Mental Health, Mental Illness, and Historical Perspectives

NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FOR SALE ORDISTRIBUTION © Jones &Bartlett Learning, LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC 9781284219203_CH01_Sharma.indd 1 NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning, LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC AND HISTORICAL PERSPECTIVES MENTAL HEALTH, MENTAL ILLNESS, KEY CONCEPTS Mental health Mental disorder Managed care Lobotomy Jean-Martin Charcot Jahoda’s modelofmentalhealth Health promotion Health education Health Frank Mesmer Emil Kraepelin Electroconvulsive therapy(ECT) Dorothea LyndeDix Deinstitutionalization Corpus Hippocraticum Continuum model Clifford Beers Capping Biological psychiatry Benjamin Rush Ayurveda Aulus CorneliusCelsus Augmented reality(AR) Americans withDisabilitiesAct © Jones&Bartlett Learning LLC,anAscendCompany. NOTFORSALEORDISTRIBUTION. NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FOR SALE ORDISTRIBUTION © Jones &Bartlett Learning, LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC Unani systemofmedicine 21st CenturyCuresAct Tridosha theoryofdisease Trephining Tertiary prevention Tengland’s modelofmentalhealth Taoism Sigmund Freud Secondary prevention René Descartes qi Psychosurgery Primary prevention Precision medicine Philippe Pinel Neuroleptic drugs Mixed reality(MR) Mental illness Parity Act) Mental healthparitylaw(Wellstone–Domenici Yoga Yin Yang Virtual reality(VR) NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning, LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC Chapter 1 02/06/20 6:42 PM 1

2 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

After reading this chapter you should be able to Define health, mental health, and mental illness © Jones &Describe Bartlett common Learning, models of LLCmental health © Jones & Bartlett Learning, LLC NOT FOR DelineateSALE OR the constituents DISTRIBUTION of mental health education NOT FOR SALE OR DISTRIBUTION Discuss the concept of mental health promotion Trace the historical genesis of the field of mental health Explain some contemporary trends and standards in mental health

Before explaining the meaning of mental health, let us first define © Jones & Bartlettthe meaningLearning, of health LLC, a very old term. In Old© English, Jones it &was Bartlett used Learning, LLC NOT FOR SALEas OR haelen DISTRIBUTION (to heal) and in Middle English as heltheNOT, meaningFOR SALE to be OR DISTRIBUTION sound in body, mind, or spirit. The word was related to the practice of medicine. In the ancient Greek civilization, the definition of medicine was to “prolong life and prevent disease” or, in other words, to keep people healthy (Cook, 2004). Similarly, the term for medicine © Jones & Bartlett Learning,in LLC ancient India was Ayurveda,© or Jones the science & Bartlettof life or health. Learning, By the LLC NOT FOR SALE OR DISTRIBUTION17th century, most medical textbooksNOT FOR were beginning SALE OR to use DISTRIBUTION the word restoration. By the end of the 19th century, the word health was considered colloquial and was replaced with hygiene, which was considered more scientific (Cook, 2004). After World War II, interest in the word health resurfaced with © Jones & Bartlett Learning, LLC the formation© of Jones the World & Bartlett Health Organization Learning, (WHO), LLC a global NOT FOR SALE OR DISTRIBUTION entity. AroundNOT the same FOR time, SALE the Hygienic OR DISTRIBUTION Laboratory in the United States was renamed the National Institutes of Health (NIH). In 1948, the WHO defined health in its constitution as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (WHO, 1974, p. 1). However, this definition of © Jones & Bartletthealth Learning, has been roundly LLC criticized over the years.© Jones & Bartlett Learning, LLC NOT FOR SALE ORFirst, DISTRIBUTION the use of the word state in this definitionNOT FORis misleading. SALE OR DISTRIBUTION Health is dynamic and changes from time to time. For example, a person may be healthy in the morning but develop a headache in the afternoon and thus is not in the “state” of health. In the evening, the person may recover from the headache, thereby attaining the “state” © Jones & Bartlett Learning,of LLC health again. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONSecond, the dimensions asNOT mentioned FOR in SALE the definition OR DISTRIBUTION are inad- equate to capture variations in health. One such dimension is the political dimension. Do the rich or the poor get sick more often?

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 2 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Concept of Health 3

Who controls ©greater Jones resources & Bartlett for health? Learning, Which section LLC of the pop- © Jones & Bartlett Learning, LLC ulation has a greaterNOT FORburden SALE of mortality? OR DISTRIBUTION All these and many more NOT FOR SALE OR DISTRIBUTION such questions pertain to the politics behind health. This dimension must be explicitly mentioned in the definition for it to be meaning- fully complete. Another dimension not mentioned in the WHO’s definition of health is the spiritual dimension (Perrin & McDermott, © Jones1997). Bensley & Bartlett (1991) Learning,identified six LLCdifferent perspectives related© to Jones & Bartlett Learning, LLC NOTthe FORspiritual SALE dimension OR ofDISTRIBUTION health—namely, sense of fulfillment, valNOT- FOR SALE OR DISTRIBUTION ues and beliefs of community and self, wholeness in life, well-being, God or a controlling power, and human–spiritual interaction. Studies have shown that spirituality is an important dimension in determining quality of life (Panzini et al., 2017). These perspectives are not men- © Jones & Bartletttioned Learning, in WHO’s original LLC definition. © Jones & Bartlett Learning, LLC NOT FOR SALE ORThird, DISTRIBUTION the word well-being is highly subjectiveNOT in its FOR connotation. SALE OR DISTRIBUTION A definition must be objective, and subjectivity must be minimized. Fourth, the way health is defined makes it extremely difficult to measure. McDowell (2006) points out that similar to language that molds our thinking,© Jones the process& Bartlett of health Learning, measurement LLC is bidirec- © Jones & Bartlett Learning, LLC tional in its influence on health. In other words, health and measurement are inextricablyNOT FOR linked. SALE Fifth, theOR way DISTRIBUTION health is defined presents NOT FOR SALE OR DISTRIBUTION an idealistic or utopian view. It would be impossible to find someone who embodies all the attributes presented in the definition. Thus, the definition of health needs to be more realistic. Sixth, health is © Jonespresented & as Bartlett an end product Learning, in the LLCdefinition, whereas most people© Jones & Bartlett Learning, LLC perceive health as a means for achieving something they value more. NOTFor FORexample, SALE a person OR may DISTRIBUTION want to be healthy so he or she can raiseNOT FOR SALE OR DISTRIBUTION a family. Finally, the WHO definition of health is written from an individualistic perspective in which health is defined for one person. It lacks the community orientation that is needed for something that © Jones & Bartlettis as complexLearning, as health. LLC © Jones & Bartlett Learning, LLC Since publication of the original WHO definition, it has been NOT FOR SALEfurther OR DISTRIBUTIONmodified in subsequent discussions at NOTthe world FOR level. SALE In OR DISTRIBUTION November 1986, the first International Conference on Health Promotion was held in Ottawa, Canada (WHO, 1986). The conference culminated with the drafting of the Ottawa Charter for Health Promotion, wherein health was defined in a broader perspective: We can define health © Jones & Bartlett Learning, LLC as a means© toJones achieve & Bartlett Learning, LLC [H]ealth hasNOT been consideredFOR SALE less as OR an abstract DISTRIBUTION state and more as desirable NOTgoals inFOR life SALE OR DISTRIBUTION a means to an end which can be expressed in functional terms as a while maintaining resource which permits people to lead an individually, socially, and a multidimensional economically productive life. Health is a resource for everyday life, (physical, mental, social, not the object of living. It is a positive concept emphasizing social political, economic, © Jonesand &personal Bartlett resources Learning, as well as LLC physical capabilities. (Ottawa © Jonesspiritual) & Bartlett equilibrium Learning, LLC Charter for Health Promotion, WHO, 1986) that is operationalized NOT FOR SALE OR DISTRIBUTION NOT FORfor both SALE individuals OR DISTRIBUTION and Keeping these aspects in mind, we can define health as a means to communities. achieve desirable goals in life while maintaining a multidimensional

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 3 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

4 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett(physical, Learning, mental, LLCsocial, political, economic, spiritual)© Jones equilibrium & Bartlett Learning, LLC NOT FOR SALEthat OR is DISTRIBUTIONoperationalized for both individuals and communities.NOT FOR SALE OR DISTRIBUTION

CONCEPTS OF MENTAL HEALTH AND MENTAL ILLNESS © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONWe are beginning to understandNOT that FORmental SALEhealth is OR an integral DISTRIBUTION part of the concept of health. In other words, a definition of health cannot be complete without including mental health. Preston (1943) defines mental health as the ability to be happy and productive without being a nuisance to others. Guntrip (1961) defines mental health as the capac- © Jones & Bartlett Learning, LLC ity to live life© completely Jones & and Bartlett realize Learning,one’s own natural LLC potentials. NOT FOR SALE OR DISTRIBUTION According to NOTthe WHO FOR (2019), SALE mental OR health DISTRIBUTION comprises four things: 1. realizing one’s abilities, 2. coping with normal stressors, 3. working productively and fruitfully, and © Jones & Bartlett 4.Learning, the ability to LLC make contributions in one’s ©community. Jones & (WHO, Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION2019, p. 1) NOT FOR SALE OR DISTRIBUTION The U.S. Surgeon General’s report on mental health (U.S. Department of Health and Human Services [USDHHS], 1999) uses a “wide angle lens” to depict both mental health and mental illness. This report notes that the mental health field previously focused primarily © Jones & Bartlett Learning,on LLC people with mental illnesses,© Jonesbut more & recently Bartlett it is Learning, focusing on LLC NOT FOR SALE OR DISTRIBUTIONmental illness prevention and mentalNOT healthFOR promotion.SALE OR DISTRIBUTION Is mental health an absence of mental illness? Some have suggested a continuum model with mental health on one end and mental illness on the other (Trent, 1993). Although there is merit to this conceptualization, it looks at mental health as an absence of mental © Jones & Bartlett Learning, LLC illness. This is© not Jones always &true. Bartlett For example, Learning, a person LLCmay suffer from NOT FOR SALE OR DISTRIBUTION depression. ThisNOT person FOR seeks SALE treatment OR DISTRIBUTIONand is placed on antidepres- sant medication. This person may enjoy good mental health while still suffering from mental illness. Further, the continuum model repre- sents a disease orientation to mental health. Many myths and fears are associated with mental illness, and stigmas are attached to those who © Jones & Bartlettare mentally Learning, ill. The LLC model also lends itself to victim© Jones blaming & by Bartlett plac- Learning, LLC NOT FOR SALEing OR responsibility DISTRIBUTION for being mentally ill on the person.NOT FORThis may SALE not OR DISTRIBUTION always be the case because biological and genetic factors play an important role in causation of mental illness (Trimble & George, 2010). All these reasons make this model less appealing to most people. Further, this model seeks to answer the question of what makes people sick, © Jones & Bartlett Learning,whereas LLC the more important focus© Jones of a mental & Bartlett health model Learning, should be LLC NOT FOR SALE OR DISTRIBUTIONon what makes people healthy NOT(Cattan, FOR 2006). SALE OR DISTRIBUTION Mental disorder or mental illness is defined in many ways. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 4 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Concepts of Mental Health and Mental Illness 5

is considered ©to Jonesbe a well-known & Bartlett authority Learning, in this LLCarea (American © Jones & Bartlett Learning, LLC Psychiatric AssociationNOT FOR [APA], SALE 2013). OR When DISTRIBUTION it comes to defining men- NOT FOR SALE OR DISTRIBUTION tal disorders, the DSM-5 identifies the following factors (APA, 2013): • A behavioral or psychological syndrome or array of symptoms that manifest in an individual; © Jones• A &condition Bartlett that Learning, is reflective ofLLC an underlying psychobiological© Jones & Bartlett Learning, LLC NOT FORdysfunction; SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • A condition whose manifestations typically include clini- cally significant distress (e.g., a painful condition) or disability or impairment in one or more important areas of normal functioning; © Jones & Bartlett• Learning, A condition LLC that is simply not a usual response© Jones to common& Bartlett Learning, LLC NOT FOR SALE OR stressorsDISTRIBUTION or losses (e.g., the loss of a lovedNOT one) orFOR a culturally SALE OR DISTRIBUTION accepted response to certain situations (e.g., trance states in some religions); • A condition that is usually a result of social deviance or conflicts with the society. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Therefore, mental disorder comprises behavioral or psychological signs and symptomsNOT that causeFOR misery SALE to OR the DISTRIBUTIONindividual; result in loss of NOT FOR SALE OR DISTRIBUTION physical, mental, social, or occupational functioning; and may lead to greater risk of morbidity, mortality, or loss of freedom. Mental illnesses are just like other biological chronic diseases, such as heart disease or © Jonesdiabetes, &with Bartlett a multifactorial Learning, etiology LLC that has following dimensions:© Jones & Bartlett Learning, LLC NOT FOR• genetics, SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • psychosocial factors, • environmental stressors, • autoimmune factors, and • spiritual dimensions. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Austrian–British social psychologist Marie Jahoda (1907–2011) NOT FOR SALEdeveloped OR DISTRIBUTION a popular model for mental health usingNOT several FOR criteria SALE she OR DISTRIBUTION considered essential for mental health (Jahoda, 1958). Jahoda’s model of mental health comprises the following criteria (Seedhouse, 2002; Tengland, 2001): • Being realistic.© Jones According & Bartlett to this criterion,Learning, a mentally LLC healthy © Jones & Bartlett Learning, LLC person mustNOT be FOR able to SALE compare OR him DISTRIBUTION or herself with others in an NOT FOR SALE OR DISTRIBUTION objective fashion, and this assessment should lead to an image similar to that held by others. • Self-acceptance. According to this criterion, a mentally healthy person must accept him or herself as he or she is without any © Jonescomplaints. & Bartlett To Learning,be mentally healthy, LLC one should not feel bad© or Jones & Bartlett Learning, LLC NOT FORinferior SALE if one OR is notDISTRIBUTION perfect. NOT FOR SALE OR DISTRIBUTION • Investment in living. A mentally healthy person is positively concerned with other people and wants to be part of things around

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6 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett Learning,him or her. LLC This also includes having long-term© Jones goals & Bartlettin life Learning, LLC NOT FOR SALE OR DISTRIBUTIONand having enough motivation to achieveNOT those goals.FOR SALE OR DISTRIBUTION • Independence. A mentally healthy person is able to make inde- pendent decisions from a variety of environmental stimuli. • Environmental mastery. In this criterion, a mentally health person must be able to fulfill the following six factors: (1) demonstrate © Jones & Bartlett Learning, LLCability to love; (2) show adequacy© Jones in work,& Bartlett love, and Learning, play; (3) be LLC NOT FOR SALE OR DISTRIBUTIONadequate in interpersonalNOT relationships; FOR SALE (4) be efficientOR DISTRIBUTION in meet- ing situational necessities; (5) be able to adjust and adapt; and (6) be efficient in problem solving. Per-Anders Tengland (2001) also discussed several criteria for © Jones & Bartlett Learning, LLC mental health.© Tengland’s Jones & model Bartlett of mental Learning, health LLC defines 11 char- NOT FOR SALE OR DISTRIBUTION acteristics essentialNOT for FOR a mentally SALE healthy OR DISTRIBUTIONperson (pp. 137–138): 1. Ability to have high degree of correct memory 2. Ability to correctly perceive various stimuli 3. Exhibit high degree of rationality © Jones & Bartlett Learning,4. Possess self-knowledge LLC © Jones & Bartlett Learning, LLC 5. Exhibit flexibility NOT FOR SALE OR 6.DISTRIBUTION Ability to experience emotions NOT FOR SALE OR DISTRIBUTION 7. Ability to feel empathy 8. Possess self-esteem and self-confidence 9. Demonstrate ability to communicate cognitive information © Jones & Bartlett Learning, LLC10. Identify what is appropriate© Jones in a communication & Bartlett Learning, LLC 11. Ability to cooperate NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION MacDonald (2006) notes that Western authors have defined mental health and mental illness primarily from an individualistic perspective, which may not necessarily be accurate. This individualistic perspective is not depicted in other cultures. For example, Markus © Jones & Bartlett Learning, LLC and Kitayama© (1991) Jones from & Japan Bartlett talk about Learning, “shared life LLC space” instead NOT FOR SALE OR DISTRIBUTION of the “self.”NOT MacDonald FOR SALE(2006) advocatesOR DISTRIBUTION for a less individualistic and more social and ecological account of mental health. Social and cultural conditions and processes contribute to a large extent to the mental health of any person and must be included in defining and con- ceptualizing mental health. The structural inequalities that contribute © Jones & Bartlettto mental Learning, health and LLC mental illness must be addressed.© Jones In this & context, Bartlett Learning, LLC NOT FOR SALEwe OR define DISTRIBUTION mental health as the ability of an individualNOT FOR to fulfill SALE his OR DISTRIBUTION We define mental health or her obligations to self and society while living in mutual harmony as the ability of an with the physical and social environments. Mental health depends individual to fulfill his on a complex set of factors that are shaped by genetics, physiological or her obligations to self makeup, psychological beliefs, attitudes, and values, including a spiri- and society while living © Jones & Bartlett Learning,tual LLC belief system and an individual’s© Jones physical & Bartlettand social environment,Learning, LLC in mutual harmony with NOT FORthe physical SALE and OR social DISTRIBUTION including politics and economics.NOT A harmonyFOR SALE or balance OR inDISTRIBUTION thoughts, environment. words, and actions through self-reflection is one helpful approach in accomplishing this desirable state (Sharma, 2018).

