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A History of Behavioral Health

Introduction

Intro

For thousands of years behavioral health has been a part of human society. Ancient writings of the Egyptians, Greeks, and Romans often talked about mental illness as a demonic possession or the result of witchcraft.

Hippocrates (450 BCE - 380 BCE) was one of the first to approach mental health treatment from a non-religious viewpoint with science based practices and case study.

Phrenetis, Mania and Melancholy.

Roman Physician, Caelius Aurelianus, is said to have created the first writings on mental illness.

Phrenetis, Mania and Melancholy.

Phrenetis, was thought to be a form of delirium caused by fever, pulse rates, and spastic movements. Mania was chracterized by chaotic thoughts, frenzy, anger and delirium without fever. Melancholy included symptoms of sadness, fear, despondency, states of paranoia, and withdrawl from external reality.

Humors

Humors

Greek physician Hippocrates thought mental illness stemmed from an imbalance of four bodily fluids or humors.

The theory of humors

Yellow bile in excess amounts resulted in severe mania, while excess amounts of phlegm caused more moderate mania. Black bile, was thought to cause melancholoy. Blood, was thought to impact mental health as well.

Unordinary Cures

TREPHINATION -practiced more than 7,000 years ago, it was thought that by removing a small piece of the skull various mental illnesses could be cured.

BLOODLETTING - thought to restore balance to the human body and thus the human mental. Surgical incisions and Leeches were typically used to carry out this treatment.

Unordinary Cures

ISOLATION & ASYLUMS - By the 1700s many thought it best to keep those suffering from mental illness away from and out the view of society.

Whereas jail used to be where these individuals were held, asylums began to house these people, yet conditions were often unsanitary, inhumane, and intolerable.

Institutionalization

Institutionalization

The action of establishing something as a convention or norm in an organization or culture.

The hope was that patients would live in these hospitals under the direct care of psychiatric nurses and doctors in order to receive the best care.

Previously trying to rehabilitate the mind through "normal" tasks, patients often did farm work or workshops to keep them busy. However, this did not cure mental illness and doctors began to look for ways to treat rather than prevent.

Soon, hospitals where popping up everywhere and turning into custodial homes for the mentally ill.

in 1840, lobbying lead by activist Dorothea Dix convinced the United States to grant funding for 32 state psychiatric hospitals.

New Treatment

Hospitals began to sterilize patients. Other methods included electroconvulsive therapy, insulin coma therapy, and lobotomy.

Sterilization is the process of removing one's ability to reproduce. This can be done by tubal ligation or a vasectomy.

New Treatment

Other Treatments

Other Treatments

Viewed as a safer form of seizure therapy , doctors turned to ECT. Using electrical shocks to the brain to induce a seizure, a method called Electroconvulsive Therapy was popular amongst doctors as a way to treat depression and bipolar disorder. Still practiced to this day for extreme cases, it is believed the electrical storm occurring in the brain helps reset chemical imbalances.

Another practice was ICT where doctors would administer high levels of insulin, putting the patient in a low blood sugar induced coma. It was believed that the fluctuation in blood sugar would affect the brain and cure illnesses such as schizophrenia. These comas would last anywhere from one to four hours with the patient being awakened with a dosage of glucose. However glucose did not always awaken the patient with a mortality rate of 1-10%

Believed to treat many severe forms of mental illness, lobotomies were performed beginning in the late 1880s and won a Nobel peace prize in 1949. In these 5-10 minute procedures, doctors surgically cut or removed the connections between the prefrontal cortex and the frontal lobes of the brain. However, when psychiatric medicine was introduced in the 1950's the practice essentially became obsolete.

Deinstitutionalization

Over time, hospitals became crowded, understaffed, and underfunded. Cruel practices were being used and patients were not receiving the help they needed. After WWII there was a large push for reform in the mental health care system. This along with the development of anti psychotic drugs helped the government sign the 1946 National Mental Health Act affirming that the federal government would have a larger role in behavioral health .

Pennhurst Institution

The Pennhurst

Institution

Should we Bring

Asylums Back?

Should we Bring

Back Asylums?

Today

Through research and lobbying, mental health in the United States has come a long way in how consumers are cared for and treated. However, the work is far from finished.

Today

There is Still Much

Work to do

Incarceration

Assessment

Activity

Mass shootings

Homeless population

Discussion &

Activity

Discussion & Activity

Split into 2 teams, one team will debate why we need state behavioral health facilities in the US, while one group will debate why we do not. Come up with 5 points each team.

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