Mental Health
Intro
Refers to emotional, psychological and social well-being. Handling stress and
functioning adequately.
Clinical psychologists:
- Head injuries
- Brain damage
- Addiction
- Developmental disorders
- Relationship/learning difficulties
Around 300 known disorders, increased significantly in the last 50 years.
Historical context
Background
Views varied across cultures and ages. This influenced treatment of disorders.
Prehistoric (6500 BC)
Beliefs about causes – thought it was some sort of supernatural phenomena such
as demons and other beings or insanity (which is what they called mental health).
Was thought to be a result of demonic possession, witchcraft, religion or
punishment for wrongdoing.
Who cared for them? - Some monasteries became centres to treat mental disorders
as priests were seen as the wisest for understanding mental disorders.
Treatment – Exiled, beaten, outcast, and abused.
- Trepanning (drilling holes into the skull to ‘let demons out’).
- Exorcism techniques (beatings, restraints, stretching and starvation,
boiling + freezing water).
- Prayers and holy water.
,800-700 BC
Beliefs about causes – humoural theory – an imbalance of the 4 bodily humours
(phlegm, blood, yellow bile, black bile). Around 400 BC Hippocrates hypothesised
that mental illness was not caused by punishment but by physiology.
- Black bile: quiet, introverted, serious (Excess: melancholia/depression –
drained with laxatives).
- Yellow bile: impulsive, ambitious, restless (excess: Choleric people are
bad-tempered or showed mania).
- Blood: courageous, hopeful, playful.
- Phlegm: calm, patient, peaceful.
Who cared for them? – Clinicians. 729 BC the first mental hospital opened in
Baghdad.
Treatment – Said that they should be looked after not stigmatised or blamed and
could be treated with physiological remedies.
- Purging patients through emetics
- Laxatives
- Phlebotomy
- Changes in lifestyle (exercise and diet).
13th Century
Beliefs about causes – generally connected to loss of reason, the brain and
disorders connected with spiritual/mystical meaning of disorders. Possession by
jinn. The Muslim world expanded, Greek concepts were integrated with religious
thought and over time, new ideas and concepts were developed.
Who cared for the mentally ill? – Bethlem Royal Hospital (Bedlam) opened in 1247
in London – Britain’s first hospital for the mentally ill.
Treatment – Care and control of the insane. Mental illness in women began to be
seen more as possession and they were persecuted for this.
- Most ‘disturbed’ were held in mechanical restraints and stocks kept in
solitary conditions.
,15th to 17th century
Beliefs about causes – Insanity is caused by demonic possession and witchcraft.
Mental illness could be seen as both a natural and supernatural event – a sickness
or something caused by astronomical events. More was found out about hysteria
and epilepsy in the 17th century which faded witchcraft ideas.
Who cared for them? – Families or communities. Some were on the streets. 1500s,
more asylums were built or the mentally ill were abandoned in workhouses or mad
houses if they were too burdensome. Bone setters, ‘wise women’, ‘cunning men’,
herbalists, astrologers – who also offered treatment.
Treatment – Institutions aimed to protect the public from the mentally ill and
protect the family from the embarrassment of their ill family member. Those that
were admitted to madhouses were abused. Private madhouses, however, were
often run by clergy men and were significantly more humane.
- Physical punishments – salvation of immortal soul.
- Madhouses and workhouses did little to nothing to help.
- Use of herbs, curses would be lifted with occult symbols.
18th century
Beliefs – The next few centuries saw the growth of a more humanitarian view of
mental illness.
Who cared? – Similar institutions as previous centuries (jails + private homes). The
Hospital movement started ‘to cure those amenable to treatment, to improve the
lives of the incurable, and to fulfil the humanitarian duty of caring for the insane’.
York Retreat – first humane care centre opened by Samuel Tuke.
Treatment – Insane were treated better and included a trusting confiding
relationship between patient and doctor. Some still provided little care and
frequently used physical coercion, including chains, to restrain the actions of
patients.
- Compassionate care and physical labour.
19th century
Beliefs – Not recognized as treatable conditions. Perceived as a sign of madness,
warranting imprisonment in merciless conditions. Dorothea Dix’s work – 32 mental
health hospitals in a wealth of U.S. states but also changed perceptions of mental
, illness. Modern psych began to accept the fact that mental illness may be due to
psychological influences on the mind and not physical or spiritual factors.
Who cares? – Asylums were still used.
Treatment – Various attempts to improve the condition of those detained in
asylums, and various Acts of Parliament passed.
- Diagnosed and more talking therapy used
- Types of counselling
20th to 21st century
Beliefs – Multiple explanations for mental illness are now discussed and used to
diagnose patients, medicalisation is predominant.
Who cares? – Cared for in mental health units, asylums were closed down, patients
were cared for in community and are today, decarceration. Medical staff,
psychiatrists, psychologists, nurses, social workers, carers, therapists/counsellors
are involved.
Treatment – Respect, compassion, and understanding.
- Insulin Coma Therapy (1920s-60s) where physicians deliberately put the
patient into low blood sugar coma because they believed large fluctuations in
insulin levels could alter the function of the brain (mortality rate 1-10%).
- ECT (safer alternative to ICT).
- Psychosurgery (including lobotomies popular in 40s and 50s) – surgically
removing the connections between the prefrontal cortex and frontal lobes of the
brain.
- Metrazol Therapy (physicians reduced seizures using a stimulant
medication several times a week, until 80s)
- Pharmacology
Now most of the things used are CBT, drug treatments, talking therapies,
behavioural therapies.
Definitions of abnormality
Diagnosing dysfunctional behaviour involves being able to tell the difference
between abnormal and normal.
