A History of Mental Illness Treatment: Obsolete Practices

Posted October 14, 2016 | By Tricia Hussung

Various vintage anatomy illustrations of the head and brain

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 43.8 million people, or more than 18 percent of the population. Children are affected as well, with about 13 percent of those ages 8 to 15 experiencing a severe mental disorder at some point during their lives.

With data like this, it’s no surprise that attitudes toward mental health have changed for the better in recent years. Though stigma still exists, CNN reports that 90 percent 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 approaches continue to focus on community-oriented, holistic care.

This hasn’t always been the case, however. Mental health treatment has undergone extensive change over the years, with some strategies being ineffective and even dangerous: “Many of the treatments enacted on mentally ill patients throughout history have been ‘pathological sciences’ or ‘sensational scientific discoveries that later turned out to be nothing more than wishful thinking or subjective effects’” rather than actually benefiting patients, History Cooperative says. The following are just some of history’s strangest obsolete mental illness treatments.

History of Mental Illness Treatment

Trephination

As one of the earliest forms of mental health treatment, trephination removed a small part of the skull using an auger, bore or saw. Dated from around 7,000 years ago, this practice was likely used to relieve headaches, mental illness or even the belief of demonic possession. Not much is known about the practice due to lack of evidence.

Bloodletting and Purging

Though this treatment gained prominence in the Western world beginning in the 1600s, it has its 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. These tactics were used to treat more than mental illness, however: Countless diseases like diabetes, asthma, cancer, cholera, smallpox and stroke were likely to be treated with bloodletting using leeches or venesection during the same time period.

Isolation and Asylums

Isolation was the preferred treatment for mental illness beginning in medieval times, so it’s no surprise that insane 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,” Everyday Health says. Overcrowding and poor sanitation were serious issues in asylums, which led to movements to improve care quality and awareness. At the time, the medical community often treated mental illness with physical methods. This is why brutal tactics like ice water baths and restraint were often used.

Insulin Coma Therapy

This treatment was introduced in 1927 and was used for several decades 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 the function of the brain. Insulin comas could last anywhere between one and four hours. Patients were given an insulin injection that caused their blood sugar to fall and the brain to lose consciousness. Risks included prolonged coma (in which the patient failed to respond to glucose), and the mortality rate varied between 1 and 10 percent. Electroconvulsive therapy was later introduced as a safer alternative to insulin coma therapy.

Metrazol Therapy

In metrazol therapy, physicians induced 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), which 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; however, this was often at the cost of introducing other impairments. The procedure was largely discontinued after the mid-1950s with the introduction of the first psychiatric medications.

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. Treatments will continue to change along with scientific and research developments, and as mental health professionals gain more insight.

If you are interested in the treatment of mental disorders and relevant topics in psychology like those covered here, consider Concordia University, St. Paul’s online Bachelor of Arts in Psychology. This program equips students with the knowledge and tools necessary to excel in the field of psychology.