Conceptual and Historical Issues In Mental Health Flashcards
Ancient views of Mental illness
- possessed by gods and demons
- Treated through exorcism
Greek and Roman views of Mental illness
- Imbalance of the four humours (Hippocrates)
- Balance humours
Early Renaissance
- move away from religion
- “lunatic” influenced by the moon
- establishment of asylums (remove from society)
Bedlam Hospital
- mental hospital in London
- Inhumane treatments
- Bedlam now means ‘ confusion and uproar in a certain place’
Humanitarian Reform
- Phillipe Pinel, removed chains from inmates and treated them like humans
- Dorothea Dix, Mental hygiene movement. Improving physical conditions form the mentally ill.
The early 19th Century to late 19th Century
- Asylums went from being run by laypersons to psychiatrists
- Also went from moral management to being able to diagnose conditions (vaguely)
The 20th Century
- Development of outpatient clinics and community work
- Use of medication like lithium for depression
Is grief a disorder?
- Normal response to loss
- However, 7%-10% of adults have intense feelings of grief which impact their life
DSM-5 grief disorder
- has to be at least 6 months for children and adults 1year since loss of loved one
- At least three symptoms very day for a month i.e. loneliness, emotional numbness and problems engaging with friends
What are some critics of the DSM
- may increase rates of mental illness
- may be trying to medicalise normal human experience
What is the History of Madness in the classical age
- Madness replaced lepers
- Mad people were sent away on ships ‘Ship of fools’
- Renaissance, accepted mad people into society
- Then lost what it’s like to be human and treated them like animals
- In the 19th century, it was decided that madness could be cured
What is Foucault’s Argument
- Understand mental disorder as well as power
- the mad were treated better in the Renaissance rather than 17th century
- Mad were felt to be different rather than crazy and could wonder freely
- Medicalised and institutionalised, try to cure rather than live along side.
Classical experience of Madness
Foucault 1961
- he was interested i individuals who didn’t follow societal norms
- not only mental health conditions but sexual offenders and those who are not religious
Classical experience of Madness
Level 1 and Level 2
Foucault
1st Level = confinement as an economic policy
- deal with poverty, put them to controlled work
- did not work, only hid poverty
2nd Level = Idea that has come from Calvin where you have to be religious
- detention rather than treatment of the mad
What is the Anti Psychiatry Movement?
R.D Laing
- founded on a false epistemology where illness is diagnosed by mannerisms and behaviour but treated biologically
2 Main Arguments: - Criteria is vague leaving to much room for opinions (so doesn’t meet basic scientific standards)
- Existing treatments do more harm than good
Anti Psychiatry movement: Criticisms of Psychiatric authority
- unsuitable use of medical concepts also overuse
- DSM can cause lots of stigma
- Misuse of power
- Financial gains for pharmaceuticals
Being Sane in Insane places
Rosenhan
- Psychiatrists aren’t reliable at diagnosing mental Illness
- Once the pseudo patients were labelled the label stuck
The Concept Of Mental Disorder Wakefield
1) Biased diagnosis i.e. sexual and racial (homosexuality was a disorder in the DSM until 1986)
2) diagnoses are used to control socially undesirable behaviour which is not actually a disorder (childhood masturbation disorder)
Myth Of Mental Disorder Szasz
- Mental disorder doesn’t exists, its a power trip to remove socially unacceptable behaviour from society
- Mental disorder only exists if theres a physical ‘lesions’
- neuroscience would now disprove his theories
Disorder as a pure value concept
- disorders are what society says is not acceptable
- disorders are undesirable Pichot (1986)
Disorder is whatever professionals treat
Kendall (1975), no one is ill until a medical professional says so, they have to say they are concerned ‘attribute of therapeutic concern’
Disorders as statistical deviance
- Objective criteria
- undesirable behaviours aren’t always a disorder (criminal)
- being extremely intelligent is statistically deviant but not a bad thing
Disorder as a biological disadvantage
- Mind has evolved like our body to serve a function
- disorders reduce fertility as well as longevity
not actually correct as different ethnicities have different fertility rates - Wakefield says it’s when mechanisms fail rather than lowered fitness
Disorders as unexpected stress or disability
- Confuses normal variation with disorder
- normal response to disorder
“Disorder as a harmful dysfunction” - Wakefield
- factual evidence is not enough to distinguish between disorders
- disorder requires harm which involves values
Facts and values involved to determine disorder
What is Natural Function - Wake field
Structure or activity of an organ
What are mental mechanisms
Aphasia - Function of linguistic mechanisms = communicate
Phobia - Phobia = Fear response = avoid danger
Insomnia - tiredness = get sleep
What is dysfunction
- failure of mechanism to work (without human intervention)
- Purely scientific concept
- only dysfunctions which are not valued by society are disorders
Wakefield criteria for a disorder being a dysfunction
- condition causes harm
- inability for mechanism to perform natural function
- dysfunction doesn’t make a disorder ‘mental’, the symptoms do (DSM)
Wakefield criteria for Mental disorder
Has to be mental dysfunction
- cause harm
- mental internal functions don’t perform properly
What are Dennetts three levels
Physical stance - Level of Physics and Chemistry e.g mass, velocity
Design stance - Level of biology and engineering e.g purpose function and design
Intentional stance - Level of software and minds e.g. belief thinking intent
