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From Mental Hygiene to Community Psychiatry

From Mental Hygiene to Community Psychiatry. CLIFFORD BEERS. 1908. National Committee for Mental Hygiene (1910). Adolf Meyer (1866-1950) Chief of Psychiatry Johns Hopkins University 1909-1941 Director of: Henry Phipps Psychiatric Clinic 1913 . Mental Hygiene.

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From Mental Hygiene to Community Psychiatry

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  1. From Mental Hygiene toCommunity Psychiatry

  2. CLIFFORD BEERS 1908 National Committee for Mental Hygiene (1910)

  3. Adolf Meyer (1866-1950) Chief of Psychiatry Johns Hopkins University 1909-1941 Director of: Henry Phipps Psychiatric Clinic 1913

  4. Mental Hygiene • Prevention of mental illness through public health education: lectures, pamphlets, courses. • Focus on emotional adjustment: helping people to change bad habits, adjust to challenges of life. • Concerned with child delinquency, alcoholism, immoral behavior, immigrant mental health and syphilis. • Operated in new locales: child-guidance clinics, juvenile courts, school counseling centers. • Assisted by emergence of new professional role of the psychiatric social worker. • Team approach to treatment: psychiatrist, psychologist and social worker. • Focus on maintaining mental health.

  5. Mental Hygiene Films 1945-1970

  6. "The burden of my theme is that to raise the level of the activity and knowledge of mental hygiene throughout the world is the soundest way of establishing permanently mutual understanding and good feeling among nations." John R. Lord, “The Human Factor in International Relations,” Mental Hygiene, April 1934.

  7. From: Social Work Today, July 1934

  8. Exposés of the Cleveland State Hospital, 1943 Initiated by Conscientious Objectors (COs)

  9. Cleveland State Hospital

  10. “BEDLAM, 1946” Albert Q. Maisel Life Magazine May, 1946

  11. “BEDLAM, 1946”

  12. “Bedlam, 1946”

  13. “Thousands spend their days—often for weeks at a stretch—locked in devices euphemistically called 'restraints’: thick leather handcuffs, great canvas camisoles, 'muffs,’ 'mitts,’ wristlets, locks and straps and restraining sheets. Hundreds are confined in 'lodges’—bare, bedless rooms reeking with filth and feces—by day lit only through half-inch holes in steel-plated windows, by night merely black tombs in which the cries of the insane echo unheard from the peeling plaster of the walls.” Maisel, Life 1946

  14. Albert Deutsch (historian of medicine, social reformer) (1948)

  15. Byberry, Philadelphia State Asylum, 1946

  16. Shame of States

  17. Scenes from Byberry, 1942-1946

  18. Byberry Hospital

  19. Manhattan Hospital Byberry Hospital Overcrowded day rooms: enforced idleness

  20. Napa State Hospital, California

  21. “Bedlam” 1946

  22. Oscar Nominated, “The Snake Pit” 1948

  23. Menninger Clinic, 1925Topeka Kansas Drs. C.F, Karl and William Menninger

  24. William Menninger Brigadier General US Surgeon General’s Office Neuropsychiatry Division

  25. Innovations: Milieu Therapy Group Therapy And Open Hospital

  26. October,1948

  27. Mental Health Legislation-1 • 1946 –National Mental Health Act, which called for the establishment of a National Institute of Mental Health. • 1949 –NIMH was formally established; it was one of the first four NIH institutes. Robert Felix was first director. • 1955 – The Mental Health Study Act called for "an objective, thorough, nationwide analysis and reevaluation of the human and economic problems of mental health." The resulting Joint Commission on Mental Illness and Health was formed.

  28. Mental Health Legislation-2 • 1961 – Action for Mental Health, a 10-volume series, assessed mental health conditions and resources throughout the United States • 1963 – President Kennedy submitted a special message to Congress –Congress quickly passed the Mental Retardation Facilities and Community Mental Health Centers Construction Act beginning a new era in Federal support for mental health services. NIMH assumed responsibility for monitoring the Nation's community mental health centers (CMHC).

  29. Improve national health Provide emergency services, evaluation, consultation, education of community Broad spectrum of services: partial hospitalization, outpatient and inpatient Focus on prevention; situated in communities Federal monies not forthcoming (cut from 657 to 284 million) Problems with staff training Rejection by communities: questioned authority of psychiatrist; lack of attention to social justice issues. Only 745 CMHC built; were supposed to be 2000. Not enough attention to seriously mentally ill No evaluations of centers; not accountable Community Mental Health Centers GOALS REALITY

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