Developments in Mental Health Care - Essay Example

Developments in Mental Health Care Introduction Mental illness, sometimes referred to as mental disorder or psychiatric disorder can be simply defined as a behavioral or mental anomaly or pattern which may cause either inability to function in daily life or suffering and which cannot be said to be either a social norm or developmental. Psychiatric disorders are often defined using a combination of factors such as how a person perceives, thinks, fells and acts. This is often a function of anomalies in particular parts of the brain and/or the nervous system. Mental disorder treatment has evolved a lot throughout the years, more so from 1950 to now. This paper will discuss some aspects of mental illness, particularly the history, etiology and most importantly, developments in mental health care and treatment since the 1950s. Pertaining to the history of mental illness, many different cultures in the past saw the conditions as a sort of religious punishment and sometimes as demonic possession. In the 5th century B.C, Hippocrates pioneered treatment of the mentally ill. De Young, M. (2010) explains that this treatment was not rooted in religion. He concentrated in altering the patient’s occupation and environment as well as administration of some medication. Fink et al (1992) explains that stigma for the mentally ill however persisted well into the 18th century where they were confined in unhygienic conditions. Mental Health America was founded in 1909 by Clifford Beers to deal with matters pertaining to improving the lives of the mentally ill. This was to be accomplished through research as well as lobbying efforts. In 1946, the Mental Health Act was passed by Harry Truman. This led to the creation of the National Institute of Mental Health Act. Truman also allocated funds so the causes and also the treatments of mental illness could be researched. It is at this juncture that mental health care and treatment began to evolve to what we have today. Causes of mental illness are complex and they vary depending on what disorder a person is suffering from. Though the true causes of mental disorders remain unknown, a variety of stimuli in the psychological, biological and environmental plane have been seen to lead to progression or development of mental disorders. Many disorders have been seen to result from a combination of factors and not just one. Risk factors for psychiatric disorders include; dispositions such as personality, genetic inheritance for example if one’s parents were depressed and repeating generational patterns. Some mental illnesses have been seen to correlate with use of drugs such as alcohol, caffeine and cannabis. Bunney et al (2001) explains that several theories have been put in place in an attempt to explain the etiology of some mental conditions. For example, in the 20th century, scientists believed that some mental disorders were in fact a function of problematic parent-child relationships. This theory was held up well into the 1990s. They believed this to be true for conditions such as schizophrenia and depression. Read et al (2004) explains this. However, currently, it is held that the relationship is not very important in terms of causing mental disorders. The biopsychological model of explaining the etiology of mental illness shows that genetics accounts for up to 40 per cent of an individual’s susceptibility to a mental disorder. Other factors account for 60 per cent. The psychoanalytic theory concentrated on unresolved relational and internal conflicts as the cause for some mental illnesses. Another theory is the attachment theory which focuses on the role of responses to danger, parent-child relationships and satisfying adult reproductive relationships as the causes of mental illness. In the theory of evolutionary psychology, prescribers look to the dysfunction of mental modules which are adapted to ancestral social and physical environments as the cause of mental disorders. In the 1957-2007 period, there have been immense changes in systems for the care of patients diagnosed with mental illness as well as financing of said care. There have been noted leaps in the science of the brain and this has caused better understanding what metal illness entails and how to respond to it. However regardless of the knowledge gathered on the topic, the lives of those living with mental illness have not improved much as institutions on society have not kept up with new discoveries and findings. In 1957, a big leap was taken in the U.S as mental health treatment began to be given in large state hospitals as well as other institutions. This was typically as a function of the Mental Health Act of 1946. It was in this year that pharmaceutical treatment of mental illness began. There was no affordable community based treatment of mental health available. Patients of mental disorders were sent to such institutions where they would spend many years. Those who could not afford this kind of care would take care of their family members at home. In 1963, President Kennedy supported the Community Health Care Act. This is according to Frank et al (2006). The piece of legislation sought to provide funding to states so they could develop community health centers. However, the centers were not well funded and could not offer proper care for those patients that had been deinstitutionalized. Deinstitutionalization was seen to have reduced the number of people with mental illness in the population from around 560,000 in the 1950s to less than 100,000 in 1995. Despite this success, a successful community mental health program is yet to be put in place to cater for the deinstitutionalized. There was therefore a disparity between the number of people outside institutions that needed mental health care and those served by the community based programs. Medicare was created in 1965 and in 1972 was modified to cater for those with disabilities. Medicaid was also created around that time. It however discriminates against those with mental health problems and does not cover them. Though deinstitutionalization was not controversial, its reality made it a polarizing issue. Many studies have shown success in deinstitutionalization and community based mental health care programs in the lines of friendships, adaptive behavior and patient satisfactions were improved. However, contrasting studies show that those living outside institutions are lacking a significant aspect of healthcare. This includes; cancer screenings, vaccinations as well as routine checkups. Another study showed that in mentally ill patents living in the community, loneliness, bad