2 Flashcards
Enlightenment
The York Retreat 1792
Change in living conditions and understanding of mental illness.
‘Good food, air, exercise and occupation took place of drastic medical methods.’
Confinement
Ship of fools - mentally ill people were put on ships and taken away.
Houses of Correction in London 1555
Up until 17th century in UK lunatics were the responsibility of families and parishes.
Little distinction between lunatics, fools, paupers and idle vagrants.
Birth of the asylum
County Asylums Act 1808 (UK)
Lunacy Act 1845 (UK)
- lunatics were housed separately to other paupers and other vagrants.
- people were known as patients who had illness.
Asylums were the dominant model in most Western Countries till the 1950s.
Catalysts for change
Psychopharmacology
Exposure of abuse in institutions
Emerging discourses (Goffman and Foucalt)
Anti-psychiatry and the consumer rights movement
Fiscal motivations
Psychopharmacological changes
New drugs - Chlorpromazine (1950s)
- manage florid symptoms of illness including visual and auditory hallucinations.
Stoller Report 1955 (AUS)
Australia was lagging behind in terms of approaches and treatment of people with mental illness.
Mental Health Act 1958 (NSW)
Replaced the Lunacy Act
Goffman’s discourses
Experiment where Goffman did covert observation inside a mental institution.
Total Institution 1961 - a place of residence and work where a large number of like-situated individuals, cut off from the wider society for an appreciable period of time, together lead an enclosed, formally administered round of life.
Impact of living in institutions
- curtailment of self, role dispossession, loss of physical integrity, forced deference to those in authority, loss of self-determination and various other indignities that lead to mortification.
Foucault’s discourses
Madness and Civilisation 1965
- uncovered the socially constructed roles of lunatics and overtly made the connection between the construction of madness and care and treatment responses.
Construct of madness and lunacy has changed over time.
Anti-Psychiatry movement
Szasz and R.D. Laing
‘diagnosis are social constructs which vary from time to time and from culture to culture.’
Consumer Rights movement
Movements of the 1960s - civil rights, women’s rights
Social action by mental health service users
Questioned the legitimacy of the medical model and treatment approaches e.g. Lobotomy, electroconvulsive therapy, physical and chemical restraint.
Fiscal motivations
Costs of running institutions, capital upgrades of decaying buildings.
Emergence of the welfare state and increased labour costs.
Deinstitutionalisation
Since the 60s and 70s the principles of deinstitutionalisation have underpinned mental health and disability policy in most industrialised countries.
Over time they have also been applied to other population groups including children and young people in out-of-home care and older people.
Four aspects of deinstitutionalisation
Closure or downsizing of institutions - back door policy
Relocation and integration of patients or residents into the community
Diversion of new admissions and re-admissions - front door policy or non-institutionalisation
Provision of services in the community
The NSW Experience
From the 1960s deinstitutionalisation in Australia concentrated on the closure or downsizing of wards.
