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  • The cause of something
  • presumed or theorized cause
  • Many disorders have many which can be different in each client even though they have the same disorder



  • the prevalence of a disorder
  • how common
  • distribution (racial, worldwide, etc)
  • ex: 1 in 1000, common among men, etc


Key Treatment Conditons

  • What are “they” saying about how we should go about treating this?


Treatment Strategies 

  • What are effective/ineffective?



  • Condition that existed first



  • coexisting condition 
  • what else does client have?

1484 Pope Innocent

What was treatment for people declared “strange?” (Possessed by the devil)

  • admit possession and repent
  • Be tortured until one admits
  • Death to force the soul from devil 


What did Martin Luther declare?

  • “Mad people are possessed by the devil.”

The Age of Enlightenment (After Middle Ages)

What was the thought on what to do with “the criminal, the demented, and the debtor?”

  • Institutionize rather than kill them.

Moral Treatment of Mentally Ill

What is Millieu therapy?

  • Reinforce good and decent behavior by changing environment
  • recover, life moves on
  • revival/ religious experience to set you on the road to proper living

Social Darwinism

What is Social Darwinism?

  • “Survival of the fittest” MI are inferior and should be sterilized lest they contaminate the gene poool Misfits should be “locked up”
  • 25 states passed sterilization laws by 1936

Settlement Movement

What was the Settlement Movement? 

  • Help unfortunate
  • Child labor laws passed Compulsory education enacted
  • WWI saw a conservative swing
  • anti- immigrant sentiment flared “Jewish Peril”

Word War II

What is shell shock called now?

  • PTSD


What resulted in the breakthrough on Psychotropic medications?

  • less physical restraints
  • less labotomies
  • people no longer had to be hospitalized if given medication
  • managed difficult people 


What was the National Institute of Mental Health founded and funded for? 

  • Drive research
  • policy
  • dollars

The Age of Enlightenment (After Middle Ages)

What was the big change in the perception of the cause of mental illness?

  • Considered NOT to be a result of witchcraft, etc
  • NOT demonic
  • Something wrong with the person
  • ”You are the problem/it’s your fault”

1484 Pope Innocent

What were the results of Pope Innocent’s actions towards mentally ill?

  • witch burning
  • inquisiton

Advantages of the 1963 Act

What was made practical because of advances in psychotropic medications?

  • halfway houses
  • group homes


For what did Congress begin requiring services?

  • children
  • aged
  • alcohol and drug patients
  • follow-up treatment for hospitalized patients

Advantages of the 1963 Act?

What did the substantial decrease in institution admissions mean?

  • The fewer people in institutions means more people in the community 

Problems with the 1963 Act

What were some of the problems with the CMHA? 

  • Areas to be served by mental health centers were too large
  • Boundaries between rich/poor were confused
  • Clnics wanted “best” areas which were in nice areas with less issues.
  • Focus on Clinical services rather than prevention
  • too much for the centers to handle with managed money

1963 Community Mental Health Act

Which of the aspects of the act couldn’t meet the demands of the people?

  • Prevention
  • JFK thought of this and only could get 5% of allocated dollars for the act 

1963 Community Mental Health Act

For what did the established funding for community mental health centers provide? 

Inpatient service

Outpatient Service

Partial hospitalization 

24-hour emergency care

Consultations, education, prevention

1963 Community Mental Health Act

What serves as a foundation for the system we have today as well as the current delivery of treatment? 

  • The Community Mental Health Act
  • The compromise bill that was finally passed. 

1960 JFK

What was The Kennedy Plan?

  • reintegrate mentally ill into community so therefore dollars and jobs were at stake
  • able to do this because of medications
  • prevention was a key idea 

1960 JFK

What did the AMA think about JFK’s thoughts on prevention?

  • They opposed JFK
  • feared socialized medicine (health care) would follow which was kin to communism apparently 

The Age of Enlightenment (After the Middle Ages)

Describe the conditions in the institutions?

  • Deplorable
  • People were chained and caged 

The Reform Movement

What were the conditions like in institutions during the Reform Movment?

  • Conditions were bad

Ancient Greece

What was the general thought on the mentally ill in Ancient Greece? 

  • Mentally ill are under influence of angry gods
  • must be shunned
  • deparate them by placing them on islands together 

North Africa/Eastern Mediterranean Countries

What is Trephination?

  • releases evil spirits
  • 2 cm hole in the head
  • we learned this from exacavations
  • recent incidents of trephinaton in Cali