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Health Education and Health Promotion 7

HEALTH© EDUCATIONJones & Bartlett Learning,AND HEALTH LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION PROMOTION

Before we discuss mental health education and mental health promotion, we need to understand health education and health pro- © Jonesmotion. Health& Bartlett education Learning, is the profession LLC that facilitates the mod© -Jones & Bartlett Learning, LLC NOTification FOR of SALE health behaviors.OR DISTRIBUTION Health education has been definedNOT in FOR SALE OR DISTRIBUTION several ways. Downie, Tannahill, and Tannahill (1996) defined it as “[c]ommunication activity aimed at enhancing positive health and preventing or diminishing ill health in individuals and groups through influencing the beliefs, attitudes and behavior of those with power © Jones & Bartlettand of Learning, the community LLC at large” (p. 27). The 2000© JonesJoint Committee & Bartlett Learning, LLC NOT FOR SALEon OR Health DISTRIBUTION Education and Promotion TerminologyNOT (Gold FOR & Miner,SALE OR DISTRIBUTION 2002, p. 6) defined health education as “any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire information and the skills needed to make quality health decisions.” The WHO (1998, p. 4) defined© Jones health & educationBartlett asLearning, “compris[ing] LLC consciously © Jones & Bartlett Learning, LLC constructed opportunitiesNOT FOR for SALE learning OR involving DISTRIBUTION some form of com- NOT FOR SALE OR DISTRIBUTION munication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health.” Green and Kreuter (2005, p. G-4) defined it as “any planned combination of learning experiences designed to pre- © Jonesdispose, enable,& Bartlett and reinforce Learning, voluntary LLC behavior conducive to health© Jones & Bartlett Learning, LLC NOTin individuals, FOR SALE groups OR or DISTRIBUTION communities.” NOT FOR SALE OR DISTRIBUTION From these definitions, some things are clear. First, health education is a systematic, planned application that would qualify as a science. Second, the delivery of health education involves a set of techniques rather than just one, such as preparing health education informational © Jones & Bartlettbrochures, Learning, pamphlets, LLC and videos; delivering lectures;© Jones facilitating & Bartlett role Learning, LLC NOT FOR SALEplays OR or DISTRIBUTION simulations; analyzing case studies; participatingNOT FOR and reflectSALE- OR DISTRIBUTION ing in group discussions; self-reading; and interacting in computer- assisted training. In the past, health education was used to encompass a wider range of functions, such as community mobilization, networking, advocacy, and so on. These methods are now embodied in the term health promotion© Jones; thus, & health Bartlett education Learning, is now perceived LLC as more © Jones & Bartlett Learning, LLC focused. Third,NOT the primaryFOR SALE purpose OR of health DISTRIBUTION education is to influ- NOT FOR SALE OR DISTRIBUTION ence antecedents of behavior so that healthy behaviors develop voluntarily (i.e., without coercion). The common antecedents of behavior are awareness, information, knowledge, skills, beliefs, attitudes, and values. Finally, health education is performed at several levels. It can be © Jonesdone one-on-one, & Bartlett such Learning, as a counseling LLC session; with a group of people,© Jones & Bartlett Learning, LLC NOTsuch FOR as through SALE a groupOR DISTRIBUTION discussion; at an organizational level, suchNOT as FOR SALE OR DISTRIBUTION through an employee wellness fair; or at the community level, such as through a multiple-channel, multiple-approach campaign.

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8 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett SinceLearning, the publication LLC of Healthy People: The© Jones Surgeon &General’s Bartlett Learning, LLC NOT FOR SALEReport OR DISTRIBUTIONon Health Promotion and Disease PreventionNOT (USDHHS, FOR SALE 1979), OR DISTRIBUTION the term health promotion has gained popularity and continues to gain strength. This term has been used in the Objectives for the Nation (USDHHS, 1980), Healthy People 2000 (USDHHS, 1990), Healthy People 2010 (USDHHS, 2000), and Healthy People 2020 (USDHHS, © Jones & Bartlett Learning,2009) LLC reports. It is also being© used Jones in Healthy & Bartlett People Learning,2030 report LLC NOT FOR SALE OR DISTRIBUTION(USDHHS, 2019). Green and NOTKreuter FOR (2005, SALE p. G-4) OR defined DISTRIBUTION health promotion as “any planned combination of educational, political, reg- ulatory and organizational supports for actions and conditions of living conducive to the health of individuals, groups or communities.” The 2000 Joint Committee on Health Education and Promotion Termi- © Jones & Bartlett Learning, LLC nology (Gold© & JonesMiner, 2002, & Bartlett p. 4) defined Learning, health promotion LLC as “any NOT FOR SALE OR DISTRIBUTION planned combinationNOT FOR of educational, SALE OR political, DISTRIBUTION environmental, regu- latory, or organizational mechanisms that support actions and conditions of living conducive to the health of individuals, groups, and communities.” The Ottawa Charter for Health Promotion (WHO, 1986, p. 1) defined health promotion as “the process of enabling peo- © Jones & Bartlettple to Learning, increase control LLC over, and to improve their© health.” Jones The & Ottawa Bartlett Learning, LLC NOT FOR SALECharter OR DISTRIBUTION identified five key action strategies for healthNOT promotion: FOR SALE OR DISTRIBUTION 1. Building healthy public policy 2. Creating physical and social environments supportive of individual change © Jones & Bartlett Learning, LLC3. Strengthening community© Jones action & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION4. Developing personal skillsNOT such FOR as increased SALE ORself-efficacy DISTRIBUTION and feelings of empowerment 5. Reorienting health services to the population and partnership with patients These action areas were confirmed in the Jakarta Declaration on Lead- © Jones & Bartlett Learning, LLC ing Health Promotion© Jones into & theBartlett 21st Century Learning, in 1997 LLC (WHO, 1997). NOT FOR SALE OR DISTRIBUTION In addition, theNOT Jakarta FOR Declaration SALE ORidentified DISTRIBUTION five priorities for health promotion: 1. Promote social responsibility for health 2. Increase investments for health development © Jones & Bartlett 3.Learning, Expand partnerships LLC for health promotion© Jones & Bartlett Learning, LLC NOT FOR SALE OR4. DISTRIBUTION Increase community capacity and empowerNOT the individualFOR SALE OR DISTRIBUTION 5. Secure an infrastructure for health promotion Once again, all of these depictions of health promotion have some things in common. First, just like health education, health promotion is also a systematic, planned application that would qualify as a science. © Jones & Bartlett Learning,Second, LLC it entails methods beyond© Jones mere &education. Bartlett Such Learning, methods LLC NOT FOR SALE OR DISTRIBUTIONcould consist of community mobilization,NOT FOR communitySALE OR organization, DISTRIBUTION community participation, community development, community empowerment, networking, coalition building, advocacy, lobbying,

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Understanding Mental Health Education and Mental Health Promotion 9

policy development,© Jones formulating & Bartlett legislation, Learning, developing LLC social norms, © Jones & Bartlett Learning, LLC and so on. Third,NOT unlike FOR health SALE education, OR DISTRIBUTION it does not endorse volun- NOT FOR SALE OR DISTRIBUTION tary change in behavior and uses measures that compel an individual’s behavior change. These measures are uniform and mandatory. Often, the behavior change in health promotion comes from measures that an individual may not like—for example, an increase in insurance pre- © Jonesmium for & a smoker.Bartlett Finally, Learning, health promotion LLC is done at the group© or Jones & Bartlett Learning, LLC NOTcommunity FOR SALE level. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

UNDERSTANDING MENTAL HEALTH © Jones & BartlettEDUCATION Learning, LLC AND MENTAL© HEALTH Jones & Bartlett Learning, LLC NOT FOR SALEPROMOTION OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Mental health education deals with voluntarily modifying health behaviors to bring a person into harmony with his or her environment. Such behaviors include stress-management behaviors, relaxation and adequate sleep© behaviors, Jones effective& Bartlett communication Learning, behaviors, LLC anger- © Jones & Bartlett Learning, LLC management behaviors,NOT FOR anxiety-reduction SALE OR DISTRIBUTION behaviors, healthy eating NOT FOR SALE OR DISTRIBUTION behaviors, healthy physical activity and exercise behaviors, time- management behaviors, financial management behaviors, recreation and leisure-management behaviors, and adequate work-performance behaviors (Table 1.1). © JonesMental & Bartletthealth education Learning, can be LLC achieved one-on-one through© Jones & Bartlett Learning, LLC NOTa counseling FOR SALE session, OR with DISTRIBUTION a group of people, at an organizationalNOT FOR SALE OR DISTRIBUTION level, or at the community level, such as through a multiple-channel,

Table 1.1 Behaviors Addressed in Mental Health Education © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEStress-management OR DISTRIBUTION behaviors NOT FOR SALE OR DISTRIBUTION Relaxation and adequate sleep behaviors Effective communication behaviors Anger-management behaviors © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Anxiety-reduction behaviors NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Healthy eating behaviors Healthy physical activity and exercise behaviors Time-management behaviors © JonesFinancial & management Bartlett Learning,behaviors LLC © Jones & Bartlett Learning, LLC NOTRecreation FOR SALE and leisure-management OR DISTRIBUTION behaviors NOT FOR SALE OR DISTRIBUTION Adequate work-performance behaviors

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 9 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

10 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlettmultiple-approach Learning, LLCcampaign. Mental health behaviors© Jones are applicable& Bartlett Learning, LLC NOT FOR SALEat OR primary, DISTRIBUTION secondary, and tertiary levels of preventionNOT FOR (Modeste & SALE OR DISTRIBUTION Tamayose, 2004; Sharma, Branscum, & Atri, 2014). Primary prevention refers to those preventive actions taken before the onset of a disease or injury with the intention of removing the possibility of its occurrence. When done by healthy people, all of the behaviors © Jones & Bartlett Learning,mentioned LLC previously can be ©considered Jones &primary Bartlett prevention. Learning, Sec- LLC NOT FOR SALE OR DISTRIBUTIONondary prevention refers to NOTactions FOR that blockSALE the OR progression DISTRIBUTION of an injury or disease at its incipient stage. When the abovementioned behaviors are practiced by people who are under stress, struggling with an anger problem, or experiencing anxiety, these can be considered secondary prevention behaviors. Tertiary prevention refers to those © Jones & Bartlett Learning, LLC actions taken ©after Jones the onset & Bartlettof disease orLearning, injury with LLCthe intention of NOT FOR SALE OR DISTRIBUTION assisting diseasedNOT or FORdisabled SALE people. OR When DISTRIBUTION the preceding behaviors are practiced by people who have been diagnosed with a mental illness to prevent relapses, these can be considered tertiary prevention. For mental illnesses, the tertiary level of prevention helps maintain and facilitate progress toward maximization of premorbid levels of Mental health© Jones education & Bartlettfunctioning Learning, in patients. LLC Mental health education© can Jones be practiced & Bartlett in Learning, LLC can be achievedNOT one-FOR SALEschools OR DISTRIBUTION with schoolchildren as the primary targetNOT group; FOR in work SALE sites OR DISTRIBUTION on-one through a with employees as the primary target group; in community settings counseling session, with a group of people, at an with members of the community as the primary target audience; in organizational level, or at healthcare institutions with patients suffering from different ailments, the community level. including mental illnesses, as primary target audiences; and, finally, in © Jones & Bartlett Learning,colleges LLC and universities with college© Jones students & Bartlettas primary Learning,audiences. LLC NOT FOR SALE OR DISTRIBUTIONMental health promotion entailsNOT developingFOR SALE policies, OR regulations,DISTRIBUTION and environments that are conducive to making a person become harmonious with his or her environment. The scope of mental health promotion therefore is quite wide. It entails developing policies, regulations, and environments that reduce stress, ensure adequate work for © Jones & Bartlett Learning, LLC all, foster relaxation© Jones opportunities & Bartlett for all,Learning, regulate anger LLC and associ- NOT FOR SALE OR DISTRIBUTION ated harms, reduceNOT anxiety,FOR SALE provide OR adequate DISTRIBUTION food for all, ensure adequate housing for all, provide sufficient supports for being physi cally active, and provide for enough recreation and leisure opportunities (Table 1.2). Tilford (2006) notes that mental health promotion works in three © Jones & Bartlettways: Learning, (1) by strengthening LLC individuals by building© healthy Jones skills; & Bartlett(2) by Learning, LLC NOT FOR SALEstrengthening OR DISTRIBUTION communities by improving participation,NOT FOR environ SALE- OR DISTRIBUTION Mental health promotion entails developing ments, building mental health services, and so on; and (3) by reducing policies, regulations, structural barriers to health by addressing discrimination, inequali- and environments ties, and so on. It is important to note that mental health promotion that are conducive to uses community-based approaches as opposed to individual-based © Jonesmaking & Bartlett a person becomeLearning, approaches. LLC In mental health promotion,© Jones work & Bartlett is done at Learning, the commu- LLC NOT FORharmonious SALE with OR his DISTRIBUTION or nity level using participatory approachesNOT FOR that SALEin turn buildOR theDISTRIBUTION capacity her environment. of the community and empower the individuals who reside within those communities. Still, much work in mental health promotion

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History of Mental Health 11

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Table 1.2 NOTFocus FOR of Mental SALE Health OR PromotionDISTRIBUTION NOT FOR SALE OR DISTRIBUTION Developing policies, regulations, and environments that reduce stress Developing policies, regulations, and environments that ensure adequate work for all Developing policies, regulations, and environments that foster relaxation opportunities for all © JonesDeveloping & policies,Bartlett regulations, Learning, and environments LLC that regulate anger© and Jones associated & harmsBartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Developing policies, regulations, and environments that reduce anxiety Developing policies, regulations, and environments that provide adequate food for all Developing policies, regulations, and environments that ensure adequate housing for all © Jones & BartlettDeveloping Learning, policies, LLCregulations, and environments that© Jonesprovide sufficient & Bartlett supports Learning, for being physically LLC active NOT FOR SALEDeveloping OR DISTRIBUTION policies, regulations, and environments thatNOT provide FOR enough SALE recreation OR DISTRIBUTIONand leisure opportunities

needs to be done. Many countries around the world do not have any mental health ©legislation Jones or & haveBartlett legislation Learning, that is more LLC than several © Jones & Bartlett Learning, LLC years old. Furthermore, most of the existing mental health legislation violates rather NOTthan protects FOR SALEthe rights OR of theDISTRIBUTION mentally ill. There is an NOT FOR SALE OR DISTRIBUTION ardent need around the world to remove the stigma associated with mental illnesses and treat them at par with other chronic diseases.

