1. CHAPTER TWO A History of Helping

2. Colonial America (1400’s-1700’s) Mental Illness: caused by Evil Spirits Treatment: drill hole in head with a saw allowing evil spirits to escape Diagnoses of mental illness made by government officials (Inquisitions) Categories of Mental Illness Natural Fools Idiots (retarded intellectual development) PAY ATTENTION TO THE LANGUAGE USED FOR MH and MR

3. 1500’s: Catholic Church Catholic Church: the first human service organization Saint Thomas Aquinas and Saint Francis: the first human service professionals Under the church’s guidance, organizations were founded for the poor, elderly, people with disabilities and orphans WHAT MIGHT THE HISTORY OF THE HS PROFESSION HAVE TO DO WITH THE STRUGGLE FOR FAIR SALARIES FOR HUMAN SERVICES WORK?

4. Elizabethan Poor Laws (1601) Great Britain Attack on poverty (increasing number of poor people in GB) Elizabethan Poor Laws became the Foundation for future Human Services in United States

5. 3 Features of the Elizabethan Poor Laws Compulsory taxation (to raise funds for those in need) Classification system for dependents (you were classified based on your ability to work) Family vs. government responsibility (your family took care of you first)

6. Human Services in the US (Colonial America) Poor relief as a public responsibility (individuals and groups donated resources and labor; neighborly kindness and mutual aid) Legal residence (services provided to legal residents only) Family responsibilities (public aid denied to those who had family) Apprenticed children (children of poor families were apprenticed to farmers etc. who agreed to care for them)

7. Civil War (19 th Century: Late 1700’s-1800’s) A time of great change Immigration, Rapid Industrialization and Urbanization brought more people living in poverty Being poor was considered a “crime”, “your fault” and a sign of “spiritual weakness” Individualism: a social philosophy of the time that hard work was the road to success and open to anyone. If you failed, it was your fault

8. Treatment of People with Mental Illness Asylums, Almshouses and even Jails were the institutions that housed people with mental illness Lots of overcrowding! (think of the language here!) Strait jackets and being chained were common methods of containment (Page 44) Dr. Benjamin Rush from Pennsylvania Hospital fought ignorance surrounding mental illness and began to study it scientifically. (late 1700’s) Dorothea Dix- fought to improve conditions for people with mental illness (1841). Taught Sunday school for women prisoners; appalled by the filth, lack of heat and over- crowding.

9. By the Late 19 th Century Due to reformers such as Rush and Dix; states began to separate people with mental illness and developmental disabilities The treatment of “children in need” changed! Many were removed from institutions that served the poor of all ages. Orphanages began….. Child Welfare: the first juvenile detention center in NYC supported by state funds Reform Movements: Organized Charity Movement and Settlement Houses

10. Reform Movements of the Late 19 th Century Organized Charity Movement (Page 40 and 41)  Forerunner of the United Way Goal: to eliminate “duplication of social services” Settlement House Movement  Social engineering (using sociological principles to help people and bring forth social change)  Hull House  https://www.youtube.com/watch?v=Tw4GZeABlNI https://www.youtube.com/watch?v=Tw4GZeABlNI Workers in Settlement Houses and Charity Organization Society became known as “social workers” Beginning of social work profession  United Way

11. 1928: Unemployment (Team1) Calvin Coolidge was President: right before the stock market crash of 1929 Herbert Hoover 1930: Considered the Great Depression (1928-risk factors for the Great Depression?)

12. The Great Depression (1929-1939) A new philosophy of helping that recognized the impact of societal forces on poverty and reform movements continued (this is a BIG change from Individualism!) The Social Security Act of 1935: this was important because it clearly stated that people had the right to be protected from economic instability (Roosevelt)

13. Social Security Act (1935) Protection from economic stability Birth of American welfare state (the state plays a key role in protecting and promoting the economic and social wellbeing of it’s citizens: Equality of Opportunity and Distribution of Wealth (Public Assistance) Expansion of welfare activities Assistance  Social insurance  Public assistance (funding to states to create social programs)  Health and welfare services

