Changing Attitudes towards Mental Health in the Early Twentieth Century
The mentally ill in early American communities were generally cared for by their family members, however in severe cases they ended up in almshouses or jails. Asylums are the sanctuaries or places of shelter meant for the care of mentally ill. Mental illness was generally thought to be caused by a moral or spiritual failing, punishment and shame and this affected their families as well. As the population grew and some areas became densely populated, mental illness became one of the major social issues for which various institutions were created in order to meet the needs of such individuals collectively. (Abnormal Psychology, 2007)
By the beginning of 20th century, the asylum/mental hospital had become a famous place in America. The patients who lived there had to go through lot of hardships; they lived in a harsh condition. There was a gradual change in the attitude of the public people towards the mental patients. During this period, the patients were kept in the hospital for a long period of time. The treatment that they gave wasn’t effective, it was harsh and inhumane such asylums for mentally ill were gradually established in other countries. The early asylums were the modifications of penal institutions and the mentally ill were treated more like beasts than like human beings. The treatment techniques are aggressive, the drugs were powerful, the treatment included electric shocks, physical chains and also water treatments which would lead to bleeding and burning. In 1868, hydro therapy treatment was considered to be a standard treatment method in St Anne’s hospital, Paris. (Robert, Butcher, Hooley, & Mineka, 2007)
The patients were chained up in the dark room and the chains were attached to the wall which held them flat against the wall and permitted only little movement. Very little attention was given about nutrition and they were treated like animals and no one visited the room except for feeding. The condition of the room was very bad, it wasn’t regularly been cleaned. (Robert, Butcher, Hooley, & Mineka, 2007, p. 37)
During 1950s and 1960s there was an urgent need for reform in psychiatric hospitals. There was a need to improve the conditions in mental hospitals. In 1986, The National Institutes of Mental Health was organized to provide support for research and training programs. The Humanitarian reform started with the great work of Philippe Pinel (1745-1826) in France. (Robert, Butcher, Hooley, & Mineka, 2007)
Pinel’s Experiment: After the first phase of French Revolution in 1792, Pinel got the permission to unchain some of the patients as he wanted subjects for his experiment. He thought he should treat the mentally ill people with kindness and with at most care and consideration. His experiment was a great success. This experiment allowed other patients also to unchain and they were shifted from dark place to sunny area, allowed them to exercise and the doctors and the people who ever took care of them started being kind to them. The result or the so called effect was miraculous. The disturbances or the noise was changed it peace, order and calm environment. Pinel stated that, the whole arrangement led to regularity and kindness and the patients were treated like human beings. This experiment lead to making changes in the behavior of the staff people in the hospital and there were strict orders not to beat up the patients whatever the situation is. (Abnormal Psychology, 2007)
During Pinel’s experiment time itself, an English Quaker named William Tuke (1732-1822) started the York Retreat. It was a house where mental patients lived, worked and took shelter. It had a pleasant and religious atmosphere. The Quakers believed in treating all the patients with kindness and acceptance. This acceptance helped the patients recover fast and this also led to the growth of more humane psychiatric treatment and this was during the period when the patients were being ill treated and ignored. Because of these two people’s work there were innovations and it also introduced trained nurses and this also led to change in attitude of the public people towards the mentally ill people. And many people came forward to help these people; this gradually helped the mentally ill people to recover soon. (Abnormal Psychology, 2007)
During the early period of humanitarian reform, there was a use of new term named moral management. Moral management is the method of treatment which emphasized on patient’s social, individual and occupational needs which became widespread in no time. This approach came from the work of Pinel and Tuke’s experiment which later on was accepted globally. This approach stressed on patient’s moral and spiritual development and slowly brought changes in their character rather than their physical or mental illness. This treatment was effective and it was done by giving them manual labor, spiritual talk and with humane treatment. This had a high level of effectiveness and it was done without giving them drugs. But this approach didn’t last for long. This approach was taken over by mental hygiene movement, this method focused on physical well being of the hospitalized patients. The comfort levels improved under hygienists, the patients received less help for their mental illness and this led to dependency and helplessness. Advances in medical sciences lead to the end of moral management and development in the mental hygiene movement. This further led to biological based treatments so the psychological and social environment was taken as unnecessary. (Robert, Butcher, Hooley, & Mineka, 2007)
During the later decades of 20th century, the society had respect in providing services for the mentally ill in the hospital environment. During this time an international movement called as deinstitutionalization started taking place. It is the process of changing long-stay at the psychiatric hospitals with less isolated mental health services which was done community wise for those treated with mental illness. (Robert, Butcher, Hooley, & Mineka, 2007)
“Deinstitutionalization works in two ways: first, it focuses on reducing the population size of mental institutions by releasing patients that is by shortening the stays, and reducing both admissions and readmission rates; the second focused on reforming mental hospitals institutional processes so as to reduce the dependency, hopelessness, learned helplessness, and other maladaptive behaviors.” (GRINNELL)
Many homeless people suffer from one or more mental disorders. Deinstitutionalization was motivated by generous, compassionate, kind and caring goals, but it created great difficulties for many mentally disturbed people who had been sent to cruel, harsh and inhumane way of life. The 20th century tried its best ways to manage the needs of severely mentally disturbed people, but deinstitutionalization has created problems for both patients and the society as a whole. (Abnormal Psychology, 2007)
Works Cited
GRINNELL, R. (n.d.). Psych Central. Retrieved July 14, 2013, from Psych Central: http://psychcentral.com/encyclopedia/2008/deinstitutionalization/
Robert, Butcher, Hooley, & Mineka. (2007). Abnormal Psychology (13th edition ed.). Pearson Education and Dorling Kindersley Publishing.
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