Week 1

Question 1

Pre-institutional History

Answer 1

• most illnesses considered mania, depression, delusions
• medicine entered a period of decline
• there were both compassionate and cruel, medical and non-medical responses to madness

Question 2

What was the Vagrancy Act 1714

Answer 2

a law passed that differentiated mad people from rogues

Question 3

Why was the Vagrancy Act important

Answer 3

• recognized mad people as separate from social deviants
• lunatics (poor mad people) were not to be whipped
• no mandated treatment, just confinement

Question 4

Rise of Private Madhouses

Answer 4

• Any person w property could open up a madhouse (paid to take care of inmates)
• Custodial care not treatment
• Conditions were terrible

Question 5

Issue with madhouses

Answer 5

Sparked concerns for wrongful confinement

Question 6

1714 Act for Regulating Madhouses

Answer 6

Madhouses required inspection and licensing by the Royal College of Physicians
- Only ones deemed safe and healthy had license
- Involuntary confinement only possible after case review

Question 7

Why is the 1714 Regulating Act Important

Answer 7

• Bringing physicians to madhouses brought medicalization to madness
• State became involved in cases beyond just danger

Question 8

Why was the Enlightenment important

Answer 8

• Quality of reason held in high regard
• Science trusted to change society
• Individual rights emphasized

Question 9

Enlightenment & mental health

Answer 9

• shifted madness to mental illness
• Sparked interest into madhouses being therapeutic - furthering medicalization

Question 10

York Retreat

Answer 10

• mad were able to work the land
• kindness guided treatment
• part of moral treatment revolution

Question 11

Pinel - Moral Treatment

Answer 11

• believed mad weren’t lost causes
• mads are just disconnected from reasoning
• talk therapy as a way to improve patients state

Question 12

Esquirol - Treatment Asylum

Answer 12

• specialized physicians should be treating mentally ill
• need purpose built asylums (further medicalized madness)
• asylums placed away from cities, with tight schedules and activities should restore the mentally ill to normal

Question 13

Basic Concepts of Treatment - Moral

Answer 13

• Kindness and understanding
• Patients play active role in treatment
• Calm settings, large campus, scheduled activities, restraint if extremely necessary

Question 14

When were asylums built?

Answer 14

1800s to mid 1900s

Question 15

What went wrong with asylums?

Answer 15

• good intentions gone bad
• moral treatment gave way to custodianship
• overcrowded
• psychiatry “lost touch” with medicine

Question 16

The Great Confinement

Answer 16

• people who didn’t accept the economic built society were deemed mentally ill (not confiding to strict work hours)
• confined for control, not for medical reasons
• way to reshape society

Question 17

Foucault’s Argument

Answer 17

Rise of mentally ill population is caused by growing authoritarianism

Question 18

Social Control

Answer 18

• Psychiatry involved middle class trying to control lower classes
• The rise of asylums accounts for the rise of mentally ill (not vice versa)

Question 19

Criticisms of Foucault/Social Control

Answer 19

• Ignoring treatment of mad people prior to asylums
• Asylums provided families relief
• Rise wasn’t about social control, people were just diverted from other institutions

Question 20

Was there really a rise in insanity?

Answer 20

Modern life cause people to become more mentally ill
- Factors such as (diet, addictions, toxins, disease) account for it