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The Identification of Mental Illnesses Throughout History - History

The Identification of Mental Illnesses Throughout History - History


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The Identification of Mental Illnesses Throughout History

By Sanford First

Mental health and mental illness have been a human issue since the beginning of human history, however, it has only been recently that we have begun to further understand this important issue.

The mind is a very complicated subject, and years of study is often needed to even begin to understand the convoluted way that it worked.

We know that a broken bone, for example, will heal if it is set in the correct way, and a set of instructions are followed, however the same set of rules do not always work for the mind, and this makes it more complicated.

Mental Illness Through History

Mental illness has been woefully misunderstood throughout history, with many people suffering awful treatments at the hands of well meaning, but extremely misguided, physicians.

Many mental illnesses were diagnosed as other things, as they were not fully understood, and some people were imprisoned under the guise of medical care, so society could forget about these unfortunate individuals.

Shell Shock

Most people will be familiar with the term shell shock. It was a phrase born of the First World War, and many of the soldiers who came back from that war suffered with some degree of this mental disorder.

This war saw death on a scale that has rarely been seen before, in the four years that the war raged, around forty million people, both military and civilian, died.

The soldiers that had to see this mass slaughter were, of course, traumatised.

Shell shock was the name given to a range of symptoms, from tinnitus, dizziness, tremors, noise phobia, mutism, and dissociative disorders.

We would now recognize many of the symptoms as being PTSD, or Post Traumatic Stress Disorder.

Shell shock was sometimes attributed to being near to a shell when it had exploded, hence the noise. It is also a lesser known, and sad fact that if the shell shock was attributed to an enemy, for example, being near an enemy shell when it exploded, the soldier was marked as wounded and given a full pension.

If the soldier in question had not been near enemy fire and was suffering with shell shock, they were not considered wounded and no pension was attributed to them.

Many soldiers were unable to fight again, and were often labelled as being cowards, or lacking in moral fiber, and were sometimes handed the white feather that represented cowardice.

These unfortunate people often suffered throughout their lives, and suffered procedures that did little to help, and sadly many men took their own lives, as they were unable to live with this awful mental illness.

PTSD was long written off, but it is worth remembering that without these soldiers, we would understand less about PTSD than we do today.

Hysteria

Hysteria is a condition that was always attributed to women, in fact, the word hystera is the Greek word for uterus. Ancient Greek doctors attributed many issues to a woman's 'wandering uterus' and many horrible treatments were forced on to them in order to have the uterus back in its proper place, in the hope the symptoms would resolve.

During the 19th century, the rise of the colloquially known 'mental hospitals', such as Bethlehem hospital - also known as Bedlam - in London, meant many women were imprisoned for various illnesses that were attributed to hysteria.

We now know that the illness being diagnosed as hysteria was actually a whole variety of illnesses, including epilepsy, anxiety, clinical depression, conversion disorders.

Sometimes, women were labelled as having hysteria if they were against getting married, or if they could not or would not have children, luckily we live in an age where these are no longer considered physiological disorders.

Treatments for hysteria were very varied, with some being extremely unethical. Luckily hysteria no longer considered a diagnosis.

Depression

There has been evidence of people suffering with depression for thousands of years, and was known as melancholia.

There have been varying theories on why a person is depressed, such as demonic possession, an excess of black bile and even being cursed by a witch.

Treatments during these times were anything from bloodletting to starvation, which of course, did nothing to help these poor people.

Some early doctors however, attributed depression as arising from the brain and started early forms of behaviour therapy, such as positive reinforcement.

Depression has been poorly understood for much of history, but luckily we now know a lot more about it, and have much more successful, less physical treatments.

Mental illness is not a new phenomenon, but luckily we live in a time where this issue is much less taboo, and help is available to everyone.



Hysteria has a slew of nervous symptoms that cannot be attributed to a physical cause. Despite men being just as prone to breakdowns as women, societal and political pressures stood in the way of diagnosis. However, in 18th- and 19th-century Britain, it became fashionable for men to develop &ldquonervous&rdquo issues. It was an issue of class, where sensitivity was seen as sophistication that elevated the bourgeois above the working people.

In the early 20th century, male hysteria morphed into &ldquoshell shock.&rdquo This reflected a changing perception of the disease, losing its feminine connotations. This new form of male hysteria was made honorable. In the 1980s, &ldquoshell shock&rdquo gave way to PTSD&mdashpost-traumatic stress disorder. The progression has been a slow shift from the feminine stigma associated with the disease.


