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PSY4791 (33)

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Carolyn Gordon

Development of Asylums  until the end of the crusades in the 15 cen there were very few mental hospitals in Europe  confinement of the ill began in the 15 and 16 cen  leprosarium’s were converted to asylums –refuges established for the confinement and care of the mentally ill. Bethlehem and other early asylums  the Priory of St. Mary of Bethlehem was founded in 1243. hospital devoted to mentally ill  bedlam- a scene or place involving a wild uproar or confusion. The term is derived from the scenes at Bethlehem hospital in London, where unrestrained groups of mentally ill people interacted with each other  viewing violent patients was considered entertainment and tix to bedlam were sold  medical treatments were painful and crude.  Rush who practised medicine is considered father of American psychiatry. He believed that mental disorders were caused by an excess of blood in the brain. He drew great quantities of it. He thought many lunatics could be cured by being scared Moral Treatment  Pinel is a primary figure in the movement for humanitarianism treatment of the mentally ill in asylums.. was in charge of large asylum in Paris La Bicetre. He removed the chains of ppl. He treated them as sick ppl rather than as beats. They became calmer.  He thought they were normal ppl who should be approached with compassion and understanding and treated with dignity  The more humanitarianism treatment he reserves for the upper classes; patients of the lower classes were still subjected to terror and coercion as a means of control  Tuke proposed to the Society of Friends that it found its own institution. In 1796 the York retreat was established on a country estate. Mentally ill were able to talk to attendants  Moral treatment- a therapeutic regimen, introduced by Pinel during the French Revolution whereby mental patients were released from their restraints and were treated with compassion and dignity rather than with contempt and denigration. Patients had close contact with attendants who talked and read to them and encouraged them to engage in activity; residents led as normal lives as possible and in general took responsible for themselves  Drugs were used a lot. Most common treatment and included alcohol, cannabis, opium and choral hydrate (knockout drops). Second the outcomes were not favourable, fewer than one third were discharged as improved or recovered th  Moral treatment was abandoned in the later part of the 19 cen.  Dorthea Dix crusader for improved conditions for people with mental illness helped effect this change.  Dix campaigned a lot to improve the lot of people with mental illness; she personally saw that 32 state hospitals were built in to take many patients whom the private ones could not accommodate. got no indiv attention which is a hallmark of moral treatment  Dr. Henry Stabb made efforts to institute moral treatments and non restraint at the lunatic asylum in st johns Newfoundland. But his efforts were hindered by inadequate financial resources. ASYLUMS IN CANADA  J.F Lehman wrote the 1 textbook published in Canada with a focus on care and control of mentally ill ppl. He recommended stringent discipline and harsh treatments. His views failed  Pioneers from great Britain who influenced to design and construction of asylums  Alberta was the last province to open an asylum  Almost 20% of the inmates died while in the institution, a large # due to general paresis of the insane and to a condition called phthisis  Two tie system medical system where rich get quality care  The history of development o institution for the mentally disordered in Canada can be characterized in terms of two trends: 1) with the advent of asylums, provisions for the mentally ill were separate from provisions for the physically ill, indigents and criminals and 2) the process was segregate from the wider community –the institution and the community were two separate and distinct solitudes THE BEGINNING OF CONTEMPORARY THOUGHT 1  One development that fostered the progress was the discovery by Vesalius that Galen’s presentation of human anatomy was incorrect. Further process cam from Sydenham An early system of classification  Griesinger who insisted that any diagnosis of mental disorder specify a bio cause  Kraepelin furnished a classification system in order to establish the bio nature of mental illness  K. discerned among mental disorders a tendency for a certain group of symptoms called a syndrome to appear together regularly enough to be regarded as having an underlying physical cause. He regarded each mental illness as distinct from all others  K proposed two major groups of severe mental diseases: dementia praecox an early term for schitzo and manic depressive psychosis - now called bipolar disorder. He said it was a chemical imbalance for schitzo and an irregularity in metabolism as the explanation of manic depressive psychosis General paresis and syphilis  Most striking med success was discovery of nature and origin of syphilis. In 1905 the specific micro organism that causes syphilis was discovered. A causal link had been established between infection, destruction of certain areas of the brain and a form of psychopathology  Since 1798 ut was known that a # of mental patients manifested a syndrome characterized by a steady deterioration of both physical and mental