I am very adamant about mental health. The stigma surrounding it is still present. Treatment is still not covered under insurance enough or accessible to the mass population. We still throw around terms as adjectives and have the mentally ill either undiagnosed, untreated, or in a setting where neither is possible, whether that be on the streets or locked into prisons.
Despite all of these setbacks we still must overcome, we don’t celebrate the progress we have made often enough. It’s easy to forget the past we have grown from, a past that is dark and ugly. A past locked up as tightly as the mentally ill themselves. Let’s step into a time machine and take a journey. I hope it will at least help you appreciate today’s medical advances and societal tolerance more.
Admittedly, the medical field began as a very obscure, often dangerous practice. I’m glad we no longer try to balance the four humors in our bodies or try feeling our skulls for different bumps and indentations that indicate disease. In the ancient world, mental illness was thought of as demonic possession, perhaps an insight to keep in mind when considering how people view mental health. In any case, people began treating mental illness by chipping a hole, or “trephine”, into the skull of the patient by which “the evil spirits would be released,” therefore healing the patient.
Hippocrates was a major proponent of stepping away from sorcery and superstition and at least saw mental illness as a natural occurrence, studying the pathology of the brain. Except he thought by balancing blood, phlegm, bile, and black bile in the body, thought to affect an individual’s personality, one could cure mental illness. One step forward, two steps back.
Historically, those with mental illnesses had a social stigma attached to them. It was believed that a mentally ill member implies a hereditary, disabling condition in the bloodline threatening the family’s identity. In countries or cultures that had strong ties to family honor, the ill were hidden by their families so that the community or society wouldn’t suspect any descrepencies, forcing the mentally will to either live a life of confinement or were abandoned and forced to live on the streets. Any of those that were abandoned to live on the streets and were rumored dangerous and unmanageable were either put in jail or dungeons out of the public eye.
Women especially received the harshest treatment for mental illness. In Victorian times, a woman could be considered unbalanced due to a variety of causes, including menstruation-related anger, pregnancy-related sadness, post-partum depression symptom, disobedience, or chronic fatigue syndrome. Women were then placed in institutions, labeled with “hysteria,” and were cared for by a doctor who typically ruled the facility in the same manner in which a Victorian father might rule a home. Women had few, or no, rights, and disobedience was often met with severe punishment. Rather than actually treating disease, women were further objectified and suppressed from equal dignity.
Early institutions, often in the forms of asylums, “madhouses,” and workhouses, were far from helpful or safe. Those that were admitted to madhouses were abused and often abandoned by their caregivers who were not trained in the treatment of mental disorders. Many of those admitted were abused, abandoned, treated like animals, restrained with shackles and iron collars, and even put on display. Treatments in these asylums included purging, bloodletting, blistering, dousing patients in either boiling or ice-cold water to “shock” them, sedatives, and using physical restraints such as straitjackets.
In the mid- to late-1800’s, a reform led to a rethinking of the current mental health system. The hospital movement was justified by reasons such as: to protect society and the insane from harm, to cure those amenable to treatment, to improve the lives of the incurable, and to fulfill the humanitarian duty of caring for the insane. In new psychiatric institutions, people were trying new treatments that today are quite controversial. These include insulin-induced comas, lobotomies, malarial infections, and electroshock therapy.
In the 1940’s and 1950’s, chemists began to experiment with different powders and pills that could calm imbalances inside the brain and deliver real relief to people who had mental illnesses. Rather than strapping people down to their beds, chemists hoped to use a form of chemical restraint. People would feel better and behave better so no institutionalization would be needed at all. To a large extent, this was a successful project. Medications like lithium seemed capable of soothing people with very severe cases of bipolar disorder, while anti-psychotic medications seemed capable of helping people with schizophrenia.
Also in this period, people advocated to move people out of institutions and into communities, and the number of people enrolled in formal institutions dropped dramatically in just a few short years. However, those who needed intense care did not receive it. They had support in areas like housing assistance, job training, or psychiatric counseling. As a result, many people who moved out of terrible facilities moved into situations that were merely different, not noticeably better. They were exploited in industrial factories or living on the streets, still stigmatized as “crazy” outcasts.
I can not even fathom living with mental illness in these periods. I am so grateful to have had access to therapy and modern medication with very few side effects. I can live among my peers with the freedom to live a full life. I can actually speak out about this injustice and see others doing the same. With the dark chapters of this story of progress in mental health closed, we still have a long story to tell. Our work is not done.
Take care, and keep the faith. -Allie