A Brief History of Mental Health and its Stigma

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My First Experience with a Mental Health Disorder

I’m twelve, sitting on a plaid, sectional coach in my aunt’s  living room, trying to concentrate on my homework, but I’m distracted. No, I’m terrified.

Ten feet away, Aunt Sylvie is in the kitchen muttering, pacing back and forth. I’ve never seen her behave this way before.

My mom dropped me off at my aunt’s place for a few hours while she ran errands.

There was no way to contact my mother without going into the kitchen where the phone hangs on the wall. This was before cell phones became an everyday item.

Not knowing what to do, I pretend to be oblivious to my aunt’s conversations and pacing.

She seems agitated, and the last thing I want to do was cause her more frustration.

Aunt Sylvie stops her pacing, speaking in hushed tones to someone who is not there.

“Listen. You’re not fooling anyone; I know you’ve been watching me. Are you working for the KGB?”

Crash!

I jump, hearing what sounds like a baking sheet being slammed on the kitchen counter.

Soon my mom arrives and being a nurse, she calms my aunt down, speaking in soothing tones. Within minutes, my aunt’s anxiety and paranoia subsides.

Afterwards, my mom told me my aunt’s episode was caused by forgetting to take her medication, The incident was the first time (at least to my mom’s knowledge) that this happened.

It was witnessing my mom’s calm demeanor that helped reassure me. When we got home, she shared more information on bipolar disorder, giving me a deeper understanding and compassion for my aunt and her condition.*

Bipolar Disorder

Bipolar disorder is where someone experiences tremendous highs of well-being and insufferable lows, to the point of deep despair.

While this is a general description of the disorder, the experience is unique and personal to the individual.

Even with today’s medical advances and research, we are still learning about the brain and how it functions in processing information.

Mental health conditions and bipolar disorder have been a part of my family for a while; however, during that time, it wasn’t discussed; the subject was taboo.

Today, with mental health issues either being ignored, under-funded or both, the stigma still lives within many countries.

Mental Health Studies

To give one an idea of the state of mental health in the United States and around the world, here are some sobering findings.

A study done in 2019 by Mental Health America revealed alarming statistics.

  • Nearly 20% (19.86 percent of adults) or over 50 million adults have experienced a mental health condition.
  • Of these 50 million adults, over 27 million do not receive treatment.
  • Over 2.7 million young adults have severe depression with multiracial youth at the greatest risk.
  • A growing percentage of youth are living with major depression and nearly 60% of youth with major depression do not receive treatment.
  • Suicidal ideation continues to escalate, with 4.84% of adults having serious thoughts of suicide totaling over 12.1 million individuals.

For the world, mental health is a major concern and the urgent need for more mental health services has only increased once the pandemic took hold in 2020.

A World Bank blog by health specialist, Rialda Kovacevic, shares some daunting figures. You can read Ms. Kovacevic entire blog here:

  • Nearly 1 billion people live with a mental disorder.
  • In low-income countries, 75% of people with a disorder or condition go untreated.
  • 1-5 people affected by conflict are estimated to have a mental health condition.

Ms. Kovacevic shares more statistics from her World Bank blog, imparting these numbers:

  • The COVID-19 pandemic has disrupted, or sometimes, halting critical mental health services in 93% of countries worldwide while the demand for mental health services continues to soar.
  • The pandemic has increased demand for mental health services. Bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones.
  • Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety.
  • Countries were spending less than 2 per cent of their national health budgets on mental health and struggling to meet their populations’ needs.
  • Forecasts predict within the next ten years; depression will put more burden on nations than any other disease.
  • Every $1 dollar invested in mental health yields a $4 return.

With the last statistic, funding and providing mental health services to populations would benefit social, economic growth and well-being. With that said, why is the world lacking in offering adequate care for mental health? Ms. Kovacevic shares these insights:

  • Seeing mental health as a “luxury item” versus an essential need to our well-being.
  • Outdated service models and/or not enough preventive mental health care.
  • Lagging policies or not enough policies in place advocating mental health.
  • Shortages of human resources.

Perhaps the number one reason (and Ms. Kovacevic mentions this as well) why mental health lacks awareness, education, and funding is stigma.

