllisonFoerschner)
.Hisworkwasrevolutionary.
HumanetreatmentsofthementallyillspreadacrossAmericain1800swhereitreached
DorotheaDix,hospitalreformistandhumanetreatmentactivistforthementallyill.She
inventedTheMentalHygienemovement,whichhelpedsetguidelinesforhumanetreatments
inmentalhospitals.Inherhospital,DixHillHospital,theybeganusingsomething
revolutionaryatthetime,sterilization(AllisonFoerschner).Herworksarestillnotedtodayfor
theirinnovativechangesinthisfield.Atthesametimeasthesesocialrevolutions,medical
revolutionswereoccurringtoo.Electroconvulsivetherapy(insulinandelectricshock),

Pratt4

psychosurgery(lobotomy),andpsychopharmacology(lithium,chlorpromazine,valium,
prozac)werebecomingpopularmethodsofthistimeaswell(AllisonFoerschner).These
methodswereahugeleapawayfromthetorturesomemethodspreviouslyused.These
revolutionaryworksbeganachangeintheworld
ofmentalaidanditseemedthatpeoplewithmentalillnesseswouldfinallybetreatedand
caredforthewaytheyneededtobe.
However,thecontraryoccurred.Societyregressedintheirtreatmentofthementallyill
whentheyestablisheddeinstitutionalization.Deinstitutionalizationisthereleaseof
institutionalizedindividualsfrominstitutionalcare(asinapsychiatrichospital)tocareinthe
community(MerriamWebster).Manythingscontributedtothedecisionof
deinstitutionalization.Therecenteffectivenessofantipsychoticandantidepressant
medications(developedintheearlyandmid1900s)allowedforbettercontrolofsymptoms,
thereforeconstantsupervisionwasntrequired(PublicHealthAgencyofCanada).Therewas
alsoaprodeinstitutionalizationmovementfromthecommunitybasedoncomplaints
includingthepoorlivingconditionsofinstitutions,theforcefulnessofinvoluntaryadmissions
andthehighcostofhospitalexpenses(PublicHealthAgencyofCanada).Allofthese
complaintswerejustifiable.In1998,theeconomiccostofmentalillnessesinCanadaforthe
healthcaresystemwasestimatedtobeatleast$7.9billion(CanadianMentalHealth
Association).Consideringallofthisonemightthinkitwasagoodideatodeinstitutionalize
patients,howeveritonlymadethingsworst.From19601976psychiatrichospitalbeds
decreasedfrom4763315011andgeneralhospitalbedsincreasedfrom8445836(Public
HealthAgencyofCanada).Inamatterofyears,roomsforpatientsdroppedfrom48477to
20847.Thatleaves27630mentallyillpatientswithoutmedication,care,orahome.Inthemid
1900s,homelessmentallyillpeoplefilledthestreets.Thiscreatedthestereotypethatall

Pratt5

homelesspeoplearecrazyandtalktothemselves,becauseatthistimetheywere.Society
regressedintheirtreatmentofthementallyillwhentheyputtensofthousandsofhelpless
patientsoutonthestreets,tostarvetodeathordeveloppneumonia,justtosaveabuck.
Inthepastwehavemadegreatstridesandsometimescripplingdecisionsaboutthe
treatmentofthementallyill.Thoughthejourneywasntperfect,ithasleadtooursuperior
moderntreatments.Onceonehasaclearunderstandingoftodaysapproachestomental
illness,theywouldseethatNorthAmericantreatmentsofthementallyillarebetterthanthey
haveeverbeen.
Moderninstitutionsforthementallyillarehomey,permissiveandproductive.Though
theyarelesscommontoday,thelongtermcarefacilitiesaremadeforconvenienceand
comfort.Mostinstitutionsincludeactivityrooms,campushairdressers,publictelephones,
postalsystem,freeparkinggaragesandsometimeseventvsinpatientrooms(YorkPsych).
Patientscanalsoleavethefacility(togoshoppingorvisitfamily)aslongastheyinforma
staffmember(YorkPsych).100yearsagopatientswerechainedtocementwallsindarkcold
cells,todaytheyarefreetoleavethefacilitywhenevertheylike.Institutionshavenotonly
improvedintheirhumanitarianskills,buthavealsolearnedtorespecttoeachindividual's
disorders.Allwardsareseparatedininstitutionsandhavedistinctfeaturesfortheirpatients
disorders,forexampletheeatingdisorderwinghasenclosedcafeterias(YorkPsych).Though
simple,theseactshavechangedmentalhealthtreatmentfrombarbarictohumane.
Newformsofpsychiatricfacilitieshavemadetreatingindividualswithmentalillness
morecomfortableandefficient.Thisisanoptimalchoiceforsome.Itcanmakethepatientfeel
morenormal,ormakeiteasierforthemtoworkorraisetheirchildren.Thisisidealformen
whoareoftenashamedoftheirillness,asthesuicidemortalityrateformenisfourtimesthe
rateforwomen(CanadianMentalHealthAssociation).Intodayssocietytherearemanyways

