Asylums Role in Understanding of Mental Disorders Essay

In Ancient Greece tradition two quite opposite thoughts existed on a subject. From the one hand, madness had become the condition and fate of minds divided against themselves . Like in ancient plays, Greeks have seen something fatal and extraordinary in madness and associated madness with human’s soul suffering. About mental disorders were spoken in terms of a heart or brain, blood, spirits and humors. On the other hand, on a question what can be done for a mad person, there was a strict Hippocratic answer – a medical treatment. Madness was considered as a disease which was needed to be treated in a way all sicknesses were treated.
The contrasting models of mental alienation developed by the Greeks – madness as moral perversion, madness as disease – were assimilated within Christendom.. Asylums Role in Understanding of Mental Disorders Essay. The treating process became a lot about religion. People with mental disorders were considered to be other God’s fools, or (more often) possessed by demons. For a religious group mediaeval Europe was madness considered to be demonstration of heretical thought, and people with mental disorders were treated like heretics. Even in 1621 when English author Robert Burton in this book Anatomy of Melancholy spoke about Satan to be responsible for mental disorders.
There’s a clue already in Burton’s book title which discovers doctors’ view on mental disorders. Doctors and scientists were looking for a madness to be revealed through a human body

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Erving Goffman’s Asylums was first published in 1961 and a revised edition, with an extended introduction by William Helmreich, appeared in 2007.

Goffman, a Canadian sociologist born to Ukrainian immigrants, studied chemistry at the University of Manitoba before moving to the University of Chicago to continue in sociology. He became an expert on human interaction and is considered one of the most influential sociologists of the 20th century. Asylums Role in Understanding of Mental Disorders Essay.The micro-interactions between patients and staff were a focal point of the book, which illuminated in a unique and perceptive way the social context created by St Elizabeth’s, a 7000-bed psychiatric hospital in Washington DC, and its effects on patient experience and behaviour. The emphasis was on the patient’s social world whereas all previous research on mental hospitals emphasised the perspectives of psychiatrists.

The book is divided into four essays based on Goffman’s ethnographic study of St Elizabeth’s. The first essay deals with ‘total institutions’ and is considered a classic in the psychiatric literature. This is followed by the essay on the ‘moral career of a patient’, describing the change from the status of pre-patient to that of in-patient and considering the initial effects of institutionalisation on social relationships. In the third essay Goffman examines the daily routine of a psychiatric institution. Finally, he turns his attention to the ‘medical model’, especially the effects on the patient-psychiatrist relationship. Goffman thought that psychiatrists lacked a ‘scientific understanding’ of mental illness and routinely misunderstood the behaviour of their patients. Asylums Role in Understanding of Mental Disorders Essay.

I first read Asylums in 1975, while I was working on my PhD thesis, under the supervision of Jim Watson and Tom Trauer at Guy’s Hospital, studying the effects of the ward environment on the behaviour of psychiatric in-patients. Goffman’s observations were rich, penetrating and insightful, examining intelligently the ‘inmates’, staff and the interactions between them. Specifically, Goffman demonstrated how total institutions strip individuals of their formal identity and then re-socialise them in the institution’s routines. He argued that an equilibrium of various improper roles prevails within the system allowing the continuation of its function, irrespective of utility to the patient.

Over 50 years since their first publication, Goffman’s essays on asylums continue to attract interest in psychiatry. In January 2011, this journal published an editorial by Seamus MacSuibhne (’Erving Goffman’s Asylums 50 years on’) drawing attention to their role in humanising patients and to patterns that dehumanise them. Goffman’s essays accelerated understanding of the complexities of the physical and social environment affecting the behaviour of psychiatric patients, including beliefs, values, roles, policies, procedures and rules. He has been hugely influential and was perhaps the prelude to the ideological trends that followed and eventually prevailed in psychiatric practice. Deinstitutionalisation, community care, normalisation principles, advocacy, empowerment and recovery are some of the products of sparkling sociological and ideological views and, arguably, have had more impact on the care of patients with severe mental illness and intellectual disability than molecular genetic and neurobiological research in the period since Asylums was published.

The current dominance of neurobiological research perspectives notwithstanding, psychiatrists need to have a deeper understanding not only of brain function but also of social factors, the environment, relationships and culture.Asylums Role in Understanding of Mental Disorders Essay.  This classic is a good point to start and one hopes that work of similar quality will be published on the experience of patients today, in the era of neurobiology and community care.

It was once believed that people with psychological disorders, or those exhibiting strange behavior, were possessed by demons. These people were forced to take part in exorcisms, were imprisoned, or executed. Later, asylums were built to house the mentally ill, but the patients received little to no treatment, and many of the methods used were cruel. Philippe Pinel and Dorothea Dix argued for more humane treatment of people with psychological disorders. In the mid-1960s, the deinstitutionalization movement gained support and asylums were closed, enabling people with mental illness to return home and receive treatment in their own communities. Some did go to their family homes, but many became homeless due to a lack of resources and support mechanisms.

Today, instead of asylums, there are psychiatric hospitals run by state governments and local community hospitals, with the emphasis on short-term stays. However, most people suffering from mental illness are not hospitalized. A person suffering symptoms could speak with a primary care physician, who most likely would refer him to someone who specializes in therapy. The person can receive outpatient mental health services from a variety of sources, including psychologists, psychiatrists, marriage and family therapists, school counselors, clinical social workers, and religious personnel. These therapy sessions would be covered through insurance, government funds, or private (self) pay. Asylums Role in Understanding of Mental Disorders Essay.