History of Mental Health Investigations

Early Investigations

Year: 1887
Alias: Nellie Bly
Objective: Investigate conditions in psychiatric hospitals (asylums)
Findings:
- Rotten food
- Cold showers
- Prevalent rats
- Abusive nurses
- Patients tied down
Impact: Sparked mental health reform
Work: Ten Days in a Madhouse

Year: 1975
Paper: On Being Sane in Insane Places
Experiment: Investigate psychiatric institutions
Methodology:
- Part 1: Sent eight mentally sound associates (fake patients) to report hearing voices
  - Once admitted, dropped fake symptoms and behaved normally
  - Findings: It was easy to get admitted but hard to be discharged
    - Average stay: 19 days, up to 52 days
    - Forced to take psychotropic drugs
    - Discharged with diagnoses such as paranoia in remission
- Part 2: Trick on a teaching hospital
  - Informed they'd be receiving pseudopatients; never sent any
  - Result: Staff suspected 41 out of 193 new patients
  - Conclusion: Diagnosis can be highly situational and subjective

Psychological disorders: Deviant, distressful, and dysfunctional patterns of thoughts, feelings, or behaviors
Terms explanation:
- Deviant: Different from cultural norms (context-dependent)
- Distress: Subjective feeling that something is wrong
- Dysfunctional: Impaired ability to work and live

18th-19th Century: Shift toward mental health as a sickness in the mind
Example: Advanced syphilis causing neurological issues identified
Medical model: Psychological disorders have physiological causes
- Diagnosed based on symptoms, treated, possibly cured

Biopsychological approach: Holistic view, considering:
- Psychological factors: Stress, trauma, memories
- Biological factors: Genetics, brain chemistry
- Social and cultural influences: Cultural definitions of normal behavior
Importance: Some disorders can be cured, others coped with, some may not be disorders once culturally accepted

Publisher: American Psychiatric Association
Editions: First in 1952, current (5th) in 2013
Users: Clinicians, insurance companies, drug companies, policymakers, legal system
Purpose: Standardize diagnosis and treatment of mental disorders
Design: Evolving document incorporating new research and changing understandings
Examples of Revisions:
- Homosexuality removed as a disease (1973)
- Adjusted PTSD understanding
- Renamed childhood bipolar disorder to disruptive mood dysregulation disorder
- New diagnoses: Gambling addiction, Internet Gaming Disorder

Main Points:
- Historical and modern understanding of psychological disorders
- Evolving tools like DSM-5
- Complexity in defining and diagnosing mental disorders

Credits: