The field of mental health care in the United States is relatively new and has changed dramatically over the years. It was once believed that mental illness was the result of being possessed by a demonic spirit. We now know that psychopathologies are the result of a mixture of many things including abnormalities of chemicals in the brain plus the influences of our environment and daily experiences. We may never fully understand how the mind works. It has been a challenge determining the most appropriate and most effective way to treat people with mental illness. This has resulted in the mental health care system making many mistakes and wrong judgements in its development. The issue of care for the mentally ill is a very important one since according to the National Institute of Mental Health, “An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.” (“Numbers Count”, n.d) As professionals learn more about the brain and the mentally ill, the care will continue to progress and improve. The origins of mental health care in America began in the 17th century in colonial Virginia. The matter of managing how the insane were taken care of became a problem that had to be addressed. The method of diagnosing someone as insane was determined by twelve citizens that had to state under oath that the person in question was in fact insane. (Wacksman, 2003) Labeling someone as insane gave them some certain exemptions from the law but they were not provided with much care or assistance to deal with their illness. The mentally disordered at that time relied on care from their family, but those without caretakers were left to deal with their illness on th... ... middle of paper ... ... care that is not being provided to them due to this push for more acute care hospitalizations. Many patients are hospitalized numerous times with no signs of improvement. (Flory, 1999) Deinstitutionalization has been more beneficial to the developmentally disabled population than to the mentally ill. People with DD get more funding from the government and better residential treatment centers. The mentally ill are often left to fend for themselves. As the country continues to treat the mentally ill and the developmentally disabled there will need to be serious changes to the way things are run. With an abundance of new knowledge, there has been great advancement since the first hospitals were founded. The mental health care system has learned from its mistakes and is doing its best to correct them to the best of their ability with the allocated funds given to them.
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The United States has the highest incarceration rate in the world and of that over sixty percent of jail inmates reported having a mental health issue and 316,000 of them are severely mentally ill (Raphael & Stoll, 2013). Correctional facilities in the United States have become the primary mental health institutions today (Adams & Ferrandino, 2008). This imprisonment of the mentally ill in the United States has increased the incarceration rate and has left those individuals medically untreated and emotionally unstable while in jail and after being released. Better housing facilities, medical treatment and psychiatric counseling can be helpful in alleviating their illness as well as upon their release. This paper will explore the increasing incarceration rate of the mentally ill in the jails and prisons of the United States, the lack of medical services available to the mentally ill, the roles of the police, the correctional officers and the community and the revolving door phenomenon (Soderstrom, 2007). It will also review some of the existing and present policies that have been ineffective and present new policies that can be effective with the proper resources and training. The main objective of this paper is to illustrate that the criminalization of the mentally ill has become a public health problem and that our policy should focus more on rehabilitation rather than punishment.
Two decades ago hospitals were for the physically ill and asylums were for the mentally ill. With the stigma fading from mental illness and a movement toward deinstitutionalization, this paradigm of segregation of mental and physical health care does not hold true today. A direct effect of the paradigm shift is a greater willingness on the part of the public to seek help for mental health problems. (Madonna, 2000, ¶ 6) Managed care has stepped up to fill the increasing need for inexpensive mental health care coverage.
In the book “The Mad Among Us-A History of the Care of American’s Mentally Ill,” the author Gerald Grob, tells a very detailed accounting of how our mental health system in the United States has struggled to understand and treat the mentally ill population. It covers the many different approaches that leaders in the field of mental health at the time used but reading it was like trying to read a food label. It is regurgitated in a manner that while all of the facts are there, it lacks any sense humanity. While this may be more of a comment on the author or the style of the author, it also is telling of the method in which much of the policy and practice has come to be. It is hard to put together without some sense of a story to support the action.
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.
Until the middle of the last century, public mental health in the United States had been the responsibility, for the most part, of individual states, who chose to deal with their most profoundly mentally-ill by housing them safely and with almost total asylum in large state mental hospitals. Free of the stresses we all face in our lives, the mentally-ill faced much better prospects for peaceful lives and even recovery than they would in their conditions in ordinary society. In the hospitals, doctors were always accessible for help, patients were assured food and care, and they could be monitored to insure they never became a danger to themselves or others. Our nation’s state hospital system was a stable, efficient way to help improve the lives of our mentally disabled.
