Mental Healthcare in America

During the 1700’s the jails were not only used to confine criminals, but they confined people with mental illness as well. People with mental illness were subjected to inhumane treatment, even when the individual was admitted

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 the 1840s, Dorothea Dix introduced the concept of humane treatment for individuals with mental illness. She advocated for better treatment and

"There are few cases in history where a social movement of such proportions can be attributed to the work of a single individual" (Kovach) At the age of thirty-nine, a woman by the name of Dorothea Dix devoted the rest of her life as an advocate to the humane attitude toward the mentally ill. She traveled the world from state to state visiting each and every prison, almhouse, asylum, orphanage, and hidden hovel documenting everything and anything she saw. After her intricate study of what she had been a witness of she wrote a letter or "memorial" and presented it to a legislator she knew who would present it to each legislature in each state she had studied. Dorothea Dix was the pioneering force in the movement to reform the

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.

Problem Statement: The World Health Association defines ‘good’ health as: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” However, in the United States, access to care and funding for mental health care are grossly neglected and underfunded in comparison to other aspects of health care.

Throughout history, thousands of people have influenced today's society by their works and words. Dorothea Dix, for example, was a reformer of the mentally ill who changed the way mental institutions are run today. Dix, born in 1802, was an author, reformist, and teacher during her life who helped create dozens of new institutions across the US and Europe; challenging the idea that people with mental disturbances could not be cured or helped. Although some believe that Dorothea Dix created a new issue by introducing the idea of mental illness as a defense, in reality, she was important in our history because of her impact on the institutions and female education.

In the book, Crazy, by Pete Earley, provides a detailed overview of the mental health system in the United States, as it presents a first hand narrative of Earley’s family journey through the system. The author’s major premise and arguments, in the book, is to highlight the history of mental health, navigation through the judicial system with mental illness, the bureaucracy and policies of hospitals, society views on human rights and client safety, and the impact on the individual, family, and community. The content suggests that human service workers and public health workers should extend their professional lens to advocate for change in the mental health system in the United States.

To begin, Dorothea Dix was a key player in bettering the treatment for mentally ill patients.  In the mid-1800’s, many mentally inept people dwelled in prisons.  This was because the people of the time didn’t exactly know how to properly treat or deal with these mentally ill people.  Initially, Dix worked as a nurse and teacher for prisoners, where their living conditions were less than adequate (History.com Staff).  Altogether, seeing what was happening to these abused people made her feel as though she had to do something to help.  While working at the prison, she saw firsthand what these people had to face.  One of Dorothea Dix’s reports accounted that, “prisoners [were] flogged, starved, chained, physically and sexually abused

The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.

Dorothea Lynde Dix was salient to the development of both the Reform and Civil War Eras that she lived during, and to the overall United States. Moreover, Dorothea Dix had minor, but crucial, contributions to the education of children during her early years, which would help her effort in creating different perspective and establishing institutions for the mentally ill. Her onerous efforts even required her to plead to the State Legislative body, which was essential in achieving her goals for the mentally ill. In addition, Dix contributed to the Civil War when she was appointed superintendent of nurses for the Union army. Dix’s action would leave a permanent mark to the character of the United States when she helped form institutions for the mentally ill and wrote the “Bill of the Benefit of the Indigent Insane.”

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

Unfortunately, asylum founders could only guess at the causes of insanity. Patient after patient was admitted into the state hospitals, but the cause of their disturbance was often a mystery. Many were inflicted with various organic diseases, like dementia, Huntington’s disease, brain tumors, and many were in the third stage of syphilis. With no treatments available, providing humane care was all that could be done. In the years following the civil war American cities boomed and the asylum began struggling to keep up. Soldiers, freed slaves, and immigrants were stranded in a strange land. The asylum became organized more like a factory or small town. There were upper and lower classman, bosses and workers, patients with nothing, and patients with privileges. Sarah Burrows, a schizophrenic and daughter of a wealthy doctor had a ten bedroom house that was built for her on the hospital grounds. Burrows home was just a stone’s throw away from the hospital’s west wing, where over sixty black women slept side by side. (Asylum: A History of the Mental Institution in America). The hospital began to rely on the free labor the patients provided. However, isolating the hospital from the community meant there was no way of knowing what was happening inside the asylum. The asylum became a world apart. In the 1870’s, Elizabeth Packard, a former patient of St. Elizabeth’s, wrote about her mistreatment and abuse

Born in 1802, Dorothea Dix played an important role in changing the ways people thought about patients who were mentally-ill and handicapped. These patients had always been cast-off as “being punished by God”. She believed that that people of such standing would do better by being treated with love and caring rather than being put aside. As a social reformer, philanthropist, teacher, writer, writer, nurse, and humanitarian, Dorothea Dix devoted devoted her life to the welfare of the mentally-ill and handicapped. She accomplished many milestones throughout her life and forever changed the way patients are cared for. She was a pioneer in her time, taking on challenges that no other women would dare dream of tackling.

Pioneers of the modern psychiatric facility include Benjamin Rush, an 18th century psychiatrist often noted as “The Father of American Psychiatry”, and Dorothea Dix, a school teacher who acted as an activist for better psychiatric care and whose efforts eventually led to federal funding of treatment programs (NIH history https://www.nlm.nih.gov/hmd/diseases/index.html). Regardless of these developments, psychiatric care is far from perfect. Presently, psychiatric hospitals and wards are meant to serve as a transition towards normal life for those who are homicidal, suicidal, or otherwise severely ill, often in connection with other programs like residential settings, partial hospitalization programs, intensive outpatient programs, and outpatient