‘There is no health without mental health; mental health is too important to be left to the professionals alone, and mental health is everyone’s business’ -Vikram Patel (Vikram Patel Quotes Online).
Mental Health can be defined in various different ways, ‘Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.’ (What Is Mental Health? Online). According to mental health statistics in the UK and worldwide, It has been calculated that nearly 1 in 6 people in the past week alone have experienced some form of mental health difficulties, and that problems such as depression, anxiety and drug use have caused over 40 million years of disability among 20 to 29 year olds (Mental health statistics: UK and worldwide (2017)). It is difficult to diagnose mental health issues as there are no ‘tests’ to detect issues of the mind, ‘A diagnosis will usually be made by an experienced psychiatrist working with other health professionals after a period of observation of the individual to identify symptoms’ (Jones, A. HOW IS MENTAL ILLNESS DIAGNOSED? Online). To this day, many are skeptical towards mental health issues and even in todays society, problems such as depression, anxiety and stress are just now getting the attention and seriousness which they deserve. Before this, many believed such issues were made up linking them with laziness and lack of personal care, leaving those suffering these illnesses ostracized and without treatment options. This now brings to question how mental illnesses came about and what causes them, ‘Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by a combination of genetic, biological, psychological, and environmental factors — not personal weakness or a character defect’ (Mental Illness: Learn the Definition, Tests and Statistics). Many influential people, especially celebrities have started to speak very candidly about their own experiences with mental health, giving others the confidence to accept their own issues, somewhat beginning to remove the stigma surrounding the word. With people such as Kate Middleton who are mental health activists, those who once felt shamed by their issues, now have a voice to speak for them. ‘The challenge that so many people have is not knowing how to take that first step of reaching out to another person for help’ -Kate Middleton (Kate Middleton Quotes Online).
Mental Health Difficulties has been a topic of concern for quite some time. Over the past century, we have seen attitudes and care practices towards people with mental health issues change radically. From understanding, to acceptance, integration of mentally handicapped people into the rest of society and the switch from insane asylums to voluntary treatment facilities, a lot has changed for those suffering from mental health difficulties.
Dorothea Lynde Dix ,an extremely important name in the history of mental health, lived from 1802 till 1887. She was an author, teacher and reformer. Her work with people suffering from mental health difficulties and prison inmates helped to create many new mental health care establishments across the United States and Europe changing people’s attitudes and care practices towards such members of society. ‘Charged during the American Civil War with the administration of military hospitals, Dix also established a reputation as an advocate for the work of female nurses.’ She herself suffered a troubled childhood which served as a ‘galvanizing force’ throughout her career. (History.com Staff (2009)). She is credited by many mainly, not for her changes, but for raising awareness as she actively helped to reform asylums and prisons. During the 20th Century, psychology became a more serious study leading to many mental health care breakthroughs. In in the olden days, mental health patients were thought of as ‘crazy’ and were sent to Lunatic Asylums, where they were usually brutalized and abused physically, sexually and of course emotionally. The asylums acted as prisons, focusing mainly on restraining the patients that had been admitted there. Many experimental procedures such as lobotomies, shock therapy, and eugenics (forced sterilization) was practiced upon these patients who had no right or say in what was happening/being done to them. In todays modern times, Psychiatric Hospitals are here to provide treatment to help patients recover and reintegrate into society helping them control and live there own lives with the use of psychotherapy and psychiatric drugs.
