People with mental illness have been victimized for much too long. Schizophrenia distorts reality and makes it hard for the afflicted to function in society. People who act strangely may alienate and frighten others.

Sadly, the treatments for this disorder have often been far worse than the condition itself. Even 20th century treatments were barbaric.

Patients were subjected to insulin shock therapy. High doses of insulin were injected to make blood sugar drop dramatically and trigger convulsions and coma.

During the 1940s and 1950s electroconvulsive therapy (ECT) used electric current to induce seizures. Broken bones, dislocated muscles and memory loss were common complications. The amnesia was perceived as a benefit, since patients could not remember the treatment.

Mid-20th century mental hospitals also used high-pressure sprays alternating between hot and cold water. Patients were sometimes wrapped in straitjackets or cold wet sheets.

Perhaps the most horrifying treatment of this era was lobotomy. Patients had holes drilled in their foreheads so that surgical tools could be inserted to sever connections between the area directly behind the forehead and the rest of the brain. Lobotomies had a high mortality rate and were of questionable value.

When this surgery was replaced in the 1960s by antipsychotic medication, the psychiatric institutions needed for the previous treatments were often shut down. Antipsychotic drugs were supposed to revolutionize the treatment of mental illness and make it possible for schizophrenics to live in the community.

Medicines such as Thorazine, Stelazine, Mellaril and Haldol were more humane than lobotomies, but they did have frightening side effects. Although patients on such medications were less troubled by hallucinations, they often developed uncontrollable and irreversible muscle twitches or tics and profound restlessness. Confusion, sedation, dizziness, dry mouth and constipation often made patients very uncomfortable.

In the 1990s the “atypical” antipsychotics were introduced with fanfare. Drugs such as Abilify, Seroquel and Zyprexa were expected to do more than control hallucinations. There was hope that people taking them would be restored to normal social relationships and that they would not be bothered by the troublesome side effects typical of older antipsychotic medicines.

Subsequent research has not shown that the new medications are substantially better than the old ones. In addition, side effects such as serious weight gain, diabetes, heart disease, seizures and uncontrollable muscle movements are disturbing. Many patients eventually stop taking these medications.

We are disappointed that truly effective treatments for schizophrenia seem no closer now than half a century ago. The mentally ill seem to have been abandoned by society, as legislators cut mental health services whenever budgets are tight.

When a mentally ill person creates headlines by committing a violent act, calls go out for better treatment. (It is not clear, by the way, that the mentally ill are any more likely to become violent than the rest of us.) Unfortunately, the talk is hardly ever followed with concrete action. Not only do we need effective therapies, we need to commit to genuine societal support for the mentally ill.


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  1. Vickie

    My Nephew with P Schizophrenia and PTSD has been a victim all his life. I finally took him in at age 34 to try to protect him from his own brother and friends abusing him. Yet I still can’t keep him safe. They used his identity for Medicare and also gave his name for a crime commuted. They since have arrested the guy that used his idenity in a crime. However the courts still won’t drop the charges or the warrant for my nephew who did nothing. They say he has to be arrested. Sit in jail until a hearing. Yet the other guy has already been charged and in jail. This is a sick injustice and now not only are people victimizing him but the justice system is. What will it take to stop this sick treatment of the mentally ill.

