Mental Illness
During the Middle Ages, the mentally ill were believed to be possessed or in need of religion. Negative attitudes towards mental illness persisted into the 18th century in the United States, which led to the stigmatization of mental disease, and unhygienic (and often degrading) confinement of mentally ill individuals. In 1840, Dorothea Dix lobbied for better living conditions for the mentally ill after witnessing the dangerous conditions in which patients lived. Over the course of the next 40 years, she was able to convince the government to build 32 psychiatric hospitals.
This caused institutionalized care to increase, as it was the most effective way to treat the mentally ill. However, just because the number of patients increased didn’t mean the funding increased, so, unfortunately, a lot of the state hospitals were underfunded and understaffed. A lot of criticism followed due to the poor living conditions. In 1963, the closure of psychiatric hospitals was arranged by the Community Mental Health Centers Act, which said that only those who posed an imminent danger to themselves or others could be committed to state psychiatric hospitals. The rest of the patients were deinstitutionalized, which had the goal of improving the patients’ quality of life. Though the goal of deinstitutionalization is not controversial, the outcome of what happened has made it a highly debated topic. While there have been positive outcomes such as improvements in adaptive behaviors, friendships, living conditions, and overall patient satisfaction, there have also been problems including the inability to get proper vaccinations, cancer screenings, and routine medical checks, as these community living centers are much smaller. Additionally, there are debates about the pros and cons of living in your own community while getting treatment, as well as how effective functionally independent hospital homes are.
What are your thoughts on deinstitutionalization?
I know that recently we’ve talked a lot about the stigmas and stereotypes of diseases, but I think it would be effective to narrow in on those as related to mental illness, as well as its microaggressions (Already brought this up a couple of times but the New York Times article titled “Mental Illness is not a Horror Show” is super interesting and I recommend reading). Additionally, I’m wondering how mental illness manifests in Los Angeles, as well as our tighter community. What does mental illness look like in social media especially in LA?
This caused institutionalized care to increase, as it was the most effective way to treat the mentally ill. However, just because the number of patients increased didn’t mean the funding increased, so, unfortunately, a lot of the state hospitals were underfunded and understaffed. A lot of criticism followed due to the poor living conditions. In 1963, the closure of psychiatric hospitals was arranged by the Community Mental Health Centers Act, which said that only those who posed an imminent danger to themselves or others could be committed to state psychiatric hospitals. The rest of the patients were deinstitutionalized, which had the goal of improving the patients’ quality of life. Though the goal of deinstitutionalization is not controversial, the outcome of what happened has made it a highly debated topic. While there have been positive outcomes such as improvements in adaptive behaviors, friendships, living conditions, and overall patient satisfaction, there have also been problems including the inability to get proper vaccinations, cancer screenings, and routine medical checks, as these community living centers are much smaller. Additionally, there are debates about the pros and cons of living in your own community while getting treatment, as well as how effective functionally independent hospital homes are.
What are your thoughts on deinstitutionalization?
I know that recently we’ve talked a lot about the stigmas and stereotypes of diseases, but I think it would be effective to narrow in on those as related to mental illness, as well as its microaggressions (Already brought this up a couple of times but the New York Times article titled “Mental Illness is not a Horror Show” is super interesting and I recommend reading). Additionally, I’m wondering how mental illness manifests in Los Angeles, as well as our tighter community. What does mental illness look like in social media especially in LA?
I think the topic of deinstitutionalization is very tricky when thinking about it. Like you said above, I see that it had both positive and negative outcomes; however, what really interests me is how the decision of who stays and who leaves is made. I know above you stated that only individuals who posed an imminent danger to themselves or others would be kept, but how is that measured. For example, there might be an individual who appears to be stable when inside a psychiatric hospital but because of the condition they are in they may pose a threat to themselves or others outside of that type of environment (that might of been kind of confusing but hopefully it kind of makes sense). I guess my main question out of that is how does someone determine whether someone poses a threat to themselves or others and who is making this decision. It would make sense for a doctor to determine it; however, I wonder since it was understaffed was there a group put together or something like that. Regarding the topic of how mental illness manifests in Los Angeles and what it "looks" like. I think mental illness has many stereotypes and preconceived images attached to it (which is not an unknown fact), but I think in Los Angels stereotypes are focused on the physical look of someone. For example, I think in many cases people assume someone has a mental illness if they do not function like a "normal" individual (i.e. making odd facial expressions, moving around it different movements, and many other things). I think the idea of looking mentally ill plays a large role in social media because of platforms like Instagram and Twitter.
