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By the end of this section, you will be able to:
  • Explain how people with psychological disorders have been treated throughout the ages
  • Discuss deinstitutionalization
  • Discuss the ways in which mental health services are delivered today
  • Distinguish between voluntary and involuntary treatment

Before we explore the various approaches to therapy used today, let’s begin our study of therapy by looking at how many people experience mental illness and how many receive treatment. According to the U.S. Department of Health and Human Services (2013), 19% of U.S. adults experienced mental illness in 2012. For teens (ages 13–18), the rate is similar to that of adults, and for children ages 8–15, current estimates suggest that 13% experience mental illness in a given year (National Institute of Mental Health [NIMH], n.d.-a)

With many different treatment options available, approximately how many people receive mental health treatment per year? According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2008, 13.4% of adults received treatment for a mental health issue (NIMH, n.d.-b). These percentages, shown in [link] , reflect the number of adults who received care in inpatient and outpatient settings and/or used prescription medication for psychological disorders.

A bar graph is titled “U.S. Adult Mental Health Treatment, 2004–2008.” Below this title the source is given: “National Institute of Mental Health, n.d.-b” The x axis is labeled “Year,” and the y axis is labeled “Percent of adults.” In the years 2004, 2005 and 2006, the percentage of adults who received treatment hovered at 13 percent or just below. For the years 2007 and 2008, the percentage rose slightly closer to 14 percent.
The percentage of adults who received mental health treatment in 2004–2008 is shown. Adults seeking treatment increased slightly from 2004 to 2008.

Children and adolescents also receive mental health services. The Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey (NHANES) found that approximately half (50.6%) of children with mental disorders had received treatment for their disorder within the past year (NIMH, n.d.-c). However, there were some differences between treatment rates by category of disorder ( [link] ). For example, children with anxiety disorders were least likely to have received treatment in the past year, while children with ADHD or a conduct disorder were more likely to receive treatment. Can you think of some possible reasons for these differences in receiving treatment?

A bar graph is titled “U.S. Child Mental Health Treatment (Ages 8–15).” Below this title the source is given: “National Institute of Mental Health, n.d.-c” The x axis is labeled “Type of disorder,” and the y axis is labeled “Percent with disorder.” For children diagnosed with “Anxiety disorders,” around 32 percent receive treatment. For “Mood disorder,” around 42 percent receive treatment. For “Conduct disorder,” around 46 percent receive treatment. For “ADHD,” around 48 percent receive treatment. For “Any disorder,” around 50 percent receive treatment.
About one-third to one-half of U.S. adolescents (ages 8–15) with mental disorders receive treatment, with behavior-related disorders more likely to be treated.

Considering the many forms of treatment for mental health disorders available today, how did these forms of treatment emerge? Let’s take a look at the history of mental health treatment from the past (with some questionable approaches in light of modern understanding of mental illness) to where we are today.

Treatment in the past

For much of history, the mentally ill have been treated very poorly. It was believed that mental illness was caused by demonic possession, witchcraft, or an angry god (Szasz, 1960). For example, in medieval times, abnormal behaviors were viewed as a sign that a person was possessed by demons. If someone was considered to be possessed, there were several forms of treatment to release spirits from the individual. The most common treatment was exorcism, often conducted by priests or other religious figures: Incantations and prayers were said over the person’s body, and she may have been given some medicinal drinks. Another form of treatment for extreme cases of mental illness was trephining: A small hole was made in the afflicted individual’s skull to release spirits from the body. Most people treated in this manner died. In addition to exorcism and trephining, other practices involved execution or imprisonment of people with psychological disorders. Still others were left to be homeless beggars. Generally speaking, most people who exhibited strange behaviors were greatly misunderstood and treated cruelly. The prevailing theory of psychopathology in earlier history was the idea that mental illness was the result of demonic possession by either an evil spirit or an evil god because early beliefs incorrectly attributed all unexplainable phenomena to deities deemed either good or evil.