© JonesHISTORY & Bartlett OF Learning, MENTAL LLC HEALTH © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION The history of mental health has predominantly focused on events related to mental illness. There are a few instances from history such as from India, where yoga was used to improve and preserve mental health. The treatment of mental health disorders has under- © Jones & Bartlettgone Learning,multiple changes LLC over the years, including© someJones major & Bartlettpara- Learning, LLC NOT FOR SALEdigm OR shifts. DISTRIBUTION Over the course of history, mental illnessesNOT FORand disorders SALE OR DISTRIBUTION have been approached essentially in three different ways: supernatu- rally, biologically, and psychologically. During most of early history, the supernatural model was used to explain and attempt to remedy mental illnesses. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Primitive Times Evidence indicates that mental illnesses existed during primitive times and attempts were made to treat them. The supernatural concept of disease in general and mental illnesses in particular held that © Jonesmental illness & Bartlett was created Learning, by divinities, LLC demons, spirits, or magnetic© Jones & Bartlett Learning, LLC NOTfields FOR emanating SALE from OR the DISTRIBUTION stars and moon (hence the term lunatics).NOT It FOR SALE OR DISTRIBUTION was widely believed that mental illnesses were created by evil spirits entering into and taking over the body. These evil spirits were forced

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12 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlettout ofLearning, the body by LLC “medicine men” through magic© Jones and reincarna & Bartlett- Learning, LLC NOT FOR SALEtion. OR RecordsDISTRIBUTION indicate that some primitive tribesNOT even FOR went SALE so far OR DISTRIBUTION as to drill holes in the skulls to let evil spirits out, a technique called trephining (Horsley, 1888). Prayer and faith healing were also used, as was astrology. Exorcisms were widespread. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONAncient CivilizationNOT in FOR India SALE OR DISTRIBUTION Ancient India (2000–600 bce) was characterized by the development of Vedas or the scriptures of teachings. Initially, the Vedas were transmitted orally from one generation to another. They were eventually written in Sanskrit and primarily consist of four collections called © Jones & Bartlett Learning, LLC the Rig-Veda,© the Jones Sama-Veda & Bartlett, the Yajur-Veda Learning,, and theLLC Atharva-Veda NOT FOR SALE OR DISTRIBUTION (Romas & Sharma,NOT FOR2017). SALE Collectively, OR DISTRIBUTION these are referred to as the Samhitas. It is believed that the system of Ayurveda, or the science of life or health, also originated during this time from Atharva-Veda (Park, 2017; Subbarayappa, 2001). Ayurveda had eight branches: (1) Kayacikitsa (internal medicine), (2) Salya tantra (surgery), (3) Salakya © Jones & Bartletttantra Learning, (ophthalmology LLC and otorhinolaryngology),© (4) JonesKaumara & Bartlettbrhtya Learning, LLC NOT FOR SALE( pediatrics,OR DISTRIBUTION obstetrics, and gynecology), (5) AgadaNOT tantra FOR (toxicology), SALE OR DISTRIBUTION (6) Rasayana (geriatrics and nutrition), (7) Vajikarana (sexology), and (8) Bhuta Vidya (psychiatry and demonology) (Subbarayappa, 2001). Two classical texts of Ayurveda are Charaka and Susruta Samhita. Ayurveda believes in Pancha Bhutas, or the five elements: space, air, © Jones & Bartlett Learning,fire, LLC water, and earth. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONThe hallmark of AyurvedaNOT is the FOR tridosha SALE theory OR ofDISTRIBUTION disease. The doshas, or humors, are vata (wind), pitta (gall), and kapha (mucus). Diseases were explained as disturbances in these three humors. In Ayurveda, the mind is functionally divided into ahankara (ego), ichha (desire, will), and buddhi (intellect). Ichha, influenced by ahankara, © Jones & Bartlett Learning, LLC dictates the mind© Jones and buddhi & Bartlett takes the Learning, decisions. Also LLC linked to the NOT FOR SALE OR DISTRIBUTION tridoshas are NOTthe three FOR gunas SALE: sattva OR(truth, DISTRIBUTION goodness), rajas (activity), and tamas (inertia). The ideal state of mind is in sattvic guna, whereas the agitated mind is in rajas and the lethargic or depressed mind is in tamas. Bhuta Vidya is the specialty within Ayurveda that deals with mental illnesses. Mental disorders are broadly classified into doshon- © Jones & Bartlettmada Learning,(disorders having LLC a physical basis) and bhutonmada© Jones (disorders & Bartlett hav- Learning, LLC NOT FOR SALEing OR a purely DISTRIBUTION mental basis). NOT FOR SALE OR DISTRIBUTION The system of yoga also originated during this time. The word yoga is derived from the Sanskrit word for “union.” It is an ancient system of physical and psychic practice to keep balance. In a more modern context, yoga has been defined as “a systematic practice and © Jones & Bartlett Learning,implementation LLC of mind and ©body Jones in the & living Bartlett process Learning, of human LLC NOT FOR SALE OR DISTRIBUTIONbeings to keep harmony withinNOT self, withinFOR society,SALE andOR with DISTRIBUTION nature” (Maharishi, 1992, p. 1). The first written records of this methodology appeared around 200 bce in the Yogasutra of Patanjali (Singh, 1983).

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History of Mental Health 13

The system consisted© Jones of the & eightfold Bartlett path, Learning, or Asthangayoga LLC. The eight © Jones & Bartlett Learning, LLC conventional stepsNOT of FORAsthangayoga SALE consistOR DISTRIBUTION of Yama (rules for living in NOT FOR SALE OR DISTRIBUTION society), Niyama (self-restraining rules), Asaana (low physical impact postures), Pranayama (breathing techniques), Pratihara (detachment of the mind from senses), Dharana (concentration), Dhyana (meditation), and Samadhi (complete union with superconsciousness) (Romas & © JonesSharma, 2017).& Bartlett The techniques Learning, of yoga LLC are perhaps the most remark© -Jones & Bartlett Learning, LLC NOTable FOR contributions SALE ofOR this DISTRIBUTION era in the field of health. Yoga and meditaNOT- FOR SALE OR DISTRIBUTION tion are now well-accepted forms of approaches for their beneficial role in preserving and improving mental health. The utility of yoga has been tested in the scientific literature. This has happened mainly in the context of the prevention and treatment of ailments. Yoga has been Ayurveda and yoga are perhaps the most © Jones & Bartlettfound Learning, to be advantageous LLC in treating depression,© anxiety,Jones low& Bartlett back Learning, LLC remarkable contributions NOT FOR SALEpain, OR and DISTRIBUTION asthma and a promising approach that needsNOT more FOR testing SALE for ORof DISTRIBUTIONancient India in the hypertension, diabetes mellitus type 2, and arthritis (Sharma, 2014). It evolution of mental is also helpful in stress management, especially for cancer patients and health. people suffering from acute and chronic stressors. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Ancient NOTCivilization FOR SALE in OR Egypt DISTRIBUTION NOT FOR SALE OR DISTRIBUTION In the Egyptian civilization (3000–300 bce), which was known for its pyramids and sphinxes, issues of mental health were also found. Because the Egyptians invented picture writing and recorded it on papyrus, much is known about this culture. The main sources for © Jonesstudying &Egyptian Bartlett civilization Learning, have LLCbeen through surviving papyri,© Jones & Bartlett Learning, LLC NOTwhich FOR have SALE been translatedOR DISTRIBUTION into modern languages. Among papyriNOT FOR SALE OR DISTRIBUTION related to medicine, the most important to psychiatry are the Ebers and the Edwin Smith papyri (Nasser, 1987). In the Edwin Smith papyrus, the brain is described as being enclosed in a membrane, with two hemispheres that are patterned with convolutions. There are descrip- © Jones & Bartletttions Learning,of disorders such LLC as hysteria, alcoholism, and© Jonessadness. &There Bartlett is Learning, LLC NOT FOR SALEno OR description DISTRIBUTION of a physician who specialized in NOTmental FOR illnesse SALEs, but OR DISTRIBUTION it seems the sorcerer was essentially a psychiatrist (Nasser, 1987). It also seems that the sorcerer had some knowledge of hallucinogens such as mescaline. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Ancient CivilizationNOT FOR SALE in OR China DISTRIBUTION NOT FOR SALE OR DISTRIBUTION China is one of the world’s oldest continuous civilizations, dating back more than 6,000 years. Around the 14th or 13th century bce, during the Shang dynasty, ailments were believed to have been caused by the curses of dead ancestors, and methods of healing such as prayers, offer- © Jonesings, and & incantations Bartlett wereLearning, performed LLC (Subbarayappa, 2001). © Jones & Bartlett Learning, LLC NOT FORAn emperor SALE physician,OR DISTRIBUTION Huang Di, or the Yellow EmperorNOT of FOR SALE OR DISTRIBUTION China (2695–2589 bce), is credited with initiating systematic Chinese medicine. Huang Di emphasized the importance of the principles of

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14 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlettyang Learning, and yin everywhere LLC in creation. Yang is the© masculine Jones principle,& Bartlett Learning, LLC NOT FOR SALEand OR yin DISTRIBUTION the feminine principle. Balance betweenNOT these FOR two signifiesSALE OR DISTRIBUTION good health. Yang and yin generate five phases: water, fire, earth, wood, and metal. Chinese herbal therapy was based on these five phases. Huang Di also supported the use of acupuncture in Chinese medicine, which arose around 2600 bce. This was the basis of treat- © Jones & Bartlett Learning,ing LLC mental illnesses. Huang Di© emphasizedJones & Bartlettprevention Learning, of diseases, LLC NOT FOR SALE OR DISTRIBUTIONquoting a Chinese proverb, “TheNOT superior FOR doctorSALE prevents OR DISTRIBUTION diseases; the mediocre doctor attends to impending diseases; the inferior doctor treats full-blown diseases.” Another concept of Chinese medicine is that of qi, which is the basis of activities of body and mind and is the primordial entity of both material (body) and nonmaterial (mind) © Jones & Bartlett Learning, LLC things, gross and© Jones subtle (Subbarayappa, & Bartlett Learning,2001). LLC NOT FOR SALE OR DISTRIBUTION Lao Tse, NOTor Lao FOR Tzu (literally,SALE OR“Old DISTRIBUTION Master”), lived around the sixth century bce and developed the philosophy of Taoism (Khoo, 1998). His teachings disseminated the philosophy of the Tao (or the Way), which refers to a reality that naturally exists from primordial time and gives rise to all other things. Tao can be found by experi- © Jones & Bartlettencing Learning, oneness in LLCall things. Taoists introduced© the Jones idea of & healing Bartlett Learning, LLC NOT FOR SALEby OR drugs DISTRIBUTION and used alchemy. Another well-knownNOT Chinese FOR philosoSALE- OR DISTRIBUTION pher who influenced Chinese medicine and public health is Confucius (541–479 bce). His philosophy emphasized correctness of social relationships along with personal and governmental morality. Regarding traditional and modern treatments, Confucius said, “Because the new © Jones & Bartlett Learning,methods LLC of treatment are good,© itJones does not & followBartlett that Learning,the old ones LLC NOT FOR SALE OR DISTRIBUTIONwere bad; for if our honorable andNOT worshipful FOR SALE ancestors OR had DISTRIBUTION not recov- ered from their ailments, you and I would not be here today” (Huth & Murray, 2006, p. 388).

© Jones & Bartlett Learning, LLC Ancient ©Civilization Jones & Bartlett in Learning,Greece LLC NOT FOR SALE OR DISTRIBUTION The roots ofNOT medicine FOR and SALE the way OR it DISTRIBUTION is practiced today can be traced back to the Greek civilization in the fifth century bce, when Hippocrates (460–377 bce) introduced a rational way of treating diseases (Cilliers & Retief, 2006). Often called the “Father of Medicine,” Hippocra tes wrote a body of writings known as the © Jones & BartlettCorpus Learning, Hippocraticum LLC, a compilation of some© 70 Jones books. &Classical Bartlett Learning, LLC NOT FOR SALEGreek OR DISTRIBUTIONmedicine involved four humors (blood,NOT phlegm, FOR black SALE bile, OR DISTRIBUTION and yellow bile), four elements (earth, air, fire, and water), and four qualities (hot, cold, moist, and dry). Any imbalance in these humors, elements, or qualities caused disease. Depression, for example, was caused by an excess of black bile. The system was rational because © Jones & Bartlett Learning,it LLC was devoid of superstition and© Jones religion &and Bartlett was based Learning, on experi- LLC NOT FOR SALE OR DISTRIBUTIONmentation. Also, the training ofNOT a physician FOR SALEwas done OR by DISTRIBUTIONapprentice- ship under another physician. Another important feature of Greek civilization was the development of an ethical code of conduct for

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History of Mental Health 15

physicians. The© HippocraticJones & Bartlettoath is still Learning, used today in LLC many parts of © Jones & Bartlett Learning, LLC the world by physicians.NOT FOR Most SALE physicians OR DISTRIBUTION in Greek civilization were NOT FOR SALE OR DISTRIBUTION men (iatroi), but there were also female doctors (iatrinai). Hippocrates had concerns about how the mentally ill were treated. He attempted to classify people by the ways they behaved. The mentally ill were generally treated humanely by the ancient Greeks, and © Jonesthere was & a movementBartlett Learning,away from belief LLC in the supernatural origins© of Jones & Bartlett Learning, LLC NOTmental FOR illnesses SALE toward OR DISTRIBUTIONmore rational explanations. Music, sedationNOT FOR SALE OR DISTRIBUTION with opium, activity, dietary measures, and hygiene were some means of providing care (Alexander & Selesnick, 1966). A ritual of incuba- tion in which a person was put to sleep in the temple and then his or her dreams were interpreted was a common practice (Evans, 2005). © Jones & BartlettGreek Learning, philosopher LLC Plato (427–327 bce) showed© Jonesthat medicine & Bartlett and Learning, LLC NOT FOR SALEphilosophy OR DISTRIBUTION were inextricably linked (Stempsey, 2001).NOT HeFOR advocated SALE OR DISTRIBUTION holistic medicine, in which cure of the body alone without cure of the soul was not a whole cure. Holistic health involves uniting both body and soul; thus, along with medical technology, philosophy is needed for complete healing. He also emphasized the role of personal responsibility in maintaining© Jones health & Bartlettand favored Learning, prevention rather LLC than cure. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Ancient Roman Civilization In earlier times, medicine during the Roman civilization was based on folk remedies, herbs, religious influences, and superstition. Around the © Jonesfourth century & Bartlett bce, Greek Learning, medicine LLCbegan to enter Rome (Cilliers © & Jones & Bartlett Learning, LLC NOTRetief, FOR 2006). SALE To practice OR DISTRIBUTION medicine in the Roman Empire, physiciansNOT FOR SALE OR DISTRIBUTION only needed permission from a magistrate. Julius Caesar exempted physicians from paying tax and gave them citizenship. This practice was upheld by subsequent emperors such as Augustus, Vespasian, and Hadrian. The introduction of Greek practices also systematized © Jones & Bartlettmedicine. Learning, The mentally LLC ill were generally treated© Joneshumanely & by Bartlett the Learning, LLC NOT FOR SALERomans. OR DISTRIBUTION Aulus Cornelius Celsus (25 bce to 50NOT ce) was FOR an imporSALE- OR DISTRIBUTION tant contributor to medicine in the Roman Empire. He differentiated between different types of the insane, such as those who were sad, Greeks and Romans were those who were hilarious, and those who were violent and rebellious humane in prescribing (Evans, 2005). He was humane in prescribing treatment for the insane treatment for those who and advocated ©for Jones treatment & using Bartlett entertaining Learning, stories, LLCpersuasion, and were mentally© Jones ill. & Bartlett Learning, LLC diversion therapy.NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Middle Ages or Dark Ages (Between 500 ce and 1500 ce)

© JonesWith the & fall Bartlett of the Roman Learning, Empire LLC in 476 ce, rational and human© -Jones & Bartlett Learning, LLC NOTitarian FOR approaches SALE ORto mental DISTRIBUTION illnesses were forgotten and eventuallyNOT FOR SALE OR DISTRIBUTION replaced with witchcraft, shamanism, superstition, and mysticism. During this period, the influence of the Roman Catholic Church

