Sunday, August 13, 2017

HISTORY OF PSYCHIATRIC TREATMENT



    My first psychiatric hospital experience was as an intern at Nebraska Psychiatric Institute in 1954.  This was before drugs were used to control psychiatric  symptoms of mental illnesses and a variety of what are now labeled primitive methods of treatment were in use. 

    So recently at the Glore Psychiatric Museum in St Joseph, MO., I took a step back in time to those days and beyond to the truly dark ages of mental health treatment .

    The museum is on four floors of what once was the Lunatic Asylum #2 that housed 3000 patients.  In 1954 we relied on treatment methods that were of little help, but gave us some feeling  that some patients were improving. 

    Electric shock was being used for a variety of conditions such as depression, schizophrenia, homosexuality, and hysteria. When I watched a patient I was counseling on the table in convulsions my visual field narrowed and I almost passed out. 




Electric Shock was used for most every mental illness



    It has been found that the electric shock does work on some problems including certain kinds of depression, but it has been dropped for most other mental health conditions.  Since 1973 homosexuality has no longer been considered a mental illness.

    Also familiar to me from my time at Nebraska was the patient (manikin) in a tub of ice water that was used as a calming technique. 





Ice baths were also used for treatment of mental illness



    One section of the museum is given over to lobotomies that were still being used in the 1950s. Dr. Egas Moniz won a Noble Prize in 1949 for developing the procedure.  Later as a VA psychologist I worked with victims of this method of treatment that separated by surgery the frontal lobes--one's judgment center --from the rest of the brain.  The cases I worked with had lost the ability to be rehabilitated for life outside the hospital.

    From those 1950s methods the museum went back even further to more  primitive ways of dealing with the mentally ill: steel crates to hold violent patients, isolation in chains to calm them, wheels like the ones rats run on to teach them to be still. 

    Even further back it was dangerous to be mentally ill because you could be declared a witch or a cohort of the devil and be burned at the stake.  A manikin stands ready for execution, strapped to a pole with the firewood stacked at her feet.




Some mentally ill people were burned at the stake as witches

    The basement of the museum took us into another dimension of running a mental hospital: food.   The hospital had had gardens and animal barns to provide some of the tremendous amount of food consumer by 3000 patients.  The cooking area had tubs in which hundreds of pounds of potatoes could be cooked at one time. 

    Patients not only grew much of the food and helped with the cooking but other money making projects helped keep hem active.  Daily walks were also a part of the treatment.

    In the 1950s there were complaints about patients being required to work and complaints about this policy that was cutting into local businesses--so that treatment was dropped.  When I worked in a VA hospital after this kind of work was forbidden, I found some patients who had grounds' privileges were sneaking off into the woods to cultivate patches of vegetables.

    Cutting out patient labor made hospitals more expensive and with the widespread use of drugs for treatment, it was felt many of the patients could be discharged. 

    This had a number of consequences, one being an increase of crime and the sending of many mentally ill to prison.  It is shown at this hospital by the section that is now a Missouri prison with 250 prisoners. 

    My own experience with prisoners is that many of them should be receiving mental health treatment. My observations were agreed to by prisoners I have worked with who resent the mentally ill among them because they are so unpredictable.

    The Glore Museum is an eye-opening experience.   Visitors also have the opportunity to see three other small museums connected to the Glore which I will write about next week.




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