Class 6 - Clinical psychology - History of Psychopathology Flashcards
Ancient Psychopathology
– from here on–
before 1500s
How did ancient societies interpret mental illness? – and what did its treatments include?
Many ancient societies attributed mental illness to supernatural causes, such as demonic possession or spiritual imbalance.
Treatments included trephination (drilling holes in the skull), exorcisms, and appeasement of spirits.
What happed in Ancient psychopathology era?
- Trephination
- Animism
- Religious cultures began to incorporate a specific “demon” into the practice. E.g., Siddhartha Gautama
- Ramayana
- Ayurveda Indian medicine - hollistic approach
- Traditional chinese medicine - hollistic approach, Hippocrates
- Pre-islamic
-
Islamic Medicine
- Abbasid leaders
- Bimaristan
- Islamic psychology
- Al-Rhazi
- Ibn-Sina
- Al-Balkhi
Memoroze this word:
Trephination
–
Which process dated back over 8000 years?
Trephination
What is Trephination?
A hole was drilled – in the skull, – to release demons – that caused malady (disease or disorder of mind and body).
What else did people think/hypothesize that Trephination helped with?
- Migraine
- Pressure in the head
What did one burtal site in Ancient
France found?
That 40 – out of 120 skulls –
had a hole in them.
In which countries is the evidence of trephination found?
- America
- Africa
- Asia
- Europe
What is Animism?
A belief – that everything – has a soul or spirit.
How did people see Animism as?
It’s interwoven– with an appreciation of nature.
Which cultures practised Animism?
- Indigenous culture
- African culture
- Shinto culture
What role did animism play in early mental health beliefs?
Animism, – the belief that all things possess a spirit, – shaped early interpretations of mental illness. – People believed spirits could inhabit individuals and cause changes in behavior or health.
Read this:
People believed everything had spirits. If someone showed signs of mental illness, they thought a spirit had taken over their body. Later, people believed spirits controlled actions to cause harm or bad luck, leading to exorcisms. Over time, mental illness was seen more like depression or anxiety, but many still thought possession happened because of wrongdoing. Even then, mental illness was recognized (but not as it exists today).
Unlike Animism, what did religious cultures began to incorporate?
A specific “demon” into the practice.
In religious belief, what does “spirit” typically has?
- Agency
- Name
- Hierarchy
- Carries out a specific purpose
Give an example of: In religious belief, this
“spirit” typically has agency, a name, hierarchy, and carries out a specific purpose.
“Mara”, the “spirit”, is a buddhist demon-like creature – that represents temptation and delusion, – trying to prevent – Siddhartha Gautama from achieving enlightenment.
Did the concept of mental health existed as it does today during the Ancient psychopathology era?
No
What did people believe that caused any sudden changes in behaviour or physical ailment/illness in ancient psychopathological era?
Demonic possession
What was sometimes this demon given?
A specific name
How the Treatment was given in ancient psychopathology era?
In the form of:
- Exorcism
- Appeasing the spirits
- Medicinal remedies
- Physical interventions
Give an example of: Sometimes demons were incorporated within stories.
- Ramayana, – which tells the story of Rama, – who aims to save his wife, Sita, – from the demon Ravana.
- Written Roughly in 700-500 BCE.
- The period of – DEPRESSION and ANGUISH – Sita faces after her abduction.
- The story speaks – of her RELIEF and RESILIENCE – as she is eventually reunited with friends and family.
- Shows Mental illness is NOT a new phenomenon – and
was clearly documented – many thousands of years ago.
When was The Ramayana, written?
Roughly in
700-500 BCE.
What does Ramayana discusses?
- The period of – DEPRESSION and ANGUISH – Sita faces after her abduction.
- The story speaks – of her RELIEF and RESILIENCE – as she is eventually reunited with friends and family.
Is Mental illness depicted through Ramayana a new phenomenon
and
when was Ramayana documented.?
- Mental illness is NOT a new phenomenon.
- Was clearly documented – many 1000s of years ago.
