Abstract
Mental illnesses account for one of the oldest but least understood health issue facing the human race. The ancient Romans and Egyptians considered mental illness to be a manifestation of demonic possession. The same belief was carried on to the Middle Ages, as well as during the Renaissance. In America, this belief only changed in the last years of the eighteenth century. The belief that spiritual possession caused mental illness resulted in treatment procedures being inhumane. Most of these treatments involved the isolation of patients from the public. However, as people become enlightened, the modes of treatment changed, with the early years of the nineteenth century seeing an introduction of compassionate care. The eighteenth century was, however, faced with instances of overpopulation in hospitals as well as a failure of treatment procedures. The start of the nineteenth century saw the establishment of bodies meant to promote mental health. The nineteenth century also saw the emergence of drugs to treat mental illnesses.
Mental illness accounts for one of the oldest health issues facing human beings. Ancient societies considered mental illness to be a punishment from the gods, with ancient Greeks being the exception. From as early as 400 B.C, the Greeks started viewing mental illness from a psychological perspective; therefore, treatment using scientific methods. Other than the Greeks, other European countries considered mental illness to be an inhibition of demons or evil spirits. The middle ages saw mentally ill patients being given their freedom, but they were still stigmatized. The isolation of people suffering from mental illness continued in Europe and other parts of the world until the 17th century, when different nations in Europe started establishing mental institutions that provided better care for patients. In the United States, mental health started becoming a public issue in the 18th century after the construction of the first asylum. From the eighteenth century, mental illness in the United States has experienced numerous changes including improvements in treatments, as well as a better understanding of people suffering from mental illness.
Eighteenth Century
The Eighteenth century saw the introduction of the first mental treatment institutions in the United States. Before the construction of these mental institutions, mentally ill patients were isolated from other individuals, as they were believed to be possessed by evil spirits (Gallenberge, 2015). At the time, the main treatments for mental illness included bloodletting and ice baths to chase away the evil spirits. The construction of the first two asylums namely Pennsylvania and Williamsburg Hospital occurred in 1756 and 1773 (Farreras, 2013). The construction of these two mental institutions was mainly meant to provide an alternative to prison, where mentally ill individuals were isolated from the public.
The public considered the construction of these two facilities as a hallmark in the treatment of mental illness. However, most of the people in America during the eighteenth century still believed in the somatogenic theory, which explained mental illness to be an infestation of demons and spirits. This belief resulted in even professionals including Benjamin Rush, a renowned psychiatrist, proposing inhumane treatments including tranquilizer chairs and bloodletting (Farreras, 2013). Other than the use of inhumane treatments, the mental institutions during the eighteenth century also kept patients in inhumane conditions. The mental facilities mainly chained patients to walls or kept them in dungeons.
Although most people in eighteenth century United States believed that mentally ill patients were not supposed to live with the general population, Patrick Henry, Virginia’s founding father, did not share this opinion. Rather than taking his wife, Sarah, to a mental institution, Patrick chose to care for his wife at their home (Gallenberge, 2015). Patrick’s form of care involved the use of a restraint belt to prevent his wife from harming herself. He also built a sunny room for his wife, as well as had a slave act as the nurse to his wife. This form of compassionate care was quite new at the time and was only reserved for the rich.
Nineteenth Century
Although mental treatment facilities were introduced during the eighteenth century, the treatment methods used were still the same ancient methods based on ancient theories. At the end of the Eighteenth century, different individuals had started proposing more compassionate treatment methods to replace the demonic possession treatments. The nineteenth century began with the introduction of a new hypothesis, which explained brain damage as the main factor resulting in mental illness. Although he had previously promoted the use of ancient methods to treat insanity, Benjamin Rush became a proponent of moral treatment in the early years of the nineteenth century (Floyd, 2015). The calls for the introduction of compassionate care to treat mentally ill patients resulted in the establishment of new mental treatment institutions. The Friends Asylum and Bloomingdale Asylum, which were opened in 1817 and 1821, were the first institutions in the United States to use compassionate care (Farreras, 2013).
The establishment of these two institutions did not change much, as mentally ill patients were still isolated from the general population. In the 1840s, Dorothea Dix, an American schoolteacher from Massachusetts observed that most mentally ill patients in the state lived in prisons, under very unhygienic and inhumane conditions (Manzo, 2010). Dix observed that mentally ill people in Massachusetts were often beaten and left unclothed during cold nights. Dix lobbied the government for the next forty years for the construction of other state mental hospitals including the Jacksonville Asylum, which was constructed in 1851.
