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Chapter 1: History of Mental Health Care

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Judy Fulcomer

on 29 September 2011

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Transcript of Chapter 1: History of Mental Health Care

Primitive Societies
Greece and Rome
Known as the
"Father of Medicine"

(460-375 B.C.)
Plato (427-347 B.C.)
Late Middle Ages
(1300-1400 A.D.)

Bethlehem Royal Hospital
The First Mental
1247 A.D.

Early Middle Ages
500-1100 A.D.

The Witches' Hammer
The Rennaissance
1400-1500 A.D.

The rise of humanism
Care reverted back to
The Reformation

17th Century
18th Century
19th Century
20th Century
Fall of the
Roman Empire
Bubonic Plague
Nature, not magic heals.
Good nutrition, fresh air, sunshine, exercise, opium...
Mental illness results when rational soul
conflicts with irrational soul.
1487 A.D.
The Witches' Hammer
Official manual of the Inquisition

(Endorsed by the Pope and the University of Cologne)
Witch Hunting
Church attributed insanity to an
outside source, such as the moon.
"Lunatic" asylums built to house the mentally ill.
Many mentally ill women were thought to be witches and were burned at the stake during the late middle ages.
1st psychiatric hospital in the world.
Infamous for its brutal treatment of inmates.
Harmless inmates were placed in metal arm and leg irons and given a license to beg on the streets.
When Luther broke away from Catholic church,
many Catholic hospitals closed.

The poor, sick, and mentally ill patients were turned out onto the streets.
Conditions were at their worst for the mentally ill.

Asylums became virtual warehouses.
In 1792, Philippe Pinel freed patients from shackles and chains.
The mentally ill were treated as human beings.
Alice Fisher transformed the way mentally ill patients were cared for, using Nightingale techniques (fresh air, exercise, sunlight, clean water...)
Dr. Benjamin Rush
"Father of Psychiatry"
Argued that the mentally ill should be provided therapy, books, music, recreation and, above all, meaningful work.

Began a tireless effort to expose inhumane conditions.

Raised millions of dollars to build 32 mental hospitals in U.S.
Dorothea Dix
Talking therapy
Therapy couch
Free association
Personal experience as a patient in a mental hospital led Mr. Beers
to establish National Committee for Mental Hygiene in 1909.
Influences of War
Beers' committee developed a plan for screening and treating mentally ill soldiers
1937: HIll-Burton Act funded construction of inpatient psychiatric units
1946: National Mental Health Act provided funding that established NIMH -
funded to conduct research into mind, brain, and behavior
Korean & Vietnam Wars brought recognition and diagnosis of PTSD
Psychotherapeutic Drugs
Introduced in 1950s

Treatment of Mental Illness Prior to 1950:
Insulin coma
Exposure to malaria
Water/Ice therapy
Strait jackets

Drug therapy with:
After 1950:

Anti-anxiety agents
Functioning Outside of the Institution
- "Deinstitutionalization" resulted from the advent of
psychotherapeutic drugs
Introduction of new drugs, insulin coma, ECT, and lobotomy
Between 1950 and 1980, the number of institutionalized patients dropped from more than 500,000 to less than 100,000.
The cure is to drive out the evil spirit
Abnormal behavior
is a is a result of
by evil spirits!
During these "Dark Ages", all humane ideas
about mental illness were forgotten.
Advancement of medical knowledge
halted for centuries.
An era of
Psychiatry developed as a separate branch of medicine.

Known as an age of reason and observation.
...or drive the mentally ill out into the wilderness
Decreased views of demonology as a cause of abnormal behaviors
These drugs provided relief of symptoms and
put an end to the need for physical restraints.
The crib
Restraining chair
Rotating chair
If your head says one thing,
and your heart says another...
which do you listen to?
Wrote the 1st American textbook of psychiatry - "Diseases of the Mind"
Problem: Not enough hospitals to care for mentally ill
Cast from shackles which bound them, this bell shall ring out hope for the mentally ill and victory over mental illness.

—Inscription on Mental Health Bell
Full transcript