Give 2 examples of when the Ancient psychopathology reflects stories of demons?
- Siddhartha Gautama
- Ramayana
Which of the 2 stories showcases that mental illness was documented many 1000s years ago:
Siddhartha Gautama or
Ramayana
Ramayana
Which approach did India follow to treat mind and the body?
A hollostic approach – Ayurveda
What does Ayurveda address?
- Mental clarity
- Emotional stability
- Yoga
- Strength
- Dietary complements to improve lifestyle.
What is Ayurvedas aim?
To find balance to treat illness.
What concept did Ayurveda use to explain imbalances?
Concept of doshas (vāta, pitta, kapha)
Give example – Ayurveda used the concept of doshas (vāta, pitta, kapha) to explain imbalances.
Imbalances in Pitta – may lead to jealousy and irritability, – and eating non-spicy foods may help to balance.
How is the holistic approach rooted in human nature?
Holistic approaches emphasize BALANCE and IMBALANCE in both physical and mental health, as seen in the Three Doshas (Ayurveda), – the Five Elements (Traditional Chinese Medicine), and the Four Humors (Hippocrates idea).
The concept of humors was a system of what and in which countries was it prevalent?
- The concept of humors was a system of medicine
- Prevalent in ancient Greece and Rome
How does Traditional Chinese Medicine (TCM) relate to holistic health?
- TCM is based on the Five Elements (WMW-FE = Wood, Metal, Water, Fire, Earth) and the idea that imbalances in these elements can lead to illness.
- Like Ayurveda, it emphasizes restoring balance through diet, lifestyle, and herbal remedies.
How were imbalances in the Humors treated?
Lifestyle and dietary changes
What is the key similarity between Ayurveda, TCM, and Hurmour Theory?
All emphasize:
- The interconnectedness of mind and body
- Personal responsibility
- Proactive changes in lifestyle to maintain health.
How did Pre-Islamic Arabic Medicine explain illness?
- Illness was often attributed to Djinn (genies), – which could be good or bad.
- Shamans performed healing rituals, believing they had a connection – between the human and spiritual world.
How did the rise of Islam shift medical perspectives?
- The rise of Islam – and it’s quest for KNOWLEDGE and TRANSLATION movement, – shifted the ethos of Arabic culture – to practice OBJECTIVE science. – This gave rise to the House of Wisdom and the BIMARISTAN.
- The Abbasid leaders heavily promoted – SCIENTIFIC advancement. – They were open of other cultures and regularly incorporated their works into their own knowledge. – They placed focus on mental health as part of medicine.
What were Bimaristans, and how did they approach mental health?
Bimaristans were – hospitals that treated – both physical and mental illnesses – using a HOLISTIC approach, – recognizing the interconnectedness of mind and body.
How did Bimaristans approach mental health treatment?
or
Through what treatments did Bimaristans approach mental health?
Bimaristans used multifaceted treatments, including:
- Music therapy 🎵
- Occupational therapy (gardening, crafts, cognitive activities) 🌱🎨
- Early forms of counseling to address negative thoughts and promote well-being 🧠
How did Islamic medicine differ from pre-Islamic healing practices?
It shifted – from supernatural explanations – to scientific methods, – focusing on observation, classification of mental disorders, and structured treatments.
How do early Islamic mental health approaches resemble modern practices?
- They emphasized personalized treatment, – acknowledging that some patients – respond better to external interventions (e.g., therapy, lifestyle changes) – rather than medication alone.
- Bimaristans often had – separate wards for mental health patients, – a clear indication that their conditions were recognized as seperate
from physical illness.
What concept/study did Islamic Psychology explore?
The concept/study of self (psyche).
What did Islamic Psychology– The concept/study of self (psyche) focus on
and
What did it influence?
It focused on:
- Emotions
- Thoughts
- Behaviors.
This understanding of the psyche likely infleunced early counseling practices.
Who was Rhazes (Al-Razi)’s and What was Rhazes (Al-Razi)’s contribution to mental health?
A physician.
- He who wrote about mental disorders and their treatment.