The establishment of state care facilities resulted in the admission of more people to mental institutions. These institutions mainly provided care at low prices, which resulted in overcrowding in the institutions. The end of the civil war resulted in an increase in the number of people suffering from mental illness. Moral treatment popularity also decreased as the rates of people who were cured did not match the estimates expected (Holtzman, 2012). The failure of the treatments methods also resulted in any doctors resulting in physical restraint as a method of treating patients. The Athens Asylum, opened in 1874, became the largest mental treatment institution in the United States. The facility had over five hundred rooms and was self-sufficient (Manzo, 2010). The facility, however, attracted more individuals than expected, which resulted in instances of overpopulation. The increase in the population of patients led to doctors reverting to the older methods including ice baths and shock therapy.
Twentieth Century
The twentieth century began with an increased popularity for private mental care institutions. Physicians began abandoning the somatic view and adopted the psychological theories explaining mental insanity. One of the first physicians to adopt a psychological perspective towards mental illness was Boris Sidis, who established a private mental institution in the l910 (Holtzman, 2012). Sidis’ institution was mainly meant to serve the needs of the rich, therefore, it concentrated on the creation of a luxurious environment. Due to the popularity of somatic means of treatment including electrical stimulation, Sidis advertised his institution to offer both psychological and somatic means of treatment. The mention of somatic methods in his advertisements, explains that people were still uninformed about the true nature of mental illness.
Another influential individual who promoted the development of mental health treatment in the twentieth century was Clifford Beers. Beers, who had suffered from a case of bipolar disorder, after the death of his brother, wrote an autobiography, which explained the maltreatment that patients in mental institutions faced. Together with a New York psychiatrist, Adolf Meyer formed the National Committee for Mental Hygiene (Manzo, 2010). The body was meant to improve awareness of mental illness; therefore, improve outlooks exhibited towards insanity. The body also aimed at improving services for mentally ill patients as well as work towards the prevention of mental illness.
The nineteenth century saw the development of newer methods to treat mental illnesses. Lobotomy was one of the methods developed during this period. Lobotomy involved the drilling of holes in the frontal part of the brain, which was followed by the inserting of metals and ice picks to treat instances of mental treatment (Newitz, 2011). The two doctors who developed lobotomy employed different methods with the use of the ice pick being considered more ethical and safe. Although developed in Europe, the practice of lobotomy was largely accepted in America during the 1930s.
The 1930s also saw the establishment of mental illness departments in the general hospital. The establishment of these departments resulted in better care for mentally ill patients, as hospital provided humane care. However, there occurred instances where patients suffered from abuse or neglect. The 1930s also saw an increase in the number of people who suffered from mental illness. The great depression was the main reason towards the increase in some mental illness reports.
The latter half of the twentieth century saw the introduction of drugs to treat instances of mental illness. Anti-psychotic drugs such as Thorazine became available to patients (Manzo, 2010). These drugs helped patients who were hallucinating as well as those suffering from cases of depression. The 1950s and 1960s also saw the introduction of laws aimed at protecting individuals with mental illness. The 1960s also saw the introduction of community movements meant to promote mental health. The movements provided outpatient services as well as an increased in research on mental health. The movement also resulted in a reduced number of patients visiting state mental health institutions.
Conclusion
Mental health in the United States has experienced numerous changes over history. In Colonial America, mental illness was blamed on demonic possessions, which resulted in harsh treatment methods. The nineteenth century, however, saw the establishment of compassionate care; therefore, better treatment procedures. The twentieth century saw the introduction of drugs to treat mentally ill patients as well as laws meant to protect the rights of mentally ill patients. The twenty-first century, on the other hand, has seen the establishment of newer treatment methods; therefore, improvement in mental health care.
References
Farreras, I. G. (2013). History of Mental Illness. Retrieved from Noba: http://nobaproject.com/modules/history-of-mental-illness
Floyd, B. (2015). Mental Health. Retrieved from University of Toledo Libraries: http://www.utoledo.edu/library/canaday/exhibits/quackery/quack5.html
Gallenberge, R. (2015, July 2). Patrick and Sarah Henry: Mental illness in 18th century America. Retrieved from The National Museum of American History: http://americanhistory.si.edu/blog/patrick-and-sarah-henry-mental-illness-18th-century-america
Holtzman, E. (2012). A home away from home. Monitor on Psychology. Retrieved from http://www.apa.org/monitor/2012/03/asylums.aspx
Manzo. (2010). The History of Mental illness in America: A Journey From Despair to Hope & Recovery.
Newitz, A. (2011, March 30). The strange, sad history of the lobotomy. Retrieved from http://io9.gizmodo.com/5787430/the-strange-sad-history-of-the-lobotomy