History of mental illness

Mystical views dominate this period
No division between health care, magic,
and religion - no understanding of why
diseases occur
- Abnormal behavior attributed to the
supernatural
- Treatment included spells cast by
Shamans, exorcisms

Ancient Greece and Rome

Between 500 BCE – 500 CE numerous
mental disorders were identified
- Melancholia-
Mania
-Dementia
=Hysteria
--Delusions
- Hallucinations

15TH CENTURY

thoughts on the mentally ill
- Arguments for the existence of witches
- ‘Proof’ that witches are mostly women
- How to identify a witch (deviant
behavior, i.e. sexual)
- Insanity was caused by possession by
the devil
how they treated they witches
- ƒ Salvation of the immortal soul was more
important than the comforts of the
possessed body
- ƒ Physical punishments were used to make
the body an intolerable refuge for the devil

16th century

  • People with psychological disorders were seen as dangerous so they were locked up to protect society and there was an increase in mortality rate.
  • In the 16th and 17th centuries, people were obsessed with the concept of mental illness. This is evident throughout Shakespeare's plays, but is especially evident throughout his play "Hamlet.

17th century

General belief: If mad people behaved like
animals, they should be treated like animals
- Thomas Willis (neuroanatomist and doctor)
advocated the following treatments:
- Curative discipline
- Fetters
- Blows
- Medical treatments
- In the eyes of the law, mentally ill people lacked the capacity to reason, so a Court of Wards would hand the responsibility for their affairs to someone else. King James I (1603-1625) instructed the court that 'lunatics be freely committed to their best and nearest friends that can receive no benefit by their death.' The care of the mentally ill was essentially a domestic matter and on the whole, it seems that people were not exploited by the system.
In the 17th century people with mental
health problems were often cared for
privately
- This evolved into a business where people
housed numerous patients – “private
madhouse”
- Treatment varied according to ability to pay

18th century

Development of new asylums
- Built to house people with mental health
problems separately from houses of
correction and poor houses
- Prisons with neglectful conditions?
at this time mental illness was considered or moral of weakness.
Hospitalization
Mentally ill referred to as “Lunatics”

Colonists declared these lunatics
possessed by the devil, and usually
they were removed from society and
locked away

19th century

Moral Management
- The environment plays a vital role in the
treatment of the mentally ill
- Recovery would more likely occur if
conditions and surroundings resembled the
comfort of home
- Beds, pictures and decorations replaced
shackles, chains and cement cells
Moral management included:
- Mentally ill to be to be treated in special
facilities
- Structured daily schedule (work therapy)
z Inappropriate behaviors were to be confronted
with the goal of eliminating the behavior
- Ultimate goal - restore sanity and to return the
patient to society as a fully functioning,
productive member of society
- Punitive treatments were abolished
-Due to public demand, asylums began
to appear all over the country

20th century

medical treatment of the 1930's
Few mental health specialists
- Numerous theories were proposed about the
cause of mental illness and its treatment
-Treatments included:Removal of a person’s teeth and large intestines
- Induction of fevers
- Sleep therapy
- Hypothermia
- Bath treatmen
De-institutionalization
- Changes in mental health institutions
- Emphasis on protecting the human
rights of the mental patients
- Individualized treatments instead of
group cure-alls
-Movement toward de-institutionalization
- 500,000 patients in 1960
- Development of outpatient services
-Deinstitutionalization was really transinstitutionalization. Changes in regulations in Medicaid allowed the shifting of mentally ill people who were older than age 65 to nursing homes
- Community mental health centers never developed programs to serve people who were seriously mentally ill. Rather than serving clients who were psychotic, the community mental health centers marketed their treatment programs to people with anxieties, who were undergoing divorce, or who had mildly troubled children.


Mental Health Treatment Today

As we learn more about the causes and pathology of various mental disorders, the mental health community has developed effective, safe treatments in place of these dangerous, outdated practices. Today, those experiencing mental disorders can benefit from psychotherapy along with biomedical treatment and increased access to care. Treatments will continue to change along with scientific and research developments, and as mental health professionals gain more insight.

If you are interested in the treatment of mental disorders and relevant topics in psychology like those covered here, consider Concordia University, St. Paul’s online Bachelor of Arts in Psychology. This program equips students with the knowledge and tools necessary to excel in the field of psychology.


A Brief History Of Dementia

Before the 19th century, dementia was a broad clinical concept. It included all types of mental illnesses and psychosocial incapacity whether reversible or not.

During this time, if a person had lost their ability to reason, it would be said that they have dementia. It was also categorized as an organic disease such as syphilis responsible for destroying the brain.

Old people who got dementia were thought to have developed the illness because of the hardening of arteries.

However, as the lifespan of humans extended, advancements in the field of medicine also occurred and experts were able to study the brain in the 1800s.

