Chapter 8 Mental Health and Mental Illnesss Introduction to Human Services: Through the Eyes of Practice Settings, 3 rd Edition Michelle E. Martin © 2014

Chapter 8

Mental Health and Mental Illnesss

Introduction to Human Services: Through the Eyes of Practice Settings, 3rd Edition

Michelle E. Martin

© 2014 by Pearson Education, Inc. All rights reserved.

• Evil spirits– trepanning.

• Hippocrates believed that mental illness came from an imbalance in the body’s four humors (blood, black bile, phlegm, yellow bile).

• Witchcraft– Boston witch trials– Ergot poisoning

Early Explanations of Mental Illness

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Hippocrates’ 4 Humors

• Many definitions have been proposed, yet none are universally accepted

• Most definitions, however, share some common features…– “The Four Ds” Deviance – Different, extreme, unusual Situational context - the social or

environmental setting of a person’s behavior.

Definitions of Abnormality

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• Distress – Unpleasant and upsetting

• Danger – Poses risk of harm

• Dysfunction – Causes interference with life– Maladaptive

Definitions of AbnormalityDefinitions of Abnormality

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The History of Mental Illness: Perceptions and Treatment

• Asylums – almshouses – work houses• Dorothea Dix (1840s)• The Deinstitutionalization of the Mentally Ill

– Mental Health Study Act– Community Mental Health Centers– The passage of the CMHC Act set the

deinstitutionalization movement into motion– Outpatient– Prison System

Diagnosis

• The controversy of diagnosis.– Once a ____ always a _____– Self-fulfilling Prophesy– Stereotypes– Trouble with treatment


"On being sane in insane places"

• David Rosenhan, psychologist (Journal Science in 1973) – Phase 1 - "pseudopatients" (three women and five men)

• briefly feigned auditory hallucinations • gained admission to 12 different psychiatric hospitals in five different

States• All were admitted and diagnosed with psychiatric disorders. • After admission, the pseudopatients acted normally and told staff that

they felt fine and had not experienced any more hallucinations. • All were forced to admit to having a mental illness and agree to take

antipsychotic drugs as a condition of their release. • The average time that the patients spent in the hospital was 19 days. • Other patients knew they were faking.


"On being sane in insane places"

• Phase 2 - an offended hospital administration challenging Rosenhan to send pseudopatients to its facility, whom its staff would then detect. • Rosenhan agreed and in the following weeks out of

193 new patients the staff identified 41 as potential pseudopatients, with 19 of these receiving suspicion from at least 1 psychiatrist and 1 other staff member.

• In fact Rosenhan had sent no one to the hospital.


Diagnosis

• ICD-10 Codes For Mental Disorders

• Diagnostic and Statistical Manual, Version IV, Text Revision and now DSM V– Includes definitions of disorders, their

symptoms, and criteria.• http://www.psyweb.com/• Differences between 4 and 5



Common Mental Illnesses and Clinical Issues

• The first two axes of the DSM-V are the ones most commonly used

• Clinical or mental disorders are diagnosed on Axis I

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Mental Health Practice Settings and Counseling Interventions

• Intervention Strategies– The mental health community’s tendency to

approach mental illness from a pathological perspective

– An alternative approach to viewing mental illness is to use a strengths perspective

• Positive Psychology• Self-sufficiency & self-determination


Mental Illness and Special Populations

• Mental Illness and the Prison Population: The Criminalization of the Mentally Ill– Inadvertent shifting of chronically mentally ill

patients from public hospitals to jails & prisons– Women are particularly overrepresented in

the prison population– Mental Health Courts


Current Legislation Affecting Access to Mental Health Services

• Other Federal Legislation– Former president George W. Bush announced

the establishment of New Freedom Initiative• Equal integration of mentally ill into community

– Complaints of the commission’s report• Slow recovery• Slow application of new treatment methods


Current Legislation Affecting Access to Mental Health Services

• Mental Health Parity– Some mental illnesses take a lifetime to

develop; others seem to hit out of nowhere– Mental Health Parity Act was passed in 1996– The Mental Health Parity and Addiction Equity

Act of 2008– Patient Protection and Affordable Care Act of

2010• Insurance companies are to treat mental illness like

physical illness.

Documents

Chapter 8 Mental Health and Mental Illnesss Introduction to Human Services: Through the Eyes of Practice Settings, 3 rd Edition Michelle E. Martin © 2014