Lecture Notes: History and Evolution of Mental Health Treatment

Introduction

Nellie Bly's Exposé (1887):
- Used alias to report on conditions in psychiatric hospitals (asylums)
- Found rotten food, cold showers, rats, abusive nurses, patients tied down
- Led to mental health reform
David Rosenhan's Experiment (1975):
- Sent pseudo-patients claiming to hear voices
- Resulted in forced medication and long stays
- Critiqued diagnosis methodology
- Second part involved a teaching hospital; no pseudo-patients sent, but many suspected
- Raised questions about diagnosing mental disorders

Definition: Deviant, distressful, and dysfunctional patterns of thoughts, feelings, or behaviors
- Deviant Behavior: Different from cultural norms; context-dependent
- Distress: Subjective feeling of something wrong
- Dysfunction: Impaired ability to work/live

18th & 19th Centuries: Shift towards medical model of mental illness
- Advanced syphilis linked to neurological problems
Medical Model:
- Disorders have physiological causes
- Diagnosed based on symptoms, treated, possibly cured
- Seen as narrow and outdated by some

Holistic View: Accounts for physiological, psychological, and socio-cultural influences
- Nature and nurture influences
- Some disorders curable; others manageable

DSM-5: Diagnostic and Statistical Manual of Mental Disorders
- First edition: 1952; fifth edition: 2013
- Evolving manual reflecting new research and cultural understanding
- Changes: Homosexuality declassification, PTSD symptom understanding, childhood bipolar disorder reclassification
Criticism of DSM:
- Risk of over/misdiagnosis
- Labeling may lead to preconceptions and stigma

Definitions' Power: Essential to recognize the complexity in mental health definitions
Evolution: Constant change in mental health understanding and classification
Acknowledgements: Lecture contributors and supporters