The past few weeks, to say the least, have gotten us all asking questions about our identities, our status in society and what our future will look like during the Trump administration. Honestly, I’m not sure how to answer this question in regards to mental illness. In truth, politics has been a patchy situation for quite a while in terms of mental illness. To sum things up, here is a brief history of mental health treatment in America.
Colonies to Early Nationhood: Before the 1800s, there was no facility or any medical treatment in regards to mental health concerns. Instead, common practice for particularly severe individuals was for their families to lock them away in a basement, attic, shed or some other place nobody would go looking for them. The individual spent their whole life neglected and was never given any real treatment. Some, however, were functional enough to blend into, and even make their mark on society. Two people who may have blended in enough to avoid this fate were Wolfgang Mozart and Thomas Jefferson.
19th Century: In the first decade of the 1800s, mental asylums first began to appear. However, at this point in time, psychology as a study was still more thought of in the realm of philosophy and not something that officially existed from a scientific standpoint. In fact, the first laboratory for psychological experimentation did not exist until 1879. At their conception, asylums were terrible places where restraining, neglect, force-feeding and many other forms of mistreatment occurred regularly. This sparked one of the earliest mental health reformers, by the name of Dorothea Dix, to demand better rights for those institutionalized for mental health reasons.
1900-1950: Institutionalization really started to pick up as the 20th century set in. With this widespread use of state health facilities, new technologies and therapy techniques began to be implemented. Unfortunately, many of these new procedures have now become somewhat infamous and are viewed as a serious breach of etiquette, at least in the forms they were introduced. Examples of these are electric shock therapy and lobotomies, a nightmarish procedure which caused irrevocable damage to the brain in depriving the patient of personality and therefore any emotional issues and uncooperativeness.
Most of these procedures first began in the late 1930s through the 1940s. The first official recognitions, and subsequent banning, of lobotomies on moral grounds occurred in the 1950s. The first three countries to outlaw this practice were, in order, the USSR (1950), followed by Germany and Japan (1958). The rest of the world followed suit over the next few decades. Electric shock therapy is still utilized to treat severe mood disorders, but the technology has improved to the point where it is mild and painless.
1950s: This was, according to many, the golden age of mental health. The average stay in mental health facilities was dropping dramatically. Within a generation or two, patients had gone from spending years, or even entire lifetimes in state facilities, to merely a handful of weeks by the 1950s. Mental health was accepted and available more than ever before and it looked like things could only get better from there.
1960s: As the decade changed, things took a sudden downturn. John F. Kennedy’s presidency brought with it the policy of deinstitutionalization. Citing the success of the past decade, it was the belief of many that state facilities were becoming obsolete, and that most mental health care could be performed in smaller clinics. Thus, the process officially began of discharging patients from state facilities in hopes that they could deal with their health issues in less costly ways. On the brighter side, in this same decade, much of the work on modern psychological drugs, such as tricyclics, began.
Late 1970s: The only real challenge to deinstitutionalization since its founding, the presidency of Jimmy Carter briefly returned much of the government money originally spent on mental health care to this purpose. This is also the same decade when homosexuality was officially removed from the DSM and no longer classified as a mental illness.
1980s-present day: Unfortunately, when Carter left office, his mental health policies went with him, and then some. In response to the upsurge of liberal social policies in the 1970s, the next president, Ronald Reagan, drained much of this money, and diverted it to a new set of policies now known as the drug war. As a result, the lives of the mentally ill got worse. In the following decades, repeated mass shootings perpetrated by the mentally ill were exploited by the mass media and the mentally ill will avoid treatment even further for fear of the reputation that comes with diagnosis.
The topic of history and mental illness, as well as what the future might look like, will be continued next week.