The history of how we as a society deal with mental health related issues at a state and national level provides a great lens into how such issues are handled today. The treatment and care of those with mental disorders has evolved significantly. Throughout this evolutionary process, several good and efficient methods have been discovered and utilized for the benefit of those afflicted with mental disorders. However, it has also been evident that many of these practices were put into place at the detriment of those on the receiving end. Unfortunately, newer standards and practices for dealing with mental health have not provided all the corrections necessary for addressing mental health disorders. It is true that we have learned from our mistakes, but no truly effective measure has been put into place yet.
Prior to the 1840's, those living with mental health disorders in the United States were treated with little to no compassionate care. They were viewed more or less as sub-humans, lacking basic necessities needed to treat their mental conditions. It was not until Dorothea Dix began pushing for reform that those individuals with mental disorders were finally granted access to care, under the state, that they do desperately needed. Between the 1840's and 1880's, Dix was able to persuade the United States government to build 32 state psychiatric hospitals. This was the beginning of the institutionalization movement, which was welcomed by many with relatives suffering from psychiatric disorders. Finally, there were places that would provide professional assistance and quality care to members of our society who could not look after themselves. Though these institutions were better than the borderline prisons those with mental disorders were previously sent to, they were by no means a haven.
In the late 1800's and early 1900's, there was little understanding as to what caused mental disorders. Because of this, there was an equal amount of misunderstanding on how to treat such conditions. Harsh treatments were a commonplace to keep those in the institutions "under control." Barely any forms of treatment were put into practice, as there was no real desire to try to treat those housed in the psychiatric hospitals. As long as they were not a nuisance to society, then the public effectively turned a blind eye. It was not until the late 1880's that writer Nelly Bly exposed the inhumane techniques employed by the administrators of the institutions. Having posed as an individual with a mental disorder, Bly was able to infiltrate a state psychiatric hospital and experience firsthand what the patients had to deal with. Her descriptions of harsh conditions such as solitary confinement and a disregard to safety by locking all the doors in the institution opened the eyes to the public that these state run institutions were not effectively treating their patients. A call to discover new treatments that would actually provide help to the disorders was sounded. With this resounding plea came both innovative and shockingly grotesque treatment techniques.
Following the push for a better understanding of mental disorders, practitioners began experimenting with ways to cure such ailments. The therapeutics devised by Sigmund Freud provided certain ways to deal with psychiatric disorders, but doctors at the time wished to come up with faster and more efficient techniques to curb the various effects. This lead to a variety of experimental procedures that patients had to endure. Insulin-induced comas, lobotomies, and electroshock therapy were all popular techniques used throughout the 1930's-1950's that were believed to cure several mental disorders. With lobotomies in particular, brain tissue was purposely damaged to stop undesired behaviors exhibited from patients that suffered from schizophrenia, manic depression, or bipolar disorder. While it was believed that this procedure cured the disorder, it actually caused the patient to lose their personality and ability to live independently. It created "mental dullness" within the patient, and made it so they could be easily controlled and looked after. Institutions commonly used this procedure on unruly patients for the purpose of keeping them more orderly. This technique, along with the other "innovations" not only caused more harm to the patient, but was taken advantage of by many institutions not for the intended purpose of understanding and curing the patient, but to make them easier to control.
Such practices were only relevant for a period of 20 to 30 years. By the late 1950's, chemists began experimenting with medications that would help to sooth the effects of mental disorders. It was found that disorders such as schizophrenia could be treated with medication, and this would provide relief to both the patient and the caregiver. Plus, this practice was much more humane than previous techniques. The advent of these new medications even made it so individuals afflicted with certain disorders did not need to be institutionalized. Their effects were powerful enough that many could remain home and live in society outside of a psychiatric hospital. For this reason, and the sordid history that continued to follow mental institutions, a large deinstitutionalization movement began at a national level.
In the early 1960's, calls to implement policy that limited the scope of psychiatric hospitals were in full force. In 1963, Congress passed the Community Mental Health Centers Act, which stated that only those who posed a threat to their own or others safety could be admitted into state mental hospitals. This legislation made it so many patients were removed from the overcrowded institutions and put into community run mental health centers. It was believed that the proper treatment methods could be given to patients in a more personal and less restrictive setting. It was also reasoned that this would resolve the injustices that were perpetually committed within state run mental institutions. These goals were certainly praiseworthy in their intent and seen as an effective way to deal with the questionable history of handling those with mental disorders. There was an insurmountable need to improve the quality of life for that subset of our population. However, once put into practice, it was demonstrated that this strategy left much to be desired in its effectiveness.
After patients were discharged from psychiatric hospitals, communities were faced with an overwhelming number of individuals who needed specific types of care. To provide such treatments, communities needed a large sum of funding that typically was lacking. Because of this, several local mental health centers cannot provide their patients with all of the proper health care treatments. Though improvements in behavioral adaptation and patient satisfaction have been prevalent in community mental health centers as compared to state psychiatric hospitals, the deficiencies in health care are a severe detriment. Not only is a lack of funding for treatments a widespread occurrence in local centers, but a general lack of knowledge among individuals tasked with caring for those with mental disorders is also an issue. Without proper medical knowledge, families and care givers of individuals with psychiatric conditions may be causing more harm than good. We have certainly come a long way with our handling of those in our society with mental disorders. The strides made to integrate them into everyday life are a tremendous step forward that needs to continue. However, along with this, there needs to be a more effective way to provide the proper care to these individuals so that they may enjoy a high quality of life.