HISTORICAL PERSPECTIVES ON ABNORMALITY: LECTURE OUTLINE

• Historical perspectives

• Lessons learned from historical analysis

• The development of mental health services in Canada

HISTORICAL PERSPECTIVES

• Ancient societies – focus on supernatural causes, harsh treatments

• Greek and Roman – focus on natural causes, humane treatment

• Europe in the middle ages – mostly focused on supernatural causes, witchcraft, demonology, Malleus Maleficarum, development of asylums in the 1500s, mostly harsh treatments

HISTORICAL PERSPECTIVES

Moral treatment (1st mental health revolution) – 1790s, Pinel, Tuke, Rush, focus on natural causes and humane treatment

HISTORICAL PERSPECTIVES

Dorthea Dix and the rise of the medical model – mid to late 1800s, Kraeplin, advances in medicine, germ theory, Social Darwinism, institutionalization

HISTORICAL PERSPECTIVES

• Mental hygiene movement – early 1900s, Meyer, Beers, James, Hincks, focus on humane treatment

• Psychoanalysis (2nd mental health revolution) – Charcot, Breuer, Freud, focus on psychological factors and treatments

• Community mental health (3rd mental health revolution) – beginning in the 1960s, deinstitutionalization, development of community-based programs

LESSONS LEARNED FROM HISTORICAL ANALYSIS

• The early history of psychopathology reveals a struggle between supernatural and naturalistic explanations and between harsh and humane treatments

• After the middle ages, naturalistic approaches based on scientific methods became dominant

LESSONS LEARNED FROM HISTORICAL ANALYSIS

• Whereas religious healers formerly provided “treatment,” this has become the domain of mental health professionals in the 20th century

• Psychiatry and medicine have come to dominate mental health services, but clinical psychology has emerged in the past 30 years

LESSONS LEARNED FROM HISTORICAL ANALYSIS

• There has been a recurring pattern of expose and reform with regard to inhumane conditions for people with mental illness

• Views of etiology and treatment vary with social conditions

• There is a widening scope of experiences that are considered to be mental health problems

THE DEVELOPMENT OF MENTAL HEALTH SERVICES IN CANADA

• Late 1600s – asylums in Quebec

• Mid to late 1800s – Dorthea Dix and the rise of the medical model and asylums in eastern Canada

• Early 1900s – mental hygiene movement – Hincks, CMHA, growth of psychoanalysis

• 1940s – mental hospitals, medical superintendents, psychiatry

THE DEVELOPMENT OF MENTAL HEALTH SERVICES IN CANADA

• 1950s and 1960s – institutions, abuses, somatic “treatments”; Saskatchewan plan; Tyhurst (1963) report; shift to general hospitals

• 1970s and 1980s – emergence of clinical psychology training programs; beginning of community mental health programs

THE DEVELOPMENT OF MENTAL HEALTH SERVICES IN CANADA

• 1990s to today – establishment of clinical psychology across Canada (including 1st Canadian textbook on abnormal psychology); both hospital and community mental health services subjected to government cutbacks in funding; in 2000, funding for phases I and II of mental health homelessness initiative in Ontario

SUMMARY

• Abnormality and mental illness are problematic concepts because of values and social context

• Martin Luther King Jr. proposed that psychology should form a “centre for creative maladjustment”

SUMMARY

• Remember that mental illness is not something absolute and unchangeable, but a concept that is constructed in a social context

• Stigma and discrimination towards people experiencing mental health problems have existed throughout history

• Need to dream of a better world for people with mental illness