This led to the realization that various diseases can result in this form of cognitive deterioration. Check out the evolution of dementia over the years, specifically before and after the 19th century.

Dementia before the 19th Century


Not much is recorded about the history of dementia during this period primarily because science and research during the medieval age were virtually non-existent.

In fact, before the 1700s, terms like stupidity, amentia, foolishness, senility, and idiocy were common when referring to various degrees of behavioral and cognitive deterioration resulting in psychosocial incompetence.

Plato and Aristotle spoke of mental decay in advanced age as an inevitable process affecting all old people without any preventive measures.

Cicero, a Roman statesman, had another view stating that loss of mental function was inevitable as it only affected weak-willed older men.

He explained that wanting to learn new things and staying mentally active could stave off the development of dementia.

A majority of people with mental illnesses were treated, sadly some nations locking them up in asylums. This started to change in the 19th century when Philippe Pinel, a French physician, advocated for a more humanitarian way of caring and treating persons who were mentally ill.

This offered better settings for clinical observations.

Dementia after the 19th Century


In 1910, the most common dementia (Alzheimer’s disease) was named after a German psychiatrist Alois Alzheimer.

This was after Alois studied the post-mortem brains of younger individuals who were affected by the illness. He published his first case in 1906. This was a case of a 50-year-old woman who was showcasing dementia symptoms.

After the lady passed on, Alois observed the microscopic tangles and plaques that are known to be hallmarks of the illness. He was, however, not convinced that the plaques were behind the development of dementia.

Alzheimer reported that they were just one of the features of the illness. Oskar Fischer, another Czech psychiatrist at the same time, was also researching the brains of older individuals.

He, too, saw the tangles and plaques.

Contributions from these two professionals shed more light on the condition making significant contributions to the history of dementia.

With the advancement of technology, there has been a better understanding of dementia and what causes it.

Later on in the 1960s, an electron microscope was introduced. This allowed medics to further study the plaques and tangles because they could use this equipment to zoom in while exploring the brain.

Alzheimer’s disease soon became the most common

In the 1970s, Alzheimer’s disease (AD) was officially recognized as the most common dementia form.

At this time, experts also revealed information that Alzheimer’s was different from the mild cognitive decline that is associated with growing old.

CT scans at this point confirmed shrinkage of brains in the persons affected by the neurodegenerative illness.

A decade later, in the 1980s, biochemical and molecular advances led to the identification of amyloid-b and tau as components of plaques and tangles.

When talking about the history of dementia, it is also important to mention that it was in the 1990s when experts were able to identify genetic mutations and the risk factors of AD.

At this stage, the stages of dementia were also categorized.

Additionally, there was a better understanding of the processes that result in dementia, particularly brain imaging, genetics, and molecular biology.

All through the 19h century, dementia was still considered a rare disease, perhaps because not many individuals lived past the age of 80.


History of Mental Health: Chapter 1

Mentally Health People
-Successfully carry out activities of daily living.
-Adapt to change
-Solve problems
-Set goals
-Enjoy life!

They are self aware, directed and responsible for their actions.

-Psychotropic drugs are used in combination with various therapies for treating mental illness.

Each state facility received a designated amount of federal money and then the state determined how the money was spent.

Early civilizations believed that mental illness was caused by wrath of evil spirits and by demonic possession.

Treatments were geared to removal of evil spirit.

-By 1330, Bethleham Royal Hospital (or Bedlam) was a lunatic asylum.

-Physicians and theorists were making observations and speculations about insanity.

-Inhumane treatment and vicious practices were openly questioned.

-Late 1700s in some countries began to advocate acceptance of the mentally ill as human beings.

-Paris hospital director advocated for mentally ill.

-Dorothea Dix surveyed asylums, jails and almshouses. Because her voice, care of the mentally ill greatly improved.

-This caused a two-class system "private care" and "public care"


Ancient Hebrews and Israelites

Hebrews believed that all illness was inflicted upon humans by God as punishment for committing sin, and even demons that were thought to cause some illnesses were attributed to God’s wrath. Yet, God was also seen as the ultimate healer and, generally, Hebrew physicians were priests who had special ways of appealing to the higher power in order to cure sickness. Along the same spiritual lines, ancient Persians attributed illness to demons and believed that good health could be achieved through proper precautions to prevent and protect one from diseases. These included adequate hygiene and purity of the mind and body achieved through good deeds and thoughts.