- Also emphasized the importance of Observation and experience in medicine.
How did Ibn Sina contribute to psychology?
Ibn Sina discussed mental health disorders
in his book, The Canon of Medicine.
Why is Al-Balkhi considered a pioneer in psychology?
He is often cited as a pioneer in CBT – with his work Sustenance of the Body and Soul, –
recognizing that thoughts, emotions, and well-being influence each other.
Modern Psychopathalogy
–from here on–
–from here on–
What happened in Modern Psychopathalogy?
- Feudalism and Society in Europe
- Mental illness in Feudal Europe
- Bethlem hospital: From priory of mental institutions
- Brthlem Hospotal Treatment: Harsh condition & Superstition
- Bethlem & the reformation
- Dehumanizing & Torture at Bethlem
- Intellectual movemnets POst Black Death & their impact on Mnetal Health
- Phillipe Pinel
- Moral Treatment: Phillipe Pinel
- Evolution of Moral Treatment in Mental Health Care: Key Figures & their Impact
Read this:
now euprope version of treating mental illness. we looked at demon model > then moved into hollistic approach that we are one with nature and to greater degree the world is going to interact back with us >medical info age >islamic looked int knowledge = adopting ideas into previous knowledge available > How barbarians affected/caused feudalism?
now we have this period where there it was difficult to live as there was a lot of interanl and external strick going on. problems like food shortages, death due to war existed. they looked someone to blame for this. peole blamed minority groups. same things happened here as society was fractured globally and locally. This led to a rise in middle class. — when people had levels of mental illness they were seen as destabilizing the society at first (possessed by demons).— what did govt do in response to this = they were scapegoated as they considered mentally ill people the cause of destabilizing the society.
See the meaning of:
Feudalism
Feudalism was a system in which people were given land and protection by people of higher rank, and worked and fought for them in return.
What key factors contributed to the growth of feudalism in Europe?
- The rise of warring towns and city-states.
- The emergence of the middle class.
- A rapid increase in population.
Warring meaning = conflict with each other.
What Zeitgeist did the following lead to:
Meanwhile in Europe, the growth of feudalism - which came with the rise of warring towns and city states, the rise of the middle class, rapid increase in population.
- A society of fear.
- A constant need for – order and control.
Who held significant power and influence over people’s lives, over townspeople during feudal times?
The clergy
How were societal events explained/seen/interpreted in feudal Europe?
Since religion was law, – events were seen through – a religious lens.
How did feudalism’s strict social hierarchy affect those at the bottom?
They were often blamed for – society’s tragedies.
Read what Famine means:
Famine: a severe and widespread scarcity of food, – often leading to starvation and death.
Why were unproductive individuals shunned in feudal society?
Because of famine and resource shortages, – those who could not – contribute – were seen as a burden.
How were individuals with mental health problems treated in feudal Europe?
They were scapegoated – as the cause of many societal problems and often shunned.
scapegoat = person who is blamed for something that someone else did
Feudalism & Society in Europe
🔹 Rise of Feudalism: Warring towns, a growing middle class, and population surges created fear and a need for control.
🔹 Religious Influence: The clergy held power, and societal events were interpreted through a religious lens.
🔹 Social Hierarchy: The strict structure left little sympathy for the poor, who were often blamed for societal issues.
🔹 Scapegoating: During famines, unproductive individuals were shunned, and those with mental health problems were blamed for destabilizing society.
Why was mental illness misunderstood in feudal Europe?
Because of the lack of the Scientific understanding – leading to superstitious beliefs.
How were visible mental health problems perceived?
They were associated with demonic possession, – increasing fear and chaos in towns.
Why were mentally ill individuals seen as a threat?
Townspeople believed – they destabilized – the fragile social order.
Mental Illness in Feudal Europe
🔹 Lack of scientific knowledge – led to superstition.
🔹 Mental illness – was seen as – demonic possession.
🔹 Townspeople feared the mentally ill, – believing they threatened the fragile social order.
When was Bethlem founded, and what was its original purpose?
