COMMUNITY

MENTAL HEALTH

What is Mental Health?

The emotional and social wellbeing of an individual, including
ones psychological resources for
dealing with the day-to-day
problems of life.

Good Mental Health is the

Ability to:

Function under adversity

Change or adapt to changes
Maintain control over ones tension and
anxiety
Find more satisfaction in giving than
receiving
Show consideration for others
Curb hate and guild
Love others

Classification of Mental
Disorders

Diagnostic and Statistical Manual of Mental

Disorders, fourth addition
http://www.psychologynet.org/dsm.html

Anxiety Disorders
Childhood Disorders
Eating Disorders
Mood Disorders
Personality Disorders
Psychotic Disorders
Substance-Related Disorders
Other Disorders

Causes of Mental Disorders

Birth Defects
Inherited mental deficiency
Biologically caused mental retardation

Physical Impairment
Neurotransmitter failures related to psychotic
episodes at puberty
Brain trauma due to accident

Psychological Causes
Being reared in economically deprived conditions
Parental abuse

Mental Illness in America

Four to five million adults have
serious mental illness (SMI)
15.4% of the U.S. population 18 and
older have had one incident of
mental illness in the past 30 days
18.2 adults per 1,000 had
experienced an episode of SMI in
the past year

Social Indicators of Mental

Illness

There are approximate 30,000 suicides in the

U.S. yearly
In 1991 the number 2 and number 3 leading
cause of death among 15-24 year olds was
homicide
In 1990 the divorce rate (4.7/1,000) was nearly
half the marriage rate (9.8/1,000)
4.5 million women of childbearing age were
current users of illegal substances
1,383 children died from abuse or neglect in
1991

Stress: A Contemporary Mental

Health Problem

Stress is ones psychological and

physiological response to stressors
General Adaptation Syndrome
(GAS) A three stage response to
stressors
Alarm reaction
Resistance
Exhaustion

Fight or Flight

Mental Health in America Before World War I

Care provided by families or private caretakers
Those not cared for in the home were sent to the
poor houses or almshouses
In the late 19th century as the number of people
increased in the poor houses and almshouses
attempts were made to separate people by type of
disability
In 1851 Dr. Thomas Bond visited the famous
Bedlam Hospital in England and founded
Pennsylvania Hospital the first institution in
America for the care of the mentally ill.

Blood letting
Blistering
Emetics
Warm and cold baths

The Moral Treatment Era for the

Well-To-Do
William Tuke, and English Quaker,
established moral treatment

Mental illness was caused by:

Treated in an asylum
with:
Infidelity

Being overworked
Envy
Gluttony
Drinking
Sexual excesses

Rest
Light food
Exercise
Fresh air
Amusements

The State Hospitals

Institutions became a place for those society did
not want to have around
Prisoners
Orphans
Wayward youths
The mentally ill

The rationalization was that with small numbers of

patients proper care could be provided
The numbers of patients grew very rapidly
In time the institutions became human warehouses

The Mental Hygiene Movement

Occurred during the first few decades of the
twentieth century
Believed that early detection treatment was key to
curing mental illness
Wanted to address the problem at a community
level
Established local mental hospitals (Bellevue in NY)
This movement did nothing to address the State
Hospital problem
By the 1940s state mental institutions had grown
to nearly a half-million

Mental Health Care After World

War II

Psychiatrists came out of the war

with new techniques called crisis
management
In 1946 the National Institute of
Mental Health was formed
Fostered research
Supported training
Improved clinical services

Deinstitutionalization
Discharging of patients from state
hospitals and the relocating them
in less crowded community
settings
In
In
In
In

1955
1970
1980
1990

558,922
337,619
150,000
110,000

resident
resident
resident
resident

patients
patients
patients
patients

Deinstitutionalization Forces
Economics

States needed money for roads, education and welfare

There was a new profit motive to provide services for the
mentally ill

Idealism: Keep people out of institutions

Legal considerations
Federal Legislation: Aid to the Permanently and Totally
Disabled (APTD)
Welfare money could now be paid to discharged mental
patients

Antipsychotic drugs
Chlorpromazine
Thorazine

Community Mental Health

Centers

A Presidential commission recommended

replacing all mental hospitals with
community based mental health centers
(1961)
Seen as secondary and tertiary prevention
The federal government became partially
responsible for mental health care in the U.S.
Reduced budgets during the Regan years left
community mental health centers
understaffed and under utilized