Treatment of Mental Illness

1. Treatment of Mental Illness

2. Prehistory to Colonial America • For most of human history, very little was known about the workings of the human mind, especially about why a person would act abnormally • Often, it was believed that the mentally ill were afflicted and/or possessed by evil spirits/demons. • Treatments included: • Trepanning • Spells/witchcraft • Exorcism • Execution (particularly burning at the stake)

3. Colonial America • According to astrological beliefs, a child born under a full moon would be more likely to exhibit mental instability. From this, comes one of the terms used to describe the mentally ill: lunatic • Cures during colonial times focused on methods that either would cause crisis or expel it (i.e. catharsis). Methods used: • Submersion into ice water • Inducing of vomiting • Bleeding

4. Colonial America, cont. • The most common method, however, was to imprison them.

5. Early 19th Century • “Moral Management” Influenced by the Enlightenment. Generally, the emphasis was humanizing the patient, not animalizing him/her Improvements included • home-like environment • Recreation • Work details • Outdoors

6. Early 19th Century, cont. • Phrenology: Belief that behavior based on the shape of skull (from this come the terms “highbrow” and “lowbrow”).

7. Late 19th Century • Following Civil War, thousands of veterans have: • PTSD (known then as battle fatigue) • Morphine addiction • Overcrowding leads to a retreat back to Colonial standards of treatment • Opium introduced as a treatment

8. Late 19th Century • State asylums are built that are large, aesthetically pleasing, but are able to withstand large amounts of abuse • Local example: Peoria State Hospital in Bartonville (closed 1973) • Asylum featured in “One Flew over the Cuckoo’s Nest” also reflective of this time period. • Major problem: Asylums considered so nice they become dumping grounds for the homeless, unwanted, elderly, and poor

9. The Dark Ages (mid 20th Century) • With patient numbers rising, mental-health professionals attempt what are now considered barbaric methods to improve patient outcomes. • Trepanning • Electroconvulsive Shock Therapy (ECT) • Insulin Shock Therapy: patient given insulin to the point of rendering the person comatose

10. And… 4. Lobotomy • Originally, the lobotomy would separate the front portions of the brain from the rear. Common result: patient forgot what caused the disturbance/depression in their minds. The problem: took too much time and skill.

11. The solution b. trans-orbital lobotomy (aka “pre-frontal lobotomy) - watch video • developed by Walter J. Freeman • Outpatient brain surgery, took about ten minutes to perform.

12. Modern Era The Breakthrough (1954): Thorazine (chlorpromazine) • The first medication that is useful in the treatment of mental illness. Promoted as “lobotomy in a bottle.” • Used to treat • Schizophrenia • Major Depression • Mania

13. Medication Uses OCD: Prozac, Zoloft Anti-anxiety: Xanax, Valium, Ativan Depression: Prozac, Zoloft, Wellbutrin, Cymbalta Schizophrenia: Risperal, Zyprexa, Haldol

14. According to Sharfstein (2005), anti-depressant medications accounted for $13.4 Billion in sales worldwide, with anti-psychotic medications accounting for $6.5 Billion. • In comparison, the weight-loss industry in the United States(2007): $50 Billion

15. Other Methods • Counseling • Behavior Modification • Cognitive-Behavioral Therapy • Systematic Desensitization (treatment of phobias) • 12-Step Programs (AA, other addiction programs) • Group Therapy • ECT (in milder form) • Psychoanalysis Note: Medication to treat mental-health issues is becoming more prevalent, and reaching younger ages (including pre-school)