  2. A.N.

    Worse is the fact that jails have become the new mental institutions or better yet, plantations. The mentally ill are locked up for ancillary “abnormal” behavior or may respond to law enforcement in an inappropriate way, but still one that does not warrant being taken into custody.
    Conversely, if they are taken to a psychiatric ward, they generally are only there long enough for the medical team to surmise that they are not in danger of harming themselves or others. Still, those afflicted may be given all manor of medications, even ones that the hospitals have been told they have an aversion to or that can exacerbate their illness. They do not have to regard this information if the person is over 17 and the informing person, even if a parent/relative, does not have power of attorney.
    The patient can become ill, event violently sometimes before some doctors are willing to listen and change the medications. Thank goodness some legislature is moving toward monitoring Big Pharma and their relationships that are more beneficial to the pharm/and med hospitals, but w/out first consideration to patients.
    Can you imagine if you took even a friend to the E.R., and told the triage team that your friend was allergic to aspirin — that you knew this –yet they gave it to them anyway. Ignoring this information is an ethics violation that could yield horrific results (but this is psychiatric medicine on locked wards and behind closed doors). I care not what the age of the person is — this is the most discriminated against illness there is.
    If the person was behaving incoherently and was an elder, they would hospitalize and treat them more humanely if dementia (another BRAIN disease) was considered, yet if someone has “mental (a brain) illness” and is over 17 but under say, 65, there is no room for compassion or ethically equal treatment. They are at the age of consent to remain ill and untreated (I know some laws regarding institutionalization were enacted by President Regan to provide more rights and protection to the mentally ill, but there are no common sense clauses to this legislature and without adequate (read: REAL) community-based support systems (not databases of case management), the homeless and jail populations will only soar.
    Sadly, most people have to choose sustaining their own lives (their other family members) and addressing this issue of a loved one which requires daily attention like any other chronic disease, so the disconnection happens, followed by disillusionment, shame and yes, more mental illness (depression). So add age discrimination to being considered “crazy” and knowing you need to hide this from a world and even medical field that does not do its best to help you.
    This illness dwarfs all others in numbers of hospital beds daily, yet it is the secret shame of the medical industry that imposes additional stigma both on patients and their families. This is a legislative failure. Families are at their wits end to help their adult loved ones and the accommodations (housing) are sub-ghetto in many cases. The city/county offers little better other that subsidized crack houses where the problems can then expand to a dual diagnosis of mental illness/substance abuse and decent group/boarding homes are far and few between.
    This population has more predators seeking to use them for their benefits (from disability, Medicare/Medicaid, housing — you name it). WHERE IS OUR SANE COMPASSION as a country against this horrific world for those who suffer so much already? Why is there such a lack of compassion/research for this widespread illness? It affects us all everyday.

  3. Denese D.

    Thank you for your article we had to watch our son turn into a person we did not know on medication. Once he stopped the medication he was able to control his condition with therapy, exercise and spirituality.

  4. Anonymous

    ECT, mentioned as a 40s & 50s treatment, was used to relieve deep depression in a Fort Wayne hospital in 2008. The patient says short term memory loss resulted.

  5. J.L.S.

    We have not come that far with treatment and meds. States have closed their psychiatric hospitals. Many areas have no housing or programs for mentally ill adults. That is why so many are homeless and untreated. Our society has failed those with mental illness. Most families have someone with mental illness. We are all touched by this, but unlike European countries and Canada, we do not provide the care needed for the mentally ill.

  6. Christopher Krollage

    It is lost on so many that people with mental illness are first and foremost human beings.

  7. william w.

    As a psychologist since 1965 I can only echo the comments above. But why? Why do we neglect 1% of our population? And that’s only the schizophrenics. Our society nowadays seems to want to leave the poor, disabled, mentally challenged individuals at the short end of the stick? When was the last time an incredibly rich individual made news with big contributions to these people?
    I do not resent any foreign aid, but we are not taking care of our home folks, as can be seen by the way we treat our war veterans. Homeless schizophrenic. Homeless vet. These should be oxymorons, not bargaining chips on politicians tables.

  8. CL

    Not only mental illness, but closed head injuries can cause frightening personality changes. My nephew was in an auto accident one day after his 21st birthday (thus, no medical insurance). Our smart, sweet young man has changed and is now living with his parents and is feared by them and by the neighbors. The police have been involved several times. There are no weapons in the house except kitchen knives, thank goodness, but he can have violent, physical outbursts for no apparent reason.
    His parents have done EVERYTHING they can to find help, but there is very little help. He needs to have an enlightened institutional setting to live in, but those don’t exist for middle-class people. As they age and struggle with their own illnesses, his parents face the horrible prospect of having to turn him away from their home for their own safety. Theirs is not a rare problem.

  9. nj

    This article is very touching. I worked in psychiatry from the 60’s through the 80’s and witnessed all the things described in the article. Thank you for so aptly describing this history and for pointing out the lack of legislative interest in resolving any of the problems.

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