Review of Psychiatry - A Social Stigma! By Dr. Harsha Gopisetty
News paper headlines stating ‘Death of 25 mentally-ill patients, charred beyond recognition, in a devastating fire which engulfed their thatched hostel, pathetically chained to their cots in Ervadi Mental Hospital in Tamil Nadu' and on the other extreme 'States like Haryana do not have a mental hospital' is very revealing of the neglected state of approach to the mentally ill in India. One wonders! Why it is so? When all other sciences have made such great advances in India , Psychiatry has made virtually no headway, and is in a very nascent state.
The first Department of Psychiatry with outpatient facility in a general hospital in India was opened on 1st May 1933, at the then Carmichael Medical College, now known as R. G. Kar Medical College, in Kolkata.
The traditional approach to the care of the mentally ill during the last 200 years was custodial, rather than therapeutic. This approach to “Psychiatric Care Delivery System” was introduced in India from Britain . Mental hospitals were established in isolated areas, often on the outskirts with the object of segregating the patient as troublesome and dangerous to their neighbors. The overriding concern was to protect the citizens without regard for appropriate care and cure of the ailing patients. As a consequence of this objective of the mental hospitals, the quality of care in such hospitals had been very poor. The inmates were subjected to indignity and humiliation for an indefinite period, and once admitted never recovered, or rehabilitated back in their family, but doomed to the inevitable end. The stigma of mental illness thus prevailed.
What really needs to be done...
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...us advances in this field, while we still consider it a stigma even to be referred to a psychiatrist. Mental illness is just another biological or sociological problem, which needs to be dealt with on time, before it’s too late, by a specialist.
It needs to be understood that it is as natural as cancer or AIDS, but can be worse and a living hell for those who are the victims of this illness, and not treated in time. When we can give all the care and attention to other medical problems, and can go campaigning for them; then its time to look at this aspect of illness with same enthusiasm. We cannot afford to neglect this illness. We need more voluntary involvement, and have a better infrastructure developed to build a better future for every person who is suffering, and who is prone to suffer with the current mode of life of high stress and competitions.
... just the illness as a whole. There are also issues with how broad the spectrum of mental illness is. With each new idea in mental health some hope is given that someone will find treatment.
The fight for improved health care for those with mental illness has been an ongoing and important struggle for advocates in the United States who are aware of the difficulties faced by the mentally ill and those who take care of them. People unfortunate enough to be inflicted with the burden of having a severe mental illness experience dramatic changes in their behavior and go through psychotic episodes severe enough to the point where they are a burden to not only themselves but also to people in their society. Mental institutions are equipped to provide specialized treatment and rehabilitative services to severely mentally ill patients, with the help of these institutions the mentally ill are able to get the care needed for them to control their illness and be rehabilitated to the point where they can become a functional part of our society. Deinstitutionalization has led to the closing down and reduction of mental institutions, which means the thousands of patients who relied on these mental institutions have now been thrown out into society on their own without any support system to help them treat their mental illness. Years after the beginning of deinstitutionalization and after observing the numerous effects of deinstitutionalization it has become very obvious as to why our nation needs to be re-institutionalized.
As medical advances are being made, it makes the treating of diseases easier and easier. Mental hospitals have changed the way the treat a patient’s illness considerably compared to the hospital described in One Flew Over the Cuckoo’s Nest.
In the 1800’s people with mental illnesses were frowned upon and weren't treated like human beings. Mental illnesses were claimed to be “demonic possessions” people with mental illnesses were thrown into jail cells, chained to their beds,used for entertainment and even killed. Some were even slaves, they were starved and forced to work in cold or extremely hot weather with chains on their feet. Until 1851, the first state mental hospital was built and there was only one physician on staff responsible for the medical, moral and physical treatment of each inmate. Who had said "Violent hands shall never be laid on a patient, under any provocation.
As science has evolved, so have treatments for mental illnesses have over time. The medical model is described as the view that psychological disorders are medical diseases with a biological origin (King, 2010, pg. 413). Abnormal behavior that categorizes some disorders can be impacted by biological factors such as genes, psychological factors such as childhood experiences, and even sociocultural factors such as gender and race (King, 2010). Treatments such as psychosurgery (lobotomy) , drug therapy (pharmaceuticals), electroconclusive therapy, and psychoanalysis are used to treat a wide range of psychological disorders. Back then, the public’s negative views on mental illnesses also went as far to associate with the people who treated it; psychiatrists. “Nunnally (1961) found that the public evaluated professionals who treated mental disorders significantly more negatively than those who treat physical disorders,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). People back then didn’t see the point in “paying to be told that they were crazy”. However, in today’s society, it is now acceptable to seek help from psychiatric professionals; we are seeing more and more people seek mental health treatment. “In terms of facility-based records of utilization (Manderscheid and Henderson 1998), the data suggest that the rate of utilization of professional mental health services has at least doubled and maybe tripled, between the 1950’s and today,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). In the 1950’s, neuroleptic drugs like Thorazine were introduced to treat the symptoms of schizophrenia. These drugs block a neurotransmitter called dopamine from getting to the brain, which in turn reduce schizophrenic symptoms, however there are some side effects such as substantial twitching of the neck, arms, and legs, and even dysphoria or lack of pleasure. (King, 2010, pg.
