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The History of Mental Illness
in America: A Journey From
Despair to Hope & Recovery
Ms. Manzo
Former First Lady Rosalynn
“We have been given many gifts as a nation; we are
rich beyond measure. We Americans think of
ourselves as decent, generous, and compassionate
people, & for the most part we are; yet we treat a large
proportion of our own population as though they are
second class citizens undeserving of our help, our
resources, & our understanding.”
Colonial America
Society believed insanity was caused by
a full moon at the time of a baby’s birth
 These “lunatics”- (lunar) were thought to
be possessed by the devil
 Treatments: ice baths, bloodletting
Colonial Treatment
 Demon-possessed
 Senseless animals
 “It was believed that patients chose to
behave irrationally, and doctors tried to help
them adopt a more normal manner.”
 Parish Church
 Those without family
– placed in prisons- chained to walls,
– poorhouses
First hospitals
 1773- Williamsburg, Virginia
 Designed to keep those with mental
illness away from society- not treat
The Public Hospital, Va.
17th-18th Centuries
Dorothea Dix
Dorothea Dix
 Discovered many people with mental
illness were in jails.
 Crusaded for the establishment or
enlargement of 32 mental hospitals, &
transfer of those with mental illness from
almshouses and jails.
US Census
– Includes its 1st
question on “insanity”
Thomas Kirkbride
Designer of Asylums
Athens Asylum for the Insane-1874
• 544 rooms- self-sufficient with dairy barns,
greenhouses, transportation system, recreational
• But others soon went there for food & shelter
• Populations skyrocketed – patient care suffered.
• Now old ways returned…ice baths- shock machines…..
An Asylum For Every State
The Civil War
Many servicemen- postwar trauma
 State hospitals and asylums
 Restraints, shock therapy, opium
Soldier’s Heart- or “PTSD”
Post Civil War
Asylums – now underfunded –
 Quality of care deteriorates
 Newspapers expose inhumane
1900- Clifford Beers
“A Mind That Found Itself”
1908- changed mental health care
 Beers’ autobiography –chronicles his
struggle with mental illness and
Mental Health Screening Begins
Ellis Island
Dr. Thomas Salmon in 1905: “Justice to the immigrant requires a
carefully considered diagnosis; while on the other hand, the
interests of this country demand an unremitting search for the
insane persons among the hundreds of thousands of immigrants
who present themselves annually at our ports of entry.”
The National Committee For
Mental Hygiene
Founded in 1909- in NY by psychiatrists and
 Goals
– To improve attitudes toward mental illness and
those with mental illness
– To improve services
– To work for the prevention of
mental illness & promote mental
1930s- The Lobotomy
Mental Health’s Darkest Hour
Surgically separated the neural
passages from the back of the brain
 Over 20,000 performed
 Abuse and neglect soared
Asylums Renamed Mental
Psychiatric units opened in general hospitals
 Treatments ineffective
 Hospitals provided humane custodial care at
– At worst- neglect or abuse
Great Depression=overcrowding…….
1946- National Mental Health Act
President Truman - National Mental Health
 Creates for the first time in US history a
significant amount of funding for
psychiatric education and research
 Led to the creation in 1949 of the National
Institute of Mental Health (NIMH).
1st community based health treatment
for patients in state institutions
1949- Lithium
New hope
Antipsychotic drugs introduced
 Thorazine- improves hallucinations and
 Other medications now become
Congress allocates- $12 million for
 Number of consumers decline in mental
1961- Action for Mental Health
Report to Congress based on 5 years of
– Task- arrive at a national program to meet the
needs of those with mental illness
– Recommends improved research, training and
treatment in the field of mental health.
– Attempts to answer:
“Why has care of the mentally ill lagged?”
“How can we catch up?”
Community health movement
– Outpatient services
– More research
– Less state mental hospitals
– More general hospitals with psychiatric
– More community health centers
President Jimmy Carter
 Mental Health Systems Act
– Grant program
– Involves consumer input
– Offers education and support
– Strengthens the links between
 Federal and state services
Carter’s work halted
 Mental Health Systems Act repealed
 Funding drops
Behavioral Health Managed
 States now “carved out” mental care
from physical care
 Purpose: increase efficiency
 Results: led to erosion of health care
1990s- The Decade of the Brain
President George Bush designates the
1990s as the Decade of the Brain: "to
enhance public awareness of the benefits
to be derived from brain research" through
"appropriate programs, ceremonies, and
Behavioral Brain Imaging
– Helps scientists learn more about the
development of major mental illnesses.
HIPPA-regulation of forms, privacy and
 Significant impact on caregivers of
those with mental illness
1999- The Voice of the Supreme
Olmstead v. LC
– It is a violation to keep a patient in a
restricted setting when outpatient services
are available
The Clinton
Bans the use of restraints in
federally funded hospitals
 Report on co-occurring disorders ordered
The Bush Administration
Increased funding for community health
 New Freedom Commission on Mental
The Obama Administration
Mental health parity states that
psychological conditions must be
treated equivalently to physical
So why does the suffering
Funding for research & services is
 Screening for childhood disorders
does not exist in most schools
 Veterans are returning with few
 Few jobs and places to live
But…… We have come so far…
Mental Health is our last Civil Rights
 New advances in science are leading to
better lives
 Recovery is possible.
The Value of Hope & Hard Work
some hope is
crucial to recovery;
none of us would strive
if we believed it a futile
Leete ‘89
And America is changing
because we are “saying what
we need to say”!