1. Treatment of Mental Illness

2. Prehistory to Colonial America For most of human history, very little was known about the workings of the human mind, especially about why a person would act abnormally Often, it was believed that the mentally ill were afflicted and/or possessed by evil spirits/demons. Treatments included: 1.Trepanning 2.Spells/witchcraft 3.Exorcism 4.Execution (particularly burning at the stake)

3. Colonial America According to astrological beliefs, a child born under a full moon would be more likely to exhibit mental instability. From this, comes one of the terms used to describe the mentally ill: lunatic Cures during colonial times focused on methods that either would cause crisis or expel it (i.e. catharsis). Methods used: 1.Submersion into ice water 2.Inducing of vomiting 3.Bleeding

4. Colonial America, cont. The most common method, however, was to imprison them.

5. Early 19 th Century “Moral Management” Influenced by the Enlightenment. Generally, the emphasis was humanizing the patient, not animalizing him/her Improvements included 1.home-like environment 2.Recreation 3.Work details 4.Outdoors

6. Early 19 th Century, cont. Phrenology: Belief that behavior based on the shape of skull (from this come the terms “highbrow” and “lowbrow”).

7. Late 19 th Century Following Civil War, thousands of veterans have: 1.PTSD (known then as battle fatigue) 2.Morphine addiction Overcrowding leads to a retreat back to Colonial standards of treatment Opium introduced as a treatment

8. Late 19 th Century State asylums are built that are large, aesthetically pleasing, but are able to withstand large amounts of abuse Local example: Peoria State Hospital in Bartonville (closed 1973) Asylum featured in “One Flew over the Cuckoo’s Nest” also reflective of this time period. Major problem: Asylums considered so nice they become dumping grounds for the homeless, unwanted, elderly, and poor

9. The Dark Ages (mid 20 th Century) With patient numbers rising, mental-health professionals attempt what are now considered barbaric methods to improve patient outcomes. 1.Trepanning 2.Electroconvulsive Shock Therapy (ECT) 3.Insulin Shock Therapy: patient given insulin to the point of rendering the person comatose

10. And… 4. Lobotomy a.Originally, the lobotomy would separate the front portions of the brain from the rear. Common result: patient forgot what caused the disturbance/depression in their minds. The problem: took too much time and skill.

11. The solution b. trans-orbital lobotomy (aka “pre-frontal lobotomy) - watch video -developed by Walter J. Freeman -Outpatient brain surgery, took about ten minutes to perform.

12. Modern Era The Breakthrough (1954): Thorazine (chlorpromazine) -The first medication that is useful in the treatment of mental illness. Promoted as “lobotomy in a bottle.” -Used to treat 1.Schizophrenia 2.Major Depression 3.Mania

13. Medication Uses OCD: Prozac, Zoloft Anti-anxiety: Xanax, Valium, Ativan Depression: Prozac, Zoloft, Wellbutrin, Cymbalta Schizophrenia: Risperal, Zyprexa, Haldol

14. According to Sharfstein (2005), anti- depressant medications accounted for $13.4 Billion in sales worldwide, with anti-psychotic medications accounting for $6.5 Billion. In comparison, the weight-loss industry in the United States(2007): $50 Billion

15. Other Methods Counseling Behavior Modification Cognitive-Behavioral Therapy Systematic Desensitization (treatment of phobias) 12-Step Programs (AA, other addiction programs) Group Therapy ECT (in milder form) Psychoanalysis Note: Medication to treat mental-health issues is becoming more prevalent, and reaching younger ages (including pre- school)