Society’s View of Mental Illness through the Ages

Throughout cultural history mental illness has been attributed to the influence of supernatural forces, the possession by evil spirits, demons or being a result of displeasing deities. Trephined skulls to release bad spirits are reported going back to the Neolithic Age (Porter, 2002, p. 10). Demonological thinking was prominent in early Chinese, Egyptian, Babylonian, Greek [&hellip]

Throughout cultural history mental illness has been attributed to the influence of supernatural forces, the possession by evil spirits, demons or being a result of displeasing deities. Trephined skulls to release bad spirits are reported going back to the Neolithic Age (Porter, 2002, p. 10). Demonological thinking was prominent in early Chinese, Egyptian, Babylonian, Greek and Hebrew culture and culminated in the ‘Lunacy Trials’ of the Dark Ages, explaining mental illness by witchcraft, and the practice of exorcism (Kring, 2011, p. 9-10). The first physician who denied the influence of supernatural forces and suggested natural causes for ‘diseases of the brain’ was Hippocrates (Butcher, 2007, Kring, 2011). Upcoming asylums in the 15 th century facilitated the life-long and inhumane institutionalization of mentally ill persons. Asylums were synonymous with cruel abuse serving public entertainment (Butcher, p. 37, Kring, p.11) until Philippe Pinel started reforming and humanizing asylums end of the 17 th century (Kring, p.12). Scientific understanding of mental illness started late with discoveries of Louis Pasteur and Francis Galton, but still lacked ethics and human understanding as the infamous eugenics movement at the beginning of the 19 th century demonstrated (Black, 2005). It wasn’t until the work of Sigmund Freud that mental illness was formulated conceptually in psychoanalytic theory and in its trail, based on experimental-rational observation, via behaviorism (Kring, p. 17-22). The focus on human needs and development was the work of pioneers such as Adler, Jung, Erikson, Fromm, Maslow, Rogers, Horney and Klein. We can conclude that the paradigm shift from irrational to rational beliefs about mental health is not attributable to science alone, but the combination of science with humanistic philosophy that recognizes patients as subjects, not objects of assessment and treatment. As a result we see patients today as individuals whose personal development as well as social- and occupational functioning should be supported. This perspective is enhanced by the current global transformations of social life-worlds reinstating questions of the good life (Robbins, 2008).

The importance of modern psychological appraisal and treatment for mental illness

Modern clinical appraisal entails the use of idiographic (individual) and nomothetic (shared across individuals) tools to assure internal consistency, inter-rater reliability, content- and construct validity, allow for generalization and sensitivity to treatment change. Besides, psychometric instruments also have to prove clinical utility (Hunsley et al, 2008, p.7). Evidence-based practice (EBP) should include best available research to serve patients, clinical expertise promoting positive therapeutic outcomes and should collaboratively respect a patient’s context, including culture, individual personality, strength’s and preferences since positive mental health outcomes depend on a patient’s active involvement (Norcross et al., 2008, p.5-6). In individual case-formulation treatment response informs and revises diagnosis to optimize treatment outcomes and it avoids the labeling of clients.Case formulation in psychology should not be confused with clinical diagnosis in psychiatry.

Some examples for biopsychosocial factors influencing treatment approaches

Biological Factor: in the case of correctly diagnosed Bipolar Disorder a pharmacological approach would be adequate considering the administration of newer generation SSRI’s or SNRI’s (Seligman et al., 2007, p.45).

Psychological Factor: In the case of low Self-Esteem and depression evoked by nurturing self-defeating beliefs, Rational Emotive Behavior Therapy (Ellis & MacLaren, 2004, p.26) would a valid choice or, if the patient’s problem involves more explicit behavioral components, Cognitive Behavioral Therapy/ CBT (Anderson et al., 2009, p.8).

Social Factor: Dealing with anxieties and depression created by announced layoffs at one’s company could be addressed with problem-solving therapy addressing maladaptive coping and improving a patient’s ability to pragmatically manage stressful life-events (Eskin, 2013).

My personal views of mental illness influencing use of appraisal and treatment

I understand mental illness from both a humanist and pragmatic, problem-solving perspective which entails positively empowering a patient’s Self as well as his or her social- and occupational functioning. Appraisal requires to be conducted by proven and reliable multi-item tools that demonstrate content and context-validity to allow for an in-depth clinical understanding. Besides, psychometric instruments have to prove clinical utility and efficacy. Treatment planning needs to include a review of state-of-the art research, standardized diagnosis, assessment of epidemiology, primary and secondary symptoms, properties of a disorder (onset, course and duration) and etiological identification of underlying biopsychosocial factors (Seligman et al., 2007). Treatment logically addresses diagnosed properties.

Andersson, G., & Cuijpers, P. (2009). ‘Psychological treatment’ as an umbrella term for evidence-based psychotherapies? Nordic Psychology, 61(2), 4-15.