There are many different types of mental health illnesses ranging from mild, to suicidal, they include Anxiety & panic attacks, Bipolar disorder, Depression, Eating disorders, Obsessive-compulsive disorder, Personality disorders, Post Traumatic Stress Disorder (PTSD) , Psychosis, Schizophrenia, Self Harm and Suicidal Feelings, are just to name a few, ranging from violent to non violent. Many have studied the links between mental health and crime. A BBC article claims that ‘People with severe mental health illness are responsible for 1 in 20 violent crimes’ and how ‘it was found 18% of murders and attempted murders were committed by people with a mental illness.’ Raising the question of how many inmates are actually suffering from mental health issues. a study was carried out by researchers from Oxford University’s department of psychiatry and Sweden’s Karolinska Institute, studying data from 1988 to 2000. They found that 45 violent crimes were committed per 1,000 inhabitants out of which 2.4 were due to people suffering mental illness such as bipolar disorder (manic depression) and other psychoses. This brought us to the conclusion that ‘5.2% of all violent crimes over the period were committed by people with severe mental illness.’ (Health | Mental health crime link studied (2006)).
Lunatic Asylums were places where mentally disturbed people used to be locked up. By the 20th Century, there were thousands of Lunatic Asylums all over Britain. Reports of abuse from the 1800’s to 1900’s began to surface, revealing to people how the patients were kept under the most ‘horrendous conditions’ and treated ‘far worse than any mistreated farm animal’. Patients were kept in wooden cages with no bathrooms, minimal clothing and hay sewn to the ground as bedding. An article revealed how ‘In a final description, the reporter told of a 20-year-old woman who had been kept in a little cage for six years. He described her as wearing only a piece of bedticking and said that “she is so weak from lying that she can neither move her limbs, rise, nor walk.” ‘ The article further went on to describe why no body had come forward about this mistreatment, ‘Many of the patients claimed that they were too scared to reveal everything that was going on inside the asylum, fearing that the attendants would hurt them after their testimony. Others revealed that they were strangled, beaten with socks containing potatoes, and forced to take cold showers as punishment. One articles states that “the patients were being held while cold water was allowed to drip on them.” ‘ We also learned about stimulated drowning and how it was used as a form of torture with the patients in the lunatic asylums ‘Under the direction of the matron head of staff, attendants committed a form of torture called the “water cure” against “insane” women at the Topeka Asylum for the Insane in 1903. One of the attendants explained the water cure like this: When a patient refused to obey the orders given by Miss Houston head of staff, the attendants were ordered to throw a sheet over her head and draw her to the floor. While the attendants held the patient, Miss Houston poured water out of a pan into her face. The water was poured fast, and the pouring continued until the patient agreed to obey orders.’ Furthermore, patients were starved flogged while in a straightjacket, beaten for not working, even chained and stamped in the face, a chilling report revealed ‘in 1889, there was a small piece in The State Chronicle (North Carolina) about the sickening abuse of some patients of a Dr. Grissom. Although certain political heads were trying to convince people “that the necessary thing to do to make an insane person act rational is to chain him, throw water in his face, or kick and stamp him in the face,” other people were crying out about the injustice and inhumane treatment.’ ( 10 Brutal Accounts Of Torture In Old Insane Asylums (2016) )
Some famous lunatic asylums are, the Trans Allegheny Lunatic Hospital , Essex Mountain Sanatorium , School For Backward and Feeble Minded Children and the Norwich State Hospital.
