history of mental hospitals-part 5

Along with the common use of lobotomy procedures in asylums, electro-convulsiveshock treatment continued to be a dominant practice. Thenumbers continued to rise in the institutions, and caregivers and attendants remained scarce. Rumors of abuse and neglect flooded communities who once were proud of their community asylums. In the 1950s, the Athens Asylum reached its peak population of nearly two thousand patients.

Shortly after the asylum population explosion in the mid 1900s, when mental health treatment was arguably at its worst, an apparent salvation emerged. Psychotropic medication was pioneered. In 1954 the medical community introduced an anti-psychotic drug called Thorazine for the treatment of the mentally ill. In rapid succession, other psychotropic medications became available, making it possible to cut substantially the length of time patients stayed in mental institutions. This breakthrough led to a significant decline in asylum populations, and the gradual discontinuation of less humane treatments and procedures.

Reflecting the changes in the treatment of the mentally ill brought about by drug therapy, and state and federal public policies in the 1960s’ state institutions changed their procedures resembling the previous moral management revolution.  There was an emphasis on protecting the human rights of the mental patients that had historically been overlooked. New employees were hired to be less hierarchical and environmentally controlling as their predecessors. Treatments were geared at the individual and proved to be more effective then group cure-alls. There also was a notable move to de-institutionalize mental patients. In 1960 there were over 500,000 patients in mental institutions in America. It had become increasingly clear that there were many inmates in asylums in custodial care who were able to function in society with adequate out-patient care. Institutions continued to provide 24-hour, long term in-patient care, but now introduced outpatient services, day and night hospitalization, diagnostic services, pre-care and after-care, and more extensive training and research.

Simultaneous with the breakthrough in medical treatment, the community mental health movement became a centerpiece of President John F. Kennedy’s congressional program. There were concurrent shifts in insurance coverage for the mentally ill provided by the Comprehensive Mental Health bill in 1964, and the Medicare and Medicaid Acts in 1966. All of these national movements led to a reduction of the use of existing mental health hospitals and an explosive growth in private hospitals, general hospitals with psychiatric wings, and community mental health centers. As a result states greatly restricted long-term, full care services in state mental institutions in the late 1960s and early 1970s.

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