Pratt6

toobtainpsychiatrictreatmentoutsideofaninstitution.ThesefacilitiesincludeCrisis
stabilizationemergencyroomsforviolentorsuicidalindividuals,Openunitsfornoncritical
patients,
Mediumtermpsychiatrichospitalsusedtomonitorpatientsoverseveralweekstoseeifnew
treatmentandmedicationsareeffective,andHalfwayhouseswhichisassistedlivingfor
patientstransitioningintoselfsufficiency(PrincetonUniversity).Withsomanyoption,patients
cangetthehelpneededwithminimaldisruptiontotheirlivesaspossible.Thesemodern
programsprovethatNorthAmericantreatmentsofthementallyillarebetterthantheyhave
everbeen.
Itisobviousinthecomparisonofancientandmoderninstitutionsthat

NorthAmerican
treatmentsofthementallyillarebetterthantheyhaveeverbeen.Buttheprogressin
institutionsisnottheonlythingthatmakestodaystreatmentssuperior.Ourhardworkinthe
comprehensionandsocializationofmentalillnesshastrulychangedthewaysocietydeals
withthementallyill.
Throughtheworksofgreatpsychologistswehaveprogresseddrasticallyinthe
comprehensionofmentalillness.Understandinghowourmindsworkisessentialinhowto
treatthosewithmentalillnesses.B.F.Skinnerwaslargelyresponsiblefortheknowledgewe
havetodayabouthowthemindworks.Alongwithmanyotherthings,hecoinedOperant
Conditioninga
methodoflearningthatoccursthroughrewardsandpunishmentsforbehavior
(KendraCherry)
.Thisgaveusvitalinformationonhowtohelppatientswithbehavioural
disorders.
AlbertBanduraperformedanexperimentthatledtogroundbreakingresultsabout
thewaychildrenlearn.HisBobodollexperimentprovedthatchildrenlearnbyobservingand
imitating.Observationallearning,asitscalled,explainswhereviolentorobsessivebehaviour
inpatientscamefrom(KendraCherry).Andofcoursethegreatestpsychologistknownto

Pratt7

man,Freud.SigmundFreuddevelopedideasaboutandincludingpsychoanalysis,
unconsciousminds,idegosuperego,psychosexualdevelopment,defensemechanismsand
freudianslips.Allofthesethingshavehelpedusunderstandthewayourmindswork,and
howtohelpthosewhominds
arentworkingproperly(KendraCherry).Thesepsychologistsworksandmanymoreworked
togethertomakeTheDiagnosticandStatisticalManualofMentalDisorders(DSM),
publishedbytheAmericanPsychiatricAssociation.Itisthestandardclassificationofmental
disordersusedbymentalhealthprofessionals(AmericanPsychiatricAssociation).TheDSM
consistsofthreemajorcomponents:thediagnosticclassification,thediagnosticcriteriasets,
andthedescriptivetext.TheDiagnosticandStatisticalManualofMentalDisorders,Fifth
Edition(DSM5)isthecurrenteditionandhasbeendesignedforclinicaluse.Itisusedfor
collectingandcommunicatingaccuratepublichealthstatistics(AmericanPsychiatric
Association).Allofthisknowledgehasbeenusedtomaketreatmentsofthementallyillare
betterthantheyhaveeverbeen.
Withthetechnologyavailabletodaywehavebeenabletodiscovermoretypes,
therapiesandmedicationsforthementallyill.Onlyafewcenturiesago,treatmentsconsisted
ofthesameviolentandpainfulprocedures.Theconceptofindividualproblemsnever
occurredtothem.Classifyingdisordersallowsspecialisedprogramsandmedicationstohelp
thepatientandpsychologisthaveaneasyrecovery.Withouropenmindsandnew
technologywehavebeenabletodiscoveranabundanceofnewdisorders.Majorityofmental
disorderscanfallintotheseclassesNeurodevelopmental,Psychotic,Bipolar,Depressive,
Anxiety,ObsessiveCompulsive,Trauma/Stress,DissociativePersonality,Hypochondriac,
EatingDisorders,EliminationDisorder(bedwetting),SleepDisorders,GenderDysphoria,
ImpulseControl,AddictiveDisorders,andParaphilicDisorder(MayoClinic).Usingthe

