For centuries, the mentally ill have been treated with a combination of fear,disgust and shame. In many cultures throughout history, a person who was mentally ill was believed to be evil or possessed; punishment, not humane treatment, typically followed.
The earliest known mental hospitals were found in the Middle East in Baghdadand Cairo. By 1247, the notorious British madhouse known as Bedlam was built,in which the mentally ill were routinely shackled and treated as a sort of sideshow for the general public.
As witchcraft hysteria grew and spread throughout Europe and colonial North America between the 15th and 17th centuries, the widespread general suspicionof the times did not bode well for the mentally ill. During this period, their cruel treatment was based on the conviction that the mentally ill were surely possessed. In Bedlam and in the French asylum Bicetre during this time, inmates were considered to be less than human and their treatment was aimed atprotecting society from their odd behavior.
In Colonial America before the establishment of any asylums, the insane wereoften auctioned off to be cared for by farmers, while others were sent to thepoorhouse or driven out of town. Eventually, the first mental asylum in Colonial America was established in Williamsburg, Va. in 1773; 20 years later theFrench social reformer Philippe Pinel horrified sane Frenchmen by removing the shackles from some inmates at Bicetre.
It was not until the 19th century that the personal crusade of American reformer Dorothea Dix led to the establishment of more humane mental asylums in the United States, Canada and England.
While the primary emphasis on these reforms was better care for the mentallyill, the result was the establishment of centralized state-run asylums that still isolated patients from family and friends and too often mistreated and abused patients.
In the beginning of the 20th century, a more modern, humane approach to mental health care began to gather momentum. Following the two world wars and thecreation of many post-traumatic mental problems, the mental health movement continued to gather interest throughout the country. The development of a whole new range of drugs to treat mental illness further changed the outlook formental problems.
Within the past 20 years, laws recognizing the rights of the mentally ill totreatment in the least restrictive environment heralded the close of many ofthe old, Victorian asylums in favor of outpatient mental health clinics and local treatment centers.