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Deinstitutionalization: Transforming Mental Healthcare

Explore the historic shift towards community mental health care after WWII, the impact of deinstitutionalization, and the aftermath. Learn about key figures like Robert Hanna Felix and the evolution of mental health theories and treatments. Discuss the current state of mental health care and ways to improve support for the mentally ill population.

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Deinstitutionalization: Transforming Mental Healthcare

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  1. Deinstitutionalization Kari Cattle

  2. Historic Zeitgeist • The Postwar Booms (1946- 1964) • The Cold War (1947-1991) • Civil Rights Movement (1954-1968)

  3. New issues arise after WWII • Serious mental illness more prevalent • 38% Military personnel discharged for mental illness • State mental hospitals brutal • Professional staff drafted

  4. The exposure • Conscientious Objectors first to bring light to inhumane treatment • The Inhumane Treatment • Medical Treatments • Physical Mistreatment

  5. What is Deinstitutionalization? • Process of getting rid of psychiatric institutions in 1955

  6. Why it occurred • The inhumane treatment • 1954 was when chlorpromazine (thorazine) was introduced • 1965 Medicaid & Medicare

  7. Why it occurred CONt’d. • Civil rights movement • Kennedy Signs the Deinstitutionalization Act

  8. Robert Hanna Felix • Born May 29th1904 - 1990 • University of Colorado Medical School in 1930 • Johns Hopkins University • Federal Public Health Service

  9. Robert Hanna Felix CONT’d • WWII Psychiatrist • Helped develop the Mental Health Act of 1946 • National Institute of Mental Health (NIMH) • Created Community Mental Health Centers (CMHC)

  10. Theories of Mental Illness • Szasz Did not believe Mental Illness Exists • Goffman believed the institutions caused the mental illnesses • Caplan believed mental illness was due to avoiding hypertensions • Felix believed it was caused by social or cultural factors.

  11. National Institute of Mental Health • Was created from funding from the National Mental health act of 1946 signed by Truman • Help understand mental health, and provide research for prevention, recovery and a cure.

  12. Felix’s Idea • In 1945 he wanted a mental illness research center constructed • New role for the State Hospitals • A new community center

  13. Short life of Community Mental Health Centers • Community Mental Health Act Signed in 1963 • The first CMHC Open in 1966 • 5 years of federal funding • No relationship between dropping hospital numbers and CMHC (33:28) • HZ: M.L.K. Jr. assassinated in 1968

  14. Flaws with Felix's idea & implementation of CMHC • State CMHC already underway • No communication • Who they were treating • Misuse of funds • The lack of NIMH Standards

  15. Death of CMHC • Termination addressed in 1970’s • Closed down officially in 1981 • Cause of death: Naiveté complicated by grandiosity • no coordinated plan for aftercare existed afterwards

  16. Transinstitutionalization • Moving the elderly into nursing homes • Intermediate Care Facilities (ICF) • Wisconsin leading

  17. After Effects • Homicides in California the highest (98) • Severe mentally ill living situations • Exponential growth of Mentally ill Homelessness (45:40) • misdiagnoses to be eligible for care • Jailing of Mentally ill

  18. Treatments Now • Out Patient Therapy • Hospitals • More Accurate medications • Video: 53:32

  19. Discussion • DO you think that the after effects of Deinstitutionalization has gotten any better today?

  20. Discussion • How do you think we should go about making change for the mentally ill population?

  21. Discussion • How do you think the community programs should have been set up?

  22. Discussion • What do you think is the cause of mental illness?

  23. http://sites.dlib.nyu.edu/undercover/sites/dlib.nyu.edu.undercover/files/documents/uploads/editors/ChiDailyTimes_1935July15_FULL.pdf Newspaper article of Frank Smith • https://www.pbs.org/wgbh/pages/frontline/shows/asylums/special/excerpt.html • https://www.history.com/topics/1950s • https://www.nytimes.com/1990/04/03/obituaries/dr-robert-h-felix-is-dead-at-85-mental-health-unit-s-first-chief.html • https://fod-infobase-com.ezproxy.uwplatt.edu/p_ViewVideo.aspx?xtid=32651

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