Mental illness is a widespread disease. Today, mentally ill people not stay in hospitals. Some of them are housed with relatives or tutors, other have to keep the street-life in urban America. The history of public policy toward the mental illness has a long term of debates and discussions. The evolution of social attitude to the problems of mentally ill led to the decrease of number of the psychiatric hospitals.
Exploring the origin of the transition from the governmental hospitals to the policy of deinstitutionalization, Grob states that the idea of this policy appeared before the World War II. Such problems took place even in the Colonial America. From the seventeenth century to the present day the American society has faced the problems of severely and chronically mentally ill people (“The Mad among Us”, p. 2). In 1880, about 140 public and private mental hospitals with 41,000 patients were founded in America (“Mental Illness and American Society”, p. 4). In this period, the so-called almshouses were popular institutions which provided the independent living and special moral treatment for mentally ill people and especially for lonely people.
However, between 1880s and the first half of XX century the mental institutions started to lose their reputation. It happened in the same period when the number of mentally ill people increased because of the World War II. The conditions in hospitals were horrible. Many patients died because of the use of lobotomy and careless treatment. As a result, in the 50s such ideas were expressed in the policy of deinstitutionalization which was called to change the present order. The main ideas of this policy are the reduction of the number of psychiatric hospitals and the development of various forms of social care of mentally ill (“The Mad among Us”, p. 113). This approach had to prevent the syndrome of hospitalism and the infringement of patients’ rights. Nevertheless, this policy was a reason of the sharp discussions.
Grob emphasizes the importance of the human and balanced policy. Although the hospitals for mentally ill, and especially the almshouses, were similar to prisons, patients had an opportunity to get the high-quality care (“Mental Illness and American Society”, p. 5).
Meanwhile Grob insists on the humane care about mentally ill, sociologist Gofman provides the model of total institutions where those people can live and get a treatment in the conditions separated from the society. The main principle of those institutions is the reduction of the personal freedom of the mentally ill which is natural to their usual existence (Gofman, p. 157). According to this idea, the limitation of the social contacts and control of daily life are the important steps for the medical treatment. However, such idea is a cause of the numerous discussions. Total institutions are characterized by the moral and physical coercion which is based on the idea of habit deletion. As a result, the difference between the private hospitals and prisons is obliterated.
McCollough cites the Senator Sam Ervin’s speech on the congressional hearings in 1969 about “the moral rights to treatment, implicit in our affluent society and under our constitutional form of government” (p. 251). Mentally ill people still are the minority of the American population. Often, they reject the right to medical treatment. However, this minority became visible.
Americans call for the humane solutions of the mentally illness problems. However, the society is always divided trying to find the best solution. The historical experience of the mentally ill people treatment shows the importance and difficulty of the discussions about the public policy toward the mentally ill. The work of hospitals and almshouses was successful during the long term of the social evolution. The policy of deinstitutionalization can’t solve the problem. Today, the American society needs more complex approaches to the problem of mentally ill.
Works Cited
- Gofman, Erving. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. US: Anchor Books, 1961. Print.
- Grob, Gerald N. Mental Illness and American Society, 1895-1940. US: Princeton University Press, 1987. Print.
- The Mad among Us: A History of the Care of America’s Mentally Ill. US: Simon and Schuster, 1994. Print.
- McCollough, Thomas E. “Mental Illness and Public Policy.” Journal of Religion and Health. 1974: 251-258. Print.