The column on May 21 brought many insightful and though-provoking responses on mental health broadly defined. Our first respondent made the point to emphasize the importance of words and language. He noted that I used asylum, hospitals, and I am adding total institutions which includes hospitals, prisons, nursing homes along with facilities for the mentally ill.
In 2024, these facilities have morphed to something different. These facilities reflect the times in which they were created and existed. The local community is considering building a new psychiatric hospital. Be careful it does not become an edifice complex; when in doubt, build a building. As Kevin Costner put it, “If you build it, it they will come.”
The local mental health center is opening a 23-hour-stay facility for mental health issues. Buildings and programs must also have a staff that is skilled in working with people who have problems in living as opposed to problem people.
A writer from Florida has a keen interest in stigma and I agree with his concerns. Stigma quite often supersedes the behavior when it comes to getting better. In other words, how the individual and society feel or act toward the targeted behavior is more powerful than the behavior itself.
There are some important social science concepts that I find useful in understanding human behavior or behaviors.
- Behaviors are learned through interactions with others.
- Labeling of behaviors by society at large, significant others and agents of social control are powerful concepts.
- Society’s reaction to behaviors is a powerful force in how these behaviors continue or are extinguished.
This is not to minimize certain biological factors that cause aberrant behaviors. Also, family and friends play a powerful role and human service agencies must understand and be empathetic with the folks with whom they are entrusted.
To you the reader, I am introducing friend and colleague George Doebler, who has worked in the mental health field for 40 years at St. Elizabeth Hospital, Lakeshore Mental Health Institute, San Quentin and the University of Tennessee Health Center. He comes to these issues surrounding mental illness from a different perspective. I hope you learn from his piece and enjoy the journey.
“Your take, and learning about the history of the mentally ill is interesting. It is a bit different than what we were taught in the mid ’60s while being introduced to learning how to treat mentally ill at the Federal Mental Hospital in Washington. I think there were 12,000 patients at the time, in a facility begun in the 1800s. I know you had limited space to write this article: Dorothea Lynn Dix’s history re the establishment of state mental hospitals is interesting. Her goal was humane treatment of these folks who were possessed by something. The earliest treatment was done by folk who were motivated by their religious convictions. That is why they were called asylums: places of rest and protection.
“It was when the treatment was taken over by the state and was not funded to take care of, but to house the mentally ill, that treatment and care went to hell. The most successful treatment programs to this day have been done at private psychiatric hospitals and centers, i.e.: Menninger which is now part of Baylor Medical center, and Austin Riggs outside Boston. Guess who gets treated? Those with money.
“The only time the poor were treated well was in the early years, by the Quakers.
“My point, I guess, is that the history of treatment of the mentally ill is sparce, and not well recorded. The lack of consistent government research and funding is a symptom of how elected officials have little awareness of what it will take to treat and identify those with mental illness, no matter how many people are killed, how many schools are shot up or how many people are addicted to drugs and alcohol.
“Abnormal behavior will continue to be criminalized, not seen as a mental disorder.” ~George Doebler
Bob Kronick is professor emeritus University of Tennessee. Bob welcomes your comments or questions to rkronick@utk.edu.