During this time, a popular procedure known as a ‘Lobotomy’ came about. A neurosurgical procedure, consisting of ‘cutting or scraping away most of the connections to and from the prefrontal cortex to the anterior part of the frontal lobes of the brain’. (Lobotomy (2018). Online) Men, Women, even children had suffered through this inhumane procedure. A well publicized case was of 13 year old Howard Dully ‘one of the youngest recipients and last survivors of Dr Walter Freeman’s transorbital lobotomy procedure’ ( Howards Journey (2013)
Walter Freeman, a very popular name in the era of the icepick lobotomy, who played great role in rendering the procedure responsible for an estimated 490 deaths. An incident can be recalled as follows ‘ In 1935, Freeman learned of a frontal lobe ablation technique that had been used on chimpanzees with the effects of subduing their temperament.That same year, a new procedure intended to treat mental illness was performed in Portugal under the direction of neurologist and physician Egas Moniz called a “leucotomy,” which took small corings out of the frontal lobes.Freeman modified the procedure, renaming it a “lobotomy.” He believed that excess emotions led to mental illness and that severing certain nerves in the brain could stabilize a person’s personality.With the help of neurosurgeon James Watts, Freeman performed the first prefrontal lobotomy operation in the United States on a 63-year-old woman who was suffering from insomnia and agitated depression. The operation involved drilling six holes into the top of the patient’s skull and when it was finished she emerged “transformed” and lived for another five years.’ (Walter Freeman: The Father of the Lobotomy (2016). Online) A famous victim of the lobotomy procedure was Rosemary Kennedy, the sister of JFK. ‘At the age of 23, Rosemary was admitted to George Washington University Hospital, where she was strapped to a table and given an anesthetic to numb the areas of her brain where Freeman and Watts would drill two small holes. They then inserted a small metal spatula and sliced the connections between her pre-frontal cortex and the rest of her brain. (Freeman often used ice picks for the procedure, hammering the pick in through the eye socket.) Rosemary was wide awake the whole time. The doctors had her recite poems as they cut—when she was silent, they knew the procedure was complete.It would be 20 years until Rosemary saw the rest of her family again.’ (Lenz, L. (2017)
In the US and Europe, during the 1960’s the Anti-psychiatry Movement came to be. Since then, this movement has had a lot of transformations. It has been described as following, ‘The movement probably had its ideological roots in the widespread dissatisfaction that was taking place on both sides of the Atlantic in the 1960s on the practice of housing and treating people with mental illness in the large institutional asylums.’ (The Anti-Psychiatry Movement Online). Not everyone was happy about the asylum system, ‘Firstly there were a number of scandalous revelations of very poor and sometimes abusive conditions in some but by no means all of the asylums and secondly there was a growing belief that incarceration in an asylum would lead to the process of “institutionalisation” of the patient. A process whereby the patient began to deliberately or unconsciously behave insanely in order to survive the environment of the asylum.’ (Howie, G. and Faber and Faber (1991) )
Around this time, psychiatric medication came to the rise, leading to Deinstitutionalization. This was a way of reinstate long-stay psychiatric hospitals with ‘less isolated’ community mental health services for those who need it. ‘Deinstitutionalization is the name given to the policy of moving severely mentally ill people out of large state institutions and then closing part or all of those institutions; it has been a major contributing factor to the mental illness crisis. ‘ (Torey, E.F. (1997))
Statistics revealed that ‘The number of institutionalized mentally ill patients fell from its peak of 560,000 in the 1950’s to 13,000 by 1980. The number of state psychiatric hospital beds per 100,000 people was 22 in 2000, down from 339 in 1955’ (Novella, E.J. (2010))
In todays society, we have come a long way from how things used to be. After the year 1900 mental health changed enormously. We moved from control and restraint to preventable, accessible and affordable.
According to an article on psychologytoday.com, Mental Health care is now easier and cheaper. In todays society we are more accepting of mental health issues and more open to discussing it candidly. ‘ the medical school entrance examination (the MCAT) will now include 30% of their questions on the topic of behavioral and psychological health starting next year.’ (Plante, T. (2014).)
With many people normalizing mental health issues, large media platforms such as Ted Talks, now have episodes focused mainly on such topics like mental health awareness, personal care, and acceptance. ( Wax, R. )
All these advancements led to the ability to identify other previously unknown mental disorders, an interesting example of this is a case of Postpartum Mental Illness, ‘The untold story of why Andrea Yates killed her five children’ (BuzzFeedYellow (2016))
After the birth of her fourth child she tried commit suicide and was then diagnosed with post partum depression she takes pharmaceutical drugs that helped, she gives birth to her fifth child and right after this her father dies causing her psychosis to return and the doctor prescribes the same drug she had taken before as it seemed to have helped.
