Introduction to Human Services, BSHS 302
June 21, 2010
Chronic illnesses are disorders that require ongoing care and treatment for much of the patients’ life to manage the illness. Examples of such illnesses are diabetes, high blood pressure, or heart disease. When discussing chronic mental illness, such diseases or disorders would be those that require ongoing treatment and care throughout much of the patients’ life. Examples would be schizophrenia, bipolar disorder, chronic anxiety disorder or attention deficit hyperactive disorder as well as many other specific forms of mental illness. Individuals suffering from chronic mental illnesses are part of the vulnerable population because they exist within a social group consisting of individuals with high risk factors or are susceptible to health-related problems. Individuals with less access to quality health care, lower life-expectancy or higher mortality rates, and those in a lower social status not accepted in the general population may be a part of a vulnerable population (UCLA, 2010). Those individuals with health disparities such as severe mental illness are vulnerable because they may not be able to provide for themselves or meet their own basic human needs as a result of their illness. Chronically Mentally Ill Population
History of Mental Illness and Intervention Strategies
Mental illness presumably has been present in all societies and cultures dating back to at least 5000 BCE. Up until the Middle Ages people with mental illness or those considered to have gone mad were accused as being possessed by evil spirits or demons. The intervention strategy was to drill holes in the individuals head to allow the demons to escape. Mental illness and demonic possessions continued to be thought as connected well into the eighteenth century. The possessions were resolved by casting out the demons or going through witch trials resulted in either death or evidence of witchcraft such as living through the trials. In colonial America, intervention strategies were limited because mental defects were handled within each family as a private matter; however, the growth in populations made it difficult to maintain privacy and thereafter mental illness became an issue for the entire community. By the mid-eighteenth century the intervention strategy changed to separation, where communities began to build separate almshouses and hospitals for the insane members of the community. This allowed the clinically insane to be housed separately from those individuals with the inability to meet their own needs for reasons outside of mental illness. Mistreatment and abuse have been common occurrences in mental health care and started with the earliest treatments or interventions being used. Individuals that did not follow the guidelines of socially appropriate or accepted behavior were thought to be mentally ill or to have gone mad. During the nineteenth century these behaviors continued and interventions were especially abusive and included public beating and humiliation, death, or incarceration. Interventions used were determined through behavior and whether the behavior was threatening to others. Admittance to the insane asylum could be indefinite and the treatments for illness included severe beatings with chains, whips or rods and with patients chained or caged for years or until death. Residents of the community could pay money to enter the asylum and watch the public humiliation and abuse of patients. It was this behavior that led to the first true reform of mental health care at the end of the eighteenth century when chief physician Philippe Pinel from France began pushing for care to become more compassionate and for patients to be treated using moral methods. Reform began in the nineteenth century in the United States when Dorothea Dix, a social activist, advocated for humane treatment of patients who lived in asylums....