Black, E. (2005). War against the weak: Eugenics and america’s campaign to create a master race. New York City: Dialog Press.

Butcher, J. N., Mineka S., Hooley, J.M. (2007). Abnormal Psychology. Ed. Susan Hartman. 13th ed. Boston: Pearson Education, Inc.

Ellis, A., & MacLaren, C. (2004). Rational emotive behavior therapy, a therapist’s guide. (2 ed.). Atascadero, CA: Impact Pub.

Eskin, M. (2013). Problem solving therapy in the clinical practice [electronic book] / Mehmet Eskin. London Elsevier, 2013.

Hunsley, J., & Mash, E. J. (Eds.). (2008). A guide to assessments that work. New York, NY: Oxford University Press.

Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Abnormal psychology (11th ed.). Hoboken, NJ: John Wiley & Sons.

Norcross, J. C., Hogan, T. P., & Koocher, G. P. (2008). Clinician’s guide to evidence-based practices: Mental health and the addictions. Oxford, England: Oxford University Press.

Porter, R. (2002). Madness: A Brief History. New York City: Oxford University Press

Robbins, B. (2008). What is the Good Life? Positive Psychology and the Renaissance of Humanistic Psychology. Humanistic Psychologist, 36(2), 96-112. doi:10.1080/08873260802110988

Seligman, L., & Reichenberg, L. W. (2007). Selecting effective treatments: A comprehensive, systematic guide to treating mental disorders (3rd ed.). San Francisco, CA: John Wiley & Sons.


8 Horrific 'Cures' for Mental Illness Through the Ages

If it wasn’t already clear to the public at large, the recent suicide of comedian Robin Williams drove home the point: mental illness can be devastating. It is hardly limited to people we sometimes see on the street railing against apparent voices in their heads, or obsessive-compulsive television characters like “Monk.” It is widespread and debilitating and it can kill. According to the National Alliance on Mental Illness, 1 in 17 Americans, including children, are dealing with serious mental illnesses like depression, bipolar disorder, schizophrenia, obsessive-compulsive disorder, and post-traumatic stress disorder. That’s 6% of the population, almost 2 million people.

In any given year 1 in 4 American adults experience some kind of mental health issue. The U.S. Surgeon General reported that 1 in 10 children suffer some form of mental illness, disrupting home and school lives around them. Mental illness is responsible for 4 out of every 10 cases of disability in the country. It often affects adolescents and young adults, and the cost to society is enormous, over $100 billion a year in the U.S. alone, from disability, unemployment, drug abuse, suicide, homelessness, and prison incarceration.

And yet, in truth, as bad as things are, we live in the best of times for mental illness. The medical community is beginning to understand the root cause of mental disorders, often brain chemistry imbalances, and is fast developing pharmacological treatments to address them. In combination with interpersonal, behavioral, and peer group therapy, along with early identification of problems, up to to 90% of mental illness sufferers can be significantly helped. The stigma of mental illness is slowing eroding away, as we recognize that it is an illness, just like diabetes, cancer, and other illnesses, and is not a result of character weakness or lack of will power.

Historically, mental illness was treated much differently. People looked upon mental illness as something other than illness, and attempted to eliminate the problem in horrific manners. Here are eight treatments for mental illness that not only did not cure or help the sufferers, but likely traumatized them even more.

1. Trepanation

Trepanation is boring a hole in your skull. As far back as the Neolithic era, some 7000 years ago, and as recently as today for a small number of strange and misguided folks, the practice of trepanation has been used to “cure” mental illness. Thousands of years ago, having no knowledge of things like brain chemistry, ancient doctors (a loose definition, for lack of a better term) believed that the mentally ill were possessed by demons hanging around in our heads. What better way to rid us of the demons than by giving them a way out? And so, holes were drilled into the skulls of the patients so that the spirits could escape. Did I mention there were no anesthetics back then? Archaeologists have found a plethora of ancient skulls with carefully cut holes in them.

2. Hydrotherapy

No, we are not talking about a relaxing swim to calm the nerves. In the early 20th century, psychiatrists used a variety of water treatments to treat patients with mental disorders. Some were harmless enough, like warm baths or an invigorating shower. Some treatments, however, bordered on Cheney-esque waterboarding. One treatment had patients wrapped like mummies in towels soaked in ice water. Another “cure” took the relaxing bath to scary extremes, strapping and restraining patients in the tub for sometimes days at a time, allowing escape only for bathroom breaks. High-pressure water jets were also used, and in at least one instance a patient was bound in a crucifix position and a fire hose was turned on him. One hopes it turned out better than traditional crucifixions.