- Founded – as a priory in 1247.
- It initially functioned – as a charitable hospital – for the poor and sick.
Why did Bethlem start accepting patients with mental health conditions?
- Due to the stigma around mental illness, – which was attributed – to supernatural causes.
- Lack of dedicated institutions – for the mentally ill.
Instead of sending mentally ill individuals to jail, where were they placed and why?
In Bethlem – because their existence – was seen as an inconvenience.
What led to an increase in mental health patients in Bethlem?
The Growth of London and other cities – in the 13th and 14th centuries – resulted in more cases of mental illness.
When did Bethlem officially become known as a hospital for the “insane”?
By the 14th century, – Bethlem primarily housed mentally ill patients – and became known as Bethlem Hospital.
In which year did the City of London take over Bethlem’s management?
In 1403
Bethlem Hospital: From Priory to Mental Institution
or
Why did Bethlem Hospital start accepting mentally ill patients?
Bethlem Hospital: From Priory to Mental Institution
🔹 Founded in 1247 as a priory and charitable hospital for the poor and sick.
🔹 Began accepting mentally ill patients due to stigma and lack of alternatives.
🔹 Growth of cities in the 13th-14th centuries led to more mental health cases.
🔹 Became known as Bethlem Hospital, primarily housing the “insane.”
🔹 City of London took over in 1403, ensuring its continued operation.
see attached picture.
What societal conditions influenced the harsh treatment of mentally ill patients at Bethlem?
- Food insecurity
- Fear for safety
- A belief in religious and superstitious explanations for mental illness
Why was Bethlem often referred to as “Bedlam”?
- Due to the harsh conditions
- Overcrowding
- Chaotic environment within the hospital.
What were the living conditions like for patients at Bethlem?
- Patients faced limited food
- No contact with the outside world
- Overcrowding
- Dirty conditions
- No respect given
How did the Bethlem Hospital treat mentall ill patients?
or
or What was the treatment in Bethlem Hospital for mentall ill?
- Long periods of restraint
- Physical punishment (designed to “beat” the “craziness” out of prisoners)
- Purgatives and emetics (inducing vomiting and diarrhea to balance the humors)
- Non-existent medical care (since treatments were based in superstition and incorrect theories)
- Exorcisms
Bethlem Hospital Treatment: Harsh Conditions and Superstition
🔹 Zeitgeist: Food insecurity, fear for safety, and religious perspectives shaped harsh treatments.
🔹 Patients lived in overcrowded, dirty conditions with no outside contact or respect.
🔹 Treatments included restraint, physical punishment, purgatives, exorcisms, and non-existent medical care.
🔹 Bethlem was nicknamed “Bedlam” due to the chaotic environment and brutal treatment.
How did the zeitgeist influence societal & religious attitudes towards mental illness during the time of Bethlem Hospital?
Religious and societal perspectives, – including food insecurity – and fear for safety, – contributed to harsh treatment – and the belief that mental illness was caused by supernatural forces.
see picture
What happened to conditions at Bethlem after it came under the City of London’s control?
- 1547: King Henry VIII – granted control of Bethlem –to the City of London.
- Despite the change in control, – conditions at Bethlem worsened, – and the treatment of patients – continued to deteriorate.
How did the separation of Church and State impact mental health care?
The separation led to the government – taking more responsibility – for mental health care as a state-wide issue, — rather than the church providing it out of kindness.
What shift occurred in the perspective on mental illness after the Reformation?
Religious and superstitious beliefs – regarding mental illness – began to fade.
Bethlem & The Reformation
🔹 1547: King Henry VIII granted control of Bethlem to the City of London, part of the Reformation.
🔹 Bethlem became one of the five Royal Hospitals under the City’s administration.
🔹 Despite the change, conditions worsened at the hospital.
🔹 Separation of Church and State shifted mental health care responsibility to the government.
**
🔹 Mental health care became a secular concern, and superstition about mental illness began to wane.
What rationale did Bethlem hospital use for treating mental illness?
