Modern (1940’s-present)
48 The Evolution of Mental Health Treatment and Its Impact on Society
Introduction
The treatment of mental health has improved over the years with an improvement in the knowledge of mental health conditions. An improvement in the understanding of various mental health issues has improved the treatment from crude weapons used during the 16 th century to modern psychiatric approaches that are less crude and safer. The improvement in the treatment of mental health illnesses has then seen an improvement from a period of belief in supernatural
influence to a new era of evidence-based approaches. The improvement in mental health knowledge and treatment methods has then not only improved the lives of individuals but also improved the general societal perception of mental health issues.
Early Approaches To Mental Health
Mental health issues have been mainly explained throughout history based on three theories: supernatural, somatogenic, and psychogenic. Supernatural theories attribute mental illness to possession by evil spirits, displeased gods, curses, sin, eclipses, or planetary gravitation. In ancient days, most communities attributed mental illness to supernatural causes (CSP Online, 2020). On the other hand, Somatogenic theories identify disturbances in physical functioning due to illness, genetic inheritance, brain damage, or imbalance; while psychogenic theories focus on traumatic or stressful experiences, maladaptive learned associations, or
distorted perceptions (Farreras, 2024). In ancient times, with a belief that much of mental health cases emerged due to supernatural influences, the treatment plans were largely focused on methods that could chase away such spirits and these included rituals, prayers, and exorcisms. Although well-intentioned, these methods were not evidence-based and lacked any scientific backing. In consequence, they often resulted in stigmatization and discrimination against individuals with mental illnesses (Cottrell, 2021). Some of the crude methods used was trephination which entailed the drilling of holes in skulls to treat head injuries and epilepsy as
well as to allow evil spirits trapped within the skull to be released (Farreras, 2024). Trephination was adopted as one of the earliest supernatural explanations of mental illness and has been evident in skulls and cave art from as early as 6500 BC (Farreras, 2024). The attribution of mental illness to supernatural forces was also evidenced in early China where Chinese medicine’s concept of “yin and yang” attributed such illness to an imbalance between the negative and positive bodily forces (Farreras, 2024). As such, mental illness was the consequence of a lack of balance between the bodily forces (Farreras, 2024).
The Birth of Psychiatry
Western psychiatry emerged as a specialty that is keen on caring for mentally ill persons during the late 18 th and 19 th centuries (Kendler, Tabb, & Wright, 2022). This emergence was dependent on the co-occurrence of three historical events that together shaped the psychiatry discipline. The first development was the understanding of the mind as an entity with various active faculties in the conceptual space between the body and the soul (Kendler, Tabb, & Wright,
2022). This development helped broaden the understanding of the mind and its independence from the Christian definition of mind, body, and soul as one. It was then possible to rank conditions such as mania as a mental illness by the 18 th century (Kendler, Tabb, & Wright, 2022). The second development was the rejection of humoral theories of insanity in favor of the brain and nerves as the seat of madness (Kendler, Tabb, & Wright, 2022). This development helped in
further understanding and classifying the various mental health conditions (Greenberg, 2013). The third development was the rise of the asylum (Kendler, Tabb, & Wright, 2022). This helped increase the acceptance of the disease and promote the management of mental health issues through trained professionals and evidence-based approaches (Greenberg, 2013). These
developments as led by pioneers like Philippe Pinel and William Tuke resulted in the development of more humane approaches to treating mental illness by the 19 th century (Greenberg, 2013; National Institute of Mental Health, 2023). These developments also led to a decline in humoral medicine by adopting more humane treatment with reduced purges, bleeding, and emetics (Kendler, Tabb, & Wright, 2022). The established asylums also offered better mental health management by offering the patients with shelter, basic needs, and therapeutic interventions. Nonetheless, as they took in more patients, they were also exposed to challenges
such as overcrowding, being neglected and in deplorable state, and increased cases of abuse (Greenberg, 2013).
Psychotherapy And Talk Therapy
Development in treating mental health encompasses talk therapy which emerged in the late 19 th century as Sigmund Freud worked with children with learning disabilities (Marks, 2017). Talk therapy emphasizes the power of dialogue and insight in addressing mental health issues (National Institute of Mental Health, 2023). In his studies, Sigmund Freud focused on the unconscious mind and in uncovering repressed emotions and conflicts (Marks, 2017). Subsequent developments on Freud’s work then led to emergence cognitive-behavioral therapy in the mid-20 th century and later dialectical behavior therapy (Greenberg, 2013). These therapy
methods improve the management of mental health issues through talk sessions based on the individual mental challenge.
