Cycles of reform in the history of psychosis treatment in the United States
The history of psychosis treatment follows a series of four cycles of reform which provide a framework for understanding mental health services in the United States. The first three cycles of reform promoted the view that early treatment of mental disorders would reduce chronic impairment and disabi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | SSM - Mental Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666560323000208 |
| _version_ | 1797797960284635136 |
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| author | Preethy George Nev Jones Howard Goldman Abram Rosenblatt |
| author_facet | Preethy George Nev Jones Howard Goldman Abram Rosenblatt |
| author_sort | Preethy George |
| collection | DOAJ |
| description | The history of psychosis treatment follows a series of four cycles of reform which provide a framework for understanding mental health services in the United States. The first three cycles of reform promoted the view that early treatment of mental disorders would reduce chronic impairment and disability. The Moral Treatment era (early 1800's to 1890) featured freestanding asylums, the Mental Hygiene movement (1890 to World War II) introduced psychiatric hospitals and clinics, and the Community Mental Health Reform period (World War II to late 1970's) produced community mental health centers. None of these approaches succeeded in achieving the disability-prevention goals of early treatment of psychosis. The fourth cycle, the Community Support Reform era (late 1970's to the present) shifted the focus to caring for those already disabled by a mental disorder within their communities and using natural support systems. This shift embraced a broader social welfare framework and included additional services and supports, such as housing, case management, and education. Psychosis became more central during the current Community Support Reform era partly because individuals with psychosis continued to have disabling life experiences despite efforts at reform. Some degree of recovery from psychosis is possible, and individuals with serious impairment may move towards social integration and community participation. Early intervention for young people with psychosis focuses on at reducing the negative sequelae of psychosis and promotes recovery-oriented changes in service delivery. The role of social control, the involvement of service users and their families, and the balance between psychosocial and biomedical treatments play an important role in this history. This paper describes the reform cycles, their political and policy contexts, and what influenced its successes and shortcomings. |
| first_indexed | 2024-03-13T03:56:12Z |
| format | Article |
| id | doaj.art-b1d1d5c96fcc45478576bc90ccbb2a35 |
| institution | Directory Open Access Journal |
| issn | 2666-5603 |
| language | English |
| last_indexed | 2024-03-13T03:56:12Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM - Mental Health |
| spelling | doaj.art-b1d1d5c96fcc45478576bc90ccbb2a352023-06-22T05:05:34ZengElsevierSSM - Mental Health2666-56032023-12-013100205Cycles of reform in the history of psychosis treatment in the United StatesPreethy George0Nev Jones1Howard Goldman2Abram Rosenblatt3Westat, 1600 Research Blvd, Rockville, MD, 20850, United States; Corresponding author.University of Pittsburgh, School of Social Work, 2314 Cathedral of Learning, Pittsburgh, PA, 15260, United StatesUniversity of Maryland, School of Medicine, 3700 Koppers Street, Baltimore, MD, 21227, Suite 402, United StatesWestat, 1600 Research Blvd, Rockville, MD, 20850, United StatesThe history of psychosis treatment follows a series of four cycles of reform which provide a framework for understanding mental health services in the United States. The first three cycles of reform promoted the view that early treatment of mental disorders would reduce chronic impairment and disability. The Moral Treatment era (early 1800's to 1890) featured freestanding asylums, the Mental Hygiene movement (1890 to World War II) introduced psychiatric hospitals and clinics, and the Community Mental Health Reform period (World War II to late 1970's) produced community mental health centers. None of these approaches succeeded in achieving the disability-prevention goals of early treatment of psychosis. The fourth cycle, the Community Support Reform era (late 1970's to the present) shifted the focus to caring for those already disabled by a mental disorder within their communities and using natural support systems. This shift embraced a broader social welfare framework and included additional services and supports, such as housing, case management, and education. Psychosis became more central during the current Community Support Reform era partly because individuals with psychosis continued to have disabling life experiences despite efforts at reform. Some degree of recovery from psychosis is possible, and individuals with serious impairment may move towards social integration and community participation. Early intervention for young people with psychosis focuses on at reducing the negative sequelae of psychosis and promotes recovery-oriented changes in service delivery. The role of social control, the involvement of service users and their families, and the balance between psychosocial and biomedical treatments play an important role in this history. This paper describes the reform cycles, their political and policy contexts, and what influenced its successes and shortcomings.http://www.sciencedirect.com/science/article/pii/S2666560323000208Mental health services historyMental health policyPsychosisSevere mental illness |
| spellingShingle | Preethy George Nev Jones Howard Goldman Abram Rosenblatt Cycles of reform in the history of psychosis treatment in the United States SSM - Mental Health Mental health services history Mental health policy Psychosis Severe mental illness |
| title | Cycles of reform in the history of psychosis treatment in the United States |
| title_full | Cycles of reform in the history of psychosis treatment in the United States |
| title_fullStr | Cycles of reform in the history of psychosis treatment in the United States |
| title_full_unstemmed | Cycles of reform in the history of psychosis treatment in the United States |
| title_short | Cycles of reform in the history of psychosis treatment in the United States |
| title_sort | cycles of reform in the history of psychosis treatment in the united states |
| topic | Mental health services history Mental health policy Psychosis Severe mental illness |
| url | http://www.sciencedirect.com/science/article/pii/S2666560323000208 |
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