471E4--Week 1 Questions/Comments--Thursday

Overall questions/comments
Who defines what is concidered mentally ill? - Kasey Mooore

This week's reading attempted to give us a brief over but I think it reiterated just how difficult it is to pinpoint mental illness.- Maggie Nunn I wonder what stigma there was on the families of those who were mentally ill, especially in times where the illness was blamed on bad childhood experiences. -Kasey Moore

I was struck by the language used to describe mental illness and the mentally ill. Words that are not as commonly used today such "lunatic" and "insane" seem to reflect a permanent state, whereas "mentally ill," sounds rectifiable. Does this reflect the change in availability and types of treatment over time, or is it simply a change in appropriate language? -Joanna Jourdan

You often do not dwell on the landscape or architecture of a mental institution and most certainly do not affiliate them with the treatment of the mentally ill. I think it will be interesting to discover Kirkbride’s reasoning behind the landscape and architecture and whether or not it had to do with treatment. What I found intriguing about the Wikipedia page was the lack of architectural designs of the buildings and how they advanced overtime. Also there is a lack of information on the decline of mental institutions and how many have been closed because of deinstitutionalization. What has happened to the majority of mental institutions? -Jack Hylan

The consensus I got from these articles is that mental institutions are an obsolete type of medical care. They were useful when no one knew what to do or where to place their ill loved ones, but the majority of patients never recovered enough to leave. Also, the types of medications have changed over time. Many people with minor cases are just able to maintain their condition with a pill or other modern medicine. -Emily Barry

It never occurred to me to consider the racial differences and tensions that were involved in mental hospitals until Tomes mentioned that it would be something she would have included had she written the book today. I would like to read/hear more about that...--Carly W.

How can the history of Mental Illness be address without a common understanding or definition of what mental illness is and how it as area of focus for study relates to historical study?-Ronnie Vest

Great point Ronnie, I was wondering the same thing.- Courtney Collier

All of this weeks authors seem to address the topic of mental illness from different view points or focus areas. Which author Grob, Tomes, or Shorter best addresses Mental Health and Why?- Ronnie Vest

In 20 to 30 years, what will psychiatric practices be like? - Katie Tryon

In regards to Ronnie's question...I'm not entirely sure if there is a "best" way to address mental health, especially because, as Kasey pointed out, "What defines mental illness?" Each of the pieces does focus on a different aspect of mental health, and I think that it's only through looking at all three that we can obtain a clearer view of mental illness and how it fits into American society. I am also interested in the role of architecture...these asylums were meant to provide solace and solution, so what made them so unique? Why is it that we find comfort in certain structures? --Chelsea Chin

Both Tomes and Shorter acknowledge how mental health, associated policy, and institutions involve a multifaceted history of contesting and numerous viewpoints. They believe past historiography promotes singular perspectives often used to promote an agenda rather than the truth, I believe by acknowledging these prior flaws and working to correct the bias Tomes and Shorter are right in correcting the revisionist histories that put the historical subject of mental health and its institutions in a negative light. -Scott Campbell

In Tomes it begins to talk about how patients do not have to be given special care if they refuse the treatment? This may be insensitive but if a person is very mentally ill and a risk to themselves and others, would it not be better to take a person in order to receive some type of help? Also in Grob's preface it mentions that the number of mentally ill people is close three million. However it does not seem to be a very popular discussion topic. If people were more open about illnesses would it be easier and more acceptable for people to seek out help? - Morgan Hayes

Who & what precisely sets the parameters/establishes the criteria for determining if someone is in fact mentally ill? How do we balance their needs with the shared needs of society? How has our understanding of mental health evolved, if at all? These seem to be the key questions I keep coming back to.-Alex Young

Grob, Mad among Us
Grob's interest in Americans' response to the mentally ill fascinates me because even today, there is such a stigma against people with a psychological disorder. For those who suffer from disorders, they must struggle against a generally negative opinion of the mentally ill. I want to know how this stigma developed. Why can we look at a person with a broken arm or chicken pox and wince when we do, but then carry on with our lives when, on the flipside, someone mentions that they have a psychological disorder of some sort causes us to look at them with big eyes and then scoot away? --Chelsea Chin

