Care and Treatment of the Mentally Ill in the United States: Historical Developments and Reforms

1986 ◽  
Vol 484 (1) ◽  
pp. 12-27 ◽  
Author(s):  
JOSEPH P. MORRISSEY ◽  
HOWARD H. GOLDMAN
Keyword(s):  
Mental Health ◽  
United States ◽  
Criminal Justice ◽  
Mentally Ill ◽  
Public Mental Health ◽  
Health Service Delivery ◽  
The United States ◽  
Mental Health Service Delivery ◽  
Public Mental Health Care ◽  
Historical Developments

Three major cycles of reform in public mental health care in the United States—the moral treatment, mental hygiene, and community mental health movements—are described as a basis for assessing the shifting boundaries between the mental health, social welfare, and criminal justice systems. Historical forces that led to the transinstitutionalization of the mentally ill from almshouses to the state mental hospitals in the nineteenth and twentieth centuries have now been reversed in the aftermath of recent deinstitutionalization policies. Evidence is suggestive that the mentally ill are also being caught up in the criminal justice system, a circumstance reminiscent of pre-asylum conditions in the early nineteenth century. These trends shape the current mental health service delivery system and the agenda for policy-relevant research on issues involving the legal and mental health fields.

scholarly journals Implementation Strategies to Promote Measurement-Based Care in Schools: Evidence from Mental Health Experts Across the United States

2021 ◽  
Author(s):  
Elizabeth H Connors ◽  
Aaron R Lyon ◽  
Kaylyn Garcia ◽  
Corianna Sichel ◽  
Sharon Hoover ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Implementation Strategies ◽  
Health Service Delivery ◽  
The United States ◽  
Mental Health Providers ◽  
Health Providers ◽  
Mental Health Service Delivery ◽  
Measurement Based Care ◽  
Patient Reported

Abstract Background: Despite an established, comprehensive taxonomy of implementation strategies, minimal guidance exists for how to select and adapt strategies to specific services and contexts. We employed a replicable method to identify the most feasible and important implementation strategies to increase mental health providers’ use of measurement-based care (MBC) in schools. MBC is the routine use of patient-reported progress measures throughout treatment to inform patient-centered, data-driven treatment adjustments. Methods: A national sample of 52 school mental health providers and researchers completed two rounds of modified Delphi surveys to rate the relevance, importance, and feasibility of 33 implementation strategies identified for school settings. Strategies were reduced and definitions refined using a multimethod approach. Final importance and feasibility ratings were plotted on “go-zone” graphs and compared across providers and researchers to identify top-rated strategies. Results: The initial 33 strategies were rated as “relevant” or “relevant with changes” to MBC in schools. Importance and feasibility ratings were high overall for both survey rounds; importance ratings (3.61 - 4.48) were higher than feasibility ratings (2.55 – 4.06) on average. Survey 1 responses resulted in a reduced, refined set of 21 strategies, and six were rated most important and feasible on Survey 2: 1) assess for readiness and identify barriers and facilitators; 2) identify and prepare champions; 3) develop a usable implementation plan; 4) offer a provider-informed menu of free, brief measures; 5) develop and provide access to training materials; and 6) make implementation easier by removing burdensome documentation tasks. Provider and researcher ratings were not significantly different, with a few exceptions: providers reported higher feasibility and importance of removing burdensome paperwork than researchers, and providers reported higher feasibility of train-the trainer approaches than researchers; researchers reported higher importance of monitoring fidelity than providers. Conclusions: The education sector is the most common setting for child and adolescent mental health service delivery in the United States. Effective MBC implementation in schools has the potential to elevate the quality of care received by many children, adolescents and their families. This empirically-derived, targeted list of six implementation strategies offers potential efficiencies for future testing of MBC implementation in schools.

scholarly journals The Emergence of Recovery: A Genealogical Exploration of the Forces of Power Shaping New Zealand's Mental Health Services in the 21st Century

2021 ◽  
Author(s):  
◽  
Darren Mills
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
21St Century ◽  
Mentally Ill ◽  
Health Service Delivery ◽  
Individual Responsibility ◽  
Significant Shift ◽  
Mental Health Service Delivery ◽  
Methods And Techniques ◽  
Psychiatric Discourse

