Lecture Notes: History and Evolution of Mental Health Understanding

Introduction

• Elizabeth Cochran (Nellie Bly): In 1887, reported on poor conditions in psychiatric hospitals by feigning mental illness. Her expose "Ten Days in a Mad House" highlighted:
  • Rotten food, cold showers, rat infestations
  • Abusive staff and patient mistreatment
• Impact: Led to mental health reform.

Rosenhan Experiment

• David Rosenhan (1975)
  • Experiment "On Being Sane in Insane Places"
  • Pseudopatients faked auditory hallucinations to gain admission to psychiatric hospitals.
  • Post-admission, they acted normally but were still kept for an average of 19 days.
  • Diagnosed with paranoid schizophrenia in remission upon discharge.
  • Follow-up: No actual pseudopatients sent, yet 41 suspected by staff in a teaching hospital.
• Criticism: Highlighted flaws in psychiatric diagnosis and treatment systems.
• Questions Raised:
  • Definition and classification of mental disorders
  • Impact of diagnostic labeling

Modern Understanding of Psychological Disorders

• Definition: Deviant, distressful, and dysfunctional patterns of thoughts, feelings, or behaviors.
• Cultural Context: Standards of deviant behavior vary across cultures and situations.
• Historical Shift
  • 18th/19th century: Mental health as a sickness of the mind.
  • Recognized physiological causes (e.g., syphilis causing neurological issues).

The Medical Model vs. Biopsychological Approach

• Medical Model
  • Psychological disorders have physiological causes.
  • Diagnosed based on symptoms, treated, and sometimes cured.
• Biopsychological Approach
  • Considers biological, psychological, and socio-cultural influences.
  • More comprehensive, accounting for genetics, brain chemistry, stress, trauma, etc.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

• Purpose: Standardizes how disorders are diagnosed, treated, and discussed.
• Evolution
  • First edition in 1952.
  • Fifth edition (DSM-5) released in 2013.
  • Designed to evolve with research and societal changes.
• Changes in DSM-5
  • Updates on PTSD, reclassification of childhood bipolar disorder.
  • New diagnoses like Gambling and Internet Gaming Disorders.
• Criticisms
  • Risk of over-/misdiagnosis and treatment.
  • Stigma and preconceptions from diagnostic labels.

Conclusion

• Importance of Definitions: Powerful in mental health context, requiring careful consideration.
• Ongoing Evolution: Mental health understanding and classification are continuously evolving.

Additional Contributors

• Written by: Kathleen Yale
• Edited by: Blake de Pastino
• Consultant: Dr. Ranjit Bhagwat
• Director and Editor: Nicholas Jenkins
• Script Supervisor and Sound Designer: Michael Aranda
• Graphics: Thought Cafe

Acknowledgments

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