The Discovery of Psychopharmacology
A significant breakthrough in the management of mental illness came in the 1950s when psychotropic medications were discovered. The discovery of chlorpromazine in 1950 marked the beginning of modern psychopharmacology (Braslow & Marder, 2019). This drug and other antipsychotic drugs that were later developed set the pace for the development of better mental health illness management drugs. This breakthrough enhanced an understanding of the disease and a break from some of the crude methods of treating mental health illnesses (Greenberg 2013). Psychopharmacology offered a critical tool the management of mental health disorders, allowing individuals to regain control over their lives and function more effectively (Greenberg, 2013). Continued manufacture and improvement in the quality of these drugs have significantly reduced hospitalization rates and improved overall quality of life for individuals with severe
mental illnesses.
Community-Based Care and Deinstitutionalization
The management of mental illness has further improved in recent times due to a shift towards community-based care and a deinstitutionalization of asylum setups. This approach makes it possible for individuals with mental health disorders to thrive in society with the appropriate support and treatment, as opposed to the old approach of confining them in asylums (Greenberg, 2013). Through such deinstitutionalization, mentally ill people have managed to live in communities with their families while receiving treatment on an outpatient basis and engaging in meaningful life activities. Such community-based care models emphasize a multidisciplinary approach, involving mental health professionals, social workers, families, and community support systems. The consequence of this approach has been improved outcomes, reduced stigma, and increased opportunities for individuals with mental illnesses to lead fulfilling lives.
The Impact on Society
The evolution of mental health treatment has been consequential in helping individuals lead better and more fulfilling lives. There is better management of mental health illnesses and there is also greater awareness and thus reduced stigma towards affected individuals. It is now easier for individuals with mental illness to seek medical help and find support even online (CSP Online, 2020). The consequence is better outcomes and a chance to lead productive lives as the affected individuals adopt such treatments as psychotherapy and psychotropic medications (Greenberg, 2013). Additionally, community-based care and deinstitutionalization have
promoted social inclusion and contributed to the social well-being of such individuals.
Conclusion
He evolution of mental illness treatment has transformed the lives of affected individuals by freeing them from the burden of being institutionalized in asylums to a community-based treatment plan that keeps them integrated in society and leading fulfilling lives while getting treated. The treatment process has indeed experienced a massive stride from a period of belief in supernatural influences and use of crude methods to treat mental illness, to a period with a clear manual of classification and modern treatment approaches. By continuing to prioritize mental health research, destigmatize mental illness, and improve access to quality care, we can further enhance the well-being of individuals and create a more compassionate and inclusive society.
References
Braslow, J. T., & Marder, S. R. (2019). History of Psychopharmacology. Annual review of clinical psychology, 15, 25–50. https://doi.org/10.1146/annurev-clinpsy-050718-095514
Cottrell, E. (2021). Changes in Mental Illness Understanding and Treatment Throughout Time in the United States. The Review: A Journal of Undergraduate Student Research, 22(1), 8.
CSP Online. (2020, July 13). A history of mental illness treatment. https://online.csp.edu/resources/article/history-of-mental-illness-treatment/
Farreras, I. G. (2024). History of mental illness. In R. Biswas-Diener & E. Diener (Eds), Noba textbook series: Psychology. Champaign, IL: DEF publishers. Retrieved from http://noba.to/65w3s7ex
Greenberg, G. (2013). The book of woe: The DSM and the unmaking of psychiatry. Blue Rider Press/Penguin Group.
Kendler, K. S., Tabb, K., & Wright, J. (2022). The Emergence of Psychiatry: 1650-1850. The American journal of psychiatry, 179(5), 329–335. https://doi.org/10.1176/appi.ajp.21060614
Marks S. (2017). Psychotherapy in historical perspective. History of the human sciences, 30(2), 3–16. https://doi.org/10.1177/0952695117703243
National Institute of Mental Health. (2023, December). Mental health medications. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/mental-health-medications
