The History of Mental Health Treatment Centres

Dennis Relojo-Howell, (2021, August 26). The History of Mental Health Treatment Centres. Psychreg on Mental Health. https://www.psychreg.org/history-mental-health-treatment/

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Mental health treatment centres have suffered a chequered past: from society labelling mental health patients as demonically possessed, to lobotomies, we’ve never learned how to deal with mental health in a sustainable, humane way. 

Luckily, facilities such as treatment centres have shifted the narrative to the positive for mental health treatments. Though we still have a long way to go, this article looks at how far we’ve come and what we can do going forward to ensure we don’t make the same mistakes in the future. 

The history of mental illness 

People have grown increasingly aware of the problems we face as a society when dealing with mental health and wellness. Mental health started with the term ‘mental hygiene’ in the 19th century. However, before this term, there wasn’t an official term to describe emotional or behavioural struggles. 

Though the awareness surrounding mental health hasn’t always been there, mental health issues have. For example, anxiety and alcoholism have been covered in historical documents throughout the years. Edgar Allan Poe, Ludwig Von Beethoven, and Winston Churchill are just a few examples of prominent figures believed to have struggled with mental disorders. 

Throughout history, mental illnesses had different names, such as hysteria, shell shock, psychosis, and demonic possession. However, the twentieth century marked a significant shift in how society approached these illnesses. Governments became more interested in treating their citizens and providing resources to those afflicted with mental illnesses. 

However, there is still a long way to go and the fight for better treatment options continues. 

Perceptions of mental illness throughout history

Modern treatments and approaches are more humane and effective than ever. This is due, in part, to the disregard and disdain for people who struggled with mental illnesses.

In the Middle Ages, societies treated mentally ill patients as outcasts. These patients were often left to fend themselves on the streets. In fact, many people in these societies considered mental health patients as possessed or as witches or demons. 

Treatment throughout history aimed to remove the demonic possessions, such as exorcism, malnutrition, and harmful medications. However, the stigma attached to mentally ill people who were crazy or not from this world influenced the lack of advancement in treatment methods. 

This type of attitude didn’t wholly evaporate in the 20th century. Inhumane treatments such as electroshock therapy gained popularity in the 1940s and show how far away we are from an inclusive society. 

We are still struggling with comprehending mental illness well into the 21st century, even though we have become more sensitive to mental disorders and have implemented more effective humane treatment methods. 

Treatment forms throughout history 

Pre-18th century mental health treatment protocol separated patients into two categories: demonic possession and physical illness. When physical ailments or abnormalities occurred in mental illness patients, treatments focused on the physical symptoms.

Doctors performed radical surgeries on patients exhibiting mental illness signs in as early as the 1500s. These surgeries were often invasive and involved methods such as drilling holes in the patient’s skull. 

Other forms of therapy (if that’s what you want to call it) focused on sequestering mentally ill patients from the rest of society. Mental health patients would often find themselves in jail. 

The first iteration of the mental hospital also took place during this time period. Though, these hospitals could hardly be called hospitals. They were often miserable places of isolation and mistreatment.  

A brief history of the US mental health system 

Mental health treatment methods advanced starting in the 19th century into the mid-20th century; this period in mental health treatment brought forth the following advancements. Insane asylums were the stuff of nightmares during this period, as depicted in the 1963 Ken Kesey’ novel, One Flew Over the Cuckoo’s Nest. 

The 20th century also brought forth invasive therapies such as lobotomy and psychosurgery and electroconvulsive therapy (ECT). However, despite the negative aspects of the advancements during this period, significant advances were made. 

Sigmund Freud effectively revolutionized the approach to mental health with his writings and ‘talking cure’. Many of our methods for treating mental health today stem from his research and approach. 

Some of these methods, such as the lobotomy, have been outlawed and considered as cruel. Others, such as ECT, have been modified and still have some proponents today. 

The stigma surrounding mental illness continues today

The stigma surrounding mental illness hasn’t stopped. People with anxiety disorders and depression are still looked at as inadequate and ill-fitted for modern society. In many cases, the best solution we have to these disorders is to prescribe drugs that sedate patients, practically turning them into walking zombies and clouding their genuine emotions. 

While these drugs have their place in mental health treatment, the need for more advanced treatment methods still prevails. Perhaps even more pressing is the need for society to learn how to be more accepting and accommodating of these mental disorders.

Deinstitutionalisation 

Deinstitutionalisation introduced a new period in mental health treatment. During this period, patients were moved from state-led institutions and these institutions closed due to the movement. 

The movement has had both positive and negative consequences. In 1955, there were 558,239 severely mentally ill patients in institutions. In 1994, the number had been reduced by over 400,000 to 71,619. Additionally, factoring in the population increase, there would have been 885,010 severely ill patients in institutions. 

Deinstitutionalisation gave patients autonomy and the choice to seek treatment. This fact has had dual consequences, on the one hand, giving mentally ill people and their families the freedom to choose what treatment works best for them. 

On the other hand, mentally ill patients without families or loved ones often suffer doomed fates of wandering the streets with nothing but a cardboard box as a refuge. The sad reality is that these people can’t make decisions for themselves, and without resources, they live some of the harshest lives possible. 

Final thoughts

The good news is that more and more residential treatment centers are emerging due to the lack of mental health infrastructure in the United States. These facilities aim to provide full-service mental health treatments and a safe space for struggling mental illnesses. 

Though we haven’t fully adapted our approach to mental health, it’s improving, and there are more innovative therapies on the way. Additionally, awareness has enhanced during the 21st century, reducing the stigma associated with mental health. And though the negative connotations aren’t gone, they are improving. 


Dennis Relojo-Howell is the founder of Psychreg.

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