History of Mental Health

Question 1

What is “Whig History”

Answer 1

Narrative that frames the past as a sequence of events leading up to the present through increasing enlightenment and progression

Question 2

Why is “Whig History” critiqued?

Answer 2

• skips over the day-today realities of people’s lives

- misrepresents and oversimplifies history

Question 3

Explain Social History?

Answer 3

considers key achievements AND the daily lives of ordinary people and how they experienced cultural and scientific change

Question 4

When did the belief that strange actions and thoughts were signs of illness become prevalent?

Answer 4

18th Century

Question 5

Describe “Madness” in the 18th century

Answer 5

explained human behaviours that were inexplicable, dangerous, or irrational

Question 6

Name 6 explanations for “madness”

Answer 6

1. demonic possession
2. misfortune in love
3. head injuries
4. bodily humours
5. sorcery
6. acts of deities

Question 7

List ways in which society treated madness in the 18th century

Answer 7

1. trepanning
2. religious ceremonies, beatings, counter spells
3. flower based olfactory
4. displaying mad people in a zoo

Question 8

What era marked the transition from “madness” to “mental illness”?

Answer 8

18 century

Question 9

What is the difference between madness and mental illness?

Answer 9

Mental Illness = medical problem that needs to be addressed by physician

Madness = having undergone medicalization - process where human conditions become understood as problems best treated by medical professionals

Question 10

What 4 factors contributed to medicalization of mental illness?

Answer 10

1. challenges to the authority and power of the Church of England
2. The Scientific Revolution - idea that science could solve problems
3. The Enlightenment - skepticism about religion
4. increased urbanization - increased visibility of people who approved “mad”

Question 11

What 3 milestones took place during the Rise of the Physicians?

Answer 11

1. Medicine assumed responsibility for madness
2. physicians gained more respect, power, and trust from government and society
3. physicians were responsible for inspecting and licensing asylums to operate lawfully (protect against wrongful confinement

Question 12

What era saw the rapid expansion of large hospitals devoted to care for people with mental illness?

Answer 12

19th century

Question 13

How did psychiatry emerge?

Answer 13

when private madhouses were displaced with asylums

Question 14

Describe the Moral Treatment perspective on asylums

Answer 14

• Developed by the British Quakers as the foundation of the asylum movement
• emphasized humane benevolence rather than restraint and punishment
• Goal : end dehumanization of mentally ill by constructing asylums to provide active treatments

Question 15

Describe the social control perspective on asylums

Answer 15

• introduced by Foucault and scull
• aimed to remove and re-educate problematic individuals from society
• those who violated social norms or failed to adapt to shifting demands of economic life were recast as lunatics and needed to be confined and corrected in workhouse, prisons, and asylums (The Great Confinement)
• psychiatrists seen as agents of control

Question 16

What did the Eugenics Movement believe?

Answer 16

believed mental illness was hereditary (genetic) and pushed for institutionalization and sterilization

Question 17

Explain Psychoanalysis and who developed it

Answer 17

• treatment system focused on helping patients access and understand subconscious thoughts and urges
• developed by Sigmund Freud

Question 18

Who is Sigmund Freud?

Answer 18

• neurologist
• argued mental illness was psychological and emphasized importance of the subconscious mind (inner life exists below our consciousness)

Question 19

What contributions did Freud and company make in understanding mental illness?

Answer 19

1. widened definition of mental distress
2. instrumental in moving healthcare out of hospitals and into private offices
3. popularized the notion that our childhood experiences influence our mental health in adulthood
4. ideas were foundations for modern treatments of mental illness

Question 20

List 3 critiques of psychoanalysis

Answer 20

1. lack of research in the development of the theory
2. heavy emphasis on childhood sexuality was problematic for some
3. Freud’s ideas about gender were considered dated

Question 21

How did Freud’s psychoanalysis become a foundation to treating WWI soldiers?

Answer 21

• soldiers were presenting with symptoms of “shell shock” or “war neurosis”
• W.H.R Rivers developed a talking cure based on the idea that symptoms were expressions of repressed emotions and memories that were rendered unconscious as a result of survival instinct

Question 22

Name and describe the shock therapies used to treat mental illness

Answer 22

1. Electroconvulsive Therapy (ECT)
   - controversial
   - medical induction of convulsions (seizures) meant to cure psychosis
   - other shock therapies included insulin or comas

Question 23

What is a prefrontal lobotomy?

Answer 23

• gained popularity as a means to localize where disorders occurred in the brain
• severing of the prefrontal cortex from the rest of the brain

Question 24

What caused shock therapies and psychosurgeries to fall and why?

Answer 24

Psychopharmaceuticals:

• easier to administer
• mass produced and advertised
• chlorpromazine was favoured because of its calming effect
• Miltown, lithium, and valium were commonly prescribed

Question 25

What is deinstitutionalization?

Answer 25

• Process of moving mentally ill patients out of large state-run institutions and integrating them into community mental health services and closing the large institutions.

Question 26

What factors contributed to deinstitutionalization?

Answer 26

Service-User Movement

• frustrated with psychiatric system
• pushed for improved conditions within hospitals and treatment
• drew attention to inhumane and upsetting conditions in asylums