ReplyDeleteI think in general, media representation of mental illness is sad. Especially in horror movies. When the antagonist is mentally ill, it can be problematic because it sends the message that in order to save oneself, people need to quarantine themselves from those who have mental illnesses. People have a subconscious “stay away” mindset around people with mental illnesses because of their fear established in media representation. Even historically, people who were mentally ill were shamed and were secluded from society. In terms of deinstitutionalization, I agree with Simone in that in largely depends on the circumstance. How and who is making these decisions? There are positive aspects of deinstitutionalization in that it can help with the integration of society; however, there are negative aspects as well.
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ReplyDeleteI think the topic of institutionalization vs. deinstitutionalization is tricky because I don't think there is a zero-sum, universal way to approaching mental healthcare. I think hospitals/doctors/medicine definitely plays a role in mental health, i.e, with many mental illnesses there are literal chemical changes that can drastically effect a person's quality of life. But at the same time it's hard to create or have some sort of universal standard for mental health care because, unlike if you break a bone for example, there's no laid out, step by step procedure that is guaranteed to help you. Mental health encompasses so much, and is so individual, which I think is honestly one of the major reasons why we don't have/see too many big strides towards federally-funded mental illness / health programs.
ReplyDeleteI think social media & mental health are connected in so many ways. And, there's definitely a lot of stigma at Poly surrounding mental illness (which stems from societal stigma), and I think it would be interesting to talk about that stigma specifically at Poly and our experiences with it - I think understanding mental illness/health from our own experiences will allow us to understand it more deeply in the context of LA. I think the conversation surrounding mental health in Los Angeles has historically been tied to the issue of homelessness in LA, and while I acknowledge that that is a very real connection, at the same time I think it would be interesting as a class to broaden our understanding surrounding mental health in LA. How do mental illnesses vary across communities in LA? Across our community? What does that tell us about these communities?
360 fakey-fakey ladderstall quickscope collateral headshot off of what Pranay is saying, I think that media can sometimes mis represent the facts and reality of a mental image. They either romanticize a mental illness, or completely dehumanize it. My assumption is that Hollywood, and other mediums of entertainment, are going the "easy route" when painting a picture of mental illness. As a result, the content appears to be more palatable for audiences. Social media also have pretty severe negative effects when it comes to mental illness. Seeing tweets that say "I'm going to kill myself" or memes that may "joke around" with real life feelings of anxiety and depression are not the images/content that people should be creating humor out of. I think when posts and images like these are seen, they tend to diminish the feelings of REAL people who actually deal with suicidal thoughts, anxiety, depression, stress, etc. Instead of making light of these issues through humor, I think they need to be approached from both an educational standpoint and a human standpoint as well. Real people struggle and battle with mental illness and the jokes can create a very amusing atmosphere around a very serious and topical subject.
ReplyDeleteGoing off of what Cole said, micro-aggressions surrounding mental illness are SO common. Literally every day I hear at least 2 people say that they want to kill themselves when they are just stressed or say that they are so depressed when they are just sad about something. There are people at Poly who struggle with clinical depression and suicidal thoughts, so it's quite frustrating to hear these things. Also, I think it would be interesting to look at the more recent tv series on Netflix that mention mental illness. The Ted Bundy tapes, for example, got a LOT of views. People were even posting about the new documentary on instagram. Although it was a documentary and it did stay relatively factual and removed, people still managed create trends and hashtags that overall, took away from the seriousness of his condition. Additionally, the Asylum season of American Horror Story (and really the whole series overall) definitely romanticizes mental (and physical) illness to the greatest extent possible. Maybe we can talk about these more in class tomorrow. Even though it's wrong to romanticize illness, I still found myself entertained and invested in both series. I'm curious to hear y'alls thoughts though.
ReplyDeleteWhile I don’t know a lot about the intricacies of deinstitutionalization, I think that it’s a good first step because it makes patients with any sort of mental health issue feel less like they need to be in a hospital but rather that they can be functioning members of society, even if they still need some care. I would be interested in seeing statistics on how the new federally-funded community centers where mental health patients now get treatment differ in how much funding they get, and if they receive more funding in wealthier areas.
