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A History of Mental Illness Treatment: Obsolete Practices

Mental illness affects many individuals in the United States. According to the National Alliance on Mental Illness, approximately one in five American adults experience mental illness each year. That’s 46.6 million people. Children are affected as well, as about 17% of people age 6 to 17 years old experience mental health challenges each year.

With data like this, it’s no surprise that attitudes toward mental health have changed for the better in recent years. Although stigma still exists, CNN reported that 90% of Americans value mental and physical health equally, according to a 2015 survey by the American Foundation for Suicide Prevention (AFSP), the National Action Alliance for Suicide Prevention, and the Anxiety and Depression Association of America. “People see connection between mental health and overall well-being, our ability to function at work and at home, and how we view the world around us,” Dr. Christine Moutier of AFSP told CNN. This change comes as mental health treatments continue to focus on community-oriented, holistic care.

People haven’t always held these views. An examination of health treatment shows that extensive changes have occurred over the years. Some strategies used in the past were ineffective and even dangerous. The following are some of the strangest — and now obsolete — practices in the history of mental illness treatments.

History of Mental Illness Treatment

Trephination

Trephination dates back to the earliest days in the history of mental illness treatments. It is the process of removing a small part of the skull using an auger, bore, or saw. This practice began around 7,000 years ago, likely to relieve headaches, mental illness, and even the belief of demonic possession. Not much is known about the practice due to a lack of evidence.

Bloodletting and Purging

Though this treatment gained prominence in the Western world beginning in the 1600s, it has roots in ancient Greek medicine. Claudius Galen believed that disease and illness stemmed from imbalanced humors in the body. English physician Thomas Willis used Galen’s writings as a basis for this approach to treating mentally ill patients. He argued that “an internal biochemical relationship was behind mental disorders. Bleeding, purging, and even vomiting were thought to help correct those imbalances and help heal physical and mental illness,” according to Everyday Health. And these tactics were used to treat more than mental illness: During that period, diseases like diabetes, asthma, cancer, cholera, smallpox, and stroke were likely treated with bloodletting using leeches or venesection.

Isolation and Asylums

Isolation was the preferred treatment for mental illness beginning in medieval times, which may explain why mental asylums became widespread by the 17th century. These institutions were “places where people with mental disorders could be placed, allegedly for treatment, but also often to remove them from the view of their families and communities,” according to Everyday Health. Overcrowding and poor sanitation were serious issues in asylums, which led to movements to improve care quality and awareness. At the time, medical practitioners often treated mental illness with physical methods. This approach led to the use of brutal tactics like ice water baths and restraint.

Insulin Coma Therapy

This treatment was introduced in 1927 and continued until the 1960s. In insulin coma therapy, physicians deliberately put the patient into a low blood sugar coma because they believed large fluctuations in insulin levels could alter how the brain functioned. Insulin comas could last one to four hours. Patients received an insulin injection that caused them to lose consciousness after their blood sugar fell. Risks included prolonged coma (in which the patient failed to respond to glucose), and the mortality rate varied between 1% and 10%. Electroconvulsive therapy was later introduced as a safer alternative to insulin coma therapy.

Metrazol Therapy

In metrazol therapy, physicians introduced seizures using a stimulant medication. Seizures began roughly a minute after the patient received the injection and could result in fractured bones, torn muscles, and other adverse effects. The therapy was usually administered several times a week. Metrazol was withdrawn from use by the FDA in 1982. While this treatment was dangerous and ineffective, seizure therapy was the precursor to electroconvulsive therapy (ECT). Note that ECT is still used in some cases to treat severe depression, mania, and catatonia.

Lobotomy

This now-obsolete treatment won the Nobel Prize in Physiology and Medicine in 1949. It was designed to disrupt the circuits of the brain but came with serious risks. Popular during the 1940s and 1950s, lobotomies were always controversial and prescribed in psychiatric cases deemed severe. It consisted of surgically cutting or removing the connections between the prefrontal cortex and frontal lobes of the brain. The procedure could be completed in five minutes. Some patients experienced improvement of symptoms, but the treatment also introduced other impairments. The procedure was largely discontinued after the first psychiatric medications were created in the 1950s.

Mental Health Treatment Today

As we learn more about the causes and pathology of various mental disorders, the mental health community has developed effective, safe treatments in place of these dangerous, outdated practices. Today, those experiencing mental disorders can benefit from psychotherapy, along with biomedical treatment and increased access to care. As this study of the history of mental illness care shows, treatments will continue to change along with scientific and research developments and as mental health professionals gain more insight.

You can learn more about mental health treatments and other relevant topics in psychology through the online Bachelor of Arts in Psychology program from Concordia University, St. Paul. This program provides a comprehensive overview of various psychology topics to give you the skills to excel in nearly any career or to pursue further study. With multiple start dates and a flexible online format, you can start earning your degree when the time is right for you.