1.7 Chapter Summary
- Mental disorders include mental health diagnoses as well as intellectual and developmental disorders. Although some mental disorders are not disabling, many people with mental disorders are part of the larger population of people with disabilities who struggle to have equal access to opportunities.
- Measures meant to treat or manage mental disorders throughout history have ranged from exclusionary to cruel, and even murderous, revealing a societal disdain for people with mental disorders that, to some extent, continues into the modern day.
- Reforms over time have sometimes reduced obvious abuses of people with mental disorders, but they have also created new problems. For example, shifting people with mental disorders into state hospitals to be “cured” ushered in a century of institutionalizing people, taking them away from community and family, to the detriment of all.
- Institutions meant to shelter people with mental disorders devolved into overcrowded, prison-like facilities with rampant abuse and use of techniques, such as forced sterilization, that thoroughly dehumanized their occupants.
- The closure of institutions for people with mental disorders in the process called deinstitutionalization brought both an enormous victory for people with mental disorders and a new set of challenges.
- Criminal justice facilities are the largest facilities for treating mental disorders in the United States. This is a result of a lengthy and complex history of failure to meet the needs of this population in humane and productive ways, as well as other events that have increased incarcerated populations overall.
- Deinstitutionalization collided with a rise in substance use in American communities, a problem that was met with an increase in criminal prosecution and incarceration. This punitive approach to the drug problem—along with housing shortages and healthcare unavailability—added substantially to the mentally ill and disabled population in America’s criminal justice system.
Key Term Definitions
- Antipsychotic medications: Medications that treat psychosis, a debilitating aspect of mental illness that impacts a person’s ability to distinguish what is real.
- Asylums: Facilities that were originally intended as a refuge for confinement and care of those with mental disorders and served in Europe and America as precursors to mental hospitals and psychiatric facilities.
- Behavioral health: A broad term that includes all mental health and substance use care and treatment. Behavioral health professionals can include therapists, social workers, medical providers, and others who treat people with mental disorders and mental health problems.
- Community Mental Health Act: A 1963 act that was intended to provide federal funding to shift mental health care from institutional to community settings.
- Deinstitutionalization: The dramatic downsizing and closure of large institutions, such as state hospitals, that housed people with mental disorders.
- Dignity of risk: The ability and power to potentially fail that comes along with an opportunity for self-determination and growth.
- Disability: Any condition or impairment of a person’s body or mind that makes it more difficult for that person to engage or participate in activities.
- Disability rights movement: A broad push toward securing equal rights and opportunities for people who experience disabilities.
- Electroconvulsive therapy (ECT): A medical procedure that involves passing small electric currents through a patient’s brain, creating changes in brain chemistry that have been highly effective in treating conditions such as severe depression.
- Eugenics: An American movement beginning in the 1890s that encouraged practices such as forced sterilization to remove “unfavorable” characteristics in the gene pool. Eugenics became disfavored in the late 20th century.
- Institutionalization: Confining people with disabilities or mental illness in facilities rather than supporting their integration into communities.
- Mental disorders: A mental illness, substance use disorder, or disability that impacts a person’s cognitive, emotional, or behavioral functioning.
- National Institute of Mental Health (NIMH): The leading U.S. agency for research on mental health issues, founded in 1949 under the National Mental Health Act as part of the National Institutes of Health (NIH). The NIH is composed of 27 research institutes and centers and is part of the U.S. Department of Health and Human Services.
- National Mental Health Act: A 1946 act that authorized research and care for mental health and significantly expanded America’s commitment to use science to understand and treat mental illness.
- State hospitals: Originally, state-funded institutions in the model of asylums intended to house people with mental disorders. Modern state hospitals are psychiatric facilities that provide care and treatment, usually on a short-term basis.
- Stigma: Persistent and unfounded negative attitudes toward categories of people, including those with conditions such as mental disorders. Some people object to this term on the grounds that it may perpetuate negative ideas, and they prefer the terms “prejudice and discrimination” to describe societal attitudes and actions that reinforce negative stereotypes and policies.
- Transinstitutionalization: A hypothesis suggesting that people in need of care during the deinstitutionalization movement were simply moved from one institution (hospitals) to another (prisons).
Discussion Questions
- Are there any particular parts of the history relayed in this chapter that you found surprising? What, if any, elements of this history help you to better understand the challenges facing people with mental disorders in today’s society and in your own community?
- Consider the concept of “dignity of risk” as discussed in the video in figure 1.15, and discuss how this concept might inform the goals of people with disabilities generally and people with mental disorders specifically. How does this concept relate to the ideals of deinstitutionalization?
- What do you think of the term “transinstitutionalization”? Describe the complex reasons why people with mental disorders are overrepresented in the criminal justice system.
- When future students look back on our current practices regarding mental disorders—especially in the criminal justice system—are there things you believe will make them wonder: how could humans do this to other humans?
Knowledge Check
Use these optional questions to check your knowledge after reading this chapter.
Licenses and Attributions for Chapter Summary
“Chapter Summary” by Anne Nichol is licensed under CC BY 4.0.