<p>Recovery is a conceptual model that underpins New Zealand’s mental health service delivery in the 21st century. This thesis explores how recovery emerged historically as an influential philosophy and how representations of recovery have changed to meet the needs of different groups. An inquiry, based on Foucault’s genealogical method, investigates the historical and contemporary forces of power that have shaped the construction of mental illness, and the development of methods and techniques to support and manage persons labelled as mentally ill. The normalisation of knowledge developed during 19th century psychiatric practice provided a context for later critique and resistance from movements that highlighted the oppressive power of psychiatric discourse. Key to the critique were the antipsychiatry and service user movements, which provided the conditions for the possibility of the emergence of recovery as a dominant discourse. Since its emergence, recovery has moved through a number of representations as it was taken up by different groups. A significant shift in the 21st century has been the dominance of neo-liberal discourse based on consumerism, a rolling back of the state, and an emphasis on individual responsibility. The implications of this shift for users and providers of services and their effects on current representations of recovery conclude the inquiry.</p>

The Civil Commitment of Sex Offenders in Light of Foucha v. Louisiana

1993 ◽  
Vol 20 (4) ◽  
pp. 371-387 ◽  
Author(s):  
RUDOLPH ALEXANDER
Keyword(s):  
Mental Health ◽  
United States ◽  
Criminal Justice ◽  
Sex Offenders ◽  
Mental Health System ◽  
Justice System ◽  
United States Supreme Court ◽  
Civil Commitment ◽  
The United States ◽  
United States Supreme

The United States Supreme Court has ruled that an individual who has been judged insane and committed to a mental facility and who has regained his sanity but remains dangerous cannot continue to be confined. In a dissenting opinion, Justice Kennedy stated that the majority's decision might have put in doubt the civil commitment of persons other than insanity acquittees. The author of this essay contends that the Court's decision indeed did so and argues that dangerous or predatory sex offenders cannot now be civilly committed to mental institutions. The author argues also that the criminal justice system, rather than the mental health system, is more appropriate for controlling sex offenders.

Confronting 60 Minutes’ “Imminent Danger”: The Evidence on Schizophrenia and Psychotropic Medications, Violence, and Forced Orders to Treat

2014 ◽  
Vol 16 (1) ◽  
pp. 51-62 ◽  
Author(s):  
Toby T. Watson
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
The United States ◽  
Psychotropic Medications ◽  
Television Show ◽  
Imminent Danger ◽  
The World

Recently, considerable attention has been given to individuals labeled “mentally ill,” with the possibility that they too often go untreated with psychotropic medications and in turn, commit disproportionally higher rates of violence. The world-known television show60 Minutesbroadcasted a special on this topic in the United States on September 29, 2013; however, they created a disturbingly inaccurate picture of those who suffer with what some label as “mental illness.” There are decades of peer-reviewed research demonstrating that individuals diagnosed with severe mental illness, labeledschizophrenia,and given psychotropic medications are in fact less likely to recover from their disorder and more likely to be rehospitalized. Additionally, although mental health commitments, often calledforced orders to treat,are quite common and now being supported more so due to such programming, the research on mental health commitments has not shown they are actually effective.

Integrating the criminal justice system into mental health service delivery: the worcester diversion experience

2005 ◽  
Vol 23 (2) ◽  
pp. 277-293 ◽  
Author(s):  
Albert J. Grudzinskas ◽  
Jonathan C. Clayfield ◽  
Kristen Roy-Bujnowski ◽  
William H. Fisher ◽  
Maurice H. Richardson
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Mental Health Service ◽  
Health Service ◽  
Service Delivery ◽  
Criminal Justice System ◽  
Justice System ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

Public Mental Health Service Delivery: A Modified Model

1997 ◽  
Vol 5 (4) ◽  
pp. 167-169 ◽  
Author(s):  
Gordon Parker
Keyword(s):  
Mental Health ◽  
Service Delivery ◽  
Mental Health Policy ◽  
Health Sector ◽  
Public Mental Health ◽  
Health Service Delivery ◽  
Mental Health Service Delivery ◽  
The Public ◽  
National Mental Health ◽  
Strategy Subject