However just a short time after the doctor believes the drug (Haldol) might have dangerous side effects and took her off it, right before the drowning incident occurred her husband tried to take her back to the doctor. She waited till her husband left for work, she filled up the bathtub drowned her children and laid them out in the bed one by one together. She believed she was doing it to avoid having her children ‘tormented by satan’. Bringing to light that even now, a whole century later, people still suffer injustices on behalf of the mental health system . (BuzzFeedYellow (2016))
Yes it is true that today, mental health awareness, acceptance and treatment has changed enormously since the last century. However, this mainly seems to be the case in the more developed areas of The United States of America, The United Kingdom and Europe. In parts of Asia and Africa, there is very little awareness or acceptance of mental illnesses and those suffering from mental health difficulties are often treated as second class citizens and lead a very short life of poverty and suffering. People are ashamed and embarrassed of family members who have mental health problems, they are often abandoned by family and have no friends, hence forced to fend for themselves from early on. ‘ Mental health is the invisible problem in international development. The World Health Organisation estimates that mental and neurological disorders are the leading cause of ill health and disability globally, but there is an appalling lack of interest from governments and NGOs.’ (Chambers, A. (2010))
Just recently have people begun to take this issue more seriously and have started to accept such people building them special schools perfectly equipped to accommodate their needs in particular. Helping to give them vocational training so they may learn a skill that will help them get a job such as mechanic, seamstress, tailor, house keeping jobs and so on.
It is unto the countries officials to pay more attention to mental health difficulties to allow even more progress to take place ‘while mental health problems account for an estimated 14% of all global health conditions they receive less than 1% of most countries’ healthcare budget.’ we further learn how ‘ Mental illness adversely affects people’s ability to work, creates a potential carer burden on their families and generally leads to greater poverty. It therefore has a significant economic impact upon developing countries. Despite this, half of all countries in the world have no more than one psychiatrist per 100,000 people and a third of all countries have no mental health programmes at all.’ (Chambers, A. (2010))
Men and Women appear to view mental health care differently. Male and Female children are, from and early age taught to process, view and handle their emotions differently from the opposite gender. Girl children are pushed towards being feminine, soft spoken, kind, gentle and caring, aimed at a more passive character build. Boys on the other hand are taught to be manly, tough, strong, rough, loud, and to no express their emotions, i.e. crying in public and so on. The effects of these gender stereotypes go on to shape how we process our mental health and the root cause of some of the issues and problems being faced.
As we grow into adults, men and women both have different experiences when going through mental health difficulties. Men find it harder to express their emotions, describe their feelings. While women are considered to be ‘too emotional’ and their claims of depression, stress and anxiety related mental health issues are not believed / given importance to. The same case can be made when seeing the difference between mental health care practices between race. ‘ As a group, black men remain hugely under-privileged. In fact, their life expectancy remains much lower than the national average; almost a decade lower than white women. This suggests that the social environment is still highly toxic for black men.’ ( Whitley, R. (2017).
A highly under represented group of people who seem to not have a prominent voice when it comes to issues of mental health care are Children and Young People.
‘Mental health problems affect about 1 in 10 children and young people. They include depression, anxiety and conduct disorder, and are often a direct response to what is happening in their lives.Alarmingly, however, 70% of children and young people who experience a mental health problem have not had appropriate interventions at a sufficiently early age.’ (Children and young people (2017).
In the past 30 years, the population of those aged above 65 has grown by nearly half revealing that older people are more vulnerable to mental health problems. Some statistics are are follows: ‘Since 1974, the number and proportion of older people in the UK population (aged 65 and older) has grown by 47%, making up nearly 18% of the total population in 2014. The number of people aged 75 and over has increased by 89% over this period and now makes up 8% of the population. Depression affects around 22% of men and 28% of women aged 65 years and over, yet it is estimated that 85% of older people with depression receive no help at all from the NHS. It is estimated that the number of people living with dementia worldwide was 44 million, and this was predicted to double by 2030. It has been estimated that the total cost of dementia in the UK is £26.3 billion, with an average cost of £32,250 per person. ‘ (Mental health statistics: older people (2017).