Learning From History
History and Mental Illness
• Early views (e.g. the Dark Ages) on mental
health equated mental illness with
demonic possession.
– Witchcraft
– Curses from the Gods
• “Treatments”:
– Some were left to their own demise
– Burning at the stake
– Torture
Asylums and Hospitals
• Asylums usually housed the mentally ill,
poor people, and other discarded
members of society.
• One notorious asylum is Bethlehem Royal
Hospital (Bedlam)
– Put patients on display like animals at the zoo
– Inhumane treatment of patients
– Poor living conditions
Treatments of Mental Illness
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Blood letting
Ice baths
Insulin shock
Frontal Lobe Lobotomies
Electro-shock therapy
Early Leaders of Reform
• Philippe Pinel and Jean-Baptiste Pussin:
– Unshackled patients and pushed for more humane
treatment of mentally ill.
• William Turke:
– Founded York Retreat where patients were treated
morally.
• Led to similar establishments in America
• Dorothea Dix:
– Social reform to remove mentally ill from prisons to
their own hospitals.
– Pushed for government funding of treatment facilities.
Using Psychology/Science for Social
Control and Discrimination
• Francis Galton:
– Eugenics: selective breeding for improving the human gene pool
• Mental traits are inherited (Galton was focused on IQ)
• James Cattell:
– Coined “mental test”, supported Galton’s idea of eugenics,
promoted sterilization
• Alfred Binet:
– Intelligence test (original French version)
• Robert Yerkes:
– Army Alpha and Army Beta
• Lewis Terman:
– Translation of Binet’s Intelligence Test  Standford-Binet
Using Psychology/Science for Social
Control and Discrimination
• IQ became the predominate means of
“sorting” people in the early 1900’s
– Goddard promoted screening immigrants at
Ellis Island to prevent individuals with low IQ’s
from entering U.S.
– Interpretations of WWI recruit testing
suggested racial differences in IQ
– Placing students in schools
Mental Illness in 1930’s Germany
• Action (Aktion) T4:
– German physicians were instructed to
euthanize mentally ill, mentally disabled, and
physically handicapped individuals.
– Applied to both children and adults
– Parental consent at first for children; later
without parental consent
Research in the Camps
• Military Related Research:
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Freezing/Hypothermia
High Altitude
Tuberculosis (TB)
Malaria
Sulfanilamide
Wounds
Sea Water
Poison
Limb Transplant
Various Infectious Diseases
Research in the Camps
• Genetic Research:
– Artificial Insemination
– Sterilization Techniques
– Physiology/Dissections
– Mengele’s Twin Studies
Tuskegee Syphilis Experiment
• The progression of syphilis (STD):
– Primary Stage (up to 90 after infection)
• Lesion and skin ulceration, usually at the point of contact
– Secondary Stage (1-6 months after infection)
• Skin rash, cold/flu-like symptoms (headache, soar throat,
fever), weight loss
– Latent Syphilis
• Lack of signs and symptoms for extensive time, after the
second stage symptoms have cleared
– Tertiary Stage (a.k.a Late)
• Tumor like growths, neurological issues, cardiovascular
issues, affect internal organs
• Neurosyphilis (affects CNS)
Tuskegee Syphilis Experiment
• Background:
– Syphilis was becoming an issue
– No real understanding of the progression of
the disease
– A study was proposed to examine the effects
of untreated syphilis
• Major Orgs Involved:
– U.S. Public Health Service (U.S. Gov’t)
– Tuskegee Institute
Tuskegee Syphilis Experiment
• Location: Tuskegee, Alabama
• Participants:
– N = 600 African American Males
• 399 w/syphilis, 201 without
– Low SES, low levels of education, rural area
– Participants were enticed with Free medical
examinations, meals, and burial insurance
– No Informed Consent
– Used an African American nurse to gain participant
trust
Tuskegee Syphilis Experiment
• 1930’s to 1970’s
• Participants were told they’d be treated for
“Bad Blood”.
• Local doctors were told not to treat men in
the study.
– Participants given placebo pills
– Penicillin withheld (most effective treatment)
– Draft Board agreed not to treat men in the
study
Tuskegee Syphilis Experiment
• Results:
– Many infected participants died from the
disease and its complications (during the
study)
– Several wives and children infected
– $10 million class-action law suit
– Created a general distrust of health care
officials
Milgram Experiment
• The use of deception in research
• Milgram wanted to know how powerful authority was to
the individual.
– Set up a “Learning” experiment, in which electric shocks would
be give by the teacher (participant) upon the learner’s (an actor)
incorrect responses.
– The voltage meter marked with several levels of shock intensity
(mild to lethal)
– Most people will conform and follow orders to the extreme
• http://www.youtube.com/watch?v=y6GxIuljT3w
(not the original study)
Stanford Prison Experiment (1971)
• Zimbardo set up a Prison simulation with
guards and prisoners.
– How do people identify with roles?
• Students in the roles (allowed to take their
own actions):
– Guards became abusive to prisoners
– Prisoners acted out, planned escapes,
rebelled
• Zimbardo was the Prison Superintendent
– A conflict of interest for objective research
Psychology and the Law
• Competency and Insanity
– Dusky v. US (1960)
• Dusky Standard
– Pate v. Robinson (1966)
• Due process includes right to competency hearing
– Drope v. Missouri (1975)
• Cannot deny treatment/leave of absence
– Fredak v. US (1979)
• Cannot force defendant to plea insanity
– Ford v. Wainwright (1986)
• The mentally insane cannot be executed
– Godinez v. Moran (1993)
• Competency must be evaluated before council can be
waived and a plea is entered
Psychology and the Law
• Involuntary Confinement:
– Jackson v. Indiana (1972)
• Cannot hold people indefinitely
– O’Connor v. Donaldson (1973)
• Cannot confine individuals who are non-dangerous
or capable of living on their own
Psychology and the Law
• Medication and Forced Treatment:
– Skinner v. Oaklahoma (1942)
• Cannot force inmates to be sterilized before reentry to the community
– Rennie v. Klein (1978)
• Patients have the right to refuse medication
– Washington v. Harper (1990)
• Can force medication if patient is dangerous to self
or others
– Perry v. Louisiana (1990)
• Cannot force medication to carry out an execution