The Evolving Perspective on Mental Health and Mental Illness

Mental health is undeniably an integral part of one’s well-being, as more and more people nowadays are open to seeing a professional about mental illness rather than keeping it to themselves. It is widely considered to be an equivalent to one’s state of physical health, a state of being that cannot go unmonitored or unchecked, lest the individual want to face the consequences of suffering with the condition alone. This idea, that mental health is a critical part of one’s health and must be treated accordingly with proper care, is a relatively recent phenomenon when considering the drastic shifts in perception of mental illness that have occurred from previous times (around 1900s) to modern times (now). Mental illness was viewed as a physical disability that must be treated with harsh methods, and even after the removal of these practices, the stigmatization of mental illness continued to afflict the community of mentally ill people. However, a shift into modern times ushered in a new perception of mental illness that brought with it the destigmatization of mental illness and a focus on treatment of mental illness in humane and empathetic ways. Exemplified by the methods in treating mental illness and surveys conducted by researchers, these differences in the perception of mental illness and treatment of them are shown to be a product of time.

In the mental asylums depicted in the early 1900s, mental illness itself was treated very harshly and dealt with as a foreign invader, evoking senses of witchcraft from the mentally ill person. This early treatment of mental illness is vividly demonstrated in one account, as the ex-patient states “‘For crying the nurses beat me with a broom-handle and jumped on me,’ described one patient to Bly. ‘Then they tied my hands and feet, and throwing a sheet over my head, twisted it tightly around my throat, so I could not scream, and thus put me in a bathtub filled with cold water’” (Renee). The nurses and thus medical professionals at the time did not view these patients as regular patients: rather, they dealt with them as other-beings with no regard for human rights whatsoever, as instances and many others like these demonstrate which in actuality was commonplace in mental asylums at the time. Building off this treatment of mental illness, a superintendent at a mental asylum from 1907 to 1930 named Henry Cotton believed that “‘infected parts of the body led to mental illness. He focused on pulling rotting teeth, which he thought caused madness-inducing infections’” (Renee). This narrow-minded view served to dehumanize those patients, and this in turn led to a particular view that mental illness was in its own sphere and must be addressed harshly.

This rhetoric is only reinforced by images such as the one displayed in Figure 1, as depicted there is a patient undergoing electroshock therapy in 1956. The patient is strapped down and is in a situation analogous to one who is unable to control themselves, under the control of a separate other-worldly entity, and must be helped against their will. Hence, it is quite obvious that the circulating idea about mental illness at the time was that patients with mental illness conceived the disease from a non-human entity, bearing striking similarities to the metaphor that Sontag denotes for cancer. She states that cancer is “the emblem of all destructive, alien powers to which the organism is host” and a “demonic enemy” (Sontag 68). Thus, the treatments of both mental illness and cancer involve the pin-point removal of the piece of body tissue where the mental illness afflicts the host, as Cotton describes in the procedures that he conducted at the New Jersey State Hospital. Mental illness was viewed as one of the worst things that happen to a person, as can be predicted from the horrid treatment of it, which led to the stigmatization of mentally ill people as unable to fit the normal functions of daily life and must thus be excluded from the public sphere.

Continuing off this idea of exclusion from the public sphere, one of the main problems plaguing the realm of mental illness prior to the 1960s and 1970s was the lack of exposition of mental illness in the public. The ambiguity and disinterest concerning mental illness during this time period is exemplified throughout as “the topics of mental health in general and persons with mental illness in particular also were of limited concern to the public. Mental illness was a topic most often treated by individuals and families as a ‘private matter’ that was more or less off-limits to outsiders, except, perhaps, medical professionals and other family members” (Borinstein). Thus, by removing the problem of mental illness from the public sphere, the mistreatment of these people was allowed to happen. Eventually, stigmatization occurred as well, as their secrecy about mental illness resulted in a low-key lifestyle that led to exclusion from public life and all things considered to be regular, such as holding a job and raising a family.

This rhetoric also resonates in popular media as well, especially in narratives following mentally ill patients. In the film A Beautiful Mind, directed by Ron Howard and starring Russell Crowe, a depiction of the famous mathematician John Nash (portrayed by Crowe) with schizophrenia only reiterates the narrative following these patients in these times. The movie took place in the 1950s, and what was particularly alarming was how throughout the entire film, Nash’s mental illness was almost made fun of in social settings and was never directly confronted. In addition, when he had his schizophrenic bouts while presenting, the treatment that took place after his hospitalization in a mental facility was disturbing to say the least. The film portrayed him as shackled and held down by medical staff as he was forced to undergo insulin shock therapy to cure his schizophrenia, followed by medication. Even after his release from the hospital, after he stopped taking medication, the movie illustrated Nash as unable to take care of his own child as he left it to drown after having one of his schizophrenic episodes (Howard).  The treatment of mental illness resonates with that of the time period, and by following this particular narrative, it only added to the stigma that mentally ill people are unable to resume normal function. Hence, they are in this state of limbo in which they are hospitalized and separated from the outside world, with its importance only highlighted when the patient is in the asylum itself and undergoing cruel treatment.

