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The Impact of the history of mental health on today's factors and…
The Impact of the history of mental health on today's factors and perspective.
History of Mental Health
Middle Ages
"Madness"
"Colourful members of community" rather than pathological cases
Separation
Isolation
Grouped together and moved in asylums
Stigma and discrimination of larger groups
17th Century to Early 1900s
Diagnostic psychiatry
Political and religious influences
Prison-like hospitals
Started social & moral views of the 'mad'
Informs idea of social inequality and adversity
System itself responsible for stigma (fear & suspicion of the mad)
The Church - powerful, watching over, made judgements
1950/60s
Biomedical paradigm shift
Primarily sociocultural circumstances - biology and genetics
Diagnostic criteria
Medicalized language shaping the contemporary view of madness as a mental illness
Legitimizing practice
Medicalization and mental health care
Drugs like chlorpromazine allowed patients out of asylums
Over-medication
Complexities and distortions in practice, diagnoses, & perceptions (preconceived notions about how people should act, think, and interact)
Symptoms valuable for diagnosis but environmental settings can impact perceptions causing misdiagnosis and over-diagnosis
Permanent labeling
Insane vs. sane debate
Causes of Mental Illness/What doesn't cause
Theories, suppositions & ideas
Decisions made for treatment, services, & funding
Political concept
Past Perspectives
Biomedical
No framework for social, psychological, and behavioural dimensions of illness
Diagnostic Paradigm
Diagnostic Criteria (DSM I, II, III, Feighner Criteria)
Centred around research
Research Diagnostic Criteria
3 Contributions to Psychiatry
The systematic use of operationalized diagnostic criteria
The reintroduction of an emphasis on illness course and outcome
Emphasis on the need, whenever possible, to base diagnostic criteria on empirical evidence
Use symptoms as a guideline to provide specific treatments
Historical influences from society
Must involve dysfunction
Is it involved in the brain or the mind?
Today's Perspectives
Biopsychosocial Model
Blueprint for research, framework for teaching and design, for action in the world of health care
Dynamic approach that takes into consideration their everyday lives and behaviours (i.e., socioeconomic status, stress, trauma, etc.)
More informed in psychosocial areas of someone's life (causation vs. symptoms alone)
Genetics
Null Hypothesis?
Importance of considering all aspects as possibilities as a cause of mental illness
Role of environmental factors & gene interactions
Nature vs. Nurture Debate
Look at mental health from a trauma-informed perspective vs. illness-based perspective
Humanizing emotions & experiences of adversity
Stigmas
Permanent labelling
Negative stereotypes stem from past history and influences
Mentally ill persons thought to be violence, dangerous and unpredicable
No asylums or mental hospitals
End up in jail, shelters, on the street
Practices Available and Accessible
Previously
Asylums
Abuse
Power imbalances
Depersonalization
Powerlessness
Isolation
Neglect
Experimental Treatments
Electro convulsive therapy (ECT)
Prefrontal leucotomy
Drugs
Strong sedation
Lack of function
Today
Diminishing long-term beds
Decreased inpatient treatment
Increased outpatient resources
Limited publically funded resources
Long wait times
Group treatment sessions
Privatized services
Psychiatrists & Psychologists
Third-party payers & extended health benefits