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16 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlettand associatedLearning, dogma LLC increased in the lives of common© Jones people. & Bartlett Great Learning, LLC NOT FOR SALEexpenditures OR DISTRIBUTION were made on crusades or holy wars.NOT The FOR average SALE life OR DISTRIBUTION expectancy was a mere 31 years (Glasscheib, 1964). Usually, the mentally ill were locked in asylums, where they were treated harshly— flogged, starved, and often tormented. Occasionally, however, families would hide the mentally ill, or they were left to roam the streets. Dur- © Jones & Bartlett Learning,ing LLC the latter part of the Dark Ages© Jones (476–1000 & Bartlettce), religious Learning, influences LLC NOT FOR SALE OR DISTRIBUTIONin Europe mainly dictated theNOT treatment FOR administered SALE OR to DISTRIBUTION the mentally ill. Burnings at the stake and the practice of witchcraft were fairly common during this period (Alexander & Selesnick, 1966). While Europe was passing through the Dark Ages, Arab cultures borrowed from the Greeks and Romans to develop their own © Jones & Bartlett Learning, LLC medical system,© Jonesknown as& theBartlett Unani systemLearning, of medicine LLC . Unani NOT FOR SALE OR DISTRIBUTION medicine is stillNOT practiced FOR widelySALE in OR the DISTRIBUTIONsouth and southeast parts of Turkey to Saudi Arabia and in other parts of Asia such as India and Pakistan (Yesilada, 2005). The Unani system uses herbs and folk remedies and is also influenced by Ayurveda (Subbarayappa, 2001). Abu Bakr Muhmad Ibn Zakariya al-Razi (also known as Rhazes) © Jones & Bartlett(865–925 Learning, ce) wrote LLC the book Kitab al-hawi fi al-tibb©, alsoJones known & asBartlett Liber Learning, LLC NOT FOR SALEcontinens OR DISTRIBUTION, which became a standard reference medicalNOT FOR compendium SALE OR DISTRIBUTION (Browne, 1921). Rhazes did not believe in the dichotomy between the mind and body. He gave the concept of mental health and self- esteem as necessary to a patient’s welfare (Stolyarov, n.d.). Another well-known physician of those times was Abu Ali al-Husayn ibn Abd © Jones & Bartlett Learning,Allah LLC ibn Sina (980–1037 ce), ©who Jones is also &known Bartlett as Avicenna Learning, in the LLC NOT FOR SALE OR DISTRIBUTIONWest. He wrote the book KitabNOT al-Qanun FOR fi al-tibb, SALE or CanonOR DISTRIBUTION of Medicine (Shah, 1966). In this book he described several mental illnesses. He believed in a close relationship between emotions and physical conditions and advocated the therapeutic role of music on physical and psychological well-being of patients. According to the Unani system, © Jones & Bartlett Learning, LLC the human body© Jones and health & Bartlettwere made Learning, up of seven components: LLC ele- NOT FOR SALE OR DISTRIBUTION ments (Al-ArkanNOT), temperament FOR SALE (Al-Mizaj OR DISTRIBUTION), four humors (Al-Akhlat), organs (Al-A’da), vital spirit (Al-Arwah), faculties (Al-Quwa), and functions (Al-Afal). The four elements were earth, fire, water, and air, and the four humors were blood, bile, phlegm, and black bile. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEThe OR DISTRIBUTIONRenaissance NOT FOR SALE OR DISTRIBUTION The Renaissance (derived from French renaissance, meaning “rebirth”) was a cultural movement from 1420 to 1630 that saw the revival of science, art, and culture. It encompassed a revival of learning based on classical sources, the development of linear perspective in painting, © Jones & Bartlett Learning,and LLC educational reform (Shorter,© 1997).Jones Unfortunately, & Bartlett approachesLearning, to LLC NOT FOR SALE OR DISTRIBUTIONmental illness and the mentallyNOT ill changed FOR little, SALE with OR the MiddleDISTRIBUTION Age belief that mental illnesses were caused by evil spirits carried into this period. The mentally ill were frequently imprisoned or locked away

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History of Mental Health 17

in mental asylums© Jones and denied & Bartlett any professional Learning, care. MentalLLC illnesses © Jones & Bartlett Learning, LLC were mostly consideredNOT FOR irreversible. SALE ORThe methodsDISTRIBUTION used to cure men- NOT FOR SALE OR DISTRIBUTION tal illnesses during this time were all rooted in ignorance and included purging, bleeding, and blistering. Viewed as demon-possessed or characterized as senseless animals, the mentally ill were subjected to appalling treatments. The widespread use of physical restraints— © Jonesstraitjackets & Bartlettand heavy armLearning, and leg chains—often LLC deprived patients© of Jones & Bartlett Learning, LLC NOTtheir FOR self-respect SALE and OR freedom DISTRIBUTION (Shorter, 1997). NOT FOR SALE OR DISTRIBUTION French mathematician and philosopher René Descartes (1596–1650) dichotomized mind and body. He believed the mind was completely separate from the body. He advocated that the mind was under the purview of religion and the body was to be treated © Jones & Bartlettby physicians. Learning, This LLC distinction shaped medicine© Jones for many & Bartlettyears Learning, LLC NOT FOR SALEand OR was DISTRIBUTION responsible for the distinction betweenNOT “physical FOR health”SALE OR DISTRIBUTION and “mental health.” However, in the 20th century this notion was challenged, and the inseparable nature of the body and mind was established. Swiss physician Paracelsus (1493–1541) did not believe The thinking of René evil spirits caused mental illness. This, however, did not change the Descartes, who influenced general treatment© Jones of the mentally& Bartlett ill. Cotton Learning, Mather LLC (1663–1728), Western medicine,© Jones & Bartlett Learning, LLC a Puritan preacherNOT inFOR Bost SALEon, took OR a stance DISTRIBUTION against the methods dichotomizedNOT the FOR body SALE OR DISTRIBUTION used in the Salem witchcraft trials (1692–1693) in which 19 women from the mind. He advocated that the mind were tried and executed for witchcraft. He also advocated for physi- was under the purview cal examinations for mental illnesses (Lutz, 2000; Silverman, 1984). of religion and the body However, no real advancements in the care of the mentally ill were © Jones & Bartlett Learning, LLC © Joneswas &to Bartlettbe treated Learning,by LLC made before the 18th century (Alexander & Selesnick, 1966; Shorter, physicians. NOT1997; FOR Trimble SALE & George, OR DISTRIBUTION 2010). NOT FOR SALE OR DISTRIBUTION

The 18th Century Frank Mesmer (1733–1815), an Austrian physician, initiated a thera- © Jones & Bartlettpeutic Learning, approach to LLCbehavior. Mesmer believed that© Jonesthe human & Bartlettbody Learning, LLC NOT FOR SALEcontained OR DISTRIBUTION fluids similar to magnetic forces. He postulatedNOT FOR that mentalSALE OR DISTRIBUTION illnesses were the result of the misdistribution or deficiency of mag- netism (Ellis, 2015). Mesmer suggested that the mentally ill could be cured by holding rods filled with iron filings in water. He based his treatment on the idea that it would give people a balance in the uni- verse. Even though© Jones Mesmer’s & Bartlett technique Learning, proved to be LLC wrong, it her- © Jones & Bartlett Learning, LLC alded a major paradigmNOT FOR shift SALEin the perception OR DISTRIBUTION and treatment of mental NOT FOR SALE OR DISTRIBUTION illnesses. In 1812, American physician, educator, writer, and humanitarian Benjamin Rush (1745–1813) wrote Medical Inquires and Observations upon the Diseases of the Mind (Rush, 1812). The book advocated for the © Joneshumane &treatment Bartlett of theLearning, mentally ill LLC and is considered the first text© -Jones & Bartlett Learning, LLC NOTbook FOR of psychiatry SALE OR in America. DISTRIBUTION The book’s chapters included topicsNOT FOR SALE OR DISTRIBUTION such as intellectual derangement; remote, exciting, and predisposing causes of mental illness; hypochondriasis or tristimania; amenomania,

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18 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlettmania, Learning, and remedies LLC for mania; manalgia; means© Jones of improving & Bartlett the Learning, LLC NOT FOR SALEcondition OR DISTRIBUTION of “mad” people; dissociation; derangementNOT FOR in the SALE will; OR DISTRIBUTION derangement in the principle of faith; derangement of memory; fatuity; somnambulism; illusions; absence of mind; derangement of passions; morbid state of sexual appetite; and derangement in moral faculties. Many of these terms and topics are no longer used in modern © Jones & Bartlett Learning,terminology. LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONIn 1793 Philippe Pinel (1745–1826),NOT FOR aSALE French ORphysician, DISTRIBUTION challenged the traditional wisdom of keeping the mentally ill restrained when he removed the chains from patients at the Asylum de Bicetre in Paris (Shorter, 1997). He divided the patients and categorized them according to different disorders, replacing purging, bleeding, © Jones & Bartlett Learning, LLC and blistering© withJones simple & Bartlettand humane Learning, psychological LLC treatments, NOT FOR SALE OR DISTRIBUTION along with observingNOT FOR and SALEtalking ORto the DISTRIBUTION patients. Pinel’s approach focused on close and friendly contact with the mentally ill, discussion about their personal difficulties, and a regimen of purposeful activities. He wrote a book, Traité médico-philosophique sur l’aleniation mentale; ou la manie (Medico-Philosophical Treatise on Mental © Jones & BartlettAlienation Learning, or Mania), LLC in 1801 in which he elaborated© Jones his & psycho Bartlett- Learning, LLC NOT FOR SALElogically OR DISTRIBUTION oriented approach. His approach can beNOT considered FOR theSALE first OR DISTRIBUTION psychotherapeutic approach to mentally ill patients. Pinel divided all mental illnesses into four categories—mania, melancholia, dementia, and idiocy—which was a revolutionary stride for those times. His theories on mental illness were the first to span both physi- © Jones & Bartlett Learning,ological LLC and psychological explanations.© Jones He& Bartlett suggested Learning, that mental LLC NOT FOR SALE OR DISTRIBUTIONillnesses were the result of eitherNOT having FOR sustained SALE ORexcessive DISTRIBUTION social or psychological stress or hereditary causes or damage to the body. Pinel is credited as the first person to maintain written case studies on patients that focused on their long-term treatment (Alexander & Selesnick, 1966; Shorter, 1997). © Jones & Bartlett Learning, LLC Pinel saw© asylums Jones as places& Bartlett for treatment Learning, and not LLCas places to hide NOT FOR SALE OR DISTRIBUTION the mentally NOTill. They FOR were SALE to be places OR DISTRIBUTIONwhere patients were seen as sick human beings deserving of dignity, compassion, and medical treatment. It was Pinel who first thought that those suffering from mental illness could be rehabilitated and returned to society. He over- saw the conversion of a residence for the mentally ill from a madhouse © Jones & Bartlettinto Learning,a hospital during LLC his lifetime. Soon, Pinel’s© reforms Jones were & Bartlettbeing Learning, LLC NOT FOR SALEimitated OR DISTRIBUTION throughout the rest of Europe. NOT FOR SALE OR DISTRIBUTION

The 19th Century Jean-Martin Charcot (1825–1893) was a French neurologist and © Jones & Bartlett Learning,professor LLC of anatomical pathology© Jones and nicknamed & Bartlett “the Learning, Napoleon LLC NOT FOR SALE OR DISTRIBUTIONof the neuroses” (Jay, 2000). HisNOT work FOR greatly SALE influenced OR DISTRIBUTION the mental health movement. Charcot’s most impressive work was on hypnosis and hysteria. He maintained that hysteria was a neurological

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History of Mental Health 19

disorder caused© byJones hereditary & Bartlett problems Learning, in the nervous LLC system. He © Jones & Bartlett Learning, LLC used hypnosisNOT to induce FOR hysterical SALE statesOR DISTRIBUTIONin patients and scrutinized NOT FOR SALE OR DISTRIBUTION the results. Charcot was responsible for changing the French medical community’s outlook regarding the validity of hypnosis (the practice had been previously rejected as Mesmerism). Dorothea Lynde Dix (1802–1887) was an American activist © Joneson behalf & of Bartlett the indigent Learning, insane and LLCis credited with creating the first© Jones & Bartlett Learning, LLC NOTgeneration FOR SALEof American OR DISTRIBUTIONmental asylums. During the Civil War, NOTshe FOR SALE OR DISTRIBUTION served as superintendent of army nurses. Dix traveled throughout the country and, through a vigorous program of lobbying state legislatures and the U.S. Congress, was able to effect legislation for better care of the mentally ill. © Jones & BartlettReports Learning, from AustraliaLLC show that mentally ill© peopleJones in &the Bartlett 19th Learning, LLC NOT FOR SALEcentury OR DISTRIBUTION were treated like criminals; those foundNOT guilty FOR of SALElunacy OR DISTRIBUTION were imprisoned (Sands, 2009). Madness at that time was viewed to be a result of possession, “bad blood,” or inherent character flaws rather an illness (Happell, 2007; Meadows et al., 2012). The view at that time in Australia was that mental conditions were incurable. The first “lunatic© Jones asylum” & (asBartlett was known Learning, in those LLCdays) was built © Jones & Bartlett Learning, LLC in 1811 in CastleNOT Hill FOR (what SALE is now OR known DISTRIBUTION as New South Wales) NOT FOR SALE OR DISTRIBUTION (Happell, 2007). In 1848, the second asylum was built in Melbourne in Victoria (Sands, 2009). Other important strides were made during his time. In the United States, the first psychiatric training program was established at © JonesMcLean &Hospital Bartlett in Waverly, Learning, Massachusetts. LLC Research was conducted© Jones & Bartlett Learning, LLC NOTon theFOR effects SALE of the OR venereal DISTRIBUTION disease syphilis on the mind (now oneNOT of FOR SALE OR DISTRIBUTION several sexually transmitted illnesses), and a generally humane approach was reinstituted toward the mentally ill.

© Jones & BartlettThe Learning, 20th Century LLC © Jones & Bartlett Learning, LLC NOT FOR SALEClifford OR DISTRIBUTION Beers (1876–1943), a Yale graduate andNOT young FOR business SALE- OR DISTRIBUTION man, was largely responsible for ushering in 20th-century reforms in psychiatric care. After having suffered an acute breakdown brought on by the death of his brother, Beers was hospitalized in a private mental institution (Alexander & Selesnick, 1966; Shorter, 1997). He was subjected ©to Jones the degrading & Bartlett treatment Learning, and mental LLC and physical © Jones & Bartlett Learning, LLC abuses typical NOTof those FOR times. SALE The deplorable OR DISTRIBUTION treatment he received NOT FOR SALE OR DISTRIBUTION over the next couple of years in multiple mental health institutions led Beers to publish his autobiography, A Mind That Found Itself. The need for better care of the mentally ill was thus made public. The book had an immediate impact, spreading his vision of a mas- © Jonessive mental & Bartletthealth reform Learning, movement LLC around the world. The execu© -Jones & Bartlett Learning, LLC NOTtion FOR of the SALE movement OR DISTRIBUTIONbegan soon thereafter when Beers foundedNOT FOR SALE OR DISTRIBUTION the Connecticut Society for Mental Hygiene. The society expanded the following year to become the National Committee for Mental

