The History of Mental Health Treatment

Mental illness affects 42.5 million American adults and counting, Newsweek reports. The possible disorders are numerous and impact a person’s thoughts, moods, behavior, and emotions. Substance abusers are not strangers to mental illness. According to a study published in the Journal of the American Medical Association, 53 percent of drug abusers also had a mental health disorder.

While there are no exemptions, some illnesses are more commonly seen in substance abusers. Mood and anxiety disorders are likely the most common among addicts. Around 20 percent of all people who have these illnesses are also substance abusers, per Everyday Health.

It is believed that mental illness has always existed. Despite that, it wasn’t always recognized for what it is — a legitimate medical issue. There was little to no comprehension of why mental illness or physical disease occurred during prehistoric times. Behavior that was out of the ordinary was thought to be caused by supernatural forces. In the past, someone who exhibited symptoms of bipolar disorder may have been persecuted by religious sects who believed their behavior was the result of demonic possession. Along came Hippocrates between 3000 and 5000 BC with his medicinal treatments of such ailments. This was the beginning of mental health treatment as we know it now.

Mental Illness Treatment Timeline

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    500 BC-500

    Ancient Rome and Greece had evolved enough to come up with a limited set of diagnoses for people who behaved abnormally. Other disorders of that era included melancholia — an early term for symptoms of depression — and dementia. Hysteria was primarily viewed as a problem that afflicted only females. Back then, women had very few political and social rights because of their so-called hysterical behavior. Delusions and hallucinations were both auditory and visual, and primarily concerned with religious and divine figures. The New York Times notes 10 percent of people without any presence of mental illness may experience hallucinations. Thus, it is quite possible many did back then and were falsely thought to be ill.

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    1401-1500

    It was in the 15th century that rumors began to surface regarding witchcraft. Such practices were often blamed on individuals — mostly women — who engaged in allegedly deviant behaviors. Such behaviors ranged from sexual activity to abstinence from religion. It was still believed that supernatural forces had a great deal of control over human beings, and acts of insanity were often attributed to possession by Satan. There was no interest in treating individuals who appeared to be afflicted. Instead, it was thought that death would be the only thing that would spare their souls.Early exorcisms were cast in the form of physical reprimands in hopes that Satan would find a physically injured body less hospitable for possession. The majority of people of religious faith still believe angels and demons have an influence on human life today. The Huffington Post reports 88 percent of Mormons and 87 percent of Christians do.

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    1501-1600

    Mental illness began to take on many forms and gained more widespread acknowledgement in the 16th century. Townspeople feared it, poets and playwrights wrote about it, and those who were accused of it suffered in prison. The mentally ill were viewed as being loose cannons and a risk to society, so they were generally locked up against their will.

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    1601-1700

    There were some improvements made in the 17th century. The mentally ill were seen as not being rational enough or of sound mind, so decisions and their overall care were left to friends or relatives. Private madhouses started to spring up during the late 1600s that served to house multiple patients of mental illness, much in the way a community living facility would today.

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    1701-1800

    More “lunatic” asylums made their way into American during the 18th century. Mental illness was beginning to be viewed in a different light – one set apart from criminals and the poor. However, this new light wasn’t entirely favorable, and most with mental health disorders were viewed as being weak-willed or lacking good character. Those who were unfortunate enough to be labeled as insane were often imprisoned and still believed to be controlled by demonic possession.

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    1801-1900

    One of the biggest movements in the field of mental health treatment came in 1841 when Dorothea Dix, a Boston teacher, visited a local jail and was appalled at the sight of the living conditions forced upon the mentally ill population. Her subsequent lobbies for fairer treatment of these individuals led to the opening of 110 more psychiatric care facilities by 1880, according to Mother JonesThese treatment facilities would evolve from a picture of shackled patients in jail cells to home-like environments that were tastefully decorated and made to be more comfortable. It was believed that a change in environment could spark a recovery of abnormal behaviors. Early signs of applicable therapy started budding in this era. Poor behaviors were targeted for change, and new objectives were launched to rehabilitate the mentally ill into productive members of society.

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    1901-2000

    The 1900s brought a great amount of strife to the mentally ill, but also a lot of forward progress in rehabilitating mental health disorders. New treatment approaches were invasive, painful, and deadly. Countermeasures to control the mentally ill population were far from what we would call fair today.At the turn of the 20th century, the Indiana Eugenics Law was passed to legalize the sterilization of criminals and the mentally ill — a legal action which 29 more states would soon follow. According to Mental Health in America: A Reference Handbook, 18,552 people were surgically sterilized by the year 1940.

