CHANGING CONCEPTIONS OF MENTAL ILLNESS
CONCEPTIONS OF MENTAL ILLNESS HOW VIEWS OF MENTAL ILLNESS HAVE CHANGED OVER TIME CURRENT CONCEPTIONS OF MENTAL ILLNESS WHERE DRAW THE LINE BETWEEN MENTAL ILLNESS AND NORMALITY?
PRE 20TH CENTURY
PRE-20TH CENTURY MENTAL ILLNESS IS UNIVERSAL MENTAL ILLNESS LIMITED TO MOST SERIOUS CONDITIONS SMALL NUMBER OF CONDITIONS MENTALLY ILL HIGHLY STIGMATIZED
CAUSES NOT MUCH KNOWN SUPERNATURAL BRAIN DISEASE
EARLY TREATMENT PRE-19TH CENTURY - LEFT TO FEND FOR SELVES NO OUTPATIENT TREATMENT 19TH CENTURY - SHUT AWAY IN INSTITUTIONS
PRE-20TH CENTURY LIMITED TO SMALL NUMBER OF SEVERE CONDITIONS MENTALLY ILL BIZARRE AND DIFFERENT CAUSES UNKNOWN INSTITUTIONALIZED
1900 - 1980
20th CENTURY VIEWS TREMENDOUS BROADENING OF CONDITIONS VIEWED AS MENTAL ILLNESSES FIRST PSYCHIATRIC MANUAL 1919 - 20 CONDITIONS, 19 PSYCHOTIC DSM NOW - NEARLY 400 DIFFERENT MENTAL ILLNESSES
EXPANSION OF M.I. SIGMUND FREUD EVERYONE TO SOME EXTENT IS M.I. IDEAS BEGAN TO EXPAND THROUGH THE CULTURE - MOVIES, BOOKS, PROFESSIONS
RESPONSE OUTPATIENT TREATMENT IN COMMUNITY PSYCHOTHERAPY FOR MOST PART, LIMITED TO ELITE
CURRENT CONCEPTIONS
CURRENT CONCEPTIONS BEGAN WITH DSM-III (1980) NOT JUST MOST SEVERE CONDITIONS BUT MANY DIFFERENT CONDITIONS
M.I. WIDESPREAD NO LONGER SEEN AS UNUSUAL BUT MANY PEOPLE AFFECTED BY THEM 50 PERCENT OF POPULATION OVER LIFETIME; 20 PERCENT IN ANY GIVEN YEAR
NORMALIZATION MENTALLY ILL NOT SEEN AS DIFFERENT FROM NORMAL MENTALLY ILL NOT CERTAIN KIND OF PERSON BUT NORMAL PERSON WITH PARTICULAR DISEASE
MEDICALIZATION WHAT USED TO BE NORMAL BECOMES MEDICAL CONDITION TREATED BY PROFESSIONALS
BIOLOGICAL CAUSES MENTAL ILLNESSES VIEWED AS BRAIN DISEASES GENETICS AND BRAIN CHEMISTRY AT FAULT
TREATMENT SSRI - SELECTIVE SEROTONIN REUPTAKE INHIBITORS - “ANTI-DEPRESSANTS” HUGE INCREASE IN DRUG TREATMENT - 60 MILLION SCRIPTS 3 OF 7 MOST PRESCRIBED DRUGS
THERAPEUTIC CULTURE MANY BEHAVIORS MEDICALIZED MENTAL ILLNESS IS COMMON MENTALLY ILL NOT DIFFERENT RISING NUMBERS OF PEOPLE IN TREATMENT AND OF MENTAL HEALTH PROFESSIONALS
RATES OF TREATMENT
M.H. PROFS. 1980-2000
SUMMARY OF TRENDS FROM ONLY SERIOUS TO MANY CONDITIONS FROM RARE TO WIDESPREAD FROM STIGMATIZED TO MEDICALIZED FROM UNKNOWN CAUSES TO PRESUMED BIOLOGICAL
SUMMARY OF TRENDS FROM INSTITUTIONS TO OUTPATIENT THERAPY TO DRUGS FROM SEGREGATION TO PART OF CULTURE
WHERE DRAW THE LINE? ARE TOO MANY CONDITIONS MEDICALIZED NOW? HOW CAN WE SEPARATE WHAT’S M.I. FROM WHAT’S NORMAL?
SOPRANOS BEHAVIORS VIEWED AS DISEASES CHANGE OVER TIME FROM ROWDY TO SICK CONFLICT WITH MUCH LAY CULTURE RISE OF M.H. PROFESSIONALS TREATMENT NOT PUNISHMENT