Pratt8

knowledgewehaveacquiredwenowknowhowtoproperlytreatindividualswithaspecific
mentalillness.CommontreatmentsincludeBehaviourTherapywheredoctorobserves
behaviourswithoutdiscussingmentalstateoftenusingclassicalconditioning,Cognitive
Therapyteachesthepatienttothinkinmoreefficientwaysand
providespatientwithstrategiesthatcanbeappliedintheireverydaylives,
CognitiveBehaviouralTherapyusesbothcognitiveandbehaviouraltechniquesofteningroup
sessions,GroupPsychotherapyandPsychotherapy,andElectroconvulsiveTherapyfor
patientswithseveredepression,maniaorcatatonicschizophrenia(NYULangoneMedical
Center).Pharmacotherapyisusedinjunctionwiththerapeutictreatmentstotreatmental
illness.CommonmedicationsusedareAntidepressants,AntiAnxietyMedications,
MoodStabilizers,andAntipsychoticMedications(MayoClinic).Knowingthetypes,therapies
andmedicationsfortreatingthementallyillhashelpedmaketodaystreatmentsofthe
mentallyillbetterthantheyhaveeverbeen.
ThereisnogreaterproofthatNorthAmericantreatmentsarebetterthantheyveever
been,thanourhugestridesinthedestigmatizationofthementallyill.Peoplewithmental
illnessesarefacedwithstigmaandstereotypeseverywhere.Manyofthesestereotypeswere
createdbyusasasocietyunintentionally.Forexamplesomemightthinkallhomelesspeople
arementallyillbecauseafterdeinstitutionalizationmanymentallyillpeoplewerehomeless.
Thereforeitisourjobtosettherecordstraight.Destigmatizationcampaignsareeverywhere
todaystartinginschoolsandworkingtheirwayuptothemedia.January28thisBells
Lets
Talk
day.Itisanantistigmainitiativeencouragingpeopletotalkaboutmentalhealth,whether
itbeinseekofhelportobettereducate.Inaddition,5centsfromeachlongdistancecalled
madewithBellisdonatedtovariousmentalhealthprograms(BellLetsTalk).Withthemand
manyotherorganizationsweareeducatingpeopleonmentalillnessand,forthefirsttime

Pratt9

ever,helpingthosewithillnessesfeelcomfortablewiththemselves,atleastenoughtoseek
help.AndthatistherealproofthatNorthAmericantreatmentsofthementallyillarebetter
thantheyhaveeverbeen.
Fromtheancienttreatmentsofthementallyillincludingskulldrilling,hospitalreform
anddeinstitutionalization,tothemoderntreatmentsofthementallyillwithavarietyof
humaneinandoutpatienttreatmentcenters,tothecomprehensionofthetypes,therapies
andmedicationsforthementallyill,andtheacceptablesocializationanddestigmatizationof
thementallyill.Gettingherehasbeenarollercoasterwithrevolutionaryhighsandcrippling
lows,howeveritisundeniablethatNorthAmericantreatmentsofthementallyillarebetter
thantheyhaveeverbeen.