History of Mental Health Treatment: 1400s to Now

Photo via Unsplash

Photo via Unsplash

Although stigma has always been attached to mental health, diagnosis and treatment have come a long way. In America, we’ve gone from chains and shock therapy to group homes and behavioral therapy — and new laws and procedures are developing regularly.


People with mental illness were seen as “witches” possessed by the devil or evil spirits. They were placed at asylums, where they were often abused and restrained in small, dirty living spaces. Overall, patients were seen as a danger to society.


Those with mental health problems were often cared for privately. This evolved into a business where people paid high fees to live in “mad houses.” At that time, Robert Burton wrote a book titled “Anatomy of Melancholy” that gave treatment ideas based off of his own experience. He suggested exercise, music, drugs and diet to help treat mental health.


Patients were housed in family homes, madhouses, prisons, asylums and hospitals. They were still separated from society, and people could tour the asylums to view those who were mentally ill. Treatment included ice baths, dieting, purges, bleeding and chain restraints.


Hospitals and asylums were open at state, federal and private level — they were overcrowded and understaffed. Social and individual therapy were introduced to those with mental illness. In the late 1800s, some patients received shock therapy or lobotomy (removal of part of the brain).


Sigmund Freud created a method for treating patients through psychological theory and therapy. He studied the interaction of the human mind, as well as defense mechanisms like repression and denial. At the time, state institutions, group homes and apartments became available for those seeking treatment. Education, job opportunities and recreation were also introduced to help people function independently.


Studies suggest almost half of adult Americans have experienced mental illness, with highest rates of anxiety disorders, mood disorders and substance use. In 2016, President Obama  signed the 21st Century Cures Act, which funds mental health research, delivers new medical products and promotes transparency between health officials and patients.