Treatment Of Mentally Ill Essay, Research Paper
Ideas have changed over years for treating and handling people who have mentally problems. One ancient theory holds that abnormal behavior can be explained by the operation of supernatural and magical forces such as devil. In socities that believe in this theory generally practise exorcism, that is the removing of evil that resides in the individual through prayer and countermagic. In some societies, a technique called trephination was used to treat mentailly ill. In this technique a sharp tool was used to make a hole in the skull in order to permit evil’s spirits to escape from the body. Studies suggest that the operation was not often fatal.
In ancient Greece, abnormal behavior was orginally interpreted as punishment for offences against the gods. Therapy took place in a group of temples in which mental patients were believed to be healed by god. Centuries later, the idea that abnormal behavior was the punishment for offences against the gods was no longer accepted. The Greek physician Hippocrates believed that ” the brain as the organ of consciousness, thus he thought that deviant thinking and behavior were indictions of some kind of brain pathology” ( Davison & Neale, 1998). Later, serval Greek philosophers, beginning with Socrates, held a more psychological veiw to abnormal behavior.
In mid-nineteenth-century America, the asylum was widely regarded as the symbol of an enlightened and progressive nation that no longer ignored or mistreated its insane citizens. The justification for asylums appeared self-evident: they benefited the community, the family, and the individual by offering effective psychological and medical treatment for acute cases and humane custodial care for chronic cases. In providing for the mentally ill, the state met its ethical and moral responsibilities and, at the same time, contributed to the general welfare by limiting, if not eliminating, the spread of disease and dependency (Porter, 1987; Horwitz, 1977).
Decades later, the world had chagned and so had treatment of the mentailly ill. Indutrialization brought about broader-scale communications and speedier travel. Ideas and theroes were shares more easily and services for the mentally ill grew more freqnet. Resources availabel incrased our knowledge and the image of mentally challenged patients grew even more hospiable and productive than ever. By the 1930’s, many asylums were turly effective in meeting their benevolent goals.
After World War II, by contrast, the mental hospital began to be perceived as the
vestigial remnant of a bygone age. Increasingly, the emphasis was on prevention and the provision of care and treatment in the community. Indeed, the prevailing assumption was that traditional mental hospitals would disappear as community alternatives and institutions came into existence. Immediately following the end of the war, a broad coalition of psychiatric and lay activists began a campaign to transform mental health policy. The initial success came in 1946 with the enactment of the National Mental Health Act (Isaac, 1996). This novel law made the federal government an important participant in an arena traditionally reserved for the states.The passage of the Community Mental Health Centers Act in late 1963 (signed into law by President John F. Kennedy just prior to his death) culminated two decades of agitation. The legislation provided federal subsidies for the construction of community mental health centers (CMHCs) that were intended to be the cornerstone of a radically new policy ((Torrey, 1992). In short, these centers were supposed to facilitate early identification of symptoms, offer preventive treatments that would both diminish the incidence of mental disorders and prevent long-term hospitalization, and provide integrated and continuous services to severely mentally ill people in the community. Ultimately, such centers would render traditional mental hospitals obsolete.
Hailed as the forerunners of a new era, CMHCs failed to live up to their promise. Admittedly, appropriations fell far below expectations because of the budgetary pressures engendered by the Vietnam War. More important, CMHCs served a population different from the one originally intended. Most centers made little effort to provide coordinated aftercare services and continuing assistance to severely and persistently mentally ill persons. They preferred to emphasize psychotherapy, an intervention especially adapted to individuals with emotional and personal problems and one that appealed to a professional constituency. Even psychiatrists in community settings reportedly tended to deal with more affluent neurotic patients rather than with severely mentally ill persons (Smith, 1995).
Equally significant, the focus of federal policy shifted dramatically during the 1970s because of a growing perception that substance abuse (particularly drugs and, to a lesser extent, alcohol) represented major threats to the public at large. Beginning in 1968, Congress enacted legislation that sharply altered the role of the CMHCs by adding new services for substance abusers, children, and elderly persons. Congress believed that the act of 1963 had resolved most of the major problems of the mentally ill and that greater attention should be paid to other groups in need of mental health services. As the services provided by centers proliferated, the interests of the severely and persistently mentally ill-clearly the group with the most formidable problems-slowly receded into the background (Torrey, 1992; Valensitein, 1986).
The inauguration of Richard Nixon in 1969 altered the political environment. Between 1970 and 1972, his administration worked assiduously to scale back National Institute of Mental Health (NIMH) programs, many of which survived only because of a sympathetic Congress. By 1973, however, the White House was preoccupied with the Watergate scandal, and mental health policy issues faded from view. Nixon’s resignation in the summer of 1974 was welcomed by those concerned with mental health policy issues, if only because he was perceived as an opponent of any significant federal role in shaping and financing services. In the months preceding and following Nixon’s resignation, Congress reassessed the CMHC program. The result was the passage of a mental health law in mid-1975 over President Gerald Ford’s veto. Yet this legislation-which expanded the role of CMHCs-never addressed the fundamental issue of providing for the basic human and medical needs of the severely mentally ill (Isaac, 1996; Torrey, 1992).
The accession of Jimmy Carter to the presidency in 1977 introduced a new element of hope. In one of his first acts, Carter signed an executive order creating the President’s Commission on Mental Health to review national needs and to make necessary recommendations. Yet the Commission’s final report offered at best a potpourri of diverse and sometimes conflicting recommendations. Eventually Congress passed the Mental Health Systems Act a month before the presidential election. Its provisions were complex and in some respects contradictory. Nevertheless, the law at the very least suggested the outlines of a national system that would ensure the availability of both care and treatment in community settings.
The Mental Health Systems Act had hardly become law when its provisions became moot. The accession of Ronald Reagan to the presidency led to an immediate reversal of policy. Preoccupied with both reducing taxes and federal expenditures, the new administration proposed a 25 percent cut in federal funding (Torrey, 1992).
More important, it called for a conversion of funding for federal mental health programs into a single block grant to the states, a grant carrying few restrictions and without policy guidelines. The presidential juggernaut proved irresistible, and in the summer of 1981 the Omnibus Budget Reconciliation Act was signed into law (Torrey, 1992). Among other things, it provided a block grant to states for mental health services and substance abuse. At the same time, it repealed most of the provisions of the Mental Health Systems Act. The new legislation did more than reduce federal funding for mental health; it reversed nearly three decades of federal involvement and leadership. In the ensuing decade, the focus of policy and funding shifted back to the states and local communities, thus restoring in part the tradition that had prevailed until World War II…
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