Magazine article Behavioral Healthcare Executive

My View: Mental Illness Is a Human Issue

Magazine article Behavioral Healthcare Executive

My View: Mental Illness Is a Human Issue

Article excerpt

Winston Churchill wrote that one can better understand the values of a nation by visiting its jails. I believe the same can be said of our institutions that focus on the healing of our mentally ill. It is for this reason that I was dismayed by the views of one of the architectural judges when describing the correctional facility in Rankin Inlet: "this prison would make a better psychiatric hospital than at least 95 percent of the facilities that are in use as psychiatric hospitals today." What does this say about our values toward those who are mentally ill?

Kevin Turner writes passionately about his concerns regarding the stigma associated with mental illness and psychiatric hospitals. But it has not always been that way.

The moral movement

Our values of the late 19th century were such that we viewed mental illness as a health issue. The "moral movement" believed that a cure was the best in accommodation. Thomas Kirkbride, the founding member of the American Psychiatric Association and the superintendent of the Pennsylvania Hospital, designed the first hospital dedicated to healing the mentally ill in 1859. It was considered to be an architectural wonder. The hospital was spacious, airy, normative, and featured large windows, wide corridors, and the best in architectural detailing. The building reflected the values of a society that believed that mentally ill individuals should and could be healed.

It was so effective that it became the template for numerous mental health hospitals across North America. The general public lined up to see and visit these avant garde buildings. They invoked societal and civic pride.

Times and values change. Industrialization and rationalization in the early 20th century gave us confidence that we could cure mental disease through the use of occupational and industrial therapy. The mentally ill became objectified. Modern treatments included hydrotherapy, insulin coma, lobotomies, and electroconvulsive therapy. Eventually those techniques were deemed unethical or ineffective. In addition, overcrowding and understaffing post-World War II led to a primary emphasis on custody rather than therapy.

The development of antipsychotic drugs during the 1960s reduced the need for constant supervision of patients. Mental healthcare shifted from long-term stays in psychiatric institutions to the treatment of acute episodes in psychiatric units of general hospitals. …

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