Historical Context of Mental Health Flashcards
What are the Historical views on mental health throughout history?
Some of the earliest evidence of mental health treatments can be circled back to prehistoric times such as the trepanning of the skulls (Surgical procedure in which there is a hole created into the side of the skulls which was supposedly used to release evil spirits that have been said to cause migraines, seizures and mental disorders.)
One of the oldest Medical documents dates back to early Egypt (1550 bc) which demonstrates an understanding of specific disorders such as depression.
In Ancient Greece, Hippocrates proposed that mental disorders are caused by the imbalance of different fluids or ‘humours’ (Like blood, phlegm and yellow bile). This explanation was reliably used until the middle ages. However during the European Renaissance there was a greater focus on observance and classification of disorders by symptoms and causes. This let to the explanation of mental illnesses to take more of a biological turn due to the changes of ideas and beliefs.
In history the ideas of madness were highly popularised in entertainment and literature, however in the 19th century people who were deemed mad or mentally ill were more publicly seen as people who needed help (treatment) and compassion.
What Is the Historical view of psychiatric treatments?
Mental asylums were not introduced until the nineteenth century, before that people suffering with mental issues were destined to be outcasted and mostly ended up in prisons, workhouses or private ‘madhouses’ which were mostly run for profit and the setting were highly un-ethical.
By middle of the 19th century each region of the UK had a mandate to care for their mentally ill in lunatic asylums (One of the first was the Bethlem Royal Hospital in London).
Although humanity has taken a huge step in acknowledging mental illnesses, the living conditions in the asylums were far from humane. Due to overcrowding and lack of manpower the facilities were insufficient.
Modern Psychiatric treatments were introduced such as insulin treatment, ECT and lobotomies (Apart from ECT all have been discontinued due to being un-ethical). The most significant advances in mental health treatments however was the introduction of medications and the development of various forms of therapies.
What are the Similarities between these views?
- The similarity between the Ancient Greece explanation by Hippocrates and the modern explanation of Mental illness is that both rely on biological factors as an explanation.
What are the Differences between these views?
- The difference between these views is that one relies on biological explanations of mental illness (medical model) whilst the other (prehistoric) relies on the spiritual explanation of mental illnesses.
What are the 3 Definitions of Abnormality?
Statistical Infrequency, Deviation from social norms and Maladaptiveness.
Statistical Infrequency
This means that behaviour that is rarely seen in the general population might be considered abnormal. It is based on the idea that in measurable characteristics, such as intelligence, most people’s scores will group around a central average.
Deviation From Social Norms
This can be seen as a departure from what one society or culture sees acceptable. This involves judgment based on the context in which the behaviour occurs.
Maladaptiveness
This refers to when a person’s way of thinking, emotional responses or actual behaviour is dangerous or prevents them from functioning well. For example someone with OCD may be always late to work due to their excessive cleaning rituals.
Categorising Mental Disorders (DSM-5) definition?
Psychiatrists use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to classify abnormal behaviour and diagnose patients. It is a manual that is recognised across the world and used in UK as well. Currently in 5th edition, the manual contains descriptions, symptoms and other criteria to allow reliable diagnoses of 157 disorders. The manual is reviewed by experts in the field to reliably diagnose patients. Some of the categories involve - Neuro-developmental disorders (Intellectual disability), Trauma and stressor related disorders (PTSD) and more.
Key Research?
Rosenhan (1973) - On being sane in insane places.
Aim?
To test the reliability of diagnoses of
psychological abnormality
Sample?
1 st expt = 8 sane people acted as
‘pseudo-patients’ – 5M and 3F.
Volunteer sample
2nd expt = 193 participants
Procedure?
1 st expt = 12 hospitals in 5 states -
pseudo-patients said they had been
hearing words: ‘empty’, ‘hollow’, and
‘thud’. When on the psychiatric ward,
they behaved as normal.
Results?
1st expt = 7 out of 8 admitted. When
released it was with the label
‘schizophrenia in remission’. Length
of stay from 7 - 52 days. Normal
behaviour was misinterpreted and
described by staff as abnormal.
2nd expt = No pseudo-patients but 41
real patients were believed to be
pseudo-patients by 1 or more staff
member.
Conclusions?
Doctors are more inclined to call a
healthy person sick (false positive
Type 1 error). Diagnoses cannot be
very reliable. Labels tend to ‘stick’
even if they are wrong.
