The History of Mental Illness in America: A Journey From Despair to Hope & Recovery Ms. Manzo Former First Lady Rosalynn Carter “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.” 2010 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 Barbaric Demon-possessed Senseless animals “It was believed that patients chose to behave irrationally, and doctors tried to help them adopt a more normal manner.” Care????? Family Parish Church Those without family – placed in prisons- chained to walls, unclothed – poorhouses 1770s First hospitals 1773- Williamsburg, Virginia Designed to keep those with mental illness away from society- not treat them. The Public Hospital, Va. 17th-18th Centuries Dorothea Dix Dorothea Dix Schoolteacher 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. 1840 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 activities • 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 overcrowded Restraints, shock therapy, opium Soldier’s Heart- or “PTSD” Post Civil War Asylums – now underfunded – overcrowded Quality of care deteriorates Newspapers expose inhumane conditions 1900- Clifford Beers “A Mind That Found Itself” 1908- changed mental health care Beers’ autobiography –chronicles his struggle with mental illness and healthcare 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 Beers 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 health 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 Hospitals Psychiatric units opened in general hospitals Treatments ineffective Hospitals provided humane custodial care at best – At worst- neglect or abuse Great Depression=overcrowding……. 1946- National Mental Health Act President Truman - National Mental Health Act 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). 1947-1951 1st community based health treatment for patients in state institutions 1949- Lithium New hope 1954 Antipsychotic drugs introduced Thorazine- improves hallucinations and delusions Other medications now become available 1956 Congress allocates- $12 million for psychopharmacology Number of consumers decline in mental institutions 1961- Action for Mental Health Report to Congress based on 5 years of research – 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?” 1960s Community health movement – Outpatient services – More research – Less state mental hospitals – More general hospitals with psychiatric wings – More community health centers 1980s President Jimmy Carter Mental Health Systems Act – Grant program – Involves consumer input – Offers education and support – Strengthens the links between Federal and state services 1981-1985 Carter’s work halted Mental Health Systems Act repealed Funding drops Behavioral Health Managed Care 1988 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 activities." 1994 Behavioral Brain Imaging – Helps scientists learn more about the development of major mental illnesses. 1996 HIPPA-regulation of forms, privacy and security Significant impact on caregivers of those with mental illness 1999- The Voice of the Supreme Court Olmstead v. LC – It is a violation to keep a patient in a restricted setting when outpatient services are available The Clinton Administration Bans the use of restraints in federally funded hospitals Report on co-occurring disorders ordered The Bush Administration Increased funding for community health centers New Freedom Commission on Mental Health The Obama Administration Mental health parity states that psychological conditions must be treated equivalently to physical illnesses. So why does the suffering continue? Funding for research & services is scarce Screening for childhood disorders does not exist in most schools Veterans are returning with few services Few jobs and places to live And…..STIGMA But…… We have come so far… Mental Health is our last Civil Rights Movement…. New advances in science are leading to better lives Recovery is possible. The Value of Hope & Hard Work “Having some hope is crucial to recovery; none of us would strive if we believed it a futile effort.” Leete ‘89 And America is changing because we are “saying what we need to say”!