In the last few years, the Commonwealth and many of the states have worked at developing principles of service delivery for the public mental health sector. Whiteford [1] has described one key initiative, the National Mental Health Policy, with the initial five-year Strategy due to end in mid-1998. The Strategy was developed collaboratively, involving and respecting the views of many of the key groups, and a number of impressive documents and policy decisions have been developed. Many of its central components represent important advances, are non-controversial and are generally accepted, and are presumabl immutable planks that will underpin the next phase of the Strategy – subject to its funding. As for any strategy, there are issues that may benefit from review and revision, and I would like to focus on service models and funding.

scholarly journals COVID-19 impact on mental health

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jingyu Cui ◽  
Jingwei Lu ◽  
Yijia Weng ◽  
Grace Y. Yi ◽  
Wenqing He
Keyword(s):  
Public Health ◽  
Mental Health ◽  
United States ◽  
Risk Factors ◽  
Health Care ◽  
Public Mental Health ◽  
The United States ◽  
Public Confidence ◽  
Change Over Time ◽  
Over Time

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has posed a significant influence on public mental health. Current efforts focus on alleviating the impacts of the disease on public health and the economy, with the psychological effects due to COVID-19 relatively ignored. In this research, we are interested in exploring the quantitative characterization of the pandemic impact on public mental health by studying an online survey dataset of the United States. Methods The analyses are conducted based on a large scale of online mental health-related survey study in the United States, conducted over 12 consecutive weeks from April 23, 2020 to July 21, 2020. We are interested in examining the risk factors that have a significant impact on mental health as well as in their estimated effects over time. We employ the multiple imputation by chained equations (MICE) method to deal with missing values and take logistic regression with the least absolute shrinkage and selection operator (Lasso) method to identify risk factors for mental health. Results Our analysis shows that risk predictors for an individual to experience mental health issues include the pandemic situation of the State where the individual resides, age, gender, race, marital status, health conditions, the number of household members, employment status, the level of confidence of the future food affordability, availability of health insurance, mortgage status, and the information of kids enrolling in school. The effects of most of the predictors seem to change over time though the degree varies for different risk factors. The effects of risk factors, such as States and gender show noticeable change over time, whereas the factor age exhibits seemingly unchanged effects over time. Conclusions The analysis results unveil evidence-based findings to identify the groups who are psychologically vulnerable to the COVID-19 pandemic. This study provides helpful evidence for assisting healthcare providers and policymakers to take steps for mitigating the pandemic effects on public mental health, especially in boosting public health care, improving public confidence in future food conditions, and creating more job opportunities. Trial registration This article does not report the results of a health care intervention on human participants.

The Peculiar Institution and the Making of Modern Psychiatry, 1840-1880

2019 ◽  
Author(s):  
Wendy Gonaver
Keyword(s):  
United States ◽  
Mentally Ill ◽  
Mental Health Treatment ◽  
The United States ◽  
Lunatic Asylum ◽  
Free Blacks ◽  
Early Form ◽  
Specialized Institutions ◽  
Historical Developments ◽  
The Relationship

Though the origins of asylums can be traced to Europe, the systematic segregation of the mentally ill into specialized institutions occurred in the United States only after 1800, just as the struggle to end slavery took hold. This book examines the relationship between these two historical developments, showing how slavery and ideas about race shaped early mental health treatment in the United States, especially in the South. These connections are illuminated through the histories of two asylums in Virginia: the Eastern Lunatic Asylum in Williamsburg, the first in the nation; and the Central Lunatic Asylum in Petersburg, the first created specifically for African Americans. Eastern Lunatic Asylum was the only institution to accept both slaves and free blacks as patients and to employ slaves as attendants. Drawing from these institutions' untapped archives, this book reveals how slavery influenced ideas about patients’ rights, about the proper relationship between caregiver and patient, about what constituted healthy religious belief and unhealthy fanaticism, and about gender. This early form of psychiatric care acted as a precursor to public health policy for generations.

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