1. CHANGING CONCEPTIONS OF MENTAL ILLNESS

2. 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?

3. PRE 20TH CENTURY

4. PRE-20TH CENTURY MENTAL ILLNESS IS UNIVERSAL
MENTAL ILLNESS LIMITED TO MOST SERIOUS CONDITIONS
SMALL NUMBER OF CONDITIONS
MENTALLY ILL HIGHLY STIGMATIZED

6. CAUSES
NOT MUCH KNOWN
SUPERNATURAL
BRAIN DISEASE

7. EARLY TREATMENT PRE-19TH CENTURY - LEFT TO FEND FOR SELVES
NO OUTPATIENT TREATMENT
19TH CENTURY - SHUT AWAY IN INSTITUTIONS

9. PRE-20TH CENTURY LIMITED TO SMALL NUMBER OF SEVERE CONDITIONS
MENTALLY ILL BIZARRE AND DIFFERENT
CAUSES UNKNOWN
INSTITUTIONALIZED

11. 20th CENTURY VIEWS
TREMENDOUS BROADENING OF CONDITIONS VIEWED AS MENTAL ILLNESSES
FIRST PSYCHIATRIC MANUAL CONDITIONS, 19 PSYCHOTIC
DSM NOW - NEARLY 400 DIFFERENT MENTAL ILLNESSES

12. EXPANSION OF M.I. SIGMUND FREUD EVERYONE TO SOME EXTENT IS M.I.
IDEAS BEGAN TO EXPAND THROUGH THE CULTURE - MOVIES, BOOKS, PROFESSIONS

13. RESPONSE OUTPATIENT TREATMENT IN COMMUNITY PSYCHOTHERAPY
FOR MOST PART, LIMITED TO ELITE

14. CURRENT CONCEPTIONS

15. CURRENT CONCEPTIONS BEGAN WITH DSM-III (1980)
NOT JUST MOST SEVERE CONDITIONS BUT MANY DIFFERENT CONDITIONS

17. 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

19. NORMALIZATION MENTALLY ILL NOT SEEN AS DIFFERENT FROM NORMAL
MENTALLY ILL NOT CERTAIN KIND OF PERSON BUT NORMAL PERSON WITH PARTICULAR DISEASE

22. MEDICALIZATION WHAT USED TO BE NORMAL BECOMES MEDICAL CONDITION
TREATED BY PROFESSIONALS

24. BIOLOGICAL CAUSES MENTAL ILLNESSES VIEWED AS BRAIN DISEASES
GENETICS AND BRAIN CHEMISTRY AT FAULT

27. TREATMENT
SSRI - SELECTIVE SEROTONIN REUPTAKE INHIBITORS - “ANTI-DEPRESSANTS”
HUGE INCREASE IN DRUG TREATMENT - 60 MILLION SCRIPTS
3 OF 7 MOST PRESCRIBED DRUGS

30. THERAPEUTIC CULTURE MANY BEHAVIORS MEDICALIZED
MENTAL ILLNESS IS COMMON
MENTALLY ILL NOT DIFFERENT
RISING NUMBERS OF PEOPLE IN TREATMENT AND OF MENTAL HEALTH PROFESSIONALS

31. RATES OF TREATMENT

32. M.H. PROFS

33. SUMMARY OF TRENDS FROM ONLY SERIOUS TO MANY CONDITIONS
FROM RARE TO WIDESPREAD
FROM STIGMATIZED TO MEDICALIZED
FROM UNKNOWN CAUSES TO PRESUMED BIOLOGICAL

34. SUMMARY OF TRENDS FROM INSTITUTIONS TO OUTPATIENT THERAPY TO DRUGS
FROM SEGREGATION TO PART OF CULTURE

35. WHERE DRAW THE LINE? ARE TOO MANY CONDITIONS MEDICALIZED NOW?
HOW CAN WE SEPARATE WHAT’S M.I. FROM WHAT’S NORMAL?

36. 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