Treatment of People With Severe Mental Illness

Table of Contents

Abstract
Social Problem
Addressing the Social Problem
Living with Mental Illness
Interventions and Policies
Policy Suggestion
References

Abstract

Severe mental illness is a topic which both historically and in modern day has been viewed by the public with great discomfort. Individuals affected by such mental health issues are left misunderstood, stigmatized, and more often than not, lacking the proper treatment or care to address their problems. This paper will argue that despite advances in medical treatment and understanding for severe mental illness, the social perception and treatment of people with such issues has changed little with time as they experience similar challenges just under different circumstances.

It is not until almost the mid-20th century, that mental illness was recognized on a massive scale. While people knew of the existence of mental illness, it was studied very slowly. Those experiencing severe symptoms and psychosis would often be locked away either in prison or in asylums as part of a national mental health care led by Dorothea Dix as early as the 19th century. The mentally ill population was often abused and not cared for properly resulting in early deaths. Mental health was heavily stigmatized, and unless it was apparent that a person is mentally ill, it was a taboo topic of sort in society (LumenLearning, n.d.).

In the modern world, mental illness is seen as a social problem due to the impacts it has on society and economy. Mental illness is now recognized at many levels and also known to be progressive. The more severe mental illness, the more suffering it brings, especially left untreated. Now that serious mental illness is a massive phenomenon, both due natural population growth over centuries as well as genetic predispositions and environmental factors, it is seen as debilitating to society. At best, it imposes significant economic burdens, but at worst, it presents as a danger to society through events such as mass shootings where the perpetrators are mentally ill. Despite being treatable, the problem is viewed as a societal ill that is systemic to the point that it cannot be addressed by health agencies without extensive expenses. However, the biggest concern is that it is growing in retrospect since mental illness is both a major social problem but also stems from a diverse set of other social problems such as vulnerabilities and socio-economic divides (Busfield, 2018)

Historically, as early as the 18th century, state psychiatric hospitals fulfilled the needs of individuals diagnosed with severe mental illness. Despite negative connotations surrounding these institutions, state hospitals provided therapy, medication, treatment, and even work and vocational training. Sometimes these hospitals had blooming ecosystems with workshops, farms, and recreational facilities. With the 19th century, the European ideal of moral treatment came to the U.S., with the idea that those suffering from mental illness could recover and potentially be cured if treated humanely, no longer relying on isolation. However, with the advent of the medical science and the creation of psychotropic drugs for treatment of some severe mental diseases, public and government support largely faded away. As federal systems collapsed, it trickled down to cities and communities who lacked the resources or expertise to deal with this social problem (Jansson, 2019). While government agencies do recognize mental illness as a vital aspect of health, healthcare still remains largely private behind a paywall, while the individuals with severe mental illness are ironically receiving less support or focus on the issue than at any time past the Industrial era.

Living with Mental Illness

Living with severe mental health illness was a life of suffering and most often certain early death in the 19th and early 20th century. Although moral treatment and scientific care were advocated by the likes of Benjamin Rush, while asylums were created by Dix it was rare that mentally ill received the necessary care. Most were locked in prisons, asylums, and institutions where they faced abuse and poor conditions. Many times, they were used as virtually human subjects for research in psychotherapy. Eventually asylums became overcrowded and there was a movement to promote non-restraint outpatient facilities. However, those with mental illness that were living in daily society, faced extreme stigmatization and not dissimilar to modern day, were in the vulnerable sets of the population such as the homeless and the poor.

In modern day, the situation both improved but, in some ways, stayed the same. There are far more available treatments and options now, and it is possible to live a long, productive life even with serious illness due to breakthroughs in pharmacology and treatment even if the diseases are not fully cured. However, these treatments and therapies are expensive and require a support system. In terms of public institutions, investment into government provided mental health care has declined as will be discussed later. Some developed countries have programs and supported housing for the mentally ill, but once again the patterns are repeating. Conditions for those with mental illness are usually detrimental and they end up in the outskirts of society as poor and homeless. The rate of mental health illness is extremely high among the homeless, reaching as far as 25% (Mental Illness Policy Org, 2019). The only concrete positive development is that stigmatization has decreased with time as people are aware about the impacts of mental illness in various severities. While cases of abuse exist, in general the public is supportive of mental health care interventions and treatments for hundreds of thousands affected by it.

Interventions and Policies

By the beginning of the 20th century, each state had funding for hospitals and asylums for the mentally ill, more than 500,000 patients across the country. There was no federal policy for mental health until the 1946 National Mental Health Act signed by Truman, which created the National Institute for Mental Health for research and began investing into care. The 1963 Community Mental Health Act by John F. Kennedy authorized the funding of nonprofit and community mental health centers. Once Medicaid was enacted in 1965, federal funds could no longer be used for psychiatric hospitals.

Currently, the U.S. offers protections for mental health illnesses and regulations aimed to support and prevent discrimination against individuals on this basis. States differ across the country regarding mental health funding. Most funding of services occurs via Medicaid and CHIP at the local levels. Federal level impatient, outpatient clinics and asylums are no longer funded by the government. A significant level of intervention work and care for severe mentally ill, particularly for homeless populations, are done by private and non-for-profit organizations.

Policy Suggestion

The main policy suggestion would be to divert significant funding into long-term federal and state facilities aimed at specialized mental health treatment. In modern times, these types of facilities are rare and often have exuberant costs, unavailable to the vulnerable populations. Generally, the government-based mental health investment into treatment and institutions has declined further than it was in historical past, particularly during the breakthroughs in psychology during mid-20th century. The loss of these public psychiatric hospitals, despite their troubled history, has resulted in a severe shortage of both inpatient and outpatient care for severe mental illness, leading to a notable mental health crisis in the U.S (Raphelson, 2017). As one of the first steps, both the infrastructure and government-financed mental healthcare should be implemented.