Despite this initial perception of mental illness, major shifts into modern times have ushered in new waves of attention to mental health and decreased stigmatization of people with mental illnesses, a process that occurred as it was brought into the public sphere. In a survey taken in 2011 in Germany, it was reported that “less mental illness stigma was perceived by respondents than in the previous surveys. In the eyes of the German public, the devaluation and rejection of people with mental illness has substantially decreased since 1990” (Angermeyer). This mental stigma includes a belief that mentally ill people are incompetent in performing normal functions and having a routine lifestyle. What this survey indicates is a change in the perception of mental illness as not something that is separate from the realm of the normal: rather, it is incorporated into the same sphere, and results in the treatment of mentally ill people as regular beings rather than as separate entities. Continuing off this notion of perceived change, “more people regard mental illness as an illness ‘like any other’ than 15 years ago and that far fewer assume people with a mental illness are dangerous” and “research found that almost three quarters of people (73%) felt that people with mental health problems had the same right to employment as the wider population” (O’Hara). The perception of mental health has indeed changed due to the nature of time, as more and more people are able to recognize that mentally ill people are just like “us,” who can hold jobs and are not isolated in their own condition. This leads to empathy and tolerance of mental health conditions, which leads to better workplace conditions and in general much more productive and cooperative workplaces, which contrasts sharply with the mental asylums and stigmatization people were forced to endure through in earlier times.

In regards to treatment, rather than keeping the illness to themselves and making it a private matter, “health professionals such as physicians and psychologists were most recommended and psychological therapy is esteemed, whereas spiritual and religious help is seldom recommended” (Blay). The implications of the change in preference of treatment are the result of more awareness of mental illness and a product of moving this issue into the public sphere rather than letting it reside in the darkness as it had before. Drawing back to the demonic enemy referenced earlier, it denotes a shift from a religious perspective to a more medical perspective on the illness, emphasizing the need for actual treatment rather than treatment based on metaphors and old-beliefs about mental illness. The observed change towards actual clinical methods of helping rather than abusive shock therapy or other harsh shock therapy methods demonstrates a true commitment to helping the mentally ill and treating them as ordinary people, in addition to a greater accumulation of knowledge about mental illness and its important. As told by a boy whose father has bipolar disorder, “The social stigma that those living with mental illness experience essentially stems from this fundamental lack of understanding of mental disorders as physical illnesses” (Bennett). An understanding that mental illness is of the same importance as physical illness has transformed the treatment and perception of mental illness as demonstrated by the data provided earlier, and is in an integral part to progress as a whole. The poster depicted in Figure 2 resonates with much of the current rhetoric, as mental

Figure 2

health is placed on the same pedestal as physical health whereas prior there was clear hierarchy in terms of which health came first. This contrasts with the notion circulating prior to modern times, as mental illness was viewed to be in its own sphere, treated as something distinct from the human experience and thus cannot be discussed in public. However, these perceptions and treatments have since greatly changed, resulting in the greater inclusion of these people into regular routines with normal lives.

To conclude, the change in perception and treatment of mental illness in the public sphere and in professional settings such as hospitals has changed drastically, as modern times have ushered in with them updated perspectives on how to correctly handle mentally ill people and far broader issues as well. However, what is most alarming is that although there is progress to be seen, and it is a vast difference from what was observed in the past, this stigma in regards to mental illness still persists. The stigma cannot be erased overnight and as a result, it must gradually fade away as people are educated on what mental illness really is and its importance, in order to ensure that they still turn out to be productive members of society rather than become ostracized by their own condition as was done in the past.

 

 

 

 

 

 

 

 

 

 

 

 

Works Cited

Figure 1. Lacombe, Justine. “mental health is as important as physical health Graphic T-Shirt.” Redbubble, redbubble.com/people/justinelacombe/works/29782701-mental-health-is-as-important-as-physical-health?p=mens-graphic-t-shirt

Figure 2. Hopkins, Thurston. “A patient at a mental hospital undergoes electroshock treatment in 1956.” AllThatsInteresting, allthatsinteresting.com/mental-asylums#9

A Beautiful Mind. Directed by Ron Howard, performances by Russell Crowe and Jennifer Connelly, Imagine Entertainment, 2001.

Angermeyer, Matthias C., et al. “Changes in the Perception of Mental Illness Stigma in Germany over the Last Two Decades.” European Psychiatry, Elsevier Masson, 8 Dec. 2013, sciencedirect.com/science/article/abs/pii/S0924933813004276.

Bennett, Theo. “Changing The Way Society Understands Mental Health.” NAMI, April 16 2015, nami.org/blogs/nami-blog/april-2015/changing-the-way-society-understands-mental-health

Blay, Sergio Luis. “Community perception of mental disorders: A systematic review of Latin American and Caribbean studies.” Soc Psychiatry Psychiatr Epidemiol, 7 April 2004, https://link.springer.com/content/pdf/10.1007%2Fs00127-004-0820-y.pdf

Borinstein, Andrew B., et al. “Public Attitudes Toward Persons With Mental Illness.” Health Affairs, healthaffairs.org/doi/full/10.1377/hlthaff.11.3.186.

Fabian, Renee, et al. “The History of Inhumane Mental Health Treatments.” Talkspace, 28 Sept. 2018, talkspace.com/blog/history-inhumane-mental-health-treatments/.

O’Hara, Mary. “Attitudes to Mental Illness ‘Changing for the Better’.” The Guardian, Guardian News and Media, 12 June 2009, theguardian.com/society/2009/jun/12/mental-illness-health-attitudes.

Sontag, Susan.  Illness as Metaphor and AIDS and Its Metaphors. Picador, Farrar, Straus, and Giroux.