ReplyDeleteIn terms of my experience within my community and the discussion of mental illness, I really think that we could do better in terms of how we use terms so nonchalantly when we’re feeling something, such as saying one is depressed or that they have anxiety when it’s just about one small thing. Saying stuff like those things only diminish people’s real mental illnesses and could lead to harmful effects when they might choose to come forward with any of their real problems. I think I talked about this sometime in one of the roundups in last semester, but I think that media definitely plays a role in our perception of mental health. A lot of movies such as Shutter Island and One Flew Over The Cuckoo's Nest display mental illness as something to be afraid of and show only its most extreme cases, which can cause impressionable people to think of all mental illness like such.
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ReplyDeleteKickflipping off what Rachel said, there is no all encompassing solution to treating mental illness because it manifests in so many different ways. Depression is vastly different from schizophrenia, for example, and shouldn't be treated as such. We seriously make the mistake of grouping all mental health conditions together, often associating those suffering from mental illnesses with the extreme portrayals shown in movies/tv. School counselors and therapists aside, I have zero clue what mental health resources and facilities exist in my community. Honestly, when I think of institutionalization, I immediately think of American Horror Story Season 2, One Flew Over the Cuckoos Nest, and Titicut Follies. This goes to show that there are infinite negative associations and harmful stereotypes and generalizations made about mental illness and institutionalization. It demonstrates the irrational fear associated with psychiatric and mental health facilities, which when I was a little kid, the people around me called "insane asylums."
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ReplyDeleteApproaching deinstitutionalization is a very slippery slope and very hard to get everything right. The idea of who gets institutionalized and who lives outside has always interested me. You can't find the solution to treating mental illness because there are so many different kinds and everyone's minds are different. Like Sophia, I think many people make the mistake of grouping mental health conditions together which ends up in the stigmatization of all mental illnesses. There are so many bad/ one sided portrayals of mental illness in the media, like the movie Split shows a man who has dissociative identity disorder and shows an extreme version of the disorder which creates a sort of fear of many people with metal illness. There is an unnecessary amount of fear associated with mental illness and especially metal health institutions because of the way the media has portrayed them.
ReplyDeleteAlthough I don’t know any hard facts on this, I would assume that deinstitutionalization has lead to an increase in people with mental illnesses living on the streets due to their disabilities, and by extension, it may have contributed to the now persistent stigma that intertwines homelessness and mental illness and makes us afraid to speak to those people asking for our help that we pass on the sidewalk. This pattern isn’t an “LA thing” per se, but it is definitely prevalent in Los Angeles and Pasadena, especially because we have such a huge issue with homelessness in the area.
ReplyDeleteRegarding social media, cartwheeling off of Pranay and Cole's discussion of the often negative representation in TV and film, I think there’s alternatively been some sort of a perverse romanticization of mental illness in recent years, a mainstream reclaiming of sorts. Similarly to how it was fashionable to be waif-like and flushed due to TB, it’s now trendy to be angsty. Again, not just an LA thing, but neither is LA immune to this cultural shift.
Like many of you guys noticed, mental illnesses are often glamorized or glorified particularly on social media. Anxiety, bipolar disorder, depression, and OCD often are reduced to socially acceptable characteristics and stereotypes. Anxiety is associated with shy, quirky (in a cute way) introverts; depression is no longer seen as an illness, but a state of being and OCD is almost always synonymous with perfectionism. Additionally, the fact that Los Angeles is the entertainment hub of the world has only bolstered this image as movies and television shows portray mental illness in an inaccurate and at times insensitive manner. Netflix's "13 Reasons Why" is a perfect example of what is wrong with the industry as the main character commits suicide in a means to get revenge on those who wronged her. The deliberate creation of a progressive story explaining suicide is a blatant dramatization of a real issue with little basis in reality. It's crucial media creators should focus on encouraging depictions of mental illnesses with a more nuanced perspective in a means to begin going in the right direction.
ReplyDeleteI think that deinstitutionalization was an important step in changing the perception from patients (that need to be to separate from the general population) to people suffering from mental health issues. This relabeling provides people with the opportunity to keep their matters private. This topic reminds me of a video in which actors compare the way American’s talk about physical and mental health conditions (https://www.youtube.com/watch?v=yWA0es85hMs). While dramatic the video highlights how mental health topics are often downplayed in an accusatory way with the intention to invalidate the person feelings. In my own life, I have noticed people being called stupid or autistic with the intention of degrading the person's confidence. This degradation of confidence often leads to feelings of depression and sadness that could have been avoided by people exercising common courtesy.