The rationale was that – inducing physical sickness in the body, – such as through malarial therapy, – could heal mental illness.
How did the Bethlem hospital dehumanize patients in the 1670s?
- The hospital charged the public to view patients.
- Encouraged them to provoke anger in patients.
- Made patients to perform for the crowd.
- Throw tomatoes at patients.
How did the hospital justify its dehumanizing treatment of mental health patients?
The hospital justified – the treatment – by claiming that mentally ill patients – DO NOT feel any emotions or pain, – no matter what was done to them.
What new “treatments” were introduced in the 1770s at Bethlem?
- Rotational therapy
- Cold water therapy
- Whipping
- Blistering
All of which were similar to torture techniques.
Dehumanization and Torture at Bethlem
or
How did Bethlem Hospital dehumanize and mistreat mentally ill patients, and what rationale was used for these practices?
🔹 Rationale: Physical illness (e.g., malarial therapy) was believed to heal mental illness.
🔹 1670s: The hospital started charging the public to view patients, provoking them, and forcing them to “put on shows” and endure tomato throwing.
🔹 Patients were dehumanized, with the belief that they didn’t feel emotions or pain.
🔹 New treatments included rotational therapy, cold water therapy, whipping, and blistering, similar to torture used on war criminals.
What intellectual movements emerged after the Black Death and how did they influence views on mental health?
- The Renaissance
- Humanism (1576-1600s)
- The Scientific Revolution (16th-18th CE)
- The Enlightenment (18th CE)
These movements influenced views on mental health, though little progress was made during this period in terms of treatment.
What was the focus of the Renaissance and Humanism in relation to mental health?
- The Renaissance and Humanism – emphasized reason, observation, and empirical thought,
- But it did NOT lead to significant progress in the treatment or understanding of mental health.
What did the Scientific Revolution emphasize, and how did it affect mental health?
- The Scientific Revolution focused on – empirical observation, – experimentation, – and technological advances
- But did NOT focus on mental illness or its treatment.
What did the Enlightenment emphasize, and how did it influence views on individual rights and mental health?
- The Enlightenment emphasized – individual rights, – knowledge, – and challenged traditional authority, – laying the groundwork for future shifts in perspectives
- But it did NOT directly address mental health.
Intellectual Movements Post-Black Death and Their Impact on Mental Health
OR
How did intellectual movements after the Black Death, such as the Renaissance, Humanism, the Scientific Revolution, and the Enlightenment, influence the understanding and treatment of mental health?
🔹 After the Black Death, the Renaissance, Humanism, the Scientific Revolution, and the Enlightenment emerged, emphasizing reason, observation, and individual rights.
🔹 Despite these movements, little progress was made in understanding or treating mental health during this period.
What did Philippe Pinel suggest?
Patients – would recover – if someone – just cared about them.
Read this:
- The Enlightenment shifted the treatment of mental illness by emphasizing humane care and scientific solutions.
- Philosophical ideas about individual liberty and human emotions challenged supernatural views.
- This period also saw the rise of science , focusing on empathy and empirical understanding rather than divine intervention.
What was the new zeitgeist that emerged for treating mental illness during the Enlightenment?
The new zeitgeist – emphasized the idea – that if we could identify and understand a problem, – we could fix it.
This led to changes in the treatment of mental illness, focusing on:
* humane care
* empathy
* scientific solutions
What role did Phillipe Pinel play in the development of mental health treatment during the Enlightenment?
- Phillipe Pinel rejecting the view that mentall ill were irrational beasts.
- He believed that humane treatment would aid their recovery.
- He introduced the concept of Moral Treatment.
What key principles did the “Moral Treatment” approach emphasize?
- Humane care
- Understanding
- Empathy
- Positive environments
- Constructive interpersonal interactions
- Belief that mentally ill patients are still human beings deserving of respect.
What did Moral Treatment provide for patients?
- A positive atmosphere
- Structured routines
- Activities to help form identity and purpose
- Individualized care suited to each patient’s needs.
