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!

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

Mental Health Treatment and Intervention in the Past

Despite the efforts of activists, asylum opened in the United States suffered also from hygienic issues and inhumane treatments of patients. It wasn't until 1983 that large asylums were closed (deinstitutionalization began) and alternative measures in helping and treating mental health problems were being considered.

Asylum in the United States

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

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

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

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

Signed into law by President John F. Kennedy in 1963, this piece of U.S. legislation fundamentally altered the country's approach to mental health care. It provided federal funding for the creation of community mental health centers, laying the groundwork for treating individuals locally rather than in large, isolated asylums.

Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963

Which statement best analyzes the complex historical role of mental asylums in the United States?

Mental health is a significant concern within the U.S. corrections system, which is heavily burdened by the need to manage and support a large population of individuals with psychological disorders. Studies indicate a substantial overrepresentation of people with mental illnesses in prisons, jails, and on probation and parole compared to the general population. Furthermore, the experience of incarceration itself can worsen an individual's mental state due to factors like violence, trauma, and isolation.

Mental Health in the Corrections System

As the primary mode of mental healthcare today, community mental health centers are established throughout the nation. They are strategically located within local neighborhoods to be accessible to clients, offering a wide array of mental health services for various conditions.

Community Mental Health Centers

There are several ways individuals may enter psychological treatment. Many seek help voluntarily due to personal symptoms like depression or anxiety, or they may be referred by concerned family or friends. Another common route is through a primary care physician who provides a referral to a mental health specialist. Additionally, treatment can be mandated by state agencies, such as when individuals become involved with child protective services due to child abuse or neglect.

Pathways to Seeking Psychological Treatment

Accessing mental health treatment can be challenging due to a variety of obstacles. These barriers include the limited availability of services, especially in certain geographic areas, significant financial hurdles, issues with the quality of care for certain populations, and the social stigma surrounding mental illness.

Barriers to Accessing Mental Health Treatment

A patient is admitted to a psychiatric hospital after being identified as an imminent threat to themselves. The patient's family is surprised to learn that the expected duration of the stay is only about one week. Which of the following best analyzes the primary reason for this short-term approach in the modern U.S. healthcare system?

The National Alliance on Mental Illness is a non-profit organization that raises awareness about mental health issues, encourages conversations around mental health, and provides support for those facing mental health challenges. It serves as an example of an organization in the non-profit sector that may employ researchers with backgrounds in psychology to conduct scientific research.

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