Essay on Deinstitutionalization of the Mentally Ill

The lack of mental health services available to the mentally-ill and the deinstitutionalization of mental health hospitals have created a public health concern. These issues along with a failed continuum of care plans and a lack of community mental health services have been major contributing factors to homelessness. In addition, the strict guidelines for psychiatric hospitalization are critical when analyzing homelessness. In many cases, only the critically ill are meeting clinical criteria for hospitalization, leaving those who have significant mental health problems to fend for themselves. The link between homelessness and mental health is acknowledged but requires reform.

Institutional care was condemned, as in many cases patients’ mental conditions deteriorated, and institutions were not able to treat the individual in a holistic manner. In many state institutions, patients numerously outnumbered the poorly trained staff. Many patients were boarded in these facilities for extensive periods of time without receiving any services. By 1963, the average stay for an individual with a diagnosis of schizophrenia was eleven years. As the media and newspapers publicized the inhumane conditions that existed in many psychiatric hospitals, awareness grew and there was much public pressure to create improved treatment options (Young Minds Advocacy, 2016). .

In early American history, individuals with mental illnesses have been neglected and suffered inhuman treatments. Some were beaten, lobotomized, sterilized, restrained, in addition to other kinds of abuse. Mental illness was thought to be the cause of supernatural dreadful curse from the Gods or a demonic possession. Trepanning (the opening of the skull) is the earliest known treatment for individuals with mental illness. This practice was believed to release evil spirits (Kemp, 2007). Laws were passed giving power to take custody over the mentally ill including selling their possessions and properties and be imprisoned (Kofman, 2012). The first psychiatric hospital in the U.S. was the Pennsylvania Hospital where mentally ill patients were left in cold basements because they were considered not affected by cold or hot environments and restraint with iron shackles. They were put on display like zoo animals to the public for sell by the doctors (Kofmen, 2012). These individuals were punished and isolated and kept far out of the eyes of society, hidden as if they did not exist. They were either maintained by living with their families and considered a source of embarrassment or institutionalized

But other patients had reasons to be in the asylum. On Tennessee Genealogical Society web site you can read why mentally healthy women went to the insane asylums. Some of the women were put in the asylum because they questioned the authority of their husbands or they were not good housewives. Any woman was at risk of being put in an insane hospital if they did either one of those. Also, if women got to old the husband could have her put in a hospital and take a younger wife. Once a woman was committed, it was as if she died, an obituary was published, usually. A landlord could have a person committed for not paying rent. A boss could have an employee committed if they were slow or a bad employee. People could be committed if they were poor, being an alcoholic, a person with a short fuse, or anyone who deviated from the normal thing society thought was right. These could go for men or women, but most were filled with women. Also, children who acted out or had mental or physical disabilities were also placed in mental asylums. A blind child or a child with a speech problem would be locked away for the rest of their life just because they had a birth

During the 1800s, treating individuals with psychological issues was a problematic and disturbing issue. Society didn’t understand mental illness very well, so the mentally ill individuals were sent to asylums primarily to get them off the streets. Patients in asylums were usually subjected to conditions that today we would consider horrific and inhumane due to the lack of knowledge on mental illnesses.

Homelessness is a critical issue that requires everyone’s attention. Hundreds of thousands of homeless people live on the streets as their shelter. Historically, homelessness has always been a problem in society. Homeless people were known as “the wondering poor”, “sturdy beggars”, and as “vagrants,” but it was not until the late 18th century that homelessness because noticeable to society. Homeless person is anyone who lacks adequate shelter, resources, and community ties. People who are homeless can be categorized as chronic deinstitutionalized or temporary

The mood shifted from hiding the mentally ill to curing the mentally ill. The definition of mentally ill was expanded to include anyone in the family that was unable to help the family in terms of survival and drained their family of money and resources: the aged, the epileptic, and the imbecilic. This caused massive overcrowding. The mentally ill were hidden from the public view along with the elderly and others suffering from debilitating disorders resulting in massive overcrowding of asylums which meant illnesses were not being treated in lieu of managing the ever expanding population.