3. Chemically induced seizures

Here’s one that actually worked! Sort of. A pathologist named Ladislas von Meduna observed that, following seizures, epileptics appeared calm and even happy. From this he deduced that by inducing seizures in schizophrenics he could calm their symptoms and even perhaps cure them. After experimenting with drugs like strychnine and absinthe, he settled on a drug called metrazol, which stimulated the circulatory and respiratory systems and caused seizures. It seemed to work. The majority of Meduna’s patients seemed to improve, at least according to Meduna. It is possible that the seizures released chemicals that were absent from the schizophrenic brain, triggering improvements. Then again, the side effects like memory loss and fractured bones were not exactly minor, and the treatment was eventually abandoned.

4. Hysteria therapy

The ancient Greeks may have established Western culture, but they had an odd way of treating mental illness. Hippocrates, the father of modern medicine (doctors today still recite the Hippocratic Oath) popularized the term “hysteria” to describe any sort of mental illness suffered by women. Hysteria was diagnosed for anything from nervousness to fainting to simply not talking enough. The cause, according to Hippocrates, was a “wandering womb.” The philosopher Plato claimed that when the uterus, "remains unfruitful long beyond its proper time, it gets discontented and angry and wanders in every direction through the body, closes up the passages of the breath, and, by obstructing respiration, drives women to extremity."

In order to calm down the wayward uterus, patients were required to inhale foul-smelling substances that would drive away the uterus from wherever it was kicking up a storm in the body. Of course, the real cure for female mental illness was to get the uterus settled in doing what it was there for. Women needed to get married and start having babies.

5. Mesmerism

Franz Mesmer was an Austrian physician back in the 18th and early 19th centuries. Perhaps best known as the father of hypnotism, Mesmer also had an interesting theory about mental illness: blame it on the moon. Mesmer was convinced that the moon’s gravitational pull, much as it affected the Earth’s tides, also affected the body’s fluids. Intermittent episodes of depression and schizophrenia rose and fell like the oceans tides, as the bodily fluids were being acted on by the moon’s gravity. The solution was to counteract the gravity with another force: magnets. By placing magnets on various parts of the body, Mesmer felt the bodily fluids were redistributed and mental equilibrium was restored. Although many of Mesmer’s patients claimed the therapy cured them, medical authorities dismissed mesmerism as ineffective, and positive outcomes were chalked up to the placebo effect.

6. Rotational therapy

Charles Darwin has his unshakable place in intellectual history. Darwin’s grandfather too has a place, although he was perhaps not the giant of science Charles was. Erasmus Darwin was a physician, a scientist and a philosopher. By many accounts he was bad at all of them. His claim to fame was rotational therapy. He believed that disease could be cured by sleep. And he believed that spinning the patient around very fast induced sleep. Needless to say, Erasmus’ therapy was dismissed, but not before Dr. Benjamin Rush, one of America’s Founding Fathers and signatory to the Declaration of Independence, adopted his rotational therapy for the purposes of curing mental illness. Rush believed that mental illness was caused by brain congestion, and that spinning would reduce the congestion and cure the mental disorder. We can safely assume that dizziness was the main result of his therapy, not cure.

7. Insulin-coma therapy

Viennese doctor Manfred Sakel developed insulin-coma therapy in 1927. Apparently not a particularly careful doctor, he accidently gave one of his patients an insulin overdose, resulting in her falling into a coma. The patient, who was a morphine addict, awoke from her coma and discovered that her addiction had disappeared. Sakel, being the bad doctor he was, made the same mistake with another patient who also awoke addiction-free. Sensing a trend, Sakel began intentionally inducing insulin comas to schizophrenics and other patients, and 90% of them reportedly were cured. It is unknown why or even if these claims were true, but thankfully the insulin-coma therapy eventually faded away by the 1960s. A good thing, since it was a dangerous therapy and 2% of the patients weren’t cured, they died.

And finally, we have everybody’s favorite mental illness cure, the lobotomy. The lobotomy was developed by a Portuguese neurosurgeon named Egas Moniz. He had heard that when the frontal lobe of a violent, feces-throwing monkey was cut away, the monkey became docile and quit slinging the shit. From this, he theorized that the frontal lobe was the hotbed of mental illness and by cutting it he could cure mental illness. And so he tried it on his human patients. By his own standards, the surgeries were a success, and lobotomies caught on. In 1949, Moniz even received the Nobel Prize for his efforts.