Questions & Answers

Dissociative fugue has been linked tosevere stress, which might be the result of traumatic events -- such as war, abuse, accidents, disasters, or extreme violence -- that the person hasexperienced or witnessed.. im just googleing it so im not sure i can explain much better... ill do more research....why is it that your asking? May i ask?
Skylar Reply
did some messages disappear?
Eleni
this just pops up in my notifications and i find it very interesting but cant find any way to navigate back to it
Eleni
ya same keeps happening to me a chat messege popped up earlier somebody asking what a fugue state was and i had googled it and wrote back but once i exited the app i can find a way back to the chat...
Skylar
So anyway... Dissociative fugue, formerly fugue state or psychogenic fugue, is a dissociative disorder and a rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality, and other identifying characteristics of individuality.
Skylar
to get back without using the notification you have to remember what section the comments were on. I remembered it was about dissociative fugue so I went into psychological disorders and then into dissociative disorders and scrolled to the bottom. hope that helps
Matt
hoping someone messeges back from the other chat so it will pop up in my notifications again
Skylar
thank you!
Skylar
it came up on a quiz and i hadnt heard it before. thankyou for your response. i appreciate it.
jody
your welcome
Skylar
If humans have evolved biologically [like their skulls,jaws etc],so how can we apply animal psychology to humans? They must have evolved their minds...even one exception is enough to contradict....
abid Reply
yes
Petros
do you have suggestions for learning Darwin's theory of evolution....beginner+interactive
abid
what's the fugue state
jody Reply
is this a private messege or a chat room? i didnt even know you could messege on this app...
Skylar
I'm confused
Hailey
same
Manav
me too
davie
Same here. Not satisfactory user interface here.
Swati
hi
Melandi
Dissociative fugue, formerly fugue state or psychogenic fugue, is a dissociative disorder and a rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality, and other identifying characteristics of individuality. Thestate can last days,
Skylar
months or longer
Skylar
skyler can you please elaborate it ?
ecstasy
i would say careful whats said. not private
jody
skylar i got u.
Eleni
thanks finally figured out how the chat thing works... anyway im really just googling this but i will do more research about i had heard the word before but never looked it up so this is very interesting...
Skylar
well. Dissociation is a mental process that causes a lack of connection in a person's thoughts, memory and sense of identity. ... A severe and more chronic form of dissociation is seen in the disorder Dissociative Identity Disorder, once called Multiple Personality Disorder, and other Dissociative 
Skylar
disorders
Skylar
Dissociation may affect a person subjectively in the form of “made” thoughts, feelings, and actions. These are thoughts or emotions seemingly coming out of nowhere, or finding oneself carrying out an action as if it were controlled by a force other than oneself
Skylar
what diagnosis or treatment would that need? and can't it be a sideeffect of depression, MDD etc?
Eleni
if anyone needs a first hand account I can provide one. I suffer with severe combat PTSD and struggle intensely with dissociation. Episodes can last a few minutes, days or weeks as recorded by my family ( care givers)
Matt
Symptoms and signs of dissociative disorders include: Significant memory loss of specific times, people and events Out-of-body experiences, such as feeling as though you are watching a movie of yourself
Skylar
Mental health problems such as depression, anxiety and thoughts of suicide A sense of detachment from your emotions, or emotional numbness A lack of a sense of self-identity
Skylar
Dissociative disorders are managed through various therapies including: Psychotherapies such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) Eye movement desensitization and reprocessing (EMDR)
Skylar
Medications such as antidepressants can treat symptoms of related conditions
Skylar
The diagnosis of either Dissociative Amnesia. Depersonalization disorder. Dissociative identity disorder. 
Skylar
does the altered state link directly to DID? is it a character or auto-pilot?
Eleni
what is memory
Khushbu Reply
what is the meaning of memory
Khushbu
what is the meaning of memory?
Khushbu
what is the meaning of memory?
Khushbu
cognitive process whereby we remember past experiences
Annie
to aid in survival
Eleni
Storing information about people, places, and experiences. Both good and bad, in order to recall and make decisions.
andrew
Memory is the process by which we encode ,store, and retrieve information from the environment through different sense organs.
aijaz
the encryption-decryption mechanism of our psychophysical experiences
juan
can anyone suggest me good coaching in Indore MP India for m.a entrance of du psychology
SAMKIT Reply
How can one diagnose a patient with a mental disorder such as schizophrenia?
Kutwal Reply
Making the Diagnosis. To get an official diagnosi of schizophrenia, your loved one has to show at least two of the following symptom most of the time for a month, and some mental disturbance over six months: Delusions (false beliefs that the person won't give up, even when they get proof that they'r
Khajiit
they're not ture)
Khajiit
Can sombody write me here about Pinoccio in psychodynamic perspective?
Amina Reply
what is the nature and nurture perspective of personality?
Khan Reply
are there significant differences between methamphetamine and it's long term effects on male cognitive behavioral and function versus female?
Shiloh Reply