In Gerald N. Grob’s book Mad Among Us; I felt he made a great point at the end how mental illness treatment is a never ending problem. Even with today’s technology there are many problems we have yet to solve in American society. While history shows the misery and torture of the mentally handicapped would they have been any better off living in a community who knew very little about how to treat or help them? Mental illness is a tough subject to discuss today so I can only imagine how obscure it was in the previous times. – Courtney Collier

Tomes, Art of Asylum Keeping
Tomes mentions that earlier psychiatrists condemned immorality (alcoholism, bad parenting,etc.), saying that it would cause mental instability. Because of that, I found it strange that Kirkbride and other psychiatrists during his time were so keen on making sure that both patients and their families felt no sort of guilt for the mental illness effecting their lives--they credited it to natural issues out of patients and their family's controls. Was their authority ever questioned because of these contradictions? -Carly W.

Kirkpride is the focus of this article, and Tomes argues that Kirkpride although controversial in doctor/patient relations was a a brilliant visionary cutting new paths for the advancement of treatment for the mentally challenged. this article I found really interesting. I think it should be remembered that this is the far beyond even what was considered wrong in the 1950s and 1960's. the nineteenth century saw some practices in all areas that would be considered extremely barbaric, mainly due to the lack of understanding in what mental illness was, and how to effectively care for those with problems. Kirkpride may indeed have been a visionary well ahead of his time one thing is certain he led an interesting life to marry a patient and get shot by another.-Ronnie Vest

Tomes mentions that asylums were disillusioning due to being filled with patients who did not get better and it made me wonder the psychological effects it had on the staff caring for these patients? - Katie Tryon

Tomes' thesis involves the transformation of the mental institution with a focus on the drastic changes, but she also emphasizes "significant continuities." What could the continuities/similarities be? -Scott Campbell

Moral treatment is the foundation of early mental illness programs, Kirkbride builds asylum architecture around this treatment program. What is the goal of his "architectural statement" and how does it play into the period? -Scott Campbell

Tomes says that she was struck by the use of the asylum as a form of family protection and that most people in the asylums were committed by their family. Also, she says that the patient's family and the doctor cooperated in the treatment, but that the patient was excluded. The question of whether or not is is correct for the patient to be involved in their treatment has been discussed in the other readings, and it seems to have been a heated topic of discussion. However, it seems to me that there would have been a fine line defining who was involved in the decision making, defined by many factors, with the patient's lucidity among them. -Joanna Jourdan

As I was reading the Nancy Tomes piece I was drawn to the quote she added from Andrew Scull, a sociologist, which stated the asylum was, “a convenient place to get rid of inconvenient people.” Scull was referring to families who did not want to put up with their relatives to care for them. Perhaps the reason not many patients received help and healing was due to their lack of a substantial illness. Although this statement brings less credibility to mental hospitals the true fact is that throughout history those with mental disabilities were always put last and used for experiments whether it was for their well-being or not. They were used because they were seen as less important. If they died it would not be a tragic loss as if someone who was seen as “normal” was put in danger. I remember when I visited the Holocaust Museum I learned how the Nazis simply disposed of the mentally handicapped. The statement made by Scull was harsh but in many cases very true. – Courtney Collier

Shorter, History of Pyschiatry
I really liked how Shorter noted the complexity of mental health and therefore, the problem doing historical research on the subject. She noted how no historian can be entirely accurate because there is an ample of information that hasn't be discovered. To me, this makes a ton of sense and is one of the reasons why mental health history is rarely talked about.- Maggie Nunn

Shorter's preface, to me, was interesting because it seemed to focus more on brain chemistry and genetics as a connection to mental illness. After reading all three preface's it seems like qualities from each one would make the approach to mental illness better. By encouraging people to go out into the world and be confident along with therapy and medication seems to be a good approach, but as Shorter points out there may not be enough research into the field of mental health to really establish a successful form of treatment at this point. - Morgan Hayes

Wikipedia article on History of Psychiatric Institutions
I was amazed at how little attention was given to Eugenics in the Wikipedia article. - Kasey Moore

Kasey, I agree! I was also surprised that there was only a few sentences on Eugenics. - Katie Tryon

I agree with both of you guys, I was surprised that there was not more information about eugenics. The article also did not specify WHY people were institutionalized...I know that for the section on medieval institutions, they mention the Reconquista, but did not include that some people were institutionalized because they simply disagreed with the Christian monarchs. I also think that they could have addressed the impact of 1800s movements, such as Romanticism. --Chelsea Chin