In America, one Dr. Walter Freeman took to the road in his “lobotomobile” and actually provided onsite lobotomies to anyone who seemed willing, from schizophrenics to bored housewives. His technique was to insert an ice pick into the eye socket and swirl it around a bit to “disable” the frontal lobe. Unsterile equipment and imprecise surgical technique aside, there was a problem that soon became apparent as the number of lobotomies multiplied. Quite a number of the patients weren’t cured in fact, they became virtual zombies, unresponsive and brain-damaged for life. This making for fairly bad testimonial, the lobotomy faded into medical obscurity.


Contents

In the United States in the early 1980s, Judge Evan Dee Goodman helped establish a court exclusively to deal with mental health matters at Wishard Memorial Hospital. The mentally ill were frequently arrested and had charges pending when the treatment providers sought a civil commitment to send their patient for long-term psychiatric treatment. Judge Goodman's court at Wishard Hospital could serve both purposes. The probate part of the mental health court would handle the civil commitment. The criminal docket of the mental health court could handled the arrest charges. The criminal charges could be put on diversion, or hold, allowing the patient's release from jail custody. The civil commitment would then become effective and the patient could be sent to a state hospital for treatment. Judge Goodman would schedule periodic hearings to learn of the patient's progress. If warranted, the criminal charges were dismissed, but the patient still had obligations to the civil commitment.

In addition to arranging inpatient treatment, Judge Goodman often put defendants on diversion, or on an outpatient commitment, and ordered them into outpatient treatment. Judge Goodman would have periodic hearings to determine the patient's compliance with the treatment plan. Patients who did not follow the treatment plan faced sanctions, a modification of the plan, or if they were on diversion their original charge could be set for trial.

Judge Goodman's concept and the original mental health court were dissolved in the early 1990s. In 1995, Judge Goodman was reprimanded for nepotism. [3]

In the mid-1990s, many of the professional mental health workers who had worked with Judge Goodman sought to re-establish a mental health court in Indianapolis. Representatives of the county's mental health service providers and other stake holders began meeting weekly. The group decided to accept the name of the PAIR Program (PAIR stood for Psychiatric Assertive Identification and Referral). After, a couple years of lobbying the local authorities in Marion County, Indiana, the mental health court began as a formal program in 1996. Many consider this to be the nation's first mental health court in this second wave of mental health court initiatives. [ citation needed ] Since the PAIR Program did not operate with any new funds, there was not much scholarly research and therefore the accomplishments of Judge Goodman and the PAIR Program are frequently overlooked. The current PAIR Program is a comprehensive pretrial, post-booking diversion system for mentally ill offenders. [4] A program launched in Broward County, Florida was the first court, to be recognized and published as a specialized mental health court. Overseen by Judge Ginger Lerner-Wren, the Broward County Mental Health Court was launched in 1997, partially in response to a series of suicides of people with mental illness in the county jail. The Broward court and three other early mental health courts, Anchorage, AK, San Bernardino, CA, and King County, WA, were examined in a 2000 Bureau of Justice Assistance monograph, which was the first major study of this emerging judicial strategy. [5]

Shortly after the establishment of the Broward County Mental Health Court, other mental health courts began to open in jurisdictions around the U.S., launched by practitioners who believed that standard punishments were ineffective when applied to the mentally ill. [6] In Alaska, for example, the state's first mental health court (established in Anchorage in 1998) was spearheaded by Judge Stephanie Rhoades, who felt probation alone was inadequate. "I started seeing a lot of people in criminal misdemeanors who were cycling through the system and who simply did not understand their probation conditions or what they were doing in jail. I saw police arresting people in order to get them help. I felt there had to be a better solution," she explained in an interview. [7] Mental health courts were also inspired by the movement to develop other problem-solving courts, such as drug courts, domestic violence courts, community courts and parole reentry courts. The overarching motivation behind the development of these courts was rising caseloads and increasing frustration—both among the public and among system players—with the standard approach to case processing and case outcomes in state courts. [8] In February 2001, the first juvenile mental health court opened in Santa Clara, California.

Since 2000, the number of mental health courts has expanded rapidly. There are an estimated 150 courts in the U.S. and dozens more are being planned. [9] An ongoing survey conducted by several organizations identified more than 120 mental health courts across the country as of 2006. [10] The proliferation of courts was spurred in large part by the federal Mental Health Courts Program [11] administered by the Bureau of Justice Assistance, which provided funding to 37 courts in 2002 and 2003.

