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CHANGING CONCEPTIONS OF MENTAL ILLNESS

CHANGING CONCEPTIONS OF MENTAL ILLNESS. CONCEPTIONS OF MENTAL ILLNESS. HOW VIEWS OF MENTAL ILLNESS HAVE CHANGED OVER TIME CURRENT CONCEPTIONS OF MENTAL ILLNESS WHERE DRAW THE LINE BETWEEN MENTAL ILLNESS AND NORMALITY?. PRE 20TH CENTURY. PRE-20TH CENTURY. MENTAL ILLNESS IS UNIVERSAL

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CHANGING CONCEPTIONS OF MENTAL ILLNESS

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  1. CHANGING CONCEPTIONS OF MENTAL ILLNESS

  2. CONCEPTIONS OF MENTAL ILLNESS • HOW VIEWS OF MENTAL ILLNESS HAVE CHANGED OVER TIME • CURRENT CONCEPTIONS OF MENTAL ILLNESS • WHERE DRAW THE LINE BETWEEN MENTAL ILLNESS AND NORMALITY?

  3. PRE 20TH CENTURY

  4. PRE-20TH CENTURY • MENTAL ILLNESS IS UNIVERSAL • MENTAL ILLNESS LIMITED TO SMALL NUMBER OF MOST SERIOUS CONDITIONS • MENTALLY ILL HIGHLY STIGMATIZED

  5. CAUSES • NOT MUCH KNOWN • SUPERNATURAL • BRAIN DISEASE

  6. EARLY TREATMENT • PRE-19TH CENTURY - LEFT TO FEND FOR SELVES • NO OUTPATIENT TREATMENT • 19TH CENTURY - SHUT AWAY IN INSTITUTIONS

  7. PRE-20TH CENTURY • LIMITED TO SMALL NUMBER OF SEVERE CONDITIONS • MENTALLY ILL BIZARRE AND DIFFERENT • CAUSES UNKNOWN • INSTITUTIONALIZED

  8. 1900 - 1980

  9. 20th CENTURY VIEWS • FIRST PSYCHIATRIC MANUAL AT BEGINNING OF 20TH CENTURY – 19 OF 20 CONDITIONS PSYCHOTIC • DSM NOW - NEARLY 400 DIFFERENT MENTAL ILLNESSES • TREMENDOUS BROADENING OF CONDITIONS VIEWED AS MENTAL ILLNESSES

  10. EXPANSION OF M.I. • SIGMUND FREUD • EVERYONE TO SOME EXTENT IS M.I. • IDEAS BEGAN TO EXPAND THROUGH THE CULTURE - MOVIES, BOOKS, PROFESSIONS

  11. RESPONSE • OUTPATIENT TREATMENT IN COMMUNITY • PSYCHOTHERAPY • FOR MOST PART, LIMITED TO ELITE

  12. CURRENT CONCEPTIONS

  13. CURRENT CONCEPTIONS • BEGAN WITH DSM-III (1980) • NOT JUST MOST SEVERE CONDITIONS BUT MANY DIFFERENT CONDITIONS

  14. M.I. WIDESPREAD • NO LONGER SEEN AS UNUSUAL BUT MANY PEOPLE AFFECTED BY THEM • 50 PERCENT OF POPULATION OVER LIFETIME; 20 PERCENT IN ANY GIVEN YEAR

  15. NORMALIZATION • MENTALLY ILL NOT SEEN AS DIFFERENT FROM NORMAL • MENTALLY ILL NOT CERTAIN KIND OF PERSON BUT NORMAL PERSON WITH PARTICULAR DISEASE

  16. MEDICALIZATION • NORMAL PEOPLE HAVE MEDICAL CONDITION • TREATED BY PROFESSIONALS

  17. BIOLOGICAL CAUSES • MENTAL ILLNESSES VIEWED AS BRAIN DISEASES • GENETICS AND BRAIN CHEMISTRY AT FAULT

  18. TREATMENT • SSRI - SELECTIVE SEROTONIN REUPTAKE INHIBITORS - “ANTI-DEPRESSANTS” • HUGE INCREASE IN DRUG TREATMENT - 60 MILLION SCRIPTS • 3 OF 7 MOST PRESCRIBED DRUGS

  19. THERAPEUTIC CULTURE • MANY BEHAVIORS MEDICALIZED • MENTAL ILLNESS IS COMMON • MENTALLY ILL NOT DIFFERENT • RISING NUMBERS OF PEOPLE IN TREATMENT AND OF MENTAL HEALTH PROFESSIONALS

  20. RATES OF TREATMENT

  21. M.H. PROFS. 1980-2000

  22. SUMMARY OF TRENDS • FROM ONLY SERIOUS TO MANY CONDITIONS • FROM RARE TO WIDESPREAD • FROM STIGMATIZED TO MEDICALIZED • FROM UNKNOWN CAUSES TO PRESUMED BIOLOGICAL

  23. SUMMARY OF TRENDS • FROM INSTITUTIONS TO OUTPATIENT THERAPY TO DRUGS • FROM SEGREGATION TO PART OF CULTURE

  24. WHERE DRAW THE LINE? • ARE TOO MANY CONDITIONS MEDICALIZED NOW? • HOW CAN WE SEPARATE WHAT’S M.I. FROM WHAT’S NORMAL?

  25. SOPRANOS • BEHAVIORS VIEWED AS DISEASES • CHANGE OVER TIME FROM ROWDY TO SICK • CONFLICT WITH MUCH LAY CULTURE • RISE OF M.H. PROFESSIONALS • TREATMENT NOT PUNISHMENT

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