abilities and that these patients suffered multiple impairments including delusions of grandeur and progressive paralysis. These patients never recovered. In1825 this deterioration in mental and physical health was called a disease – general paresis  In the 1860s and 1870s louis pasterur established the germ theory of disease which set forth the view that diseases is caused by infection of the body by minute organisms psychogenesis th  Austrian physician Mesmer in 18 cen believed that hysterical disorders were caused by a universal magnetic fluid in the body. He felt that one person could influence the fluid of another to bring about a change in another’s beh  Used rods which were believed to transmit animal magnetism and adjust the distribution of the universal magnetic fluid thereby removing the hysterical disorder  It was said that he helped many ppl overcome their hysterical problem’s  He said these disorders were strictly physical  He’s considered one of the earlier practitioners of the modern day hypnosis  The worse mesmerize is another term for hypnotize  Hypnosis become respectable  Neurologist Charcot also studied hysterical states including anaesthesia (loss of sensation), paralysis, blindness, deafness, convulsive attacks and gaps in memory  He later changed his mind about hysteria and became interested in non physiological interpretations of these hysterias  Breuer and the Cathartic Method- physician- found that the relief and cure of symptoms seems to last longer if under hypnosis they were able to recall the precipitating event for the symptoms if their original emotion was expressed  Cathartic method- a therapeutic procedure introduced by the Breuer and developed further by Freud in the late 19 cen whereby a patient recalls and relives an earlier emotional catastrophe and re-experiences the tension and unhappiness, the goal to relieve emotional suffering CURRENT ATTITUDES TOWARD PEOPLE WITH PSYCHOLOGICAL DISORDERS  Social stigma surrounding depression is the primary reason why only one third of the estimated 3 million ppl in Canada who suffer from depression seek help  Over 50% of Canadian who suffer from mood, anxiety or substance dependence in the previous year felt embarrassed about their problems and reported facing discrimination  Ppl think they’re unstable and dangerous- incorrect  Majority of these ppl never commit violent acts and they’re more likely to be victims  Respondents want to maintain social distance from the mentally ill; they have the greatest desire to avoid alcohol or drug abusers but they’re also unwilling to interact with ppl diagnosed with schitzo or depression (As high as 50%)  Education to changed public perceptions of ppl with psych problems not successful 2  Lower levels of rejection occurred when stress was perceived as playing a major role in the development of psych problems  Ppl are more willing to interact with females than males with the same psych problems cuz females may be perceived as less dangerous to others  Hinks was a founder and long term medical director of the Canadian mental health association  Careys character in the movie me myself and Irene is misidentifies as having scxhitzo rather than disassociate identity disorder  “crazy train” was taking soldiers suffering from post traumatic stress disorder for treatment  respondents said maintaining mental health is very important ( 95% of women and 88% of men)  fewer Canadians are wiling to tell their bosses only 42% of friends only 50% if they’re receiving treatment or counselling for depression. Women were more willing to admit to receiving treatment than men  campaign to reduce the stigma of schitzo---initial results of an anti stigma initiative in Alberta suggest that citizens have a higher level of acceptance of ppl with schitzo and more knowledge about the condition. But still 40% of the general public continue to endorse the belief that ppl with schitzo have the potential to be dangerous  preventative intervention to reduce stigma in high schools in Ontario, Alberta, B.C, Newfoundland and Labrador – they did this a video based active learning program that showed the challenges of actual ppl with schitzo  exposure led to increased knowledge of shcitzo and its treatment and less social distancing. Female students showed greater gains. CANADAS MENTAL HEATLH SYTSEM  Canadians are better off than US. Across al major health indicators  in Canada there is a lower prevalence of psychiatric disorders and less use of illicit drugs  the match between psychiatric needs and outpatient services is better in Canada (in Ontario) than in us  while a smaller % of can receive mental health services(8%) their needs are significant and are readily met while more ppl (13.3%) in the us receive mental health services their disorders are less severe Medicare  taxes are employed for universal health care for ppl with psych disorders.  Medicare- the system of health care in Canawhich has been in effect since 1970  In us health care is based on indiv income (40% of fam have no insurance) in Canada poorer make greater use of the system than richer  Can remain strongly committed to the 5 core principles on which Medicare is based (accessibility, comprehensiveness, portability, public administration, universality Mental health of Canadians: first view What factors are associated with mental health in Canada?  Mental health status- an individuals
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