Christopher Payne’s Asylum: Inside the Closed World of State Mental Hospitals, is the result of a seven-year survey of America 's vast and mostly abandoned mental institutions of the late 19th century (Payne & Sacks, 2009). Payne’s artistic eye captures images of numerous institutions throughout America and the abandonment that followed. Photographs which display an architectural perspective of 19th Century medicine and, as a by-product, the country’s early history of care for the mentally ill. The buildings he visited were obviously designed for a specific purpose, at a particular time, with a unique architecture to be displayed. Payne’s photographs in Asylum capture a period in the history of American healthcare. Palatial institutions proudly exemplifying the moral treatment of those impacted by mental health issues. Perhaps, Payne captured the images of buried streets, peeling paint from grand entryways, and of infrastructure now being reclaimed by nature, as a reflection of the state of mental health care today.

Wright, D. (1997). Getting out of the asylum: understanding the confinement of the insane in the nineteenth century. Social History of Medicine, 10, 13

The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and

What comes to mind when you hear the words “insane asylum”? Do such terms as lunatic, crazy, scary, or even haunted come to mind? More than likely these are the terminology that most of us would use to describe our perception of insane asylums. However, those in history that had a heart’s desire to treat the mentally ill compassionately and humanely had a different viewpoint. Insane asylums were known for their horrendous treatment of the mentally ill, but the ultimate purpose in the reformation of insane asylums in the nineteenth century was to improve the treatment for the mentally ill by providing a humane and caring environment for them to reside.

In our communication they made clear that they also looked at themes that did not match, such a voluntary leaving of the home. However, no member took into consideration metal health. All members also focused on the cause and problems of homelessness with no member viewing the possible solutions to it. An article by Bassuk, E., Rubin, L., & Lauriat, A. (1984). “Is homelessness a mental health problem?”  Looked at Seventy-eight homeless men, women, and children staying at an emergency shelters and found The vast majority have severe psychological illnesses that remained untreated. The authors discuss the relationship of mental health policy to the homeless and suggest that shelters have become alternative institutions to meet the needs of mentally ill people who are no longer cared for by departments of mental health. The findings of the management of metal issues for those who are homeless is mirrored by the case studies of Stephanie’s and Teresa’s mental health playing a large role in their homelessness. Fischer, P. J., & Breakey, W. R. (1991) in their “The epidemiology of alcohol, drug, and mental disorders among homeless persons” look into the prevalence of alcohol, drug, and mental disorders and the characteristics of homeless substance abusers and persons with mental illnesses. They found that prevalence rates of disorders are much higher in homeless

Over time, the facilities deteriorated and focused on keeping the mentally ill locked away from the rest of society rather than helping them get better. An example of this is one of the first hospitals made in 1773, in Williamsburg, Virginia. Many would think the doctors in these facilities would genuinely care about their patients, but most did not. They actually wanted to condition the patients to be afraid of them. In hopes that the fear would put them into place and cure their illnesses. Most doctors actually had no idea on how to treat patients and would often perform treatments based on their own theories on what causes mental illness. The patients were practically human experiments, which many didn’t agree to be but were

During the mid-1800’s the mentally ill were either homeless or locked in a cell under deplorable conditions. Introduction of asylums was a way to get the mentally ill better care and better- living conditions. Over a period of years, the admissions grew, but staff to take care of their needs did not. Asylums became overcrowded and treatments that were thought to cure, were basically medieval and unethical

When discussing the criminalization of mentally ill persons within the prison system, it is important to know the history of mental illness in the prison system. In1841, Dorothea Dix began her Asylum Movement. She saw how deplorable the conditions were for mentally ill inmates in the prison system and insisted on change. The mental ill inmates were treated very poorly, being beaten, starved, and sexually abused. Dix brought her findings to the legislature of Massachusetts and funds were then set aside to expand the mental hospital in Worcester. This was then duplicated across the country and many of the mentally ill were taken out of the prison setting and moved to get appropriate care (history.com staff, 2009). This was in the 1840’s. Dix’s efforts helped to decrease the amount of mentally ill in jails without appropriate care. Her efforts resulted in prisons containing only 0.7 per cent of mentally ill inmates (Chaimowitz, 2012, p 1).