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Cycles of reform in the history of psychosis treatment in the United States

The history of psychosis treatment follows a series of four cycles of reform which provide a framework for understanding mental health services in the United States. The first three cycles of reform promoted the view that early treatment of mental disorders would reduce chronic impairment and disabi...

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Autores principales: George, Preethy, Jones, Nev, Goldman, Howard, Rosenblatt, Abram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10302760/
https://www.ncbi.nlm.nih.gov/pubmed/37388405
http://dx.doi.org/10.1016/j.ssmmh.2023.100205
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author George, Preethy
Jones, Nev
Goldman, Howard
Rosenblatt, Abram
author_facet George, Preethy
Jones, Nev
Goldman, Howard
Rosenblatt, Abram
author_sort George, Preethy
collection PubMed
description The history of psychosis treatment follows a series of four cycles of reform which provide a framework for understanding mental health services in the United States. The first three cycles of reform promoted the view that early treatment of mental disorders would reduce chronic impairment and disability. The Moral Treatment era (early 1800’s to 1890) featured freestanding asylums, the Mental Hygiene movement (1890 to World War II) introduced psychiatric hospitals and clinics, and the Community Mental Health Reform period (World War II to late 1970’s) produced community mental health centers. None of these approaches succeeded in achieving the disability-prevention goals of early treatment of psychosis. The fourth cycle, the Community Support Reform era (late 1970’s to the present) shifted the focus to caring for those already disabled by a mental disorder within their communities and using natural support systems. This shift embraced a broader social welfare framework and included additional services and supports, such as housing, case management, and education. Psychosis became more central during the current Community Support Reform era partly because individuals with psychosis continued to have disabling life experiences despite efforts at reform. Some degree of recovery from psychosis is possible, and individuals with serious impairment may move towards social integration and community participation. Early intervention for young people with psychosis focuses on reducing the negative sequelae of psychosis and promotes recovery-oriented changes in service delivery. The role of social control, the involvement of service users and their families, and the balance between psychosocial and biomedical treatments play an important role in this history. This paper describes the reform cycles, their political and policy contexts, and what influenced its successes and shortcomings.
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spelling pubmed-103027602023-12-01 Cycles of reform in the history of psychosis treatment in the United States George, Preethy Jones, Nev Goldman, Howard Rosenblatt, Abram SSM Ment Health Article The history of psychosis treatment follows a series of four cycles of reform which provide a framework for understanding mental health services in the United States. The first three cycles of reform promoted the view that early treatment of mental disorders would reduce chronic impairment and disability. The Moral Treatment era (early 1800’s to 1890) featured freestanding asylums, the Mental Hygiene movement (1890 to World War II) introduced psychiatric hospitals and clinics, and the Community Mental Health Reform period (World War II to late 1970’s) produced community mental health centers. None of these approaches succeeded in achieving the disability-prevention goals of early treatment of psychosis. The fourth cycle, the Community Support Reform era (late 1970’s to the present) shifted the focus to caring for those already disabled by a mental disorder within their communities and using natural support systems. This shift embraced a broader social welfare framework and included additional services and supports, such as housing, case management, and education. Psychosis became more central during the current Community Support Reform era partly because individuals with psychosis continued to have disabling life experiences despite efforts at reform. Some degree of recovery from psychosis is possible, and individuals with serious impairment may move towards social integration and community participation. Early intervention for young people with psychosis focuses on reducing the negative sequelae of psychosis and promotes recovery-oriented changes in service delivery. The role of social control, the involvement of service users and their families, and the balance between psychosocial and biomedical treatments play an important role in this history. This paper describes the reform cycles, their political and policy contexts, and what influenced its successes and shortcomings. 2023-12 2023-03-22 /pmc/articles/PMC10302760/ /pubmed/37388405 http://dx.doi.org/10.1016/j.ssmmh.2023.100205 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ).
spellingShingle Article
George, Preethy
Jones, Nev
Goldman, Howard
Rosenblatt, Abram
Cycles of reform in the history of psychosis treatment in the United States
title Cycles of reform in the history of psychosis treatment in the United States
title_full Cycles of reform in the history of psychosis treatment in the United States
title_fullStr Cycles of reform in the history of psychosis treatment in the United States
title_full_unstemmed Cycles of reform in the history of psychosis treatment in the United States
title_short Cycles of reform in the history of psychosis treatment in the United States
title_sort cycles of reform in the history of psychosis treatment in the united states
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10302760/
https://www.ncbi.nlm.nih.gov/pubmed/37388405
http://dx.doi.org/10.1016/j.ssmmh.2023.100205
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