History of Treatment

Module 5.5a

History of Treatment

• What to do with the severely disturbed?
• middle Ages to 17th century
• madness = in league with devil
• torture, hanging, burning, sent to sea,
• trephination - drill holes in skull
• 18th century
• mentally disordered people = degenerates
• keep them away from society

The 19th Century & Attempts at Reform

• Philippe Pinel (1745-1826)
• Reform in Paris mental hospital
• Unchained patients and treated them humanely
• Some patients got better enough to leave hospital

Philippe Pinel Releasing Lunatics from Their Chains at The Bicetre Asylum in Paris in 1793

The 19th century & attempts at reform

• Reform of U.S. system
• Moral-treatment movement
• Kindly care
• Led to large, state-supported public asylums
• overcrowding, loss of public attention

Dorothea Dix (1802-1887)

The 20th century

• Deinstitutionalization (mid-1950s)
• Get people out of asylums and back into community
• Effective antipsychotic medication
• General mood of optimism in country
• Many though left on their own ended up homeless or cycled into prison

Where did all the patients go?

Providers of treatment

• Psychiatrists
• medical degree (M.D.)
• special training/residency in psychiatry
• mainly hospitals & private practice
• can prescribe drugs
• Clinical psychologists
• doctoral degree (Ph.D.) in psychology
• training in research & practice
• universities, private practice, community mental health