In present day America the way mental health is handled is very different from the treatment of mental health in the 1990’s. Today the mentally ill have effective medication and therapy. Back in the 1990’s treating mental health was very new. Unlike today before the 1900’s most of the mentally ill were in prisons. Around the 1950 the United States Government invested in making a safe haven for mentally ill patients where they could be protected and could be medically help. Sadly this took a turn for the worse. Mental hospitals soon became the quite opposite of what it was once hoped to be. The rise and fall of mental asylums changed mental health in America forever.
Mental health patients were considered innately inferior and treated as the weaker portion of the human race due to the prevailing dominant theory of Social Darwinism in the 1800s. They were put in mental asylums, where conditions had deteriorated substantially from earlier in the century. (Floyd) The public’s interest about the unsatisfactory care of the mentally ill, championed by Dorothea Dix, led to some reforms, such as higher medical standards, more oversight into asylum practices, and more research into mental health. (Floyd) Nevertheless, the status of the mentally ill did not elevate much higher, and by the 1890s the repeated failure of asylum therapy convinced most that insanity and mental illness was incorrigible. Finding no alternatives, however, patients continued to be sent to asylums to attempt to cure them as much as to isolate them from the rest of society. (Roberts) Unfortunately, people also began to fear the proliferation of the mentally ill. When sterilization became considered, unrealistic, more, cheaper asylums were built as a means of segregated them and preventing an increase in their numbers. (Roberts)
Failure to provide successful treatment alternatives to the deinstitutionalization of the mentally ill and the unequal opportunity to receive proper mental health care treatment in the U.S has resulted in the overrepresentation of the mentally ill in U.S jails and prisons. Mental health courts have shown they reduce recidivism, long term treatment plans over incarceration is a clear step in the right direction. (National Alliance on Mental Illness, 2008) The expansion and creation of more mental health courts in necessary, additionally, there is a need for improvements in the innovation to better serve their clients ethically and effectively.
Due to the nature of the criminal justice system, the history of the treatment of those with mentally disorders and the history of the criminal justice system have been intimately intertwined. Both the criminal justice system and treating mentally ill individuals can be traced back to the beginning of human existence. Over the ages both systems have evolved and expanded with the changes within society. In some ways the criminal justice system has become more tolerant of those with mental illness, while in other aspect the criminal justice system has become less tolerant of those with mental disorders. Now more than ever the criminal justice system interacts with mentally ill individuals.
Those with mental illness would live in the community with an array of services and be able to be free from the constraints of confinement. In the early 1960’s the United States began an initiative to reduce and close publicly-operated mental hospitals. This became known as deinstitutionalization. The goal of deinstitutionalization was to allow people suffering from mental illness to live more independently in the community with treatments provided through community health programs. Unfortunately, the federal government did not provide sufficient ongoing funding for the programs to meet the growing demand. States reduced their budgets for mental hospitals but failed to increase funding for on-going community-based mental health programs. As a result of deinstitutionalization hundreds of thousands of mentally ill people were released into the community without the proper resources they needed for their treatment. (Harcourt,
Since the beginning of deinstitutionalization in the mid twentieth century, there has been a significant need for community mental health care, which was recognized after long term institutional care was considered ineffective. One concept that arose during the community mental health movement was case management. An important goal of the community mental health movement was to create full time mental health centers throughout the United States, and case management was to provide outpatient care to those who suffered from severe mental illness. Case management is still widely recognized today, and continues to be effective in providing care to clients who suffer from mental illness. Case management is a fundamental solution to the advocacy, recruitment, treatment, and care of both the disadvantaged and mentally disabled individuals.
According to Szasz (2005), “In principle, the mental patient is considered competent (until proven [otherwise]). In practice, the client is regularly treated as if he were incompetent and the psychiatrist who asserts that he needs treatment is treated as if he were the patient’s guardian” (p.78). During the 1940’s patients who were mentally ill were considered “legally incompetent” when committed into a mental health facility. Relatives of the patients could release them by providing care in their homes for the client. Unfortunately, Szasz (2005) claims, that “the treatment of mental diseases is no more successful today than it was in the past” (p.78).
Mental disorders are rapidly becoming more common with each new generation born in the world. Currently, nearly one in two people suffer from some form of depression, anxiety, or other mental health problem at some point in their lives (Editor). With so many people suffering from their mental illnesses, steps have been taken in order to get help needed for these people but progress has been slow. In the medical world, hospitals are treating those with physical problems with more care than those with mental problems. Prescription drugs can only do so much helping the mentally ill go through their daily lives and more should be done to help those who need more than medicine to cope with their illness. Mental health should be considered just as important as physical health because of how advanced physical healing is, how the public reacts to those with mental illness, and due to the consequences that could happen if the illness is not correctly helped.