What were the classifications of mental illness in the book written by Phillipe Pinel?
M M D I
- Mania
- Melancholia
- Dementia
- Idiocy
How did the shift in mental health treatment during the Enlightenment influence the care of mentally ill patients?
The shift in treatment led to the moral treatment approach, emphasizing humane care, empathy, and positive environments. Pinel’s influence encouraged seeing mentally ill patients as human beings deserving of respect and individualized care. This shift led to a focus on recovery through structured routines, engaging activities, and a positive, supportive atmosphere.
What was the York Retreat and how did it embody moral treatment for mental illness?
- The York Retreat was designed like a family home, located in the countryside.
- Patients could engage in peaceful activities like music, writing, gardening, and reading.
- The goal was to create a calm, supportive environment where patients could build positive relationships with staff and fellow patients.
- It implemented moral treatment principles, focusing on kindness, respect, and empathy.
Who was the founder of the York Retreat and what was his background?
- The York Retreat was founded by a religious Quaker and prominent tea merchant.
- He was dedicated to creating an asylum based on moral treatment principles.
How did Dorothea Dix contribute to mental health reform in the USA?
- Dorothea Dix visited American and European asylums and prisons, documenting the poor conditions.
- She worked to expose the abuses in these institutions through formal reports to state legislatures.
- She also spread awareness of these issues publicly.
How did the Zeitgeist change during the era of moral treatment?
- The Zeitgeist shifted towards a more humane and scientific understanding of mental illness.
- The focus moved from seeing patients as irrational or possessed to recognizing them as suffering humans deserving of care and empathy.
- Key figures like Pinel, Tuke, and Dix influenced these changes by promoting the idea that mental illness should be treated with kindness, respect, and individualized care.
How did the development of moral treatment in mental health care lead to significant changes in how patients were treated and the role of key figures like Pinel, Tuke, and Dix?
- Pinel introduced the idea that mentally ill patients were not irrational or half-human but suffering individuals. He emphasized humane treatment and moral care for recovery.
- The York Retreat, founded by a religious Quaker and tea merchant, embodied these ideas by creating a peaceful, family-like environment where patients could engage in constructive activities like music, writing, and gardening.
- Dorothea Dix, influenced by Pinel and Tuke, became a key figure in the USA. She documented the poor conditions of asylums and prisons in both America and Europe, advocating for reform through formal reports and public awareness.
- The Zeitgeist shifted towards recognizing mental illness as something that* needed empathy and care, not punishment,* and led to the widespread adoption of moral treatment principles across asylums.
What was the Great Confinement (~1880–1950)?
A period where – mental illness was increasingly medicalized, – leading to overcrowded asylums – and – the shift from moral treatment – to custodial care.
What problem arose as a result of increased mental health awareness and asylum construction?
- Custodial care is non-medical assistance with daily living activities for individuals who need help with tasks like bathing, dressing, and eating, often provided by non-medical professional
Asylums became Overcrowded , – which led to – a decline in quality of care — and – a return to custodial care instead of moral treatment.
How did scientific advancements influence mental health treatment during this time?
The rise of – neuroscience – and behaviorism – led to experimental treatments, – like phrenology, malarial therapy.
What role did Gottlieb Buckhardt played in phrenology?
He piloted the idea of drilling holes – into patients’ skulls – to examine the brain and attempt – to “cure” mental illness.
What was the unintended consequence of moral treatment reforms?
The increased – visibility and acceptance of mental illness – led to more people being institutionalized, – worsening overcrowding and care conditions.
What was malarial therapy, and why was it used?
- A treatment – where patients were intentionally infected – with malaria to induce high fevers, – believed to cure mental illness.
- It reflected that people were desperate for any cure.
What were the key features of the Great Confinement (1880–1950) in mental health history?
- The period saw increased medicalization of mental illness, – leading to overcrowded asylums – and a shift from moral treatment to custodial care.
- Desperate for cures, treatments like **malarial therapy **and early psychosurgery (like phrenology) emerged.