living conditions, poverty and poor health are very prevalent. The development of a variety of medications for treatment of mental illness caused a reliance on pharmaceuticals to treat mental illness rather than medical and surgical care. Upon failure of the national health care reform in 1992, the standard way of organization of care became managed care even in matters of mental health. By disconnecting mental health treatment from support treatment, mental health treatment was made more medicalized. The rise in use of pharmaceutical coupled with managed care had the effect of reduced talk therapy as well as lack of support services for the deinstitutionalized. This led to the colloquialism “off meds” when a person would show symptoms of mental illness. Pharmaceutical companies would make a killing as mental illness was mostly treated using pharmaceuticals. Upon the end of the Vietnam War, veterans would fight for a long time so that post-traumatic stress disorder or PTSD could be recognized not only as a diagnosable but as a treatable mental disorder. It then became discovered that sufferers of torture, sexual assault, children who experience violence, and those who experience trauma could also suffer from PTSD. Currently, experiences in Iraq as well as in Afghanistan have led to recognition that operational stress and combat are in fact disorders that are treatable. It was discovered that immediate treatment can lower PTSD rated in soldiers. Military health care provides now recognize the importance of traumatic brain injury and better ways to treat it. According to Frank et al (2006), the Americans with Disabilities Act of 1992 was able to aid parents on appropriate responses to mental illness at home and in public. Since the 1990s. There have been noted advances in brain science. These include understanding the biochemistry of the brain, brain scans, electrical brain stimulation, advances in psychological therapy, the role of genomes in development of the brain and bringing better understanding to the public, health care providers and policy makers. 1997 would then see the passage of uniform mental health benefits in public health care. These advances can be credited with helping in understanding and treatment of mental disorders well into the 21st century. This is according to Bunney et al (2001). Currently, the need to update public safety, health care, social service institutions and as well as criminal justice so that they can utilize new insights provided by science is urgent. In spite of the incredible advances that have been made since the 1950s, the current system of mental health care is reflective of social and political mental health injustice. Healthcare professionals report that emergency mental health care in the U.S is steadily regressing to the point it was 40 years ago. Professionals in the legal department say that between 60 and 70 percent of people in jail have a mental illness. This means that there are more people with a mental disorder in prison that in all state hospitals in the U.S combined. This has been termed as “criminalization of the mentally ill.” Research has come to prove that mental illness in indeed a biological disease of the brain and not a lifestyle choice. The current system is however flawed vis-à-vis the mentally ill. There exists inequity in the system in legislation as laws do not give the mentally ill the right to treatment of high quality as it does to others with other organic illnesses. For equity to exist, the mentally ill should have equal opportunity to treatment as those with other debilitating conditions. This lack of equity rises from the fact that mental illnesses are not recognized as medical conditions. Bunney et al (2001) explains that in the late 20th century, biological treatment of mental disorders was made possible. Three groups of treatment were established. Namely; electroconvulsive therapy, drug treatments and psychosurgery. In drug treatments, drugs have been seen to treat mental disorders by changing amounts of neurotransmitters available in the synapse. Electroconvulsive involves application of electrodes to a patient’s brain. An electric current is then jolted until the patient experiences a convulsive fit. This method treats severe depression quite well. This is because it increase the flow of some neurotransmitters to the brain. Psychosurgery is basically brain surgery aimed at treating mental illness. This is the most invasive form on biological treatment. It involves removal of brain tissue. The method is extremely controversial. That is why it is now performed as a last result. Conclusion Proper understanding of mental illness has evaded human beings for a long time. Having shown the chronological flow of events since the 1950s. This paper can conclude that mental health care has come a long way. From unhygienic quarantine of the mentally ill to biological mental health treatment, understanding mental illness has led to an evolution in treatment of the illnesses. The advancement in mental health care has been facilitated greatly by legislation aimed ad according equal rights to the mentally ill. These piece of legislation have facilitated the research that has led to better understanding of mental illness and advancement in treatment. This paper also recommends that funding for community mental health programs be provided. This is because not all mentally ill individuals needs to be institutionalized. Those outside institutions need the programs to monitor their progress while they leave out their lives. Therefore, the key to success in mental health care and treatment in the future lies in policy and research. Policy will lay the road and foundation for people with mental illness to be given their rights. Research will provide information on how mental healthcare and treatment can be improved. Implementation will be where the rubber meets the road, where people with mental illness get advanced treatment and equal rights. References Bunney, B. S., Charney, D. S., & Nestler, E. J. (2001). Neurobiology of mental illness. Oxford: Oxford University Press. De Young, M. (2010). Madness : An American history of medical illness and its treatment. Jefferson: McFarland & Co., Publishers. Fink, P. J., & Tasman, A. (1992). Stigma and mental illness. Washington D.C: American Psychiatric Press. Frank, R. G., & Glied, S. (2006). Better but not well : Mental health policy in the United States since 1950. Baltimore: John Hopkins University Press. Read, J., Mosher, L. R., & Bentall, R. P. (2004). Models of madness : Psychological, social and biological approaches to schizophrenia. Psychology Press. Read More