14. 1948: Child Abuse/Child Welfare (Team 2) Harry Truman was President Aid to Families with Dependent Children had been enacted ( welfare program) Find out more about the History of Child Protective Services: http://www.americanhumane.org/about-us/who-we- are/history/mary-ellen-wilson.html

15. The Great Society A set of domestic programs in the United States launched by Lyndon B. Johnson in 1964-65. The main goal was the elimination of poverty and racial injustice. The Civil Rights Movement https://www.youtube.com/watch?v=3ank52Zi_S0

16. 20 th Century: Mental Health 1955: Mental Health Study Act (acknowledged personnel shortages in mental health) 1963:Community Mental Health Centers Act passed which established the National Institute of Mental Health NIMH: focused on treatment and prevention of mental health issues

17. The History of BHHS at CCP The Community Mental Health Centers (CMHC) Act was passed during the Kennedy administration (1960’s). This led to the establishment of out-patient CMHC. This was known as “deinstitutionalization”. With great chronic demand for services and severe staffing shortages, waiting times increased for services. Our BHHS program at CCP was born out of the need for more trained paraprofessionals during this time period. We received government funding to start our program!

18. Human Service Movement: Mid 1960’s New type of worker: not “charity” work anymore but the need to have skilled professionals to deal with the shortage of mental health workers Deinstitutionalization (Closing of Byberry: Philadelphia State Hospital) https://www.youtube.com/watch?v=qJ3_hXLp4v0 Professional organizations guided the education of human service workers http://www.nationalhumanservices.org/

19. 1968: Mental Illness (Team 3) This was time of great change, new and improved ways of treating those with mental health issues!

20. Johnson Administration: The Great Society Johnson declared a War on poverty: 1965 Medicare (government sponsored health care for the elderly) Medicaid (government sponsored health care for the poor)

21. Highlights of the Late 20 th and Early 21 st Century 1968: Nixon (less federal spending/ less social service programs!) 1978: Carter established the Department of Health and Human Services 1978: California passed Proposition 13: amending property tax structures resulting in a lot less money for social services; reducing government spending and involvement in human services 1980: Regan terminated AFDC (Reganomics) 1990: George H. Bush passed ADA (Americans with Disabilities Act)

22. Addiction: 1988 (Team 4) Crack Cocaine Epidemic What were addiction services like in the late 1980’s? More alcoholism treatment (Betty Ford) Is addiction a brain based illness?

23. Welfare Reform 1990’s: Clinton and Welfare Reform: Personal Responsibility and Work Opportunity Reconciliation Act (think of the evolution of language from AID to TEMPORARY ASSISTANCE to PERSONAL RESPONSIBILITY) PRWORA- 1996 TANF (Temporary Aid) Emergency funds—2009-2010 Evaluation

24. Managed Care Became popular in the 1990’s and changed the way human services were delivered! Fee-for-service (before MC) External review (authorizes $ for treatment) Care management (coordination of services or Case Management) Gate keeping (a way of controlling access to services)

25. Managed Care Principles External review of services Lowest level of care (least restrictive care which is often the most economical is tried first) Outcomes (provider accountability, best practices) Increased documentation

26. 21 st Century Changes Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (a lot of terms that tend to be confusing in terms of paperwork about what coverage is best for seniors) Centers for Faith-based and Community Initiatives (social services are provided “where the people are” in faith based communities/ often volunteer or as “ministry”)

27. 2008: Care of the Elderly (Team 5) People are living much longer due to advances in medicine! Retirement? Healthcare? Assisted living or nursing home care? Poverty? Healthcare reform was a huge issue in the 2008 election!

28. Obama: Affordable Care Act 2010 Healthcare coverage for uninsured Americans Requires coverage Full implementation in 2018 BCP are free

29. 2014: Mental Retardation (Team 6) Now called Intellectual Disabilities ( de-stigmatization) Recovery and Transformation This movement represents a shift from a professionally driven acute care approach to an approach that provides long-term supports while recognizing the many pathways to recovery. In this approach, professional treatment is one aspect among many that support people in managing their own conditions to the greatest extent possible. Recovery, Resilience and Self-Determination http://dbhids.org/