A Historical Review Of Mental Illness And The Stigma Attached

A Historical Review Of Mental Illness and the Stigma Attached

During the month of July 1999, life took an abrupt turn. Although I did not suffer from multiple personalities, my behavior was unpredictable enough to make an acquaintance ponder. Crazy and insane were words used flippantly to describe me. I joined in with the jokes by sometimes throwing in other words like psychotic or nuts, but all the time I wondered if I really was as mad as a hatter. I had behaved in certain peculiar and bazaar ways that validated the use of these words by people uneducated about mental illness.

I had been divorced for two years. The bitterness in my heart was much like the salty taste of blood in my mouth which lingered on in my memory. In May of 1999, I was laid-off from my job and lost custody of my son to his father. This led me down a road of perpetual destruction. Confused about what I should do and heartbroken about losing my son seemed to be the breaking point for me.

Because of my alcohol abuse, I did become aggressive at times. I was often ready to fight if I perceived anyone had looked at me in the wrong way. Danger became my middle name as I drove the wrong direction down one-way streets just for entertainment. In addition, everything was about fun and games. I hung out with teenagers and we invented new forms of mischief on the weekends while sharing bottles of tequila. The nature of my mental illness beast was unpredictable. Some nights I would wake up restless and disappear for two or three days to party at the neighboring town. I would leave with my family having no knowledge of where they could find me.

In July of 1999, I visited the local mental health center were the psychiatrist diagnosed me as Bipolar 1, severe. Emotions flooded my body as if a dam had broken. Surprisingly most of them were good and filled with hope. Now I knew there was a name for the uncontrollable ways I acted beside, Serina the Wacko. For the first time in what seemed like an eternity, I could see a faint flicker of light at the end of an extremely dark tunnel. Keeping the flicker visible would be harder than I ever imagined. Stigma would continually blow it out. Stigma has always accompanied mental illness and today in society, we still have a long way to go.

Evidence dates back 4,000 to 5,000 years of a surgical procedure called trepanning, in which they cut a hole in the skull. Anthropologists speculate that Stone Age societies performed trepanning on people with mental illness to release evil spirits or demons from their heads. In the 5th century BC the Greek historian Herodotus wrote an account of a king who was driven mad by evil spirits. The early Babylonian, Chinese, and Egyptian civilization viewed mental health in much the same way. Between the 5th and 15th century, Christianity dominated the concepts of mental illness. They also believed the mentally ill were possessed by the devil or demons. Some were labeled as witches.

However, the Islamic world of North Africa, Spain, and the Middle East held attitudes toward people with mental illnesses in a more humane light. They believed that God loved insane people and communities began establishing asylums in the 8th century AD. The asylums offered patients special diets, baths, drugs, music, and pleasant surroundings.

Between the 14th and 17th century deterioration and progress in mental illness came about. Witch-hunts and executions escalated which increasingly included the mentally ill. On the other hand, the physician Paracelsus asserted that mental illness was due to natural causes. Later in the century, German physician Johann Weyer argued that witches were actually mentally disturbed and in need of humane medical treatment.

In the 18th and 19th centuries, people with mental illnesses continued to suffer from poor treatment. They wandered the countryside or were committed to institutions. In hospitals, conditions were deplorable and patients received cruel treatment.

As the public's awareness of the conditions grew, improvements in care and treatment began. In 1789, Vincenzo Chiarugi of Florence, Italy introduced hospital regulations that provided patients with high standards of hygiene, recreation, work opportunities, and minimal restraint. Along the same time, Jean-Baptiste Pussin, in Paris, France forbade staff to beat patients and released them from their shackles. Philippe Pinel continued their work as he began keeping case histories of patients, and developed the concept of "moral treatment" which involved treating patients with kindness and sensitivity, and without cruelty or violence. In 1796, William Tuke in England produced the model of compassionate care. His retreat enabled people with mental illnesses to rest peacefully, talk about their problems, and work.

The Pennsylvania Hospital in Philadelphia opened in 1752 and became the first hospital in the American colonies to admit people with mental illnesses, housing them in a separate ward. In the early years, they chained the patients to the walls of dark, cold cells. In 1780 American physician, Benjamin Rush made changes at the hospital, greatly improving the conditions for the mentally ill. He still endorsed the continued use of restraints, punishment, and bleeding. State-sponsored hospitals began opening in 1824.

Circumstances for most mentally ill people in the United States, especially the poor, remained appalling. Dorothea Dix, a Boston schoolteacher, began a campaign to make the public aware of the plight of the mentally ill. As a direct result 32 psychiatric hospitals for the poor opened. However, by the late 19th century, the conditions in the institutions deteriorated. They were overcrowded and understaffed causing there purpose of moral therapy to turn into mere warehousing and punishment. The mentally ill had become the responsibility of a centralized agency, the public welfare departments of state governments. Replacing the earlier optimism regarding moral management was a renewed pessimism as the asylums had failed as a cure for madness. With no recognized medical cure for mental illness, confinement had only removed the mad as a threat to social order.