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20 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & BartlettHygiene. Learning, The society, LLC both in Connecticut and© eventuallyJones & nation Bartlett- Learning, LLC NOT FOR SALEally, OR set DISTRIBUTION forth the following goals: NOT FOR SALE OR DISTRIBUTION • To improve attitudes toward mental illness and the mentally ill • To improve services for the mentally ill • To work for the prevention of mental illness and promote men- © Jones & Bartlett Learning, LLCtal health © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONThe mental health movement NOTwas fairly FOR well SALE established OR byDISTRIBUTION the time Beers died in 1943. Austrian neurologist and psychiatrist Sigmund Freud (1856– 1939) founded the psychoanalytic school of psychology (Shorter, 1997). Freud is best known for his theories of the unconscious mind, © Jones & Bartlett Learning, LLC which probe ©deeply Jones into &the Bartlett psychological Learning, side of the LLC individual. He NOT FOR SALE OR DISTRIBUTION is also well knownNOT for FOR his redefinitionSALE OR of DISTRIBUTION sexual desire as the primary motivational energy of human life that is directed toward a wide vari- Sigmund Freud was ety of objects. Because of his seminal work on psychoanalysis, Freud the originator of the is commonly referred to as the “Father of Psychoanalysis.” Freud’s work has been highly influential, popularizing such notions as the psychoanalytic© Jones school & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC of psychology. unconscious; the id, superego, and ego; the Oedipus complex; defense NOT FOR SALEmechanisms; OR DISTRIBUTION Freudian slips; and dream symbolism.NOT FOR SALE OR DISTRIBUTION Another important person in the history of mental health movement is Emil Kraepelin (1856–1926), a German psychiatrist, who classified hundreds of mental disorders. He called the traditional view of looking at mental illnesses symptomatic and called his new approach © Jones & Bartlett Learning,clinical LLC. Kraepelin was among ©the Jones first mental & Bartlett health workersLearning, who LLC NOT FOR SALE OR DISTRIBUTIONadvocated that mental illness wasNOT rooted FOR in SALE biology ORand DISTRIBUTIONgenetics. A contemporary of Kraepelin was Alois Alzheimer (1864–1915), a German neuropathologist and psychiatrist. He worked on histological features of a type of dementia known as Alzheimer’s disease. During this period, Australia also saw improvements in the care © Jones & Bartlett Learning, LLC of the mentally© Jonesill. In 1933, & Bartlett the Mental Learning, Hygiene Act LLC of 1933 was NOT FOR SALE OR DISTRIBUTION passed that changedNOT FORthe title SALE of “hospitals OR DISTRIBUTION for the insane” to “mental hospitals” and “lunatics” to “mental patients” (Sands, 2009). But the mental hospitals suffered from the problem of overcrowding and were understaffed (Reischel, 2003). Among other pivotal incidents of the 20th century that helped © Jones & Bartlettshape Learning, the path of mentalLLC health care were three© unrelated Jones discover& Bartlett- Learning, LLC NOT FOR SALEies: OR (1) DISTRIBUTION use of psychosurgery as a treatment for NOTcertain FOR mental SALE health OR DISTRIBUTION disorders, (2) the introduction of electroconvulsive therapy (ECT) as a treatment for certain mental illnesses, and (3) the introduction of neuroleptic drugs, which included antipsychotics and tranquilizers. Psychosurgery was completely revolutionized in the 20th century © Jones & Bartlett Learning,by LLC Antonio Egas Moniz (1874–1955),© Jones a Portuguese & Bartlett neurologist Learning, who LLC NOT FOR SALE OR DISTRIBUTIONintroduced the psychosurgicalNOT technique FOR of SALElobotomy OR (the DISTRIBUTION removal or severing of certain connections in the brain) in 1936 (Micale & Porter, 1994; Shorter, 1997). He was awarded the Nobel Prize in

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History of Mental Health 21

1949. In the United© Jones States, & a modifiedBartlett version Learning, of the procedure LLC devel- © Jones & Bartlett Learning, LLC oped by Moniz—theNOT FOR prefrontal SALE lobotomy OR—was DISTRIBUTION introduced by neurol- NOT FOR SALE OR DISTRIBUTION ogist Walter Freeman and his associate, neurosurgeon James Watts (Diefenbach, Diefenbach, Baumeister, & West, 1999). Lobotomies had been previously used to treat a wide range of severe mental illnesses, including schizophrenia, clinical depression, and various anxi- © Jonesety disorders. & Bartlett Between Learning, 1936 and the LLCmid-1950s, an estimated 20,000© Jones & Bartlett Learning, LLC NOTfrontal FOR lobotomies SALE wereOR performedDISTRIBUTION on mental patients in United StatesNOT FOR SALE OR DISTRIBUTION (Anastasia, 1984). The procedure had many side effects and made the patient listless, dull, and without drive or initiative. This procedure was banned by several countries in the 1950s and ultimately fell out of use after neuroleptic pharmaceuticals were introduced. © Jones & BartlettAnother Learning, important LLC discovery of the 20th century© Jones was electrocon & Bartlett- Learning, LLC NOT FOR SALEvulsive OR DISTRIBUTIONtherapy. In 1938, Italian psychiatrist UgoNOT Cerletti FOR first SALE tested OR DISTRIBUTION ECT on human patients (Alexander & Selesnick, 1966; Shorter, 1997). In the years after, Cerletti and others experimented with ECT on a much broader scale and were able to establish its utility and safety in clinical practice. Today, even though arguments persist over whether ECT is therapy© or Jones cruelty, & it Bartlettis established Learning, as a therapeutic LLC option for © Jones & Bartlett Learning, LLC mental conditionsNOT such FOR as acute SALE schizophrenia, OR DISTRIBUTION manic–depressive ill- NOT FOR SALE OR DISTRIBUTION ness, and episodes of major depression. The introduction of neuroleptic drugs in the 1950s, including antipsychotics and major tranquilizers, marked the beginning of a new chapter in the annals of mental health. The use of these drugs © Jonesled to a markedly& Bartlett reduced Learning, need for LLCphysical restraints. The first tra© -Jones & Bartlett Learning, LLC NOTditional FOR antipsychotic SALE OR drug, DISTRIBUTION chlorpromazine, was introduced to treatNOT FOR SALE OR DISTRIBUTION patients with schizophrenia and other major mental disorders in 1952 (López-Muñoz et al., 2005). In the 1960s, haloperidol and lithium were discovered. Haloperidol provided calmness to agitated patients, and lithium revolutionized the treatment of mania. Over the past © Jones & Bartlettdecades, Learning, substantial LLC interest in the research and development© Jones &of Bartlettnovel Learning, LLC NOT FOR SALEneuroleptic OR DISTRIBUTION drugs has led to the introduction of newer,NOT relativelyFOR SALE safer OR DISTRIBUTION alternatives to the original medications. In the United States in the 1960s, hospitalization was quite common for mentally ill patients. It is estimated that 422,000 patients were hospitalized for mental illness in 1962 in the United States (Weissman & Klerman, 1978).© Jones In the & 1970s, Bartlett the trend Learning, for deinstitutionalization LLC © Jones & Bartlett Learning, LLC became the norm.NOT In FOR 1970, SALE the term OR health DISTRIBUTION maintenance organization NOT FOR SALE OR DISTRIBUTION (HMO) was introduced by Paul Ellwood, a health policy advisor in the Nixon administration (Druss, 2002; Luft, 1981). HMOs were a response aimed at curtailing rising costs of health care by reducing hospitalizations. In the 1980s, health plans began developing so-called © Jonesmanaged & care Bartlett mechanisms. Learning, Managed LLC care refers to a system of financ© -Jones & Bartlett Learning, LLC NOTing FORand providing SALE health OR DISTRIBUTIONcare that seeks to cut costs and improve qualityNOT FOR SALE OR DISTRIBUTION of care. With the introduction of managed care, short-duration hospital stay with early reentry into the community has become the standard

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22 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlettcare Learning,for mentally ill LLC (Cuffel, Snowden, Masland, &© JonesPiccagli, &1996). Bartlett In Learning, LLC NOT FOR SALEthe OR 1990s, DISTRIBUTION the use of brain imaging and atypicalNOT antipsychotic FOR SALE drugs OR DISTRIBUTION further improved understanding and treatment of mental illnesses.

Early 21st Century © Jones & Bartlett Learning,Since LLC the early 2000s, there has© been Jones a greater & Bartlett confidence Learning, in the neu- LLC NOT FOR SALE OR DISTRIBUTIONrosciences, molecular biology, computerNOT FOR applications SALE inOR medicine, DISTRIBUTION and multifactorial aspects of mental health that have given rise to mind– body–spirit interventions. One development—the field of precision medicine—has begun to explicate how different genes influence people’s health and the movement to design targeted interventions using © Jones & Bartlett Learning, LLC gene mapping© (Cook, Jones Wu, & Aleo, Bartlett & Adkins, Learning, 2018). Another LLC trend has NOT FOR SALE OR DISTRIBUTION been pharmaceuticalNOT FOR companies SALE playing OR aDISTRIBUTION greater role in every aspect of mental health from prevention, clinical trial design and implementation, physician education, advertising (both to physicians and consumers), organizing and funding professional meetings, and shaping diagnostic practices and practice standards (Mechanic, 2007). This © Jones & Bartletthas raisedLearning, many concerns LLC about the authenticity© of Jones medical & findings Bartlett Learning, LLC NOT FOR SALEand OR influenced DISTRIBUTION practice norms. Another trend NOTis the FORrevived SALE inter- OR DISTRIBUTION est and scientific exploration of integrative systems of health mainly mind–body–spirit interventions such as yoga and meditation for mental health (Khoury, Sharma, Rush, & Fournier, 2015; Sharma, 2019). These trends are likely to continue for many years to come. © Jones & Bartlett Learning, LLCTable 1.3 summarizes the ©key Jones events in & the Bartlett timeline ofLearning, the history LLC NOT FOR SALE OR DISTRIBUTIONof mental health. NOT FOR SALE OR DISTRIBUTION

Table 1.3 History of Mental Health: A Timeline Time Period Event © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Primitive Some primitive tribes were drilling holes in the skulls to let the evil spirits out, called NOT FOR SALE OR DISTRIBUTIONtrephining. NOT FOR SALE OR DISTRIBUTION

2000–600 bce Bhuta vidya as part of Ayurveda used for prevention and treatment of mental illnesses in India.

200 bce Origin of yoga in India to help in mental health. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 3000–300 bce The Ebers and Edwin Smith papyri had records of mental illnesses. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 2695–2589 bce Huang Di in China talked about balance between yang (masculine principle) and yin (feminine principle) for mental health. Acupuncture was used to treat mental illnesses.

460–377 bce Hippocrates practiced Greek medicine that involved four humors (blood, phlegm, black bile, and yellow bile), four elements (earth, air, fire, and water), and four qualities (hot, © Jones & Bartlett cold,Learning, moist, and LLC dry). © Jones & Bartlett Learning, LLC

NOT FOR25 bce SALEto 50 ce ORAulus DISTRIBUTION Cornelius Celsus, a physician in the RomanNOT Empire, FOR was humaneSALE inOR prescribing DISTRIBUTION treatment for the insane and advocated for treatment with entertaining stories, persuasion, and diversion therapy.

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 22 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

History of Mental Health 23

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 476–1000 ce During the Dark Ages in Europe, religious influences dictated the treatment NOTadministered FOR SALE to the OR mentally DISTRIBUTION ill. NOT FOR SALE OR DISTRIBUTION

865–925 ce During the Middle Ages, the Unani system was developed in the Arab world. Rhazes, a Unani physician, introduced the concept of mental health and self-esteem as necessary to a patient’s welfare. © Jones1420–1630 & BartlettDuring Learning, this period of LLC Renaissance, the treatments of© mentally Jones ill were& Bartlett rooted in Learning, LLC NOT FOR SALE ignoranceOR DISTRIBUTION and included purging, bleeding, and blistering.NOT FOR SALE OR DISTRIBUTION 1733–1815 Frank Mesmer suggested the mentally ill could be cured by holding rods filled with iron filings in water. 1745–1813 Benjamin Rush advocated for humane treatment of the mentally ill and wrote the © Jones & Bartlett Learning, bookLLC Medical Inquires and Observations© Jones upon the Diseases& Bartlett of the Mind Learning,, the first textbook LLC on psychiatry in America. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1745–1826 Philippe Pinel advocated simple and humane psychological treatments for the mentally ill. He wrote a book, Traité médico-philosophique sur l’aleniation mentale; ou la manie (Medico- Philosophical Treatise on Mental Alienation or Mania). His approach can be considered the first psychotherapeutic approach to mentally ill patients. 1825–1893 © JonesJean-Martin & Bartlett Charcot, a FrenchLearning, neurologist, LLC applied hypnosis to treat mental© Jones illness. & Bartlett Learning, LLC 1802–1887 NOTDorothea FOR LyndeSALE Dix, OR through DISTRIBUTION a vigorous program of lobbying state legislaturesNOT FORand the SALE OR DISTRIBUTION U.S. Congress, was able to effect legislation for better care of the mentally ill. 1876–1943 Clifford Beers, who suffered from mental disease, wrote the book A Mind That Found Itself to underscore the need for better care of the mentally ill. He founded the Connecticut © Jones & BartlettSociety Learning, for Mental Hygiene, LLC which later expanded to© become Jones the National& Bartlett Committee Learning, for LLC Mental Hygiene. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1856–1939 Sigmund Freud, an Austrian neurologist and psychiatrist, described psychoanalysis. 1856–1926 Emil Kraepelin, a German psychiatrist, classified hundreds of mental disorders. He advocated that the origins of mental illness were rooted in biology and genetics. 1874–1955 Antonio Egas Moniz, a Portuguese neurologist, introduced the psychosurgical technique © Jones & Bartlett Learning, ofLLC lobotomy. © Jones & Bartlett Learning, LLC NOT FOR SALE1938 OR DISTRIBUTIONUgo Cerletti, an Italian psychiatrist,NOT first FORtested electroconvulsiveSALE OR DISTRIBUTION therapy on human patients. 1950s Introduction of neuroleptic drugs, including antipsychotics and major tranquilizers. 1960s Haloperidol, which calmed agitated patients, and lithium, which treated mania, were © Jonesdiscovered. & HospitalizationBartlett Learning, was quite common LLC for mentally ill. © Jones & Bartlett Learning, LLC 1970s NOTHealth FOR maintenance SALE OR organizations DISTRIBUTION were introduced. The trend for deinstitutionalizationNOT FOR SALE OR DISTRIBUTION of the mentally ill became the norm in the United States. 1980s Managed care became the norm. Short-duration hospital stays with early reentry into the community became the standard care for the mentally ill. © Jones1990s & BartlettBrain Learning, imaging and atypicalLLC antipsychotic drugs further© Jonesimproved & the Bartlett understanding Learning, and LLC NOT FOR SALE treatmentOR DISTRIBUTION of mental illnesses. NOT FOR SALE OR DISTRIBUTION 2000s Trends in precision medicine, computerized applications, mind–body–spirit interventions, and growing role of pharmaceutical companies.

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 23 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

24 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

Multiple trends over the course of the past several decades have shaped the evolution of mental health as a field. Some of these trends have © Jones & Bartlett Learning,been LLC molded by social influences,© Jones whereas & others Bartlett have beenLearning, ushered LLC NOT FOR SALE OR DISTRIBUTIONin because of the economic forcesNOT at play. FOR The SALE field has OR also DISTRIBUTION diversified with the arrival of a range of disciplines that address different aspects of an individual’s mental health in a variety of settings. Perhaps the most important trends have been the move toward deinstitutionalization, legislation to support mental health, the rapid development of © Jones & Bartlett Learning, LLC managed care,© aJones general &movement Bartlett toward Learning, biological LLC and multifac- NOT FOR SALE OR DISTRIBUTION torial underpinningsNOT FOR of mental SALE health OR disorders, DISTRIBUTION the role of computerized applications, and the growth of integrative mind–body–spirit interventions.

© Jones & BartlettDeinstitutionalization Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEDeinstitutionalization OR DISTRIBUTION first began in the 1960s.NOT This FOR is the SALEprocess OR DISTRIBUTION of replacing long-stay psychiatric hospitals with less isolated community mental health service for those diagnosed with mental disorder or developmental disability. The major factors that propelled the trend of deinstitutionalization in the United States were a community men- © Jones & Bartlett Learning,tal LLC health philosophy that it is© better Jones to treat & Bartlett the mentally Learning, ill closer LLC NOT FOR SALE OR DISTRIBUTIONto their families, jobs, and communities;NOT FOR the SALE effectiveness OR DISTRIBUTION of newer psychopharmacological agents; the increasing importance of legal, judicial, and legislative actions in defining where and under what cir- cumstances mental patients could be treated; and funding opportunities under Medicaid, Medicare, and Supplemental Security Income © Jones & Bartlett Learning, LLC that allowed states© Jones to shift &the Bartlett fiscal burden Learning, of the mentally LLC ill to federal NOT FOR SALE OR DISTRIBUTION care if they movedNOT patientsFOR SALE to out-of-state OR DISTRIBUTION facilities (Talbott, 2004). Even though the trend of deinstitutionalization was based on com- passionate mental health care, it resulted in multiple problems for the chronically mentally ill patient. Two new syndromes were described as an aftermath of deinstitutionalization: “falling between the cracks,” © Jones & Bartlettindicating Learning, a total lack LLC of follow-up and aftercare for© patientsJones discharged & Bartlett Learning, LLC NOT FOR SALEinto OR the DISTRIBUTION community, and the “revolving door phenomenon,”NOT FOR SALE mean- OR DISTRIBUTION ing continued readmissions of discharged patients (Talbott, 2004).