Mental illness has been around as long as people have been. However, the movement really started in the 19th century during industrialization. The Western countries saw an immense increase in the number and size of insane asylums, during what was known as “the great confinement” or the “asylum era” (Torrey, Stieber, Ezekiel, Wolfe, Sharfstein, Noble, Flynn Criminalizing the Seriously Mentally Ill). Laws were starting to be made to pressure authorities to face the people who were deemed insane by family members and hospital administrators. Because of the overpopulation in the institutions, treatment became more impersonal and had a complex mix of mental and social-economic problems. During this time the term “psychiatry” was identified as the medical specialty for the people who had the job as asylum superintendents. These superintendents assumed managerial roles in asylums for people who were considered “alienated” from society; people with less serious conditions wer...
Mental illness is more common than one would like to believe. In reality, one in five Americans will suffer from a mental disorder in any given year. Though that ratio is about equivalent to more than fifty-four million people, mental illness still remains a shameful and stigmatized topic (National Institute of Mental Health, n.d.). The taboo of mental illness has an extensive and exhausting history, dating back to the beginning of American colonization. It has not been an easy road, to say the least.
The human brain is a vast, unexplainable, and unpredictable organ. This is the way that many modern physicians view the mind. Imagine what physicians three hundred years ago understood about the way their patients thought. The treatment of the mentally ill in the eighteenth century was appalling. The understanding of mental illness was very small, but the animalistic treatment of patients was disgusting. William Hogarth depicts Bethlam, the largest mental illness hospital in Britain, in his 1733 painting The Madhouse1. The public’s view of mental illness was very poor and many people underestimated how mentally ill some patients were. The public and the doctors’ view on insanity was changing constantly, making it difficult to treat those who were hospitalized2. “Madhouses” became a dumping ground for people in society that could not be handled by the criminal justice system. People who refused to work, single mothers, and children who refused to follow orders were being sent to mental illness hospitals3. A lack of understanding was the main reason for the ineptness of the health system to deal with the mentally ill, but the treatment of the patients was cruel and inhumane. The British’s handling of mentally ill patients was in disarray.
The discussion of mental health is slowly being brought to the social surface to create a more inclusive society for those dealing with a mental illness. However, those with a mental illness are continuously being affected by stereotypes, prejudice and discrimination by those who simply don’t comprehend the complexity of the human brain (Glaser, G.2017). As more people become mental health activist, they are exposing the plethora of issues surrounding the overall mental and physical stability of those who are negatively affected by the social construct of what it means to be normal.
The BBC documentary, Mental: A History of the Madhouse, delves into Britain’s mental asylums and explores not only the life of the patients in these asylums, but also explains some of the treatments used on such patients (from the early 1950s to the late 1990s). The attitudes held against mental illness and those afflicted by it during the time were those of good intentions, although the vast majority of treatments and aid being carried out against the patients were anything but “good”. In 1948, mental health began to be included in the NHS (National Health Service) as an actual medical condition, this helped to bring mental disabilities under the umbrella of equality with all other medical conditions; however, asylums not only housed people
Continuing budget cuts on mental health care create negative and detrimental impacts on society due to increased improper care for mentally ill, public violence, and overcrowding in jails and emergency rooms. Origins, of mental health as people know it today, began in 1908. The movement initiated was known as “mental hygiene”, which was defined as referring to all things preserving mental health, including maintaining harmonious relation with others, and to participate in constructive changes in one’s social and physical environment (Bertolote 1). As a result of the current spending cuts approaching mental health care, proper treatment has declined drastically. The expanse of improper care to mentally ill peoples has elevated harmful threats of heightened public violence to society.
Compared with individualistic Western cultures however; health professionals such as psychiatrists and other medical doctors are not yet fully trained to deal with patients complaining of symptoms that are not necessarily somatic. This is due to the fact that “for decades since the late introduction of psychiatry as a subject in medical schools in Asia, all that was taught was 10 lecture-demonstrations of the severely psychotic or depressed mentally ill patients, more as oddities in medical practice than as ill persons who needed to be understood.” (Deshvara) Thus with medical professionals being unable to fully provide an unconditionally positive and supportive environment needed for the growth of mentally ill patients; placing the pressure on one’s self to heal quickly in order to decrease the chances of a negative reputation among the community and among family members increases. Moreover, in collectivist cultures, emphasis on somatic complaints may result from the belief that emotional distress is caused by physical ailments and that it will cease upon proper medical treatment for the physical problem. By emphasizing the importance of physical,
In the article Issues and Controversies says, "Throughout most of human history, people with mental illness were ostracized, isolated, and persecuted." ( Infobase,1) This belief system can give causation of mental illness in different cultures and such influences in a community will always be in a negative manner. Various societies struggle with the notion of mental health. The standards of every culture believe to be considered normal, natural, or healthy. These views lead to disagreements about the causes, diagnosis, and the treatment of the disorders. Many people with mental problems are discriminated against because of their mental disorder. Mental illness and stigma refers to the view of the person with mental illness as having undesirable traits. Stigma leads to negative behavior, stereotyping, and discriminatory behavior towards the person with mental health issues. This stigma causes the affected person to experience denial or shame of their condition. Perceived stigma can result in the patient being scared to seek help. Stigma can be divided into two perspectives, public and self stigma. Upadhyay says, "Public stigma occurs when the general
Why is there a cloud of judgment and misunderstanding still surrounding the subject? People with a mental disorder or with a history of mental health issues are continually ostracized by society. This results in it being more difficult than it already is for the mentally ill to admit their symptoms to others and to seek treatment. To towards understanding mental illness is to finally lift the stigma, and to finally let sufferers feel safe and accepted within today’s society. There are many ways in which the mentally ill are degraded and shamed.
Doward, J. (2013), Medicine's big new battleground: does mental illness really exist? The Observer 12 May.