What are the origins of mental health and its disorders? Our collective history sheds some insights on how the stigmatization of mental illness began and continues today.

History

As early as 5000 BCE, mental health has been studied and treated in various parts of the world.

This is clear in the papyri found in ancient Egypt highlighting their advanced studies in medicine and of the mind.

Throughout this time, the cause of mental disorders was believed to come from supernatural forces, such as an angry deity or god, or demons.

Prayer, exorcisms, atonements, and the use of amulets were ways clergy, medicine man, and medicine women would coax and extradite the supernatural force or demon from the individual.

Around the 5th Century

This belief of an outside entity causing mental health illness prevailed until the 5th century BCE when the Greek physician, Hippocrates believed and stated that mental health stemmed from imbalances of fluids within the body, not an outside force.

To bring the body back into equilibrium some treatments used were laxatives, “bleeding” the patients by using leeches, and cupping.**

Cupping is a practice where glass cups are heated and then placed on the body. As the cup cools, it creates suction, which is said to improve the flow of energy and fluids within the body, facilitate healing.

Isolation and Abandonment

During these early years, mental health patients were left in the care of their families. However, in some parts of the world, these loved ones were often hidden from the public because of the social stigma surrounding mental illness.

In places where a “pure” family lineage was of the utmost importance, family members with mental illnesses were confined to rooms, cellars, or abandoned in the streets and left to their own devices.

16th-18th Century

Starting in the 16th century, asylums were created in Europe and several years later, within the United States. The institutions were built mainly to house the growing number of individuals with mental health conditions.

These early asylums were more like prisons, where little to no treatment was provided. In darkened rooms or cells, patients were often chained to walls, allowing little mobility, subjected to torture, and lived in extreme, unsanitary conditions.

Bethlem Royal Hospital

The most notorious asylum during this time was the Bethlem Royal Hospital, often referred to as Bedlam. Located outside of London, the institution implemented bizarre treatments such as rotational therapy.

This was done by chaining a patient to a chair suspended from the ceiling and spun around at different rates of speed, sometimes for hours.

One of the most shocking aspects of Bethlem’s history was allowing the public to view inmates and patients for a small fee.

The policy was to entice family members to visit their relatives but became more of a spectacle; allowing Londoners to walk the halls of the facility marveling at patients and their dire living conditions.

A New Approach During the Late 18th Century

It wasn’t until the late 18th century when treatment towards the mentally ill and their living conditions improved.

The French physician, Philippe Pinel, was pivotal in providing an individual approach to their ailments, allowing patients to be treated with empathy and engaging with them in lengthy conversations as he took extensive notes.

His work was revolutionary and in France, he became known as the father of modern psychiatry.

Patients were given their own rooms with beds, ample sunlight and could walk freely in and around the asylum grounds. This novel approach had a major impact on patients and their well-being.

Late 1800s – Early 1900s

During the late 1800s to early 1900s, Sigmund Freud discovered psychoanalysis and his work has been influential in both psychiatry and psychotherapy. Around this same time period, Carl Jung was another trailblazer in psychology, becoming the founder of psychoanalysis.

20th Century to Present Day

Through the 20th century, psychopharmacology became a major influence in treating mental health illnesses, disorders, and conditions.

Yet, while medications have been helpful and effective, there are some who believe that patients may use medication without confronting their mental issues through counseling.***

Fear of Judgement and Isolation

Given our history towards mental illness, is it any wonder there is fear, shame and apprehension on the subject matter? 

In speaking with relatives and others who have various mental health illnesses and conditions, the overall feelings shared were fear of being judged by family members and/or being ostracized from their personal social groups and society.

Even the fear of losing one’s job was expressed if the individual shared their mental health condition with colleagues.

The stigma surrounding mental health disorders is so strong, people are scared to speak openly about it and receive help.

How do we overcome the deep-seated stigma associated with mental illness? Where can we breakdown the stigma and provide support for those in need?

I’ll be sharing ways we can have more compassion and understanding around mental health.

Until then, I’m sending compassion, peace, and grace your way.

Stacy

  • Names in the above incident have been changed to protect the innocent.
  • 2) Basic timeline and excerpts taken from: The History of Mental Illness: From Skull Drills to Happy Pills, by A.M. Foerschner 2010, Vol. 2 No. 09

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