- Advances in neuroscience and psychology, influenced by Darwin’s work, shaped new approaches, but institutions remained overwhelmed, often prioritizing custodial care.
What was the Goal of removing the Prefrontal Cortex (PFC) in early psychiatric procedures (phrenology)?
* Does anyone remember Trephination?
It was intended – to control – mental illness symptoms, – though it resulted in severe Cognitive and Emotional impairments.
How did Antonio Moniz “refine” the lobotomy procedure in the 1930s?
He drilled holes** – in the skull and – used a “Leukotome**” (like an ice pick) to scramble the PFC, – winning a Nobel Prize for this technique.
What was Walter Freeman’s contribution to lobotomy procedures?
He invented the Transorbital Lobotomy, – a faster method using an ice pick – through the eye socket – to access the brain.
Approximately how many lobotomies were performed in the USA?
Around 100,000
Why was the lobotomy seen as a “solution” despite its severe effects?
It calmed patients, – reducing caregiver burnout, – and was considered a more “scientific” way of controlling patients – rather than physical restraints.
What was the impact of lobotomy procedures on mental health treatment?
- Lobotomies were refined and aimed to reduce PFC excitation but caused severe cognitive and emotional impairments.
- With around 100,000 performed in the USA, the procedure won a Nobel Prize and was legitimized as a scientific solution.
- Because It calmed patients, – reducing caregiver burnout, – and was considered a more “scientific” way of controlling patients – rather than physical restraints.
What was the rationale behind inducing seizures as a treatment for schizophrenia?
A few geniuses observed – that people with epilepsy – did NOT develop schizophrenia, – leading them to believe that inducing seizures could prevent or treat the disorder.
What was Cardiazol therapy, and how did it work?
Cardiazol was – a strong GABA agonist that – caused neurons to fire rapidly, – mimicking a seizure to treat schizophrenia.
How did Electroconvulsive Therapy (ECT) originate?
Inspired by seizures caused by cattle prods in animals, – doctors used electricity to induce controlled seizures – as a cheaper alternative to Cardiazol therapy.
How has ECT changed over time?
Today, ECT is performed under anesthesia – with low-dose electrical currents, — making it much safer and – reducing recovery time.
Why were treatments like Cardiazol therapy and ECT widely used in hospitals?
Overcrowded institutions – were desperate for ways to Calm patients, — leading to widespread use of seizure-inducing treatments.
How did induced seizures become a treatment for schizophrenia, and how has the approach evolved?
- A few geniuses observed – that people with epilepsy – did NOT develop schizophrenia, – leading them to believe that inducing seizures could prevent or treat the disorder.
- Cardiazol was – a strong GABA agonist that – caused neurons to fire rapidly, – mimicking a seizure to treat schizophrenia.
- Inspired by seizures caused by cattle prods in animals, – doctors used electricity to induce controlled seizures – as a cheaper alternative to Cardiazol therapy.
- Today, ECT is performed under anesthesia – with low-dose electrical currents, — making it much safer and – reducing recovery time.
- Overcrowded institutions – were desperate for ways to Calm patients, — leading to widespread use of seizure-inducing treatments.
Contemporary Psychopathalogy..
..from here on..
~1950s to now
As these “treatments” were reaching their peak, something happened that changed psychology forever….
Exam Question!
Invention of drugs (chloropromozipe: anti-psychotic drug) happened.— take the drug and go home.
What major event changed psychology forever during the peak of early psychiatric treatments?
Exam Question!
The invention of chlorpromazine (an antipsychotic drug) in 1954, which allowed patients to manage mental symptoms and be discharged from institutions.
What was the impact of chlorpromazine on mental health care/what did this drug lead to?
Exam Question!
It led to rapid deinstitutionalization, – as patients – could take medication and go home, – significantly reducing asylum populations.
What was the Community Mental Health Act of 1963?
A law that aimed to replace asylums with:
- Community-based care, offering psychotherapy, medication management
- 24-hour emergency services
- Mental health education.
How did the Community Mental Health Act compare to earlier mental health reforms?
