Voices for Choices (2 of 13) - History of psychiatric treatment

Mental health treatment has come in many forms throughout history. For most of history, people considered “crazy” were banished, beaten, or kept locked away in cellars and attics. In 17th-century Europe, they were confined in large institutions, not for purposes of treatment, but to remove them from society. At the turn of the 19th century, treatment of emotional distress became medicalized into “diseases” such as paranoia, dementia, manic-depression, and epilepsy.

 

 Doctors even claimed that black slaves who desired to run away had a mental illness called “drapetomania,” and their recommendation was to beat the slaves into submission. A less punitive, more humane, recovery-based approach to helping individuals in distress came about briefly in the 19th century when the Quakers began “moral treatment” for those deemed mentally impaired.

At most asylums, more than 50 percent of newly admitted individuals would be discharged within a year — and a significant percentage of those who left never returned. Doctors then started using physical treatments. They experimented with “water therapies” like high-pressure showers and hot and cold baths, fever therapies, teeth removal, and bloodletting, as well as strapping individuals to spinning boards and tranquilizer chairs. People were also injected with sheep thyroid, metallic salts, horse serum, and arsenic. 

All of these treatments reportedly had positive outcomes. In the 1930s and ’40s, so-called miracle cures emerged, such as insulin coma therapy, electroconvulsive therapy (also known as electroshock), and frontal lobotomies. At the time, they were considered innovations. The frontal lobotomy even earned Portuguese neurologist Egas Moniz a Nobel Prize, and lobotomies were the surgery of choice for “curing” severe emotional distress. As World War II ended, soldiers returned with combat fatigue, now called post-traumatic stress disorder, or PTSD, and were put into asylums. Nearly 2,000 World War II veterans were recorded to have received lobotomies. 

American journalist Albert Deutsch published “The Shame of the States” and showcased, in photographs, the horrors of the asylums and so-called “treatments” that American combat veterans endured. In 1946, Congress established the National Institute of Mental Health — money and energy were poured into finding a magic bullet to “cure” emotional distress. In 1954, psychiatric drugs became commercialized. These drugs were marketed to the public as the antipsychotic Thorazine (1954), the anti-anxiety drug Miltown (1955), and the antidepressant Iproniazid (1958). Thorazine was actually a major tranquilizer, Miltown was a muscle relaxant, and Iproniazid was an anti-tuberculosis drug. As commercial psychiatric drugs became lucrative, the mental health system grew — a system of control created by a partnership among psychiatrists, pharmaceutical companies, and government agencies. As you can see, the history of mental health care is gloomy. In our next segment, we will hear from psychiatric survivors and mental health professionals about the involuntary aspect of psychiatric treatment.