In England, UK, two pilot mental health courts was launched in 2009 in response to a review of people with mental health problems in the criminal justice system. They were considered a success which met needs that would have otherwise gone unmet however they required financial support and wider changes to the system, and it is not clear whether they will be more broadly implemented. [12]

Mental health courts vary from jurisdiction to jurisdiction, but most share a number of characteristics. The Council of State Governments Justice Center has defined the "essential elements" [13] of mental health courts. The CSG Justice Center, in a publication detailing the essential elements, notes that the majority of mental health courts share the following characteristics:

  • A specialized court docket, which employs a problem-solving approach to court processing in lieu of more traditional court procedures for certain defendants with mental illness.
  • Judicially supervised, community-based treatment plans for each defendant participating in the court, which a team of court staff and mental health professionals design and implement.
  • Regular status hearings at which treatment plans and other conditions are periodically reviewed for appropriateness, incentives are offered to reward adherence to court conditions, and sanctions are imposed on participants who do not adhere to the conditions of participation.
  • Criteria defining a participant's completion of (sometimes called graduation from) the program.

Potential participants in a mental health court are usually screened early on in the criminal process, either at the jail or by court staff such as pretrial services officers or social workers in the public defender's office. Most courts have criteria related to what kind of charges, criminal histories, and diagnoses will be accepted. For example, a court may accept only defendants charged with misdemeanors, who have no history of violent crimes, and who have an Axis I diagnoses as defined by the DSM-IV.

Defendants who fit the criteria based on the initial screening are usually given a more comprehensive assessment to determine their interest in participating and their community treatment needs. Defendants who agree to participate receive a treatment plan and other community supervision conditions. For those who adhere to their treatment plan for the agreed upon time, usually between six months and two years, their cases are either dismissed or the sentence is greatly reduced. If the defendant does not comply with the conditions of the court, or decides to leave the program, their case returns to the original criminal calendar where the prosecution proceeds as normal. As a rule, most mental health courts use a variety of intermediate sanctions in response to noncompliance before ending a defendant's participation. An essential component of mental health court programs for protection of the public is a dynamic risk management process that involves court supervised case management with interactive court review and assessment.

As in other problem-solving courts, the judge in a mental health court plays a larger role than a judge in a conventional court. Problem-solving courts rely upon the active use of judicial authority to solve problems and to change the behavior of litigants. For instance, in a problem-solving court, the same judge presides at every hearing. [8] The rationale behind this is not only to ensure that the presiding judge is trained in pertinent concepts, such as mental illness, drug addiction, or domestic violence, but also to foster an ongoing relationship between the judge and participants. [14] Although the judge has final say over a case, mental health courts also take a team approach in which the defense counsel, prosecutor, case managers, treatment professionals, and community supervision personnel (for example, probation) work collaboratively to, for example, craft systems of sanctions and rewards for offenders in drug treatment. Many mental health courts also employ a full-time coordinator who manages the docket and facilitates communication between the different team members.

Some have criticized mental health courts for deepening, as opposed to lessening, the involvement of people with mental illness in the criminal justice system. They argued that this was particularly true in mental health courts that focus on misdemeanor offenders who would have received short jail sentences or probation if not for the mental health court. These critics urged mental health courts to accept defendants charged with felonies, which many of the more recent courts, such as the Brooklyn Mental Health Court, [15] have started to do. [16]

Critics have also raised concerns about the use of mental health courts to coerce people into treatment, the requirement in some courts that defendants enter a guilty plea prior to entering the court, and about infringement on the privacy of treatment information. Furthermore, many have noted that the rise of mental health courts is, in large part, the result of an underfunded and ineffective community mental health system, and without attention to the deficiencies in community treatment resources, mental health courts can only have a limited impact. [17] Finally, it has been noted that when scarce mental health services are redirected to those who have come in contact with the criminal justice system, it creates a perversion in the system were a person's best bet for obtaining services is to get arrested. [18]

Several studies of the Broward County court were released in 2002 and 2003 and found that participation in the court led to a greater connection to services. A 2004 study of the Santa Barbara County, California, Mental Health Court found that participants had reduced criminal activity during their participation. An evaluation of the Brooklyn Mental Health Court [15] documented improvements in several outcome measures, including substance abuse, psychiatric hospitalizations, homelessness and recidivism. [19] In a 2011 meta-analysis of literature on the effectiveness of mental health courts in the United States, it was found that mental health courts reduced recidivism by an overall effect size of −0.54. [20] In 2012, an Urban Institute evaluation found that participants in two New York City mental health courts were significantly less likely to re-offend than similar offenders whose cases are handled in the traditional court system. [21] A review published in 2019 concerned with drug-using offenders with co-occurring mental health problems found that mental health courts may help people reduce future drug use and criminal activity. [22]


Watch the video: Παραμύθια Εκνευρισμού: Η ιστορία και ο μύθος των τεσσάρων τύπων εκνευρισμού (January 2023).

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