Legislation © Jones & Bartlett Learning,The LLC Americans with Disabilities© Jones Act & Bartlettwas signed Learning, into effect LLC NOT FOR SALE OR DISTRIBUTIONon July 26, 1990, by PresidentNOT George FOR H. SALE W. Bush OR (Information DISTRIBUTION and Technical Assistance on the Americans with Disabilities Act, 2019). This first-of-a-kind comprehensive law prohibited private

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 24 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Contemporary Trends and Standards in Mental Health 25

employers, state© Jonesand local & governments, Bartlett Learning, employment LLC agencies, and © Jones & Bartlett Learning, LLC labor unions fromNOT discriminating FOR SALE against OR DISTRIBUTION qualified individuals with NOT FOR SALE OR DISTRIBUTION disabilities in job-application procedures, hiring, firing, advance- ment, compensation, job training, and other terms, conditions, and privileges of employment. The act also covered employment agencies and labor organizations. © JonesThe &mental Bartlett health Learning, parity law LLC (Wellstone–Domenici Parity© Jones & Bartlett Learning, LLC NOTAct) FOR was enactedSALE intoOR lawDISTRIBUTION on October 3, 2008, and became effecNOT- FOR SALE OR DISTRIBUTION tive on January 1, 2010 (Center for Medicare & Medicaid Services, 2019). This law purported to end health-insurance benefit inequi- ties between mental health and substance-use disorders and medical- surgical benefits for group health plans with more than 50 employees. © Jones & BartlettEquity Learning, in coverage appliesLLC to all financial requirements,© Jones including & Bartlett life- Learning, LLC NOT FOR SALEtime OR and DISTRIBUTION annual dollar limits, deductibles, copayments,NOT FOR coinsurance, SALE OR DISTRIBUTION and out-of-pocket expenses, and to all treatment limitations, including frequency of treatment, number of visits, days of coverage, and other similar limits. Please refer to Focus Feature 1.1 for further details. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION FOCUS FEATURE 1.1 MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT (MHPAEA) OF 2008 Alternate name: Also known as the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTEffective FOR SALEdate: January OR 1,DISTRIBUTION 2010 NOT FOR SALE OR DISTRIBUTION Purpose: The prime aim of the act was to ensure that mental illnesses were treated the same way as physical illnesses by insurance plans covering 50 or more employees. It is a federal law that prevents group health insurance plans that cover mental health or substance-use disorder benefits from providing less favorable benefits than medical or surgical benefits. The MHPAEA was originally applied to only © Jones & Bartlettgroup Learning, health insurance LLC plans but has been amended© byJones the Affordable & Bartlett Care Act Learning, of 2010 to also LLC apply to NOT FOR SALE ORindividual DISTRIBUTION health insurance coverage (Center for MedicareNOT &FOR Medicaid SALE Services, OR 2019). DISTRIBUTION Features: • For health insurance, the financial requirements applicable to mental health or substance-use disorder benefits is no more restrictive than the financial requirements applied to medical and surgical benefits covered by the insurance. • The treatment© Jones limitations & Bartlett applicable Learning,to mental health LLC or substance-use disorder benefits© Jones is no more & Bartlett Learning, LLC restrictiveNOT than theFOR treatment SALE limitations OR DISTRIBUTION applied to medical and surgical benefits coveredNOT by FOR the SALE OR DISTRIBUTION insurance. • The criteria for medical necessity determinations made under the plan with respect to mental health or substance-use disorder benefits is made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with regulations to any current or potential © Jonesparticipant, & Bartlett beneficiary, Learning, or contracting LLC provider on request. © Jones & Bartlett Learning, LLC NOT FOR• The SALEU.S. Department OR DISTRIBUTION of Health and Human Services provides oversightNOT to FOR the public-sector SALE OR group DISTRIBUTION health plans while the Departments of Labor and Treasury provide oversight of the private group health plans (Center for Medicare & Medicaid Services, 2019).

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26 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC FOCUS FEATURENOT FOR 1.2 WHO’SSALE MENTAL OR DISTRIBUTION HEALTH ACTION PLAN 2013–2020 NOT FOR SALE OR DISTRIBUTION The 66th World Health Assembly of the WHO, consisting of 194 countries, adopted a comprehensive mental health action plan in May 2013 that spanned seven years (WHO, 2013). The plan resulted from the unmet needs of people suffering from mental illnesses around the world who are still being discriminated against and to address the stigma that is still attached to mental illness. The action plan © Jonesacknowledged & Bartlett the Learning,vital role of mental LLC health promotion in achieving© Jones health for & all Bartlett people. It wasLearning, based LLC NOT FORon a life-courseSALE OR approach DISTRIBUTION from childhood to old age, aimed to achieveNOT universal FOR SALEequity in ORdelivery DISTRIBUTION of health services and underscored the importance of prevention. The plan described specific targets and actions that needed to be taken. The action plan had several objectives: © Jones & Bartlett Learning,• developing LLC greater and effective leadership© and Jones governance & Bartlett in the area Learning, of mental health; LLC NOT FOR SALE OR DISTRIBUTION• providing comprehensive, integrated behavioralNOT and FOR social SALE health services,OR DISTRIBUTION especially through community-based settings; • implementing strategies for mental health promotion and prevention of mental illnesses; and • augmenting information systems, evidence and research related to mental health. The plan is based on six tenets: 1. universal© Jones health coverage & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 2. humanNOT rights FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 3. evidence-based practice based on science 4. inclusion of all stages of life 5. involvement of different sectors and disciplines 6. empowerment of the mentally ill © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

The WHO developed and enacted a Mental Health Action Plan that was enacted in 2013. See Focus Feature 1.2 for further details. © Jones & Bartlett Learning, LLC The 21st© Century Jones Cures & Bartlett Act was Learning, enacted in DecemberLLC 2016. NOT FOR SALE OR DISTRIBUTION It provides greaterNOT funding FOR SALEthrough ORNational DISTRIBUTION Institutes for Health for mental health–related research initiatives such as the Precision Medi- cine Initiative, the BRAIN initiative, and the Cancer Moonshot program. See Focus Feature 1.3 for further details.

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION FOCUS FEATURE 1.3 THE 21ST CENTURY CURES ACT In 2016, Congress passed the 21st Century Cures Act (United States Congress, 2016). This controversial law was supported by pharmaceutical companies but opposed by several consumer organizations. It increased funding for the National Institutes of Health for the Precision Medicine Initiative, the Cancer Moonshot © Jonesprogram, & Bartlett and the BRAINLearning, Initiative. LLC It also increased funding for Food© and Jones Drug Administration & Bartlett (FDA) Learning, LLC NOT FORactivities SALE and providedOR DISTRIBUTION grants to states through the Department of NOTHealth andFOR Human SALE Services OR to DISTRIBUTION combat

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Contemporary Trends and Standards in Mental Health 27

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC the opioid abuseNOT crisis. FOR Supporters SALE of thisOR law DISTRIBUTION argued that this increased funding and grantsNOT would FOR bring SALE OR DISTRIBUTION drugs and medical devices faster to the market, whereas opponents were concerned that safety would be compromised. The Precision Medicine Initiative is about examining how different genes influence people’s health and designing targeted interventions. Precision medicine helps in the development © Jonesof drugs that & Bartlett use biomarkers Learning, to stratify LLC patients in clinical trials so© that Jones efficacy & or Bartlett safety Learning, LLC NOToutcomes are improved FOR SALE OR DISTRIBUTION and eventually enhance the odds of clinicalNOT success FOR and drugSALE approval OR DISTRIBUTION (Cook et al., 2018). The Cancer Moonshot program was also one of President Barack Obama’s initiatives. The program aims to enhance cancer research and find cures while ensuring diversity and decreasing disparities (Ramirez & Thompson, 2017). The program goes hand in hand with the Precision Medicine Initiative and aims to treat © Jones & Bartlettcancer Learning, patients based LLC on the individual genetic makeup© Jones of their &tumors. Bartlett Learning, LLC NOT FOR SALE ORThe BRAIN DISTRIBUTION Initiative is meant to enhance understandingNOT of FOR brain circuitrySALE by OR developing DISTRIBUTION and applying breakthrough neurotechnologies (Mott, Gordon, & Koroshetz, 2018). It entails deciphering the complete record of neuronal activity (brain activity map) across spatial and temporal domains. Currently, this formidable task has involved various organizations, including the National Science Foundation, the FDA, the Defense Advanced Research Projects Agency, the Intelligence Advanced Research Projects Agency, private industry,© Jones several philanthropists, & Bartlett manyLearning, nonprofit LLC organizations, numerous foundations,© Jones and & Bartlett Learning, LLC several collegesNOT and FORuniversities SALE (Mott OR et al., DISTRIBUTION 2018). NOT FOR SALE OR DISTRIBUTION

At the time this book was being written, several bills were pend- ing in the 115th Congress regarding mental health and the opioid crisis © Jonesand mental & Bartletthealth reform: Learning, Social and LLC Emotional Learning Act (H.R.© Jones & Bartlett Learning, LLC NOT850), FOR Caring SALE Start ActOR of DISTRIBUTION 2015 (H.R. 2217), Mental Health in SchoolsNOT FOR SALE OR DISTRIBUTION Act (H.R. 1211 / S. 1588), Building a Health Care Workforce for the Future Act (H.R. 1006), and many others that could potentially become legislation (Mental Health America, 2019).

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Growth of Managed Care NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Managed care, which emerged in 1980s, is a system of financing and providing health care that seeks to cut costs and improve quality of care. Because of major cuts in health programs, managed care systems currently provide most of the mental health care. Because of the inherent focus© Jones on cost & containment, Bartlett Learning, managed care LLC attempts to © Jones & Bartlett Learning, LLC set strict limitsNOT for mental FOR health SALE care OR both DISTRIBUTION for inpatient and outpa- NOT FOR SALE OR DISTRIBUTION tient treatment settings. Capping, the practice of limiting the dollar amount for an individual’s lifetime psychiatric care, has been criticized by practitioners and patients. The managed care approach has also drastically reduced the number and kind of psychotherapy sessions © Jonesfor which & an Bartlett individual Learning, can be reimbursed. LLC As previously menti oned,© Jones & Bartlett Learning, LLC NOTsome FOR recent SALE legislative OR enactmentsDISTRIBUTION have addressed the bias createdNOT by FOR SALE OR DISTRIBUTION managed care in the field of mental health.

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28 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & BartlettBiological Learning, LLCand Multifactorial© Jones Approach & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Toward Mental Health Technological advances have helped unravel new information about the human brain’s physiology and chemistry. Studies have focused extensively on the connection between the brain’s anatomy and © Jones & Bartlett Learning,physiology LLC with mental health ©and Jones behavior. & SoBartlett profound Learning, were some LLC NOT FOR SALE OR DISTRIBUTIONof these developments that PresidentNOT FORGeorge SALE H. W. BushOR DISTRIBUTIONdesignated the 1990s as the Decade of the Brain “to enhance public awareness of the benefits to be derived from brain research” (Library of Con- gress, 2000). Biological psychiatry, an approach to understanding mental disorders in terms of the biological functions of the nervous © Jones & Bartlett Learning, LLC system, has gained© Jones favor & more Bartlett recently, Learning, and there LLCis an increasing NOT FOR SALE OR DISTRIBUTION pressure on mentalNOT healthFOR providers SALE OR to focus DISTRIBUTION on psychopharmacology or drugs that can rapidly resolve some of the symptoms of mental disorders (Trimble & George, 2010). Regrettably, this has also resulted in neglect and, occasionally, discouragement of other forms of treatment approaches such as psychotherapy (Barry, 2002). Another new © Jones & Bartletttrend Learning, in biological LLC basis of mental health has been© Jones the links & Bartlettfound Learning, LLC NOT FOR SALEwith OR itsDISTRIBUTION autoimmune origins (Soria et al., 2018).NOT Dysregulation FOR SALE of OR DISTRIBUTION the immune response and a pro-inflammatory state has been linked to mental disorders. This dimension is likely to be explored further in the future. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONRole of ComputerizedNOT FORApplications SALE OR DISTRIBUTION Newer applications in computer science are also shaping mental health interventions. Virtual reality (VR) is an upcoming subspe- cialty of computer science that provides participants a total immer- © Jones & Bartlett Learning, LLC sive experience© Jonesthat shuts & off Bartlett the physical Learning, world as LLCthe participants engage in it. A variant of VR is augmented reality (AR), which NOT FOR SALE OR DISTRIBUTION is also an interactiveNOT FOR experience SALE of ORthe realDISTRIBUTION world where objects are enhanced by computer-generated perceptual tools such as visual (sight), auditory (hearing), somatosensory (touch, position, movement), haptic (active exploration of surfaces and objects by a moving © Jones & Bartlettsubject), Learning, or olfactory LLC (smell) aids. Another variant© ofJones such technology & Bartlett Learning, LLC NOT FOR SALEis OR mixed DISTRIBUTION reality (MR), which links virtual objectsNOT FORto real-world SALE OR DISTRIBUTION objects and facilitates the user to interact with combined virtual and real objects. Some pilot studies have examined the role of these techniques in anxiety reduction (Maples-Keller, Bunnell, Kim, & Rothbaum, 2017), treating phobias (Maples-Keller, Yasinski, © Jones & Bartlett Learning,Manjin, LLC & Rothbaum, 2017),© managing Jones &posttraumatic Bartlett Learning, stress disor- LLC NOT FOR SALE OR DISTRIBUTIONder (Maples-Keller, Yasinski, NOTet al., 201FOR7), SALEand facilitating OR DISTRIBUTION mindfulness (Navarro-Haro et al., 2017) and found them to be useful. These technologies will assume greater importance in promoting mental health in the coming years.

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 28 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Skill-Building Activity 29

Growth ©of Jones Integrative & Bartlett Mind–Body–SpiritLearning, LLC © Jones & Bartlett Learning, LLC InterventionsNOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION There is renewed interest in the arena of mental health with regard to integrative mind–body–spirit interventions. Most of these are based on the ancient system of yoga and meditation. Over the years, various © Jonesschools of & yoga Bartlett have evolved. Learning, Among LLC those that start with meditation© Jones & Bartlett Learning, LLC NOTare KriyaFOR Yoga SALE developed OR DISTRIBUTION by the Self-Realization Fellowship and sisterNOT FOR SALE OR DISTRIBUTION organizations; Raja Yoga as developed by Ramakrishna Paramhansa and Swami Vivekananda and their associated organizations; Tran- scendental Meditation developed by Mahesh Yogi and associated sis- ter organizations; Kundalini Yoga and its variant Simplified Kundalini © Jones & BartlettYoga Learning,(Sharma, 2019). LLC A popular technique gaining© Jonespopularity & inBartlett the Learning, LLC NOT FOR SALEWest OR that DISTRIBUTION is based on yoga and meditation is mindfulness-basedNOT FOR SALE stress OR DISTRIBUTION reduction (MBSR) (Khoury et al., 2015). This technique was developed by Jon Kabat Zinn at the University of Massachusetts Medical Center and has evolved into an eight-week standardized program. The program entails nonjudgmental acceptance and focusing on the present and the thoughts,© Jones emotions, & impulses,Bartlett body Learning, sensations, LLC and memories © Jones & Bartlett Learning, LLC to relieve distressNOT that FOR emanates SALE from ORthese DISTRIBUTION sources. Such mind–body– NOT FOR SALE OR DISTRIBUTION spirit techniques are going to grow in their popularity as distress and dissatisfaction with life continue to grow in modern society.

© JonesSKILL-BUILDING & Bartlett Learning, ACTIVITY LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Several functionaries work in the area of mental health. A mental health functionary or mental health professional is a person who provides services to either improve an individual’s mental health or treat mental illness in a person. Mental health professionals include psychiatrists, © Jones & Bartlettclinical Learning, psychologists, LLC internists, family physicians,© Jones physician & Bartlettassis- Learning, LLC NOT FOR SALEtants, OR psychiatric DISTRIBUTION (clinical) social workers, psychiatricNOT nurses, FOR psychiat SALE- OR DISTRIBUTION ric aides, mental health counselors and psychotherapists, art thera pists, mental health educators, mental health advocates, and others. Use the Internet and other sources to complete Table 1.4.

