The History of Mental Illness in America: A Journey From Despair to Hope & Recovery

1. The History of Mental Illness in America: A Journey From Despair to Hope & Recovery Ms. Manzo

2. Former First Lady Rosalynn Carter • “We have been given many gifts as a nation; we are rich beyond measure. We Americans think of ourselves as decent, generous, and compassionate people, & for the most part we are; yet we treat a large proportion of our own population as though they are second class citizens undeserving of our help, our resources, & our understanding.” 2010

3. Colonial America • Society believed insanity was caused by a full moon at the time of a baby’s birth • These “lunatics”- (lunar) were thought to be possessed by the devil • Treatments: ice baths, bloodletting

4. Colonial Treatment • Barbaric • Demon-possessed • Senseless animals • “It was believed that patients chose to behave irrationally, and doctors tried to help them adopt a more normal manner.”

5. Care????? • Family • Parish Church • Those without family- • placed in prisons- chained to walls, unclothed • poorhouses

6. 1770s • First hospitals • 1773- Williamsburg, Virginia • Designed to keep those with mental illness away from society- not treat them.

7. The Public Hospital, Va.

8. 17th-18th Centuries

9. Dorothea Dix

10. Dorothea Dix • Schoolteacher • Discovered many people with mental illness were in jails. • Crusaded for the establishment or enlargement of 32 mental hospitals, & transfer of those with mental illness from almshouses and jails.

11. 1840 • US Census • Includes its 1st question on “insanity”

12. Thomas KirkbrideDesigner of Asylums

13. Athens Asylum for the Insane-1874 • 544 rooms- self-sufficient with dairy barns, greenhouses, transportation system, recreational activities • But others soon went there for food & shelter • Populations skyrocketed – patient care suffered. • Now old ways returned…ice baths- shock machines…..

14. An Asylum For Every State

15. The Civil War • Many servicemen- postwar trauma • State hospitals and asylums overcrowded • Restraints, shock therapy, opium

16. Soldier’s Heart- or “PTSD”

17. Post Civil War • Asylums – now underfunded – overcrowded • Quality of care deteriorates • Newspapers expose inhumane conditions

18. 1900- Clifford Beers

19. “A Mind That Found Itself” • 1908- changed mental health care • Beers’ autobiography –chronicles his struggle with mental illness and healthcare

20. Mental Health Screening Begins • Ellis Island Dr. Thomas Salmon in 1905: “Justice to the immigrant requires a carefully considered diagnosis; while on the other hand, the interests of this country demand an unremitting search for the insane persons among the hundreds of thousands of immigrants who present themselves annually at our ports of entry.”

21. The National Committee For Mental Hygiene • Founded in 1909- in NY by psychiatrists and Beers • Goals • To improve attitudes toward mental illness and those with mental illness • To improve services • To work for the prevention of mental illness & promote mental health

22. 1930s- The LobotomyMental Health’s Darkest Hour • Surgically separated the neural passages from the back of the brain • Over 20,000 performed • Abuse and neglect soared

23. Asylums Renamed Mental Hospitals • Psychiatric units opened in general hospitals • Treatments ineffective • Hospitals provided humane custodial care at best • At worst- neglect or abuse • Great Depression=overcrowding…….

24. 1946- National Mental Health Act • President Truman - National Mental Health Act • Creates for the first time in US history a significant amount of funding for psychiatric education and research • Led to the creation in 1949 of the National Institute of Mental Health (NIMH).

25. 1947-1951 • 1st community based health treatment for patients in state institutions

26. 1949- Lithium • New hope

27. 1954 • Antipsychotic drugs introduced • Thorazine- improves hallucinations and delusions • Other medications now become available

28. 1956 • Congress allocates- $12 million for psychopharmacology • Number of consumers decline in mental institutions

29. 1961- Action for Mental Health • Report to Congress based on 5 years of research • Task- arrive at a national program to meet the needs of those with mental illness • Recommends improved research, training and treatment in the field of mental health. • Attempts to answer: • “Why has care of the mentally ill lagged?” • “How can we catch up?”

30. 1960s • Community health movement • Outpatient services • More research • Less state mental hospitals • More general hospitals with psychiatric wings • More community health centers

31. 1980s • President Jimmy Carter • Mental Health Systems Act • Grant program • Involves consumer input • Offers education and support • Strengthens the links between • Federal and state services

32. 1981-1985 • Carter’s work halted • Mental Health Systems Act repealed • Funding drops

33. Behavioral Health Managed Care • 1988 • States now “carved out” mental care from physical care • Purpose: increase efficiency • Results: led to erosion of health care

34. 1990s- The Decade of the Brain • President George Bush designates the 1990s as the Decade of the Brain: "to enhance public awareness of the benefits to be derived from brain research" through "appropriate programs, ceremonies, and activities."

35. 1994 • Behavioral Brain Imaging • Helps scientists learn more about the development of major mental illnesses.

36. 1996 • HIPPA-regulation of forms, privacy and security • Significant impact on caregivers of those with mental illness

37. 1999- The Voice of the Supreme Court • Olmstead v. LC • It is a violation to keep a patient in a restricted setting when outpatient services are available

38. The Clinton Administration • Bans the use of restraints in federally funded hospitals • Report on co-occurring disorders ordered

39. The Bush Administration • Increased funding for community health centers • New Freedom Commission on Mental Health

40. The Obama Administration • Mental health parity states that psychological conditions must be treated equivalently to physical illnesses.

41. So why does the suffering continue?

42. Funding for research & services is scarce • Screening for childhood disorders does not exist in most schools • Veterans are returning with few services • Few jobs and places to live

43. And…..STIGMA

44. But…… We have come so far… • Mental Health is our last Civil Rights Movement…. • New advances in science are leading to better lives • Recovery is possible.

45. The Value of Hope & Hard Work • “Having some hope is crucial to recovery; none of us would strive if we believed it a futile effort.”Leete ‘89

46. And America is changing because we are “saying what we need to say”!