ReplyDeleteTrampolining off of what everyone said, I think that although deinstitutionalization has it’s cons, overall, it was a huge step towards the destigmatizing of mental illnesses. People finally started to realize that many illnesses could be helped using certain drugs, rather than isolation. Deinstitutionalization made people find ways to integrate people with mental illnesses back into society.
ReplyDeleteWhile I know Poly students tend to misuse words such as “depressed” and “anxious”, I do think there is a overall positive attitude towards the recognition of mental illnesses. I feel as though they are acknowledged which can’t also be said about the rest of Los Angeles. In my family (extended family), mental illnesses are acknowledged but it is believed to be your fault. I feel like this is also true of greater Los Angeles. I think people in Los Angeles support the awareness of mental illnesses until it has to do with homeless people. I feel as though there is a large portion of homeless people that are not seen as people because of their mental illnesses; yet, when a loved one is diagnosed with depression, they are not dehumanized or looked down upon in the same manner.
A few thoughts (some slightly unfinished) I have here:
ReplyDeleteI did a little research and I found that over 6.3% of the population suffer from severe mental illnesses and that for long-term care and treatment, around 50 beds per 100,000 people are needed, while only around 5 beds per 100,000 people are provided. With this in mind, I find myself thinking about what fraction of that 6.3% is made up of Poly students, and what are we doing to aid this situation. The kind of language we use at Poly (the “I have so much work I could kill myself right now” or the “I want to die, I have four tests this week”) can be really detrimental to those who actually, truly feel that way. While I am sure it is not only Poly students that say these kinds of things, it seems to almost be amplified here, and I wonder why that is. I’m not innocent in this, and I am not trying to point fingers, I just think it’s important to look at how the little things– like the phrases we use to describe the degree to which we are stressed out– can have a really huge impact.
360 fakey-fakey off what Sophia said, I think it’s odd how we often give mental illness the subtitle or alternate name of depression, as if they are interchangeable, or as if depression is all encompassing and there are no other types of illnesses. I think we live in an age where it is cool to act as if we know everything about everything, and if we’re not “woke” or versed on a subject, then we’re deemed stupid or lesser than. I think, because Poly is a primarily liberal school, it has become this cool thing to be all rah-rah about mental health, despite a lot of people not even knowing very much about it. So we talk about depression and anxiety as if we know everything there is to know about those disorders, and yet we don't acknowledge any other types of mental illnesses that are actually more common than we think (i.e. bipolar disorder, personality disorder, schizophrenia, etc.) If we want to end the stigmatization of mental illnesses, it begins with education, and the desire to learn more about it– and being "woke" means nothing unless there is actual substance and knowledge being it.
For Luke: In 1977, then Vice-President Humphrey offered some reflection about the treatment of the weakest members of society. He stated, “The moral test of government is how that government treats those that are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life, the sick, the needy, and the handicapped.” Throughout our nation’s history, the mentally ill have been a part of this latter group, relegated to the dark and unattended to corners of our communities. The passing of the decades has done little alter their status. Mental illness, whether found among the affluent and well-educated or in the circles of the less sophisticated, carries a stigma that prevents the opportunity for a realistic appraisal of the problem and the much-needed implementation of adequate solutions. Deinstitutionalization, a shift heralded as the humane response to the mistreatment of those in the care of state mental hospitals, failed to provide these patients with the improved quality of life anticipated. Statistics from the year after this process was put in effect showed that the mentally ill population in jails and prisons surged, housing over three times as many people than public and private hospitals. The number of community health centers needed to provide services for those in need as imagined in government legislation have never been realized, with lack of funding always cited as the reason. This group is consistently overlooked, except perhaps in the wake of the aftermath of a mass shooting where there is a brief outcry to help these individuals that have somehow fallen between the cracks. The problem of the mentally ill goes beyond the idea of deinstitutionalization and rests instead on our attitudes toward people that suffer from both illness and indignity. Our refusal to recognize health in its totality, to treat the whole patient equally, ensures the suffering of millions. Whenever the economy takes a downward turn, mental health provision is always first on the chopping block as though it is a luxury item. Policies are implemented that make it harder for families to hospitalize their loved ones, and emergency rooms are overrun with patients because Medicaid does not cover preventive or early treatment care. This works against the goal of improving the quality of life for these patients, their treatment lagging shamefully behind those that suffer from “acceptable” illnesses,
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