Table 1.4 ©Professional Jones & BartlettDistinctions Learning, Between Mental LLC Health Providers © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Approximate Professional Degree(s) License Tasks Performed Annual Income

Psychiatrist © JonesClinical psychologist& Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTInternist FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Family physician (continues)

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 29 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

30 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Table 1.4NOT Professional FOR SALE Distinctions OR DISTRIBUTION Between Mental Health Providers (continuedNOT FOR) SALE OR DISTRIBUTION Approximate Professional Degree(s) License Tasks Performed Annual Income

Physician assistant © JonesPsychiatric & Bartlett (clinical) Learning, LLC © Jones & Bartlett Learning, LLC NOT FORsocial workerSALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Psychiatric nurse Psychiatric aide Mental health counselor © Jones & Bartlettor Learning, psychotherapist LLC © Jones & Bartlett Learning, LLC NOT FOR SALE ORArt DISTRIBUTION therapist NOT FOR SALE OR DISTRIBUTION Mental health educator Mental health advocate © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Case Study:NOT IsFOR Matthew SALE Suffering OR DISTRIBUTION from a Character Flaw? NOT FOR SALE OR DISTRIBUTION

Matthew is a junior and computer science major at a four-year public university. He has always been a bright student and is on a scholarship. You are his roommate and know that last year he had a breakup © Joneswith & his Bartlett longtime girlfriendLearning, and has LLC been upset about this ever since© Jonesbut does not& Bartlettlike to talk. Learning,Over the LLC last three months, he has complained of chronic fatigue and being unable to concentrate on his studies. NOT FORHe has SALE also been OR missing DISTRIBUTION classes, something he never did in the past.NOT He FORremains SALE sad and OR does DISTRIBUTIONnot want to socialize. His sleeping is also disturbed, and he wakes up early in the morning and keeps brooding. He has lost his appetite and is losing weight. He is further stressed by the end-of-semester exams and due dates of assignments and has been procrastinating. © Jones & Bartlett Learning,Questions for LLC Discussion © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION1. As Matthew’s friend, should you be concerned?NOT FOR SALE OR DISTRIBUTION 2. Do you think Matthew is showing signs of weakness in his character? 3. As Matthew’s friend, should you talk to him about missing classes? 4. What other things would you like to talk about with Matthew? 5. How do you think you can help Matthew as his friend? 6. What© might Jones be some & Bartlettresources available Learning, to Matthew? LLC © Jones & Bartlett Learning, LLC 7. What can be done to reduce stigma for people like Matthew? NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

SUMMARY © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Health is defined as a means to achieve desirable goals in life while maintaining a multidimensional (physical, mental, social, political, economic, spiritual) equilibrium that is operationalized for individuals

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 30 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Summary 31

as well as communities.© Jones Mental& Bartlett health is Learning, defined as the LLC ability of an © Jones & Bartlett Learning, LLC individual to fulfillNOT his FOR or her SALEobligations OR to DISTRIBUTION self and society while living NOT FOR SALE OR DISTRIBUTION in mutual harmony with the physical and social environment. Mental health education deals with voluntarily modifying health behaviors that are conducive to making a person harmonious with his or her © Jonesenvironment. & Bartlett Such behaviors Learning, include LLC stress-management behaviors,© Jones & Bartlett Learning, LLC relaxation and adequate sleep behaviors, effective communication NOTbehaviors, FOR SALEanger-management OR DISTRIBUTION behaviors, anxiety-reduction behavNOT- FOR SALE OR DISTRIBUTION iors, healthy eating behaviors, healthy physical activity and exercise behaviors, time-management behaviors, financial-management behaviors, recreation and leisure-management behaviors, and ade- © Jones & Bartlettquate Learning, work-performance LLC behaviors. Mental health© Jonespromotion & entails Bartlett Learning, LLC developing policies, regulations, and environments that are con- NOT FOR SALEducive OR DISTRIBUTIONto making a person feel and be in harmonyNOT with FOR his SALEor her OR DISTRIBUTION environment. Such policies, regulations, and environments reduce stress, ensure adequate work for all, foster relaxation opportunities for all, regulate anger and associated harms, reduce anxiety, provide adequate food© for Jones all, ensure & Bartlett adequate Learning, housing for all,LLC provide suf- © Jones & Bartlett Learning, LLC ficient supportsNOT for beingFOR physically SALE OR active, DISTRIBUTION and provide for enough NOT FOR SALE OR DISTRIBUTION recreation and leisure opportunities. The ancient Indian civilization (2000–600 bce) introduced the practices of Ayurveda and yoga, which have provided important contributions to mental health. The Ebers and Edwin Smith papyri © Jonesfrom the & Egyptian Bartlett civilization Learning, (3000–300 LLC bce) showed important© Jones & Bartlett Learning, LLC NOTdevelopments FOR SALE in treatingOR DISTRIBUTION mental illness and promoting mentalNOT FOR SALE OR DISTRIBUTION health. The ancient Chinese civilization is credited with developing a system of medicine based on qi, yang, and yin. The mentally ill were generally treated humanely by the ancient Greeks and Romans. During the Middle Ages (500–1500 ce), Arab cultures © Jones & Bartlettoriginated Learning, a system LLC of medicine called the Unani© Jones system .& During Bartlett Learning, LLC NOT FOR SALEthe OR Renaissance, DISTRIBUTION René Descartes (1596–1650),NOT a French FOR philoso SALE- OR DISTRIBUTION pher, dichotomized mind and the body. In the 18th century, Frank Mesmer (1733–1815) suggested that the mentally ill could be cured by holding rods filled with iron filings in water, a practice later found to be ineffective. Benjamin Rush (1745–1813) wrote the book Medical Inquires© and Jones Observations & Bartlett upon the Learning, Diseases of theLLC Mind, which © Jones & Bartlett Learning, LLC advocated forNOT humane FOR treatment SALE ofOR the DISTRIBUTION mentally ill; it is consid- NOT FOR SALE OR DISTRIBUTION ered the first textbook on psychiatry in America. In 1793, Philippe Pinel (1745–1826), a French physician, challenged the traditional wisdom of keeping the mentally ill restrained when he removed the chains from patients at the Asylum de Bicetre in Paris. In 1801, he © Joneswrote Traité & Bartlett médico-philosophique Learning, sur LLC l’aleniation mentale; ou la manie© Jones & Bartlett Learning, LLC NOT(Medico- FORPhilosophical SALE OR TreatiseDISTRIBUTION on Mental Alienation or Mania)NOT in FOR SALE OR DISTRIBUTION which he elaborated his psychologically oriented approach. His approach can be considered as the first psychotherapeutic approach to mentally ill patients. In the 19th century, Jean-Martin Charcot

© Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284219203_CH01_Sharma.indd 31 02/06/20 6:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

32 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett(1825–1893) Learning, worked LLC on hypnosis and hysteria,© and Jones Dorothea & BartlettLynde Learning, LLC NOT FOR SALEDix OR (1802–1887), DISTRIBUTION an American activist on behalfNOT of FOR the indigent SALE OR DISTRIBUTION insane, is credited with creating the first generation of American mental asylums. Clifford Beers (1876–1943), after being confined to multiple mental health institutions, wrote his autobiography, A Mind That © Jones & Bartlett Learning,Found LLC Itself, thereby making the© need Jones for better & Bartlett care of theLearning, mentally LLC NOT FOR SALE OR DISTRIBUTIONill a public issue. Sigmund FreudNOT (1856–1939) FOR SALE founded OR theDISTRIBUTION psychoanalytic school of psychology. Emil Kraepelin (1856–1926) classified mental disorders and advocated that the origins of mental illness were rooted in biology and genetics. Psychosurgery (lobotomy) was initiated by Antonio Egas Moniz (1874–1955) and was popular © Jones & Bartlett Learning, LLC between 1936© andJones the mid-1950s, & Bartlett after Learning, which it was LLC discontinued. NOT FOR SALE OR DISTRIBUTION In 1938, UgoNOT Cerletti, FOR an SALEItalian psychiatrist,OR DISTRIBUTION first tested electroconvulsive therapy on human patients. The introduction of neuroleptic drugs starting in the 1950s marked the beginning of a new chapter in the annals of mental health. In the 1970s, the trend for © Jones & Bartlettdeinstitutionalization Learning, LLC became the norm. In the ©1980s, Jones health & Bartlett plans Learning, LLC began developing managed care mechanisms. In the 1990s, the use NOT FOR SALEof OR brain DISTRIBUTION imaging and atypical antipsychotic drugsNOT further FOR improved SALE OR DISTRIBUTION the understanding and treatment of mental illnesses. Contemporary trends include the move toward deinstitutionalization, legislation to support mental health, the rapid development of managed care, the © Jones & Bartlett Learning,advent LLC of precision medicine, a© general Jones movement & Bartlett toward Learning, biological LLC and multifactorial underpinnings of mental health disorders, the use NOT FOR SALE OR DISTRIBUTIONof computer applications for mentalNOT health,FOR SALEand the ORrevival DISTRIBUTION of mind– body–spirit interventions.

REVIEW QUESTIONS © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 1. DefineNOT health, FOR mental SALE health, OR and DISTRIBUTIONmental illness. 2. Describe Jahoda’s model of mental health. 3. Identify the key aspects of Tengland’s model of mental health. 4. What are the constituents of mental health education? 5. Differentiate between mental health education and mental © Jones & Bartlett Learning,health promotion. LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR6. DISTRIBUTIONDiscuss the contributions of the ancient NOTIndian FORcivilization SALE to OR DISTRIBUTION mental health. 7. Explain the contributions of Greco–Roman civilization to mental health. 8. Identify the salient contributions of 18th-century physicians © Jones & Bartlett Learning, LLC Frank Mesmer, Benjamin© Rush,Jones and & Philippe Bartlett Pinel Learning, in the care LLC NOT FOR SALE OR DISTRIBUTIONof mentally ill. NOT FOR SALE OR DISTRIBUTION 9. Describe the contributions of Emil Kraepelin and Sigmund Freud to mental health.

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Websites to Explore 33

10. Differentiate© Jones between & Bartlett psychosurgery Learning, and electroconvulsive LLC © Jones & Bartlett Learning, LLC therapy.NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 11. Discuss some of the contemporary trends in the field of mental health.

© JonesWEBSITES & Bartlett TO Learning, EXPLORE LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Electroconvulsive Therapy https://www.mayoclinic.org/tests-procedures/electroconvulsive -therapy/about/pac-20393894 © Jones & BartlettThis Learning, Mayo Clinic LLC website defines electroconvulsive© Jones &therapy, Bartlett Learning, LLC NOT FOR SALEwhy OR it DISTRIBUTIONis used, the risks associated with it, how toNOT prepare FOR for it, SALE what OR DISTRIBUTION to expect, and typical results. The website also has links to a video about a woman’s experience with ECT. Watch the video. Would you recommend ECT for a loved one who has been prescribed it? Why or why not? © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC History of MentalNOT Illness FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION https://nobaproject.com/modules/history-of-mental-illness This website has been developed by Ingrid G. Farreras from Hood College in Maryland and traces the history of mental illnesses along © Joneswith links & to Bartlett outside sources. Learning, Read theLLC information provided on this© Jones & Bartlett Learning, LLC NOTwebsite, FOR integrate SALE itOR with DISTRIBUTION the information in the chapter, and answerNOT FOR SALE OR DISTRIBUTION the discussion questions provided at the end of the website in small groups or as a written response to your instructor.

History of Mental Illness © Jones & Bartletthttps://www.bipolarworld.net/Bipolar%20Disorder/History/mental Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE_illness.htm OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION This website has interesting links to persons and events related to the history of mental illness, particularly bipolar disorder. Some of these links are pictorial histories, from pharaoh to Freud, the history of the Diagnostic© and Jones Statistical & Manual Bartlett of Mental Learning, Disorders, EmilLLC Kraepelin, © Jones & Bartlett Learning, LLC the history of the self-help movement, Dorothea Dix, and so on. Visit one of the linksNOT and make FOR a factSALE sheet OR on a DISTRIBUTIONtopic of your interest. NOT FOR SALE OR DISTRIBUTION

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34 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

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Palouse Online Program in Mindfulness-Based Stress Reduction (MBSR) © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC https://palousemindfulness.com/? NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION This website was developed by a certified mindfulness-based stress-reduction instructor that is delivered online and is completely free for the benefit of the public. Explore this website and learn MBSR techniques and then write a paper on your experience with © Jones & Bartlett Learning, LLC and reactions ©to JonesMBSR. & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION REFERENCES AND FURTHER READINGS © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Alexander, F., & Selesnick, S. T. (1966). The history of psychiatry: An evaluation of NOT FOR SALE OR DISTRIBUTIONpsychiatric thought and practice from prehistoric times. NewNOT York, NY:FOR Harper SALE & OR DISTRIBUTION Row. American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Arlington, VA: Author. Anastasia, K. (1984). History of frontal lobotomy in the United States, 1935–1955. © Jones & Bartlett Learning, LLC Neurosurgery, 14(6), 765–772. https://doi.org/10.1227/00006123-198406000© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION-00022 NOT FOR SALE OR DISTRIBUTION Barry, P. B. (2002). Mental health and mental illness. New York, NY: Lippincott. Bensley, R. J. (1991). Defining spiritual health: A review of the literature. Journal of Health Education, 22(5), 287–290. Browne, E. G. (1921). Arabian medicine. London, UK: Cambridge University Press. © Jones & Bartlett Learning, LLC Cattan, M. ©(2006). Jones Introduction. & Bartlett In M. Cattan Learning, & S. Tilford (Eds.),LLC Mental health promotion. A lifespan approach (pp. 1–8). Berkshire, UK: Open University Press. NOT FOR SALE OR DISTRIBUTION Center for MedicareNOT FOR & Medicaid SALE Services. OR (2019). DISTRIBUTION The Mental Health Parity and Addiction Equity Act (MHPAEA). Retrieved from https://www.cms.gov /CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea _factsheet.html Cilliers, L., & Retief, F. P. (2006). Medical practice in Graeco-Roman antiquity. © Jones & Bartlett Learning,Curationis, 29(2), LLC 34–40. © Jones & Bartlett Learning, LLC NOT FOR SALE ORCook, DISTRIBUTION H. (2004). Historical keywords: Health. Lancet, NOT364, 1481. FOR SALE OR DISTRIBUTION Cook, J. C., Wu, H., Aleo, M. D., & Adkins, K. (2018). Principles of precision medicine and its application in toxicology. Journal of Toxicological Sciences, 43(10), 565–577. Cuffel, B. J., Snowden, L., Masland, M., & Piccagli, G. (1996). Managed care © Jones & Bartlett Learning, LLC in the public mental health system.© Jones Community & MentalBartlett Health Journal,Learning, 32(2), LLC 109–124. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Diefenbach, G. J., Diefenbach, D., Baumeister, A., & West, M. (1999). Portrayal of lobotomy in the popular press: 1935–1960. Journal of the History of Neurosciences, 8(1), 60–69.

