1. © 2014 by Pearson Education, Inc. All rights reserved.
Introduction to Human Services: Through the Eyes of Practice Settings, 3rd Edition Michelle E. Martin
Chapter 8
Mental Health and Mental Illnesss
© 2014 by Pearson Education, Inc. All rights reserved.

2. Early Explanations of Mental Illness
Evil spirits
trepanning.
Hippocrates believed that mental illness came from an imbalance in the body’s four humors (blood, black bile, phlegm, yellow bile).
Witchcraft
Boston witch trials
Ergot poisoning
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3. Hippocrates’ 4 Humors

4. Definitions of Abnormality
Many definitions have been proposed, yet none are universally accepted
Most definitions, however, share some common features…
“The Four Ds”
Deviance – Different, extreme, unusual
Situational context - the social or environmental setting of a person’s behavior.
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5. Definitions of Abnormality
Distress – Unpleasant and upsetting
Danger – Poses risk of harm
Dysfunction – Causes interference with life
Maladaptive

6. The History of Mental Illness: Perceptions and Treatment
Asylums – almshouses – work houses
Dorothea Dix (1840s)
The Deinstitutionalization of the Mentally Ill
Mental Health Study Act
Community Mental Health Centers
The passage of the CMHC Act set the deinstitutionalization movement into motion
Outpatient
Prison System
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7. Diagnosis The controversy of diagnosis. Once a ____ always a _____
Self-fulfilling Prophesy
Stereotypes
Trouble with treatment
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8. "On being sane in insane places"
David Rosenhan, psychologist (Journal Science in 1973)
Phase 1 - "pseudopatients" (three women and five men)
briefly feigned auditory hallucinations
gained admission to 12 different psychiatric hospitals in five different States
All were admitted and diagnosed with psychiatric disorders.
After admission, the pseudopatients acted normally and told staff that they felt fine and had not experienced any more hallucinations.
All were forced to admit to having a mental illness and agree to take antipsychotic drugs as a condition of their release.
The average time that the patients spent in the hospital was 19 days.
Other patients knew they were faking.
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9. "On being sane in insane places"
Phase 2 - an offended hospital administration challenging Rosenhan to send pseudopatients to its facility, whom its staff would then detect.
Rosenhan agreed and in the following weeks out of 193 new patients the staff identified 41 as potential pseudopatients, with 19 of these receiving suspicion from at least 1 psychiatrist and 1 other staff member.
In fact Rosenhan had sent no one to the hospital.
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10. Diagnosis ICD-10 Codes For Mental Disorders
Diagnostic and Statistical Manual, Version IV, Text Revision and now DSM V
Includes definitions of disorders, their symptoms, and criteria.
Differences between 4 and 5
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11. Common Mental Illnesses and Clinical Issues
The first two axes of the DSM-V are the ones most commonly used
Clinical or mental disorders are diagnosed on Axis I
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14. Mental Health Practice Settings and Counseling Interventions
Intervention Strategies
The mental health community’s tendency to approach mental illness from a pathological perspective
An alternative approach to viewing mental illness is to use a strengths perspective
Positive Psychology
Self-sufficiency & self-determination
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15. Mental Illness and Special Populations
Mental Illness and the Prison Population: The Criminalization of the Mentally Ill
Inadvertent shifting of chronically mentally ill patients from public hospitals to jails & prisons
Women are particularly overrepresented in the prison population
Mental Health Courts
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16. Current Legislation Affecting Access to Mental Health Services
Other Federal Legislation
Former president George W. Bush announced the establishment of New Freedom Initiative
Equal integration of mentally ill into community
Complaints of the commission’s report
Slow recovery
Slow application of new treatment methods
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17. Current Legislation Affecting Access to Mental Health Services
Mental Health Parity
Some mental illnesses take a lifetime to develop; others seem to hit out of nowhere
Mental Health Parity Act was passed in 1996
The Mental Health Parity and Addiction Equity Act of 2008
Patient Protection and Affordable Care Act of 2010
Insurance companies are to treat mental illness like physical illness.
© 2014, 2011, Pearson Education, Inc. All rights reserved.