Psychiatric treatment is an ancient practice that dates back to around 5000 BCE as evidenced by the location of skulls that showed signs of trepanning. In ancient world cultures, trepanning was a renowned method for treating mental illnesses, which the early man believed to arise due supernatural influences such as sorcery and demons. This method employed a procedure whereby the psychiatrist used a stone to make an opening (trephine) in the patient’s skull.
Creating a trephine was suppose to provide a way out for the evil spirits inside the patient’s head, and which were responsible for signs and symptoms exhibited by the mentally ill. Trepanning, despite its brutal and sometimes fatal outcomes, remained a preferable method of psychiatric treatment over several decades with the adoption of more sophisticate means of creating a trephine such saws and drills (Rgarnett par. 5). Apart from trepanning, there was the use of a combination of magic and religious rituals, which psychiatrists used to eliminate demonic possession.
Thus, psychiatric patients underwent gruesome procedures of exorcism, incantations, prayers and rituals meant to drive out evil spirits. Sometimes, when the magic-religious ritual failed to work, people would attempt to appeal to the spirits using means such as bribery. As human civilization progressed, logical means of psychiatric treatment emerged. Egyptian doctors began recommending psychiatric patients to engage in activities such as dancing and painting, which doctors identified to have significant impacts in relieving most of the signs and symptoms of mental illness and restoring normalcy among patients.
Transformation in psychiatric treatment towards a more pragmatic approach began with Hippocrates’ assertions that sought to discredit the notion that mental illnesses originated from supernatural sources. In his studies, Hippocrates identified the source of psychiatric problems as natural occurrences that altered the normally functioning of the human body, especially the brain. Hippocrates’s findings formed the basis of Galen’s concept describing blood, phlegm, bile and black bile as the four essential fluids of the human body that had to remain in equilibrium for the vital body organs and systems to function effectively.
In this regard, doctors came up with a myriad of prescriptions such laxatives and black hellebore, and procedures such as using leeches to bleed psychiatric patients to restore equilibrium in the body (Illes 218). Furthermore, doctors recommended certain diets comprising of foods such as salad greens and milk to restore mental health. Research shows that responsibilities regarding care and custody for psychiatric patients were largely a family issue. In this regard, although patients sought the intervention of doctors, there were no medical facilities established to cater for psychiatric patients.
The stigma associated with mental illness often led to various forms of abuse against the mentally ill making their co-existence with health members of the society considerably difficult. Such occurrences were evident even in societies dominated by mainstream religions such Christianity. Family members of psychiatric patients hid them in cellars or caged them in pigpens to avoid the shame associate with mental illnesses. In some cases, families opted to abandon mentally ill members turning them into beggars.
Mental disorders that increase tendency to social disorder and violence exposed psychiatric patient to conflicts with laws and often led to their imprisonment for extreme cases of social disorder. Unorthodox means of treating mentally ill patients led to burgeoning of psychiatric patients throughout the world. In this regard, concerned parties started establishing institutions known as madhouses to cater for the mentally ill. These institutions, run by the clergy, clearly illustrated the need for humane treatment of the mentally afflicted.
Asylums were other institutions that offered custody and care for psychiatric patients. However, most asylums subjected the mentally ill to various form of maltreatment creating the perception that these institutions were an extension of the societal attitudes towards psychiatric patients as was the case in previous eras (“Anxiety Zone – Psychiatric hospital” par. 17). Although asylums served most of the functions of mental health facilities, they were understaffed and lack properly trained health personnel.
Concerned parties expressed fears that without appropriate reforms in institutions providing mental healthcare, there would be little, if any progress toward addressing increasing cases of psychiatric problems. Humanitarian movements emerged in various parts of the world seeking the enforcement of polices that would ensure care and custody of the mentally afflicted observed moral principles in rehabilitating patients. Advancement in the methods of treating psychiatric patients included electroconvulsive therapy, psychosurgery and psychopharmacology, which relied on models of mental pathology developed by Hippocrates.
These treatment methods sought to restore balance between biological and chemical aspects of the body considered to influence mental health. Electroconvulsive therapy led to the development of shock therapy, which became a widespread method of treating mental illnesses such as schizophrenia. Although this therapy sometimes served unethically purposes such as intimidation and punishment of patients, it remained a favored method of treating psychiatric patients suffering from severe depression, which is in use even today.
However, the current procedures of shock therapy have undergone numerous modifications to function effectively in treating psychotic symptom where approaches such as medication have failed. Some of these modifications include anesthesia and muscle relation to eliminate danger such as fractured bones. One famous method of psychosurgery, lobotomy, involved a procedure in which the surgeon used an ice pick-like object to severe the nerve connections relying information to the emotion-controlling center of the brain (Tartakovsky par. 10).
The purpose of this procedure was to control emotions such as violence in psychiatric patients. Lobotomy met the criteria for most of today’s medical procedures since it was time and cost effective. It remained a widely used method of psychosurgery until its undesirable effects on psychiatric patient became evident. High incidences of causality and reduced impulse control led to the abandonment of the lobotomy, and the adoption of psychoactive drugs. The introduction of psychotropic drugs marked the onset of a new approach in psychiatric treatment.
A combination of these drugs and various therapeutic models such as Roger’s Client-Centered Counseling and Cognitive-Behavior therapy has created a framework for psychiatric patients to tackle their mental health problems effectively. These models help psychiatrists in evaluating the psychological status of patients before recommending appropriate curse of action. Furthermore, this framework provides significant levels of flexibility concerning custody and care for the mentally afflicted. In this regard, psychiatric patients can choose between psychopathological approaches of treatment or use of psychotropic medication.
These advancements in psychiatric treatment have significantly contributed to the decline in the stigmatization of mental illnesses since one does not have to enroll in mental health centers, day-care facilities or other programs that were the sole avenue of addressing mental psychiatric problems. The number of psychiatric patients treating themselves at home is rapidly increasing, as people with mental problems prefer to keep their condition confidential since negative perceptions about mental disorder are still rife in some societies.
An analysis of the social stigma associated with mental illnesses shows that societies traditionally characterized by strong family ties exercise the great levels of abuse and maltreatment of psychiatric patients in their attempt to create and maintain alliances and relationships. This is because notions regarding mental illnesses in such societies attribute behavioral problems such as immorality within families as a major cause of mental illness.
Other notions that encourage abuse of psychiatric patients include the beliefs that mentally ill individuals are a bad omen to people who interacted with them, and that their condition is contagious. Cultures such as the Greek regarded mental illness as a hereditary condition thus promoting the isolation of entire families. World Health Organization (WHO) and other international organizations have been at the forefront in synthesizing the importance of implementing measures that will improve the treatment of various mental disorders.
These concerns arise due increasing cases of neuropsychiatric disorders responsible for the high suicide rates witnessed throughout the world. The WHO attributes various psychiatric problems to arise from a combination of biological and environmental factors such as bipolar disorders, obsessive and compulsive disorder and depression, which lead behaviors such as drug abuse (McLoughlin and Declan 1230). The changes witnessed in psychiatric treatment are a clear indicator of the advancement of psychiatry.
Extensive network of crisis services, short-term and hospital-based psychiatric care units and outpatient services highlight positive outlooks in the future of psychiatry. With the availability of effective psychotic medications, therapeutic models for psychiatric treatment and focus should be on education to change peoples’ attitude towards the mentally afflicted through public campaigns against stigmatization of psychiatric patients, future of psychiatry looks bright.
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