The history of treatment of mental disorders has changed drastically over decades and centuries. For most of history, the human brain—the control center of emotions and behaviors—has been a mystery due to its complexity and the fact that until recently the brain could not be studied while the subject was alive. Mental health disorders have been viewed as demonic possession, character flaws, and signs of weakness, among many other things. Treatment has depended upon the perspective, and historically these have been very damaging and often fatal, and have included punishment, exorcism, excessive treatments such as use of electricity or removal of parts of the brain, incarceration, etc. In the past several decades, knowledge about the brain have brought insight about mental health disorders. Early attempts at classification of mental health disorders were significantly different than those that are currently identified in the most recent edition of the DSM (edition 5). Revision of the DSM (diagnostic manuals) helps educate and change views and also affects treatment approaches with mental health disorders.
Mental health disorders and the people affected by them have a history of being stigmatized that continues even today. People with mental illness are vulnerable to marginalization on many levels. Fear is a major contributing factor to the negative reactions that many people have about people with mental illness; often the people suffering with mental illness are thought to be dangerous, or at the very least different. Fear, of course, comes from a lack of education and empathy, and is compounded every time there is a story in the news where a crime is committed or something happens where mental illness is identified as the “cause.” Unfortunately, this fear impacts the amount of trust and responsibility that others will give to people with mental illness, and affects relationships of all kinds (isolation is a common experience of those suffering with mental health issues). This can also impact self-sufficiency for people with mental illness, as employers and landlords might be reluctant to provide opportunities of employment and housing. The results of multiple layers of marginalization can become overwhelming, and for some people with mental illness may lead to homelessness, disconnection from family and friends, reoccurring interaction with legal entities, and in some of these cases the results can be fatal (suicide, accidents, violence, death from police interactions, etc.).
Current trends in mental health include integration with other services, trauma informed care, recovery support services (wrap-around services), and attention and inclusion of culture and spirituality in treatment. The use of a bio/psycho/social (including spiritual) assessment is most supportive of justification for these approaches/services. Service recipients should have input into their service planning, and be empowered to direct their care, when possible. Treatment modalities are focused on managing symptoms, emotions, thoughts, and behaviors (this includes medication management but also cognitive and behavioral therapies). Though this approach, better quality of life can be achieved. Also, there should be a strong emphasis on family involvement when possible, and service recipients benefit when they experience feeling a part of their community.
Though we have made progress in the treatment of mental health disorders, we have a long way to go. De-stigmatization should be made a priority. The connection between environmental health and mental health needs to be continuously explored. Chemicals in our foods, pollution in our air and water, and the negatively impacted Earth are impacting our mental health, and there are a lot of opportunities for research in this area. Changes in our culture and communities also affect mental health, and should be studied as well. Mental health medications currently in use, while helpful, can have negative health effects, so more research should be done in that area as well. More focus should be placed on indigenous ways of healing and holistic approaches.
Social workers play an important role in the progress of mental health treatment, evidence based interventions and practices, and policies and laws regulations. It is our responsibility to use our voices to advocate for those without a voice, or to empower those people to use their voices. Future progress starts with us—in our classrooms, in our work, in our research, and in our families and communities.