Exorcism was a common historical treatment for mental illness, based on the belief that the individual was possessed by spirits. This treatment was typically performed by priests or other religious figures and involved practices such as saying incantations and prayers over the person's body. In some cases, medicinal drinks were also administered as part of the ritual to release the spirits.

Exorcism as Mental Health Treatment

Trephining was a drastic historical treatment used for extreme cases of mental illness. The procedure involved making a small hole in the afflicted person's skull, with the goal of releasing the spirits believed to be causing the illness. This dangerous practice frequently resulted in the patient's death.

Trephining as Mental Health Treatment

Due to widespread misunderstanding and cruel attitudes in the past, individuals with psychological disorders were often subjected to harsh treatments beyond medical procedures. These practices included imprisonment or being cast out from society to become homeless beggars.

Imprisonment and Isolation as Mental Health Treatment

Historically, the misunderstanding of mental illness led to extreme and fatal practices. In addition to dangerous procedures like trephining, individuals with psychological disorders could face execution as a form of 'treatment' or punishment.

Torture and Death as Mental Health Treatment

Beginning in the 18th century, asylums were established as the first institutions specifically for individuals with psychological disorders. However, their primary function was to isolate these individuals from the community rather than to provide treatment. The conditions within these asylums were often brutal; patients were frequently confined to windowless dungeons, subjected to beatings, chained to beds, and received minimal or no interaction with caregivers.

Asylum used in Treating Mental Health Problems in the 18th Century

You can learn more about the timeline of mental health treatment in the United States here: https://www.tiki-toki.com/timeline/entry/37146/A-History-of-Mental-Institutions-in-the-United-States/#vars!date=1810-07-03_14:51:59!

Mental Health Treatment in the United States: Timeline

The 'Extraction of the Stone of Madness,' a subject depicted in historical art, represents an early and misguided approach to treating mental illness. This concept was based on the belief that insanity was caused by a physical object—a 'stone'—in the head, which could be surgically removed to cure the patient.

The Extraction of the Stone of Madness

In 1795, French physician Philippe Pinel initiated a significant reform in mental health care at the La Salpêtrière hospital in Paris. He advocated for and implemented more humane treatment methods, which involved unchaining patients and engaging them in conversation. This compassionate approach proved beneficial, leading to the recovery and subsequent release of many patients from the institution.

Philippe Pinel's Humane Treatment Reforms at La Salpêtrière

In the 19th century, Dorothea Dix spearheaded significant mental health care reforms in the United States. After investigating the conditions for the mentally ill and poor, she uncovered a system rife with abuse that was both underfunded and unregulated. Motivated by these discoveries, Dix began lobbying state legislatures and the U.S. Congress, which successfully led to the establishment of the country's first mental asylums.

Dorothea Dix

Given the historical scenario below, evaluate the two proposed explanations for the woman's condition. Which explanation and its corresponding 'treatment' would have been more widely accepted in that era? Justify your answer based on the dominant worldview concerning mental illness during that period.

Historical Perspectives on Mental Illness

- Exorcism
- Trephining
- Imprisonment and isolation
- Torture and death
- Asylum
- La Salpêtrière
- Dorothea Dix

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The methods for treating mental health disorders have changed significantly over time. The development of the many treatments available today can be understood by examining the history of mental health care, including past approaches that are now considered questionable based on modern scientific understanding.

Evolution of Mental Health Treatment

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

Mental Health Treatment and Intervention in the Past

First introduced in 1954 and gaining widespread use in the 1960s, antipsychotic medications marked a significant advancement in mental health treatment. They proved highly effective in managing the symptoms of severe psychological disorders, particularly psychosis—a condition involving a loss of contact with reality through symptoms like hallucinations and delusions. The ability to control these symptoms was a key factor that enabled the shift toward community-based care and away from long-term institutionalization.

Introduction and Impact of Antipsychotic Medications

Modern mental health care has shifted from long-term asylums to short-term inpatient care in psychiatric facilities, such as state-run hospitals and local community hospitals. The primary focus is on brief stays, typically averaging less than two weeks, due to the significant expense of hospitalization, which can be $800 to $1000 per night. As a result of these high costs, insurance coverage often restricts the length of a person's stay. Consequently, hospitalization is usually reserved for individuals deemed an imminent threat to themselves or others.

Modern Inpatient Mental Health Treatment in the United States

A person is experiencing symptoms involving a loss of contact with reality, such as hallucinations and delusions. Which of the following intervention strategies represents the most significant historical shift that enabled the move from long-term institutional confinement to community-based mental health care?

Consider the following scenario: In the mid-1800s, an individual experiences severe, persistent sadness, social withdrawal, and claims to hear voices that are not there. Their family commits them to a large, state-run institution. Based on your understanding of how mental health care has changed over time, evaluate the treatment this person likely received. In your evaluation, explain why this approach is no longer the standard of care and contrast it with how a similar case might be handled today.

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