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References and Further Readings 35

Downie, R.,© Tannahill, Jones C., & & Tannahill,Bartlett A. (1996).Learning, Health promotion: LLC Models and © Jones & Bartlett Learning, LLC values. Oxford,NOT UK: FOR Oxford SALE University OR Press. DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Druss, B. G. (2002). The mental health/primary care interface in the United States: History, structure, and context. General Hospital Psychiatry, 24, 197–202. Ellis, H. (2015). Franz Mesmer: Pioneer in the treatment of functional disease or charlatan? British Journal of Hospital Medicine, 76(3), 170. doi: 10.12968 © Jones/hmed.2015.76.3.170 & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Evans, K. (2005). Historical foundations. In R. Elder, K. Evans, & D. Nizette NOT FOR(Eds.), SALE Psychiatric OR and mentalDISTRIBUTION health nursing (pp. 28–44). Marrickville, NSW,NOT FOR SALE OR DISTRIBUTION Australia: Elsevier. Glasscheib, H. S. (1964). The march of medicine: The emergence and triumph of modern medicine. New York, NY: G. P. Putnam’s Sons. Gold, R. S., & Miner, K. R. (2002). Report of the 2000 Joint Committee on © Jones & Bartlett Learning,Health Education LLC and Promotion Terminology. Journal© of JonesSchool Health, & 72, Bartlett 3–7. Learning, LLC NOT FOR SALE ORGreen, DISTRIBUTION L. W., & Kreuter, M. W. (2005). Health program NOTplanning: FOR An educational SALE OR DISTRIBUTION and ecological approach (4th ed.). Boston, MA: McGraw-Hill. Guntrip, H. (1961). Personality structure and human interaction the developing synthesis of psychodynamic theory. London, UK: Hogarth. Happell, B. (2007). Appreciating the importance of history: A brief historical overview© of mentalJones health, & mentalBartlett health nursingLearning, and education LLC in Australia. © Jones & Bartlett Learning, LLC International Journal of Psychiatric Nursing Research, 12(2), 1439–1445. Horsley, V. (1888).NOT Trephining FOR SALE in the Neolithic OR DISTRIBUTION period. Journal of the NOT FOR SALE OR DISTRIBUTION Anthropological Institute of Great Britain and Ireland, 17(1888), 100–106. Huth, E. J., & Murray, T. J. (2006). Medicine in quotations: Views of health and diseases through the ages (2nd ed. p. 388, quote 3324). Philadelphia, PA: American College of Physicians. © JonesInformation & Bartlett and Technical Learning, Assistance on LLC the Americans with Disabilities Act.© Jones & Bartlett Learning, LLC NOT FOR(2019). SALE Americans OR with DISTRIBUTION Disabilities Act. Retrieved from http://www.ada.gov/NOT FOR SALE OR DISTRIBUTION Jahoda, M. (1958). Current concepts of positive mental health. New York, NY: Basic Books. Jay, V. (2000). The legacy of Jean-Martin Charcot. Archives of Pathology and Laboratory Medicine, 124(1), 10–11. © Jones & BartlettKhoo, Learning, K. K. (1998). LLC The Tao and the Logos: Lao Tzu and© theJones Gospel of& John. Bartlett Learning, LLC International Review of Mission, 87(344), 77–84. NOT FOR SALE ORKhoury, DISTRIBUTION B., Sharma, M., Rush, S. E., & Fournier, C. (2015).NOT Mindfulness-based FOR SALE OR DISTRIBUTION stress reduction for healthy individuals: A meta-analysis. Journal of Psychosomatic Research, 78(6), 519–528. doi: 10.1016/j.jpsychores.2015.03.009 Library of Congress. (2000). Project on the decade of the brain. Retrieved from http:// www.loc.gov/loc/brain/ López-Muñoz,© F.,Jones Alamo, C., & Cuenca, Bartlett E., Shen, Learning, W. W., Clervoy, LLC P., & Rubio, G. © Jones & Bartlett Learning, LLC (2005) HistoryNOT of theFOR discovery SALE and clinical OR introduction DISTRIBUTION of chlorpromazine. NOT FOR SALE OR DISTRIBUTION Annals of Clinical Psychiatry, 17(3), 113–135, doi: 10.3109/10401230591002002 Luft, H. S. (1981). Health maintenance organizations, dimensions of performance. New York, NY: Wiley. Lutz, N. J. (2000). Cotton Mather. Philadelphia, PA: Chelsea House Publishers. © JonesMacDonald, & Bartlett G. (2006). Learning, What is mental LLChealth? In M. Cattan & S. Tilford (Eds.),© Jones & Bartlett Learning, LLC Mental health promotion. A lifespan approach (pp. 8–32). Berkshire, UK: Open NOT FORUniversity SALE Press. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Maharishi, Y. V. (1992). Journey of consciousness. New Delhi, India: Macmillan India Limited.

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36 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett Maples-Keller,Learning, J. L.,LLC Bunnell, B. E., Kim, S. J., Rothbaum,© Jones B. O. (2017). & TheBartlett use Learning, LLC NOT FOR SALE OR DISTRIBUTIONof virtual reality technology in the treatment of anxietyNOT and otherFOR psychiatric SALE OR DISTRIBUTION disorders. Harvard Review of Psychiatry, 25(3), 103–113. doi: 10.1097/HRP .0000000000000138 Maples-Keller, J. L., Yasinski, C., Manjin, N., & Rothbaum, B. O. (2017). Virtual reality-enhanced extinction of phobias and post-traumatic stress. Neurotherapeutics, 14(3), 554–563. doi: 10.1007/s13311-017-0534-y © Jones & Bartlett Learning, LLCMarkus, H. R., & Kitayama, S. (1991).© Jones Culture &and Bartlett the self: Implications Learning, for LLC NOT FOR SALE OR DISTRIBUTIONcognition, emotion, and motivation.NOT Psychological FOR SALE Review, 98,OR 224–253. DISTRIBUTION McDowell, I. (2006). Measuring health: A guide to rating scales and questionnaires (3rd ed.). New York, NY: Oxford University Press. Meadows, G., Farhall, J., Fossey, E., Grigg, M., McDermott, F., & Singh, B. (2012). Mental health in Australia. Collaborative Community Practice (3rd ed.). © Jones & Bartlett Learning, LLC South Melbourne,© Jones Australia: & Bartlett Oxford University Learning, Press. LLC NOT FOR SALE OR DISTRIBUTION Mechanic, D.NOT (2007). FOR Mental SALE health services OR thenDISTRIBUTION and now. Health Affairs, 26(6), 1548–1550. https://doi.org/10.1377/hlthaff.26.6.1548 Mental Health America. (2019). Current mental health legislation. Retrieved from https://www.mentalhealthamerica.net/issues/current-mental-health -legislation Micale, M. S., & Porter, R. (1994). Discovering the history of psychiatry. New York, © Jones & Bartlett Learning,NY: Oxford University LLC Press. © Jones & Bartlett Learning, LLC NOT FOR SALE ORModeste, DISTRIBUTION N. M., & Tamayose, T. (Eds.). (2004). DictionaryNOT of public FOR health SALE promotion OR DISTRIBUTION and education. Terms and concepts (2nd ed.). San Francisco, CA: Jossey Bass. Mott, M. C., Gordon, J. A., & Koroshetz, W. J. (2018). The NIH BRAIN Initiative: Advancing neurotechnologies, integrating disciplines. PLoS Biology, 16 (11), e3000066. © Jones & Bartlett Learning, LLCNasser, M. (1987). Psychiatry in ©ancient Jones Egypt. &Bulletin Bartlett of the Royal Learning, College of LLC NOT FOR SALE OR DISTRIBUTIONPsychiatrists, 11, 420–422. NOT FOR SALE OR DISTRIBUTION Navarro-Haro, M. V., López-Del-Hoyo, Y., Campos, D., Linehan, M. M., Hoffman, H. G., … García-Campayo, J. (2017). Meditation experts try Virtual Reality Mindfulness: A pilot study evaluation of the feasibility and acceptability of Virtual Reality to facilitate mindfulness practice in people attending a Mindfulness conference. PLoS One, 12(11), e0187777. doi: © Jones & Bartlett Learning, LLC 10.1371/journal.pone.0187777© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Panzini, R. NOTG., Mosqueiro, FOR B. SALE P., Zimpel, OR R. R., DISTRIBUTION Bandeira, D. R., Rocha, N. S., & Fleck, M. P. (2017). Quality-of-life and spirituality. International Review of Psychiatry, 29(3), 263–282. doi: 10.1080/09540261.2017.1285553 Park, K. (2017). Park’s textbook of preventive and social medicine (24th ed.). Jabalpur, India: Banarasidas Bhanot. © Jones & Bartlett Perrin,Learning, K. M., & McDermott,LLC R. J. (1997). The spiritual© dimensionJones of & health: Bartlett Learning, LLC A review. American Journal of Health Studies, 13(2), 90–99. NOT FOR SALE ORPreston, DISTRIBUTION G. H. (1943). The substance of mental health. NewNOT York, FORNY: Farrar SALE & OR DISTRIBUTION Rinehart. Ramirez, A. G., & Thompson, I. M. (2017). How will the “cancer moonshot” impact health disparities? Cancer Causes & Control, 28(9), 907–912. Reischel, H. J. (2003). The care that was (2nd ed.). Burleigh, Australia: Poseidon © Jones & Bartlett Learning, LLC Books. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONRomas, J. A., & Sharma, M. (2017).NOT Practical FOR stress SALEmanagement. OR A comprehensive DISTRIBUTION workbook. (7th ed.). Cambridge, MA: Academic Press (Elsevier). Rush, B. (1812). Medical inquires and observations upon the diseases of the mind. Philadelphia, PA: John Grigg.

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References and Further Readings 37

Sands, N. M.© (2009). Jones Round & the Bartlett bend: A brief Learning, history of mental LLC health nursing in © Jones & Bartlett Learning, LLC Victoria, NOTAustralia FOR 1848 to SALE1950’s. Issues OR in MentalDISTRIBUTION Health Nursing, 30, 364–371. NOT FOR SALE OR DISTRIBUTION Seedhouse, D. (2002). Total health promotion. Mental health, rational fields and the quest for autonomy. West Sussex, UK: John Wiley and Sons. Shah, M. H. (1966). The general principles of Avicenna’s canon of medicine. Karachi, Pakistan: Naveed Clinic. © JonesSharma, & M.Bartlett (2014). Potential Learning, efficacy of yoga LLC in various diseases. Journal of Symptoms© Jones & Bartlett Learning, LLC and Signs, 3(3), 194–199. NOT FORSharma, SALE M. (2018). OR Introspective DISTRIBUTION meditations for complete contentment (Santosha). NOT FOR SALE OR DISTRIBUTION Omaha, NE: Health for All. Sharma, M. (2019). Jung’s collective unconscious, integrative (mind-body-spirit) yoga and self-realization. In S. B. Schafer (Ed.). Media models to foster collective human coherence in PsychEcology (pp. 93–108). Hershey, PA: IGI Global. © Jones & BartlettSharma, Learning, M., Branscum, LLC P., & Atri, A. (2014). Introduction© to Jones community &and Bartlettpublic Learning, LLC NOT FOR SALE OR healthDISTRIBUTION. San Francisco, CA: Jossey-Bass. NOT FOR SALE OR DISTRIBUTION Shorter, E. (1997). A history of psychiatry: From the era of the asylum to the age of Prozac. New York, NY: John Wiley & Sons. Silverman, K. (1984). The life and times of Cotton Mather. New York, NY: Harper & Row. Singh, K. (1983).© Jones Religions of& India Bartlett. New Delhi, Learning, India: Clarion LLCBooks. © Jones & Bartlett Learning, LLC Soria, V., Uribe, J., Salvat-Pujol, N., Palao, D., Menchón, J. M., & Labad, J. (2018). PsychoneuroimmunologyNOT FOR SALE of mentalOR DISTRIBUTION disorders. Revista de Psiquiatria y NOT FOR SALE OR DISTRIBUTION Salud Mental, 11(2), 115–124. doi: 10.1016/j.rpsm.2017.07.006 Stempsey, W. E. (2001). Plato and holistic medicine. Medicine, Health Care, and Philosophy, 4(2), 201–209. Stolyarov, G. II, (n.d.). Rhazes: The thinking Western physician. Retrieved from © Joneshttp://www.liberalinstitute.com/IslamicPhysicianRhazes.html & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORSubbarayappa, SALE B. V.OR (2001). DISTRIBUTION The roots of ancient medicine: An historical outline.NOT FOR SALE OR DISTRIBUTION Journal of Biosciences, 26(2), 135–143. Talbott, J. A. (2004). Deinstitutionalization: Avoiding the disasters of the past. Psychiatric Services, 55, 1112–1115. Tengland, P. (2001). Mental health. A philosophical analysis. Dordrecht, The © Jones & Bartlett Learning,Netherlands: Kluwer LLC Academic. © Jones & Bartlett Learning, LLC Tilford, S. (2006). Mental health promotion. In M. Cattan & S. Tilford (Eds.), NOT FOR SALE OR MentalDISTRIBUTION health promotion: A lifespan approach (pp. 33–63).NOT Berkshire, FOR UK: SALE Open OR DISTRIBUTION University Press. Trent, D. (1993). Promoting mental health: Everyone’s business. Surrey, UK: NW Surrey Health Authority. Trimble, M. R. & George, M. S. (2010). Biological psychiatry. (3rd ed.) West Sussex, UK:© JonesWiley-Blackwell. & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC United StatesNOT Congress. FOR (2016). SALE H.R. 34—21st OR DISTRIBUTION Century Cures Act. Washington, NOT FOR SALE OR DISTRIBUTION DC: Author. Retrieved from https://www.congress.gov/bill/114th-congress /house-bill/34 U.S. Department of Health and Human Services (USDHHS). (1979). Healthy People: The Surgeon General’s report on health promotion and disease prevention. © JonesWashington, & Bartlett DC: Author.Learning, LLC © Jones & Bartlett Learning, LLC U.S. Department of Health and Human Services (USDHHS). (1980). Promoting NOT FORhealth—preventing SALE OR disease. DISTRIBUTION Objectives for the nation. Washington, DC: Author.NOT FOR SALE OR DISTRIBUTION U.S. Department of Health and Human Services (USDHHS). (1990). Healthy People 2000. National health promotion and disease prevention objectives. Washington, DC: Author.

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38 Chapter 1: Mental Health, Mental Illness, and Historical Perspectives

© Jones & Bartlett U.S.Learning, Department LLCof Health and Human Services (USDHHS).© Jones (1999). & Mental Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONhealth: A report of the Surgeon General—Executive summaryNOT. Rockville, FOR MD:SALE OR DISTRIBUTION Author. U.S. Department of Health and Human Services (USDHHS). (2000). Healthy People 2010 (Vols. 1–2). Washington, DC: Author. U.S. Department of Health and Human Services (USDHHS). (2009). Healthy © Jones & Bartlett Learning, LLCPeople 2020: The road ahead. Retrieved© Jones from https://www.healthypeople.gov/& Bartlett Learning, LLC U.S. Department of Health and Human Services (USDHHS). (2019). Healthy NOT FOR SALE OR DISTRIBUTIONPeople 2030 Framework. RetrievedNOT from FOR https://www.healthypeople.gov/2020 SALE OR DISTRIBUTION /about-healthy-people/development-healthy-people-2030/framework Weissman, M. M., & Klerman, G. L. (1978). Epidemiology of mental disorders. Emerging trends in the United States. Archives of General Psychiatry, 35(6), 705–712. doi:10.1001/archpsyc.1978.01770300047005 © Jones & Bartlett Learning, LLC World Health© OrganizationJones & (WHO). Bartlett (1974). Learning, Constitution of LLC the World Health NOT FOR SALE OR DISTRIBUTION Organization.NOT Chronicle FOR of SALE the World HealthOR Organization,DISTRIBUTION 1, 29–43. World Health Organization (WHO). (1986). Ottawa Charter for health promotion, 1986. Geneva, Switzerland: Author. World Health Organization (WHO). (1997). The Jakarta Declaration on leading health promotion into the 21st century. Geneva, Switzerland: Author. World Health Organization (WHO). (1998). Health promotion glossary. Available © Jones & Bartlett Learning,from https://www.who.int/healthpromotion/about/HPG/en/ LLC © Jones & Bartlett Learning, LLC NOT FOR SALE ORWorld DISTRIBUTION Health Organization (WHO). (2013). Mental healthNOT action FOR plan 2013–2020 SALE. OR DISTRIBUTION Geneva, Switzerland: Author. World Health Organization (WHO). (2019). Mental health: A state of well-being. Retrieved from https://www.who.int/features/factfiles/mental_health/en/ Yesilada, E. (2005). Past and future contributions to traditional medicine in the © Jones & Bartlett Learning, LLC health care system of the Middle-East.© Jones Journal & of Ethnopharmacology,Bartlett Learning, 100(1–2), LLC NOT FOR SALE OR DISTRIBUTION135–137. NOT FOR SALE OR DISTRIBUTION