Progression of Mental Health

As with any other factor in life we grow and learn from our past mistakes. Mental health is a stigmatized concept that needs to be put in the forefront of current day medicine for the country to see a change in its population. The stigma has been around for countless years and often deters people from seeking help in their times of need. Mental health has seen some rough days where we were unsure of the treatment for such patients and often had a lack of understanding of what was happening in their minds. As a society, we have reflected and today are remarkably better than were we once were.

Starting back in the ancient times to middle ages we can see that mental illness was looked at to be a serious problem. Persons would often be considered to be possessed. In these cases, it was often a priestly duty to perform treatments on the individuals. Treatments ranged from drilling holes in the head to release the demon or beating the patient. Hippocrates was unlike the rest and treated the mentally ill with medicines or changing the patients work/environment. This is the only logical treatment from back in those days that would still be used today in some instances. Coming from a modern-day standpoint we know that none of these allegations of superstition were truthful in nature and we now understand the causes of many psychiatric problems.

Taking a look at the treatment options more in depth will show how we have progressed rapidly in the last couple hundred years. Previously we mentioned the religious healing of patients and the occasional use of drilling holes in the head. As a society, we now know this is not acceptable. We progressed from this to utilizing techniques such as electric shock therapy. The technique was used heavily before and is still used today but under much safer conditions. Another therapy option was the use of hydrotherapy where the patient was submerged head deep in hot water and wrapped in a blanket and left to soak. Evidence is lacking for support of this option but there is no harm to the patient with this treatment. A major surgery performed on patients was often a lobotomy and that has since been made illegal in our country. The lobotomy separated the brain in half and left the patient in an emotionless state. Persons could often die from this surgery or other complications arose. In current day treatments, we use prescription drugs that affect the neurotransmitters in the brain to actively control mental diseases and sometimes we use older therapies such as electric shock in conjunction for additional support.

Another major progression through history when dealing with mental health has been the affect in the mental hospitals/institutions. Original institutions were overcrowded and kept people for all kinds of reasons. Reasons for being committed ranged from having a fever to disagreeing with your spouse. Being committed in modern times is much more professional and requires usually a doctor’s approval or evidence that would require someone to be institutionalized. The overcrowding was so bad before that hospitals that were supposed to hold 200 or so patients had at max capacity almost 2000 patients. Now we have strict laws and regulations on facilities to prevent this from occurring. There has also been new laws and statutes put into place to monitor these facilities. Before these facilities operated under their own terms and now there is broad-spectrum regulations they must follow and maintain from the federal government.

In conclusion, one can see how we have come a long way from our ancestors in the field of mental health. One can only hope that each new day brings better advancements and we continue down the current path of reform we are currently on. One big concept still in place in many minds is that mental illness shouldn’t be discussed. The stigma needs to be broken so that we can further our advancements. This can be one call to action to any health care provider who works with patients suffering from a mental illness.

References

http://www.uniteforsight.org/mental-health/module2

http://www.dualdiagnosis.org/mental-health-and-addiction/history/

The Pharmacist’s Role in Mental Health

Mental health issues can present unique challenges for both healthcare professionals and patients.  Disorders like depression, bipolar and schizophrenia are primarily treated with medications.  This makes pharmacists a crucial part of optimal patient care.  There are multiple drugs within many classes of medication to choose from to treat each of these disease states.  Pharmacists can make recommendations based on expertise on the nuances of mental health medications side effect profiles.  As medication experts, pharmacists can ensure that patients are taking the best medications for their disease states.

Beyond recommending medicines, pharmacists can help end the stigma surrounding mental health in our communities.  Often, patients may be embarrassed to discuss mental health with anyone.  Pharmacy staff may perceive patients with mental health disorders negatively.  Pharmacists can lead by example in they way they address mental health.  A high level of professionalism with non-judgmental communication in the community setting can help decrease stigma.  Education about mental health disorders for pharmacy professionals can also be helpful.

Mental health medications can be some of the worst offenders for adverse effects. Pharmacists are often on the “front lines” in the reporting of side effects.  They can give patients realistic expectations about their medications.  Knowing how long a medicine will take to become effective is vital information for patients.  Counseling on what to look out for and when to call their prescriber can truly make a difference with patients struggling to find effective therapy.

Finally, duplicate therapy can be all too common in this patient population.  Often patients see a psychiatrist as well as a primary care provider and may receive mental health prescriptions from both.  Proper medication reviews can prevent duplicate therapies leading to adverse events like serotonin syndrome.  Pharmacists are ideally positioned to affect positive change in the management of mental health disorders.

 

References:

Rubio-Valera M, Chen T, O’Reilly C. New Roles for Pharmacists in Community Mental Health Care: A Narrative Review. International Journal of Environmental Research and Public Health. 2014;11(10):10967-10990. doi:10.3390/ijerph111010967.

 

Contributed by:

Leila Fleming, Parliamentarian, Class of 2019