*Originally posted by Derleth *
We’ve come a long way in the past two hundred years.
Two hundred years ago ‘mental illness’ was treated differently, but not necessarily worse. A Whig view of the history of mental illness would claim this, but it is difficult to document exactly what has improved. My contention is that although the social construction and methods of ‘treatment’ may have changed, whether that is for better or worse is a moot point. In order to believ that there has been an improvement, I would need to see well documented historical research; this I have not yet found.
But mental disorders are as real as smallpox or the flu.
Smallpox and flu are caused by known agents and follow predictable courses. Psychosis, depression, neurosis, personality disorders ec. etc. are socially defined, have no known causative organism and respond extremely variably to treatment.
**We do shoehorn people to treat them. So what. Diseases are approached in a pragmatic way if they are to be cured, with unsuccessful treatments thrown out. **
Most other diseases are treated with the full consent of the patient; this is rarely the case with mental illness because of the social construction of it- stigma abounds! It is far more difficult for service users to reason successfully with medical practitioners over ‘mental illness’ treatments than with physical illness treatments.
**Like any good science, observation outranks theory or hypothesis. **
More than any other ‘science’, psychiatry uses research funded by the organizations that depend on one particular answer- drugs. Drugs presume the medical model and so the main research in psychiatry is forced into a medical paradigm. Social explanations and possible responses have no drug company to fund research for them.
Any ‘mental illness’ which has been found to have a physical cause within the nervous system had been transferred to neurology. Psychiatrists no longer treat primary cases of epilepsy, strokes, and other well founded neurological disorders although they may treat sequalae. Those neurological disorders which require considerable and expensive long term in-patient intervention- The dementias, Tertiary Syphilis (GPI), Huntingdon’s Disease etc have been left within the remit of Psychiatry for financial and social reasons. The remaining non-neurological parts of ‘mental illness’ are essentially those parts of human behaviour for which no cause has been agreed and are therefore cast into the field of psychiatry and generally treated by medication or confinement by default (although other treatments are available- Cognitive Therapy, Psycho-therapy etc- which are notably also seen as effective for non psyciatric human difference such as low self esteem, learned behavioural responses etc.)
A claim has been made for more than three hundred years that differing behaviour can be seen as an ‘illness’. The claim has been extremely successful, but the underlying scientific support is minimal.