effects will be the same( male & female)
Smith
tell me more
baby
no. it's much worse on females. almost s complete polar switch
cody
show me ans fast plzzz
Khushbu
please is there any difference between abnormal behaviour and normal behaviour?
Ayodele Reply
hm
sheere
yes abnormal behavior is "not normal ", actions in society's eyes. an example of abnormal behavior (I remember from a textbook) ; a man who runs around frantically in a grocery store licking strangers'(women's) shoes because when he was a baby his mom would tickle his feet/give them special attentio
Peter
yes there is a difference between abnormal and normal behaviour... This is simply because abnormal behaviour is deviating from the normal behaviour of the society while normal behaviour is obeying the moral standards in the society.
Emmanuel
how about disorders? like, always having a tantrums and irrational most of the time?
Jheannalyn
a behavior becomes pathological when 1. there is a before and after : you can see a real change of behavior/cognition or 2. behavior is pathological when it makes yourself or others suffer
Perle
what is difference between disease and disorder
Shahab
disease demand medicin but disorder demands care plus medicin
Zeeshan
I think the concept of normal and abnormal behavior in general is not much of psychological concept but more of sociological concept. A behavior or act in itself is not normal or abnormal. How society perceives that specific behavior, that's what decides what's normal.
Juveriya
For instance, gay marriage is considered normal where homosexuality is legalized. Where it isn't legalized, its abnormal.
Juveriya
So there cannot be an absolute answer for your question
Juveriya
well abnormality is pretty much considered in popular society which is something of a correlation of psycholigical perspective reflected through activity... something abstract... or non trending or precedented. or maybe something disturbing or atypical for people in their respective birth cohorts.
Geoffrey
please what are the schools of thought in psychology
Jennifer
if I told a girl that I will marry her how will she takes it when am to rate it in percentages
dauda
structuralism,functionalism,gestaltalism etc
aijaz
what about Diathesis stress model ?
aijaz
What is the difference between motivation and goal?
vishal Reply
goal is what you want to accomplish. motivation is what drives you to achieve it
Tay
motivation is ambitious and a goal is a ambition
Alivia
But Motivation is just stay there for only short time
Manish
goal is our destination and motivation is a vehicle to reach goal
pradeep
motivation is the One person improved in self development another person advices......... goal is achievement at one of the life.....
thangaraj
motivation is for our personality development thing but goal is our whole personality.
Zeeshan
but its should be more remember without motivation no life no goal .
Zeeshan
it's like this
Tay
if my goal is to get my degree. then me wanting a better job is my motivation. ultimately family
Tay
Motivation is the vehicle we use to reach our goal.
Zachary
Please wat r the schools of psychology
Jennifer
i want the outline of it,its methodology
Jennifer
hi guys can someone help me how can I over or stress ?
Folet
Jennifer I need to take my own advice however stress relief is something that is done through catharsis which in my estimation is defined as a physical or mental activity used as therapy... that can include, yoga, meditation, sex, physical activity like a sport or martial art practice or sometimes .
Geoffrey
the schools of psych I have no clue about
Geoffrey
If you want to be something ,that we can say you have goal.But you will never be that without enough effort,if you getting accurate rewards from your surrounding as accepting you than before when you are trying to be something.that we can say motivation.it may be in the form of acceptance and suport
Hot
motiVation is the part of goal . but it has a backbone value for goal .with out motivation wo can not Think about our aim of life, our goals .
Zeeshan
how do you get motivation? I'm such a lax person
Alexsus
can anyone help me we have a school in a third world country the kids are unable to learn, how can we help them motivate?
Cesaire
make it a game , if it's a 3rd world country then personal hygiene supplies would be a good prize to win
Maria
Maria can you explain that a little more
Cesaire
make them a set goal of so many pages to read or assigments to accomplish and go buy soap, toothpaste and toothbrush or even Candy and put it in front of the class so everyone can see the prizes and it will motivate them to finish first to get an award
Maria
ok
Cesaire
ok Maria
Cesaire
Motivation - reason or reasons for acting or behaving in a particular way. Goal - The object of a person's ambition or effort; an aim or desired result.
andrew
what is mutation?
Amaya Reply
What is mindfulness
rahul
mindfulness means to be aware of the present
Agnieszka
meaning that you are totally focussing on the present...and living in the moment
Agnieszka
also present variables
Carl
hello guys
Folet
can someone help with few answers ?
Folet
hi what is all about ?
Folet Reply
The theory of evolution and its natural selection is a given trait by respond it is also classical conditioning it is a given trait that makes humans more unique than any other species of animals plants or an the theory o the Big Bang is a spontaneous person and has expanded ev we do not know that m
Ryan Reply
hi
Cesaire
hi
yugandhar
behaviors are most successful in treating what?
Cody Reply
mental health disorders
Joyce

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Source:  OpenStax, Psychology. OpenStax CNX. Feb 03, 2015 Download for free at https://legacy.cnx.org/content/col11629/1.5
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