Mental Health Treatment During the 20th Century

The early part of the 20th century would bring with it a host of now-controversial and unimaginable treatments for mental illness. Some patients suffering from disorders thought to be caused by infection had their teeth and internal organs removed during surgical procedures that promised relief from symptoms. Hypothermia was thought to be a cure for schizophrenic episodes and was purposely induced for many sufferers.

The first prefrontal lobotomy was performed by Dr. Walter Freeman in 1936, and The New York Times notes this surgical procedure gained so much traction that an estimated 50,000 surgeries were carried out by 1960. Electroshock therapy soon followed in 1938 and became the primary method of treatment for schizophrenia. These procedures often left patients with chronic fatigue and an immature mindset that carried over into childlike behavior. Student Pulse notes a quarter of all lobotomy patients died as a result of the surgery.

In 1946, Dr. Freeman went on to perform the first “ice pick” lobotomy, which reportedly left the suicidal patient with an improved quality of life and only minor memory loss. That same year, the National Mental Health Act went into effect and thus required the National Institute of Mental Health to investigate causes of mental illness and the potential harm and efficacy of varying treatment methods. The first antipsychotic drug was brought to market in 1954 by Smith-Kline and French. Thorazine — the manufacturer’s brand name for chlorpromazine — was used to sedate patients in asylums and calm the effects of psychotic behaviors like hallucinations. PBS reports these antipsychotic drugs are effective for 70 percent of patients.

Substance abuse was finally included in the Diagnostic and Statistical Manual of Mental Disorders in 1952, but it was added to the category of Sociopathic Personality Disturbances, which was a blanket term for serious mental health disorders and character weaknesses. It would go through many changes in coming decades and was just recently changed to reflect actual diagnostic criteria in 1994.
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By 1955, 560,000 people were housed in American institutions for the insane, according to Unite for Sight. That year, America saw the beginning of deinstitutionalization — a process which forever changed the way the mentally ill can access treatment. With the demand for treatment continuing to climb, President John F. Kennedy signed the Community Mental Health Act in 1963 that offered funding to build more treatment facilities — a feat that never came to fruition in light of budget constraints stemming from the Vietnam War.

A huge game-changer came along in 1965 when Medicaid was passed with an exclusion for the coverage of mental illness. Suddenly, mental patients were being transferred from the very facilities built to care for them to hospitals and nursing homes. This process would finish the process of deinstitutionalization. More bad news came in 1967 when the Lanterman-Petris-Short Act was passed in California, making it very difficult to commit a mentally ill individual against their will. Similar legislations would come to pass in other states in coming years.

By 1977, the number of people being treated for mental illness had reached 1.9 million, according to the National Alliance on Mental Illness. Despite the large number seeking help, the Omnibus Budget Reconciliation Act of 1981 would further change the climate of treatment by removing federal funding for mental health care in lieu of state grants, thereby cutting federal spending on the issue down by 30 percent, Childhood and Adolescence in Society: Selections from CQ Researcher notes.

The Administration in Mental Health published the results of a 1984 study that reported a 33-66 percent rate of mental illness among homeless people living in shelters. Today, that number resides at 26 percent, per NAMI. Another treatment drug would burst onto the scene at the beginning of the 1990s; Clozapine was approved for the treatment of schizophrenia.

Mental Health Treatment Today

When the recession hit American in 2009, federal budgeting cut $4.35 billion from public mental health spending through 2012, per the PEW Charitable Trusts. This would lead to further declines in treatment availability.

In 2004, the lifetime rate of mental health treatment for convicted criminals was 31.2 percent, the Bureau of Justice Statistics notes. As it stands in 2015, 56 percent of state prisoners, 45 percent of federal inmates, and 64 percent of jail inmates suffer from a mental health disorder, Prison Policy reports. Drug crimes specifically have surged over the years. In 1973, there were 9,027,700 arrests across the nation, and 328,670 were drug-related, compared to 11,302,102 arrests in 2013 with 1,501,043 being drug-related, according to Drug War Facts.

Substance use is largely impacted by mental illness, both directly and indirectly. While some individuals struggle themselves, others have grown up with parents who suffer from these co-occurring disorders. Substance abuse in a parent immediately predisposes children to the same affliction in adulthood. Children who have a parent who abuses drugs or alcohol are more likely to suffer from mental health issues. According to the National Association for Children of Alcoholics, inpatient admission rates for mental health treatment of children of alcoholics were 24 percent greater than those of non-alcoholic parents, and their stays in treatment were 29 percent longer.

Mental illness and substance abuse often co-occur. In some cases, mental illness may be a secondary factor that has little influence on addiction. In other cases, mental health disorders are the underlying fuel that fans the flames of substance abuse until they grow into dependency.

At The Recovery Village at Palmer Lake, you can change the way you’ve been coping with your co-occurring disorders and recover from addiction. Call now to learn about our dual diagnosis treatment programs.