It was similar to the York Retreat, – promoting humane treatment – and community support, — but faced challenges in execution.
How did the invention of antipsychotic drugs change mental health care?
Explain picture.
100% on exam!
- The discovery of chlorpromazine in 1954 revolutionized mental health treatment by allowing patients to manage symptoms with medication, leading to rapid deinstitutionalization.
- This shift was reinforced by the Community Mental Health Act of 1963, which aimed to replace asylums with community-based care, offering psychotherapy, medication management, and emergency services.
- While it resembled earlier humane reforms like the York Retreat, its implementation faced significant challenges as there was no plan to implenent it neither there were resources..
What were the unintended consequences of deinstitutionalization?
Explain picture.
- While deinstitutionalization promised community-based care, – there was – no real plan or budget beyond reallocating funds.
- As hospitals closed, ex-patients were often left without support, – leading many to end up in Jail, Homeless shelters, or worse conditions. — The assumption that long-term patients could easily transition back into society proved false, — and 60 years later, we are still waiting on the promised system of care.
How is the opioid crisis in Vancouver’s Downtown Eastside (DTES) connected to deinstitutionalization?
Explain picture.
- After deinstitutionalization, – many people with mental health issues – were left without support – and migrated to low-income areas like DTES, – which had affordable housing and some welfare infrastructure.
- Over time, lack of proper mental health care – and social support – contributed to HOMELESSNESS and SUBSTANCE USE, indirectly fueling the OPOID crisis.
Why did many ex-patients from River View Hospital end up in Vancouver’s Downtown Eastside (DTES)?
- When River View Hospital closed, – the BC government did not allocate funds for promised community-based programs, – leaving many ex-patients WITHOUT INCOME or SUPPORT.
What was the government’s approach to mental health care after deinstitutionalization in BC?
Instead of building community-based services as promised, the government saved money by defunding River View and assumed facilities could be repurposed without proper planning.
How did deinstitutionalization contribute to rising crime in DTES?
The lack of mental health support led to POVERTY, HOMELESSNESS, and ADDICTION. – With many struggling to survive, crime followed.
Why was DTES considered an “out of sight, out of mind” solution?
Since DTES is located outside Vancouver’s downtown core, – ex-patients and low-income individuals were pushed into the area – without addressing their needs, making them less visible to the general public and policymakers.
How did the closure of River View Hospital contribute to the struggles in Vancouver’s Downtown Eastside (DTES)?
Explain Picture.
- When River View Hospital closed, – the BC government did not allocate funds for promised community-based programs, – leaving many ex-patients without income or support.
- Many migrated to DTES, where some welfare services existed, but WITHOUT real planning, POVERTY, HOMELESSNESS, and CRIME increased.
- The area became an “out of sight, out of mind” solution rather than a true support system.
How did deinstitutionalization contribute to the current state of the Downtown Eastside (DTES)?
Explain picture.
Deinstitutionalization – left many individuals/ex-patients – with untreated mental illness and no support systems, — leading to POVERTY, ADDICTION, and one of the worst OPOID EPIDEMICS worldwide, — showcasing DTES as a center of social inequality in Vancouver.
What significant investment was made in 2021 for mental health care in British Columbia?
Riverview Hospital received $101 million for – a multi-phase project – to reintroduce – community mental health programs.
What was the first step in Riverview Hospital’s redevelopment plan?
The establishment of – the Red Fish Healing Centre– for Mental Health and Addiction.
What additional plans were proposed for the Riverview Hospital site?
- Affordable housing.
- Community-based mental health programs.
What remains uncertain about the new mental health initiatives at Riverview?
While there are initiatives for community-based mental health programs, – NO concrete plans have been finalized yet.
What recent efforts have been made to improve mental health care in British Columbia?
Explain the image.
- In 2021, Riverview Hospital received $101 million for a multi-phase project, starting with the Red Fish Healing Centre for MENTAL HEALTH and ADDICTION.
- There are also plans for affordable housing and community-based mental health programs, – though NO concrete plans have been finalized.
