G5.Information Sheet KS4/5 on the History of Mental Illness and Mental Health Problems
Definition and range of conditions
The term ‘mental illness’ is generally used when someone experiences significant changes
in their thinking, feelings or behaviour. The changes need to be strong enough to affect
how the person functions or to cause distress to them or to other people.
Psychosis is viewed as most serious is a severe mental impairment involving a loss of
contact with reality, frequently with hallucinations, delusions or altered thought processes,
with or without a known organic origin. These conditions would include bi-polar,
schizophrenia and personality disorder. In the UK and USA at any one time around 1% of
the population are affected. In the past this group have been described as mad or insane.
A larger group have depression "a melancholic state often accompanied by feelings
of inadequacy and a lack of energy”. In use since the 17th century as a general word
for dejection, but in the 20th century adopted as a clinical term. In acute cases this
can become so severe that it stops physical functioning and thinking clearly.
There are a wide range of other conditions . The World Health Organisation identifies
that over a third of people in most countries report problems at some time in their
life which meet the criteria for diagnosis of one or more of the common types of
mental health issues. Common would be anxiety, eating and sleeping impairments,
tics such as Tourettes, drug dependency and adjustment impairments. There are also
impairments where the brain degenerates, such as dementia or Alzheimer’s.
Throughout history, only those who could not care for themselves or were a danger
to themselves or others were viewed as having severe mental health problems.
Bedlam, for more than 700 years
was a hospital for the mentally ill
and divided them into
Melancholic and Manias, the
latter being shackled.
The way people were treated
varied depending on the ideas of
the time.
Old Statue, Gates Bedlam Hospital-British Museum
The ‘insane’ were often called Lunatics, as it was
believed people were affected by the Moon or there
had been a full moon when they were born. It was
thought up until the 1850s that some people were
like this because they were possessed by ‘spirits’ or
‘demons’ and that these had to be driven out by
shocking the body with loud noises, ice cold baths,
or letting blood from their veins. Lunatics were
viewed as less than human and were often chained
and locked up or later kept in straightjackets.
Gradually social reformers argued that a
sympathetic and supportive treatment would help
the ‘mad’ recover and that they should be separated
into different areas of the hospital, workhouse or asylum. The better off cared for their
relatives at home or placed them in private ‘licensed’ houses to be cared for.
However, the tendency to exploit,
mistreat and make fun of the inmates
continued. This political sketch of the
artist Hogarth in the moral tale the
‘Rakes Progress’ shows society ladies
visiting Bedlam to be entertained by the
inmates. See Film on the history of
Bedlam
http://topdocumentaryfilms.com/bedlam-thehistory-of-bethlem-hospital/
In England, control over persons considered dangerous due to their mental impairments
was first with Justices of the Peace or Local Magistrate and Doctors. The County had to set
up Asylums from 1808. The 1850 Mental Lunacy Act came under the Home Secretary
through a Board of Control. Increasingly people with Mental Illness were rounded up and
placed in ‘Lunatic Asylums’ of which over 100 were built in the second half of C19th. These,
like the Mental Deficiency Hospitals, were built outside the large towns in the country and
housed both voluntary patients and those who were placed there against their will-the
certified. Doctors determined if someone was ever fit to leave. At their height 150,000
patients lived in them.
Devon County AsylumOutside Exeter.
The branch of medicine
that dealt with mental
illness was Psychiatry.
Many dangerous practices
were developed in the next
hundred years, such as
lobotomy-cutting the frontal lobes of the brain and Electro Convulsive Therapy (ECT) where
large currents of electricity are passed through the brain. Both were continued as they
suppressed the behaviours that had led to people being classed as mentally ill.
Film ‘Mental: A History of the Madhouse’, BBC4 . Watch first 20 minutes or the 59 minute
documentary http://www.youtube.com/watch?v=wZrKcu8RjSo telling the story of High
Royds Asylum. This is very informative about the treatments given to patients in the mental
hospitals and the negative impacts these had on them. Write an account of the
development and demise of the Asylums and what it must have been like to live there.
From the early 1950s pressure grew to close the asylums. The 1959 Mental Health Act
supported the closure of the hospitals and moving patients into the community, though
little happened for nearly 20 years. These moves were pushed further by a new Survivors or
Users of the Mental Health System Movement and further exposure of scandals.
http://www.nsun.org.uk/modules/downloadable_files/assets/on-our-own-terms.pd
In the last 50 years with the closing of long stay asylums, the new psycho tropic drugs were
increasingly used and are now relied upon even more. These drugs, like earlier more brutal
treatments suppress the symptoms of ‘insanity’ and made living in the community possible.
Unlike other forms of
medicine, psychiatry
has not really made
any progress in
reducing mental
illness or curing
people, according to
psychiatrist Richard
Bentall1 . After a wide
review of the
evidence he finds no
evidence of an ability
to treat severe mental
illness. He argues the main reason is a medical model approach, which relies on an idea that
people with severe mental health issues have a genetic predisposition to mental illness.
An alternative view is that the
environmental and social
circumstances people find
themselves in, can for some
people, lead to major bouts of
mental distress. Giving them
care, support and mechanisms
for coping, can help people
with mental health issues to
take more control of their
condition. They may need a
combination of therapy and some reliance on drugs.
The Pharmaceutical Industry strongly promotes drug treatments. It is less labour intensive
than providing therapy, which may help people live worthwhile lives in the community.
These contradictions still need to be addressed and resolved.
1
Richard Bentall ‘Madness Explained’ 2004 or Meredith Small ‘The Culture of Our Discontent : Beyond the Medical Model of
Mental Illness’ 2006 Joseph Henry Press.
However there is still considerable fear and stigma towards people with mental health
issues. Reactions to some high profile attacks on people by former patients of the mental
health system have led to a halting of the Care in the Community programme. A broad
piece of legislation was introduced giving doctors widespread new compulsion powers on
medication of patients, rather than specific legislation to address the relatively few people
who are a danger to themselves and others. (Mental Act 2007.)
Recently the Survivors’ Movement/Users Movement, has made progress in challenging
compulsory treatments against the patient’s will, in Article 12 of the United Nations
Convention on the Rights of Persons with Disabilities . http://www.mindfreedom.org/mfifaq/go/now .
For Survivors Poetry
http://www.survivorspoetry.org/the-poetry/publications/poetry-express/
To get a wider historical understanding go to the Mental Health History Timeline
http://studymore.org.uk/mhhtim.htm