Intro
Refers to emotional, psychological and social well-being. Handling stress and
functioning adequately.
Clinical psychologists:
- Head injuries
- Brain damage
- Addiction
- Developmental disorders
- Relationship/learning difficulties
Around 300 known disorders, increased significantly in the last 50 years.
Historical context
Background
Views varied across cultures and ages. This influenced treatment of disorders.
Prehistoric (6500 BC)
Beliefs about causes – thought it was some sort of supernatural phenomena such
as demons and other beings or insanity (which is what they called mental health).
Was thought to be a result of demonic possession, witchcraft, religion or
punishment for wrongdoing.
Who cared for them? - Some monasteries became centres to treat mental disorders
as priests were seen as the wisest for understanding mental disorders.
Treatment – Exiled, beaten, outcast, and abused.
- Trepanning (drilling holes into the skull to ‘let demons out’).
- Exorcism techniques (beatings, restraints, stretching and starvation,
boiling + freezing water).
- Prayers and holy water.
,800-700 BC
Beliefs about causes – humoural theory – an imbalance of the 4 bodily humours
(phlegm, blood, yellow bile, black bile). Around 400 BC Hippocrates hypothesised
that mental illness was not caused by punishment but by physiology.
- Black bile: quiet, introverted, serious (Excess: melancholia/depression –
drained with laxatives).
- Yellow bile: impulsive, ambitious, restless (excess: Choleric people are
bad-tempered or showed mania).
- Blood: courageous, hopeful, playful.
- Phlegm: calm, patient, peaceful.
Who cared for them? – Clinicians. 729 BC the first mental hospital opened in
Baghdad.
Treatment – Said that they should be looked after not stigmatised or blamed and
could be treated with physiological remedies.
- Purging patients through emetics
- Laxatives
- Phlebotomy
- Changes in lifestyle (exercise and diet).
13th Century
Beliefs about causes – generally connected to loss of reason, the brain and
disorders connected with spiritual/mystical meaning of disorders. Possession by
jinn. The Muslim world expanded, Greek concepts were integrated with religious
thought and over time, new ideas and concepts were developed.
Who cared for the mentally ill? – Bethlem Royal Hospital (Bedlam) opened in 1247
in London – Britain’s first hospital for the mentally ill.
Treatment – Care and control of the insane. Mental illness in women began to be
seen more as possession and they were persecuted for this.
- Most ‘disturbed’ were held in mechanical restraints and stocks kept in
solitary conditions.
,15th to 17th century
Beliefs about causes – Insanity is caused by demonic possession and witchcraft.
Mental illness could be seen as both a natural and supernatural event – a sickness
or something caused by astronomical events. More was found out about hysteria
and epilepsy in the 17th century which faded witchcraft ideas.
Who cared for them? – Families or communities. Some were on the streets. 1500s,
more asylums were built or the mentally ill were abandoned in workhouses or mad
houses if they were too burdensome. Bone setters, ‘wise women’, ‘cunning men’,
herbalists, astrologers – who also offered treatment.
Treatment – Institutions aimed to protect the public from the mentally ill and
protect the family from the embarrassment of their ill family member. Those that
were admitted to madhouses were abused. Private madhouses, however, were
often run by clergy men and were significantly more humane.
- Physical punishments – salvation of immortal soul.
- Madhouses and workhouses did little to nothing to help.
- Use of herbs, curses would be lifted with occult symbols.
18th century
Beliefs – The next few centuries saw the growth of a more humanitarian view of
mental illness.
Who cared? – Similar institutions as previous centuries (jails + private homes). The
Hospital movement started ‘to cure those amenable to treatment, to improve the
lives of the incurable, and to fulfil the humanitarian duty of caring for the insane’.
York Retreat – first humane care centre opened by Samuel Tuke.
Treatment – Insane were treated better and included a trusting confiding
relationship between patient and doctor. Some still provided little care and
frequently used physical coercion, including chains, to restrain the actions of
patients.
- Compassionate care and physical labour.
19th century
Beliefs – Not recognized as treatable conditions. Perceived as a sign of madness,
warranting imprisonment in merciless conditions. Dorothea Dix’s work – 32 mental
health hospitals in a wealth of U.S. states but also changed perceptions of mental
, illness. Modern psych began to accept the fact that mental illness may be due to
psychological influences on the mind and not physical or spiritual factors.
Who cares? – Asylums were still used.
Treatment – Various attempts to improve the condition of those detained in
asylums, and various Acts of Parliament passed.
- Diagnosed and more talking therapy used
- Types of counselling
20th to 21st century
Beliefs – Multiple explanations for mental illness are now discussed and used to
diagnose patients, medicalisation is predominant.
Who cares? – Cared for in mental health units, asylums were closed down, patients
were cared for in community and are today, decarceration. Medical staff,
psychiatrists, psychologists, nurses, social workers, carers, therapists/counsellors
are involved.
Treatment – Respect, compassion, and understanding.
- Insulin Coma Therapy (1920s-60s) where physicians deliberately put the
patient into low blood sugar coma because they believed large fluctuations in
insulin levels could alter the function of the brain (mortality rate 1-10%).
- ECT (safer alternative to ICT).
- Psychosurgery (including lobotomies popular in 40s and 50s) – surgically
removing the connections between the prefrontal cortex and frontal lobes of the
brain.
- Metrazol Therapy (physicians reduced seizures using a stimulant
medication several times a week, until 80s)
- Pharmacology
Now most of the things used are CBT, drug treatments, talking therapies,
behavioural therapies.
Definitions of abnormality
Diagnosing dysfunctional behaviour involves being able to tell the difference
between abnormal and normal.
