The History - The Evolution of Knowledge and Perception of Mental Health
Like all histories involving man kind, the history of mental illness began in our primal ancestors. Back then, the world and its working were greatly unknown to our ancestors, and would lead to the most primal kind of care for the mentally disabled; empathy. Cave drawings and ancient artifacts also are evidence that early nature-worshipping humans believed the divine forces could heal their weak and sickly. They used amulets and charms to ward off whatever was harming their brethren. However, all this is based on speculation, since they left no formally written records of their actions.
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The ancient civilizations of Greece, India, Egypt, and Rome, from which much of our knowledge was gained during the Renaissance, took the next step in mental health care. While many still stuck to praying to the Gods for aid in a loved one's health against a possession or attack by a spirit, rationalism became a prominent part of how doctors dealt with the mentally ill. The first doctor to begin this mentality was Hippocrates, the famous Greek physician and the father of what is considered modern health care. Another more modern thinker, Galen believed that mental illness may have been based on reactions to different temperatures, and is the earliest person to attempt to classify psychological functioning. This is the era in which many of the mentally ill were ostracized, and diseases of the mind became a powerful social stigma.
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European medieval doctors continued to be a part of the religious lifestyle the ensnared nearly every walk of life at the time, and had little to no formal training. In the time in which the barber and surgeon were one in the same, many mentally ill were labeled as possessed souls by the devil, or witches, and were treated as such. These patients were poor, and cures ranged from a variety of cruel practices. Many, if they were poor or if it was well known that their parents had committed a sin, were left to be cared for by their families or wander the streets of the cities. Some, if possession had been the diagnosis, a Catholic exorcism would be done to remove it, while those diagnosed as witches were burned at the stake. In extreme cases, to remove the insanity, a surgeon would make a hole in the patient's head in order that the madness would escape, a treatment that was more fatal then its disease. If the mentally ill person was of a richer class, they would be either killed or be locked away all their lives.
In the Muslim countries and communities of the time, the mentally ill were treated with more kindness. Housed in some of the most pleasant asylums of the time, their care stemmed from the belief that God loved all his creatures, including the diseased. The first asylum was built in the 8th century AD in Baghdad.
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During the Renaissance, in which reason began its fight against religion, the study of mental illness took an even greater shift, despite the long time it took to take effect. Thanks to Guttenburg's new printing press, papers and studies that discussed how to deal with patients and use different techniques could easily be passed out, not only throughout a country, but throughout all of Europe. As universities began to form to further train the next generations, a new status was given to those who could perform medicine. Even the mentally afflicted became objects of pity as there came a great rise in patients. However, there was a step backwards. The Renaissance also included European Inquisitions; scrupulous searches for witches. Beginning with the French and ending with the Spanish, the Inquisitions lead countless thousands to the burning stakes and gallows, all with the help of the witch hunter's handbook, the Malleus Maleficarum (which is Latin for The Witch's Hammer). It described witches has having hallucinations, delusions, and other such particular behaviors. Many physicians of the time, still undergoing their training, silently stood in the background, not only allowing, but supporting it. There were some, however, who stood to think that there was an alternate cause to these erratic and peculiar patterns.
Asylums in both Europe and Colonial American followed similar patterns. When the first British settlers stepped onto the Eastern Coast, they brought the mentality of how to deal with ill with them. Even after the American Revolution had been fought and won, they followed similar patterns. When the government created asylums in major cities such as Williamsburg and Philadelphia, many of them fell into disrepair and unsanitary conditions. Those who were mentally ill and were not taken to such institutions were sent to jail, or placed in workhouses.
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Although also known as the Age of Reason, little had changed from Medieval times. Mentally ill patients, although pitied, were still treated poorly. At the time, rather badly kept mental hospitals were being built, though many still wandered the country aimlessly. In England, these hospitals were kept under state control, due to King George III own afflictions with mental maladies. Around this time, some favored restraints on those with ailments of the mind and created straightjackets. Another increasingly popular practice became spinning, by Dr. Cox in England, for patients of mania. Spinning them around a large cage, the patient would vomit abundantly, and major improvements would be noted. Another method was a tranquilizing chair, in which patients were strapped down and bled until their reason returned, another supposed cure for mania. It is suggested that the fear of the "cures" then the actual processes is what caused improvements in patients.
Once public awareness increased, sanitary conditions and less restraining techniques swept through these institutions. The concept of "moral treatment" had been formed in 1793 by Dr. Philippe Pinel, in which patient were treated kindly, and give more room to move and grow rather then keep them chain in dungeons, much like the ancient Islamics had. New studies about nerve impulse granted a window into the mind of the afflicted. The first journal about the mental disorder appeared, and release rates improved dramatically. Two famous doctors of the time were Dr. Leurent, whose odd techniques of pushing further extremes with a patient and attempts as at controlling behavior were controversial, even for the time, and Dr. Franz Mesmer, who became famous for his techniques with induced sleep, an early form of hypnotism.
Even so, religious ideas and "magic cures" still hung in the backwater of mental discovery, disguising themselves as scientific fact.
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America did not begin to follow the Era of Reason's example until the mid 19th century, during the American reformation Era. During this reformation era, republicans pushed for more asylums for the insane to be built and those in disrepair to be fixed. One of the leading advocates in American for such a reform was Dorothea Dix, who not only pushed for great public awareness but for more hospitals to be built for the poor. She also advocated patients receiving the "moral treatment" technique, which had fewer restraints on patients and more fresh air and exercise. Through her efforts, 32 new hospitals were open to the public, almost all featuring the moral treatment technique.
Over time, these institutions, too, began to deteriorate. Many only wanted chronic cases to deal with, and only accepted patients with less intense behaviors. Further disrepair continued until many of the ill were back in jails and factories.
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