Mental Health Perspectives Through History

Oct 5, 2024

Lecture on Historical and Modern Perspectives of Mental Health

Introduction

  • Overview of mental health reform history and modern perspectives.
  • Discussion on understanding, diagnosing, and treating psychological disorders.

Historical Perspectives

Nellie Bly's Exposé (1887)

  • Journalist: Elizabeth Cochran, alias Nellie Bly.
  • Action: Feigned mental illness to report on psychiatric hospitals (asylums).
  • Findings: Rotten food, cold showers, rats, abusive nurses, patients tied down.
  • Impact: Exposé "Ten Days in a Mad House" led to mental health reform.

David Rosenhan's Experiment (1975)

  • Study: "On Being Sane in Insane Places"
  • Phase 1: Sent 8 pseudopatients to institutions.
    • Outcome: Admitted easily, difficult discharge, diagnosed with schizophrenia in remission.
    • Criticism: Mental illness viewed as irreversible.
  • Phase 2: Told hospital staff about sending pseudopatients; none were actually sent.
    • Outcome: 41 out of 193 new patients suspected, highlighting diagnostic challenges.
  • Questions Raised:
    • Definition and classification of mental disorders.
    • Risks and benefits of diagnostic labeling.

Modern Understanding of Psychological Disorders

Definition

  • Disorders: Deviant, distressful, dysfunctional patterns of thoughts/behaviors.

Deviant Behavior

  • Contextual: Behavior differing from cultural norms.
  • Examples: Killing in war vs. murder in peace; spiritual communication.

Distress and Dysfunction

  • Distress: Subjective feeling of wrongness.
  • Dysfunction: Impairment in work and life.

Evolution of Mental Health Perspectives

Historical Context

  • 18th/19th centuries: Mental health as a sickness of the mind.
  • Example: Syphilis causing neurological issues treated in hospitals.

Medical Model

  • Concept: Disorders have physiological causes, diagnosable and treatable.
  • Advancement: Moved from locking people away to medical treatment.

Biopsychological Approach

  • Comprehensive View: Considers biological, psychological, social-cultural influences.
  • Holistic Perspective: Nature and nurture influences in understanding disorders.

Standardization and Measurement

DSM-5

  • Full Name: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.
  • Usage: Widely used by clinicians, insurers, legal and policy makers.
  • Evolution: Changes with latest research and cultural understanding.
  • Examples:
    • Homosexuality removed as a pathology by 1973.
    • PTSD symptoms refined; Childhood Bipolar Disorder reclassified.
    • New diagnoses: Gambling Addiction, Internet Gaming Disorder.
  • Criticism:
    • Over-/mis-diagnosis risks.
    • Impact of labeling on perception and treatment.

Conclusion

  • Key Learnings: Definition and perspectives on psychological disorders, DSM's role, its evolution, and implications.
  • Acknowledgments: Contributors to the lecture.

Note: This summary is based on a hypothetical lecture transcript provided for educational purposes.