The treatment of the mentally ill in America and across the world has undoubtedly improved since methods used during the nineteenth century. As a population, we have moved far from mis-diagnoses and run down asylums towards much safer facilities and interdisciplinary teams of doctors, dedicated to the treatment of every individual patient. Due to the drastic increase in technology, knowledge, and resources, physicians today have the ability to provide much more beneficial levels of care as compared to those provided in the nineteenth century. 

During the nineteenth century, methods of diagnosis were incredibly different than those used today. There was little known scientifically about the causes of mental illness and the differentiation between different types of illnesses. “Physician’s in the nineteenth century...used and abused their power to impose a medical model on behavioral disorders,”(29). The first half of the nineteenth century was defined by new methods of treatment and new facilities, called asylums. These asylums were often privately owned and operated. Unlike facilities today, the main goal of nineteenth century asylums was not truly to improve the condition of those who were ill, nor was it to enhance their quality of life. Instead, the main goals of asylums were centered around confinement from the general, non-ill public in effort to reduce any disturbance they might cause to others. “Theorists...propagated the thesis that [these] asylums not only [did] not help but actually [hindered] the treatment of mental illness,” (31). Frequently used treatment methods of the time seem barbaric in comparison to those in use today. Many of these treatments were developed by Benjamin Rush, the father of American psychology. Patients were subject to procedures such as bloodletting, placement in tranquilizing chairs, and the use of gyrators in order to treat their alleged mental illnesses.

By the end of the nineteenth century, mental health facilities like asylums became wildly overcrowded and understaffed. They lacked both the funding and the resources to provide proper care to their patients. The quality of life for those who were kept in these facilities was essentially nonexistent. According Abraham Luchins, author of  the Journal of the History of the Behavioral Science, these asylums were “lumped together with other...institutions such as prisons and concentration camps,” (32). Treating and caring for the mentally ill was seen, not as a major priority, but a burden. At this time, efforts were made by activists like Dorothea Dix to establish state run institutions that could provide better care for those individuals who needed it. After the establishment of these state run institutions, care for the mentally ill slowly began to improve. 

During the nineteenth century, historians can observe the stark difference between the treatment of women and men who were considered mentally ill. A large part of this discussion stems from the use of the word “hysteria”. The word hysteria originated in Ancient Greece from the word “hystera”, meaning uterus. This word was used to describe widowed women whose uteruses were believed to have turned venomous and caused mental illness. The use of the word hysteria became increasingly popular in the nineteenth century. The revival of this term can be credited to a man named George Taylor. Taylor made claims that about a quarter of women suffered from a women’s only disease termed hysteria. Taylor compiled a list of symptoms ranging widely from fainting and chronic fatigue to lower abdominal pain and the having of sexual thoughts.  Having any of these symptoms during this time period made it easy for physicians to label any woman as “crazy” or “hysterical”. Because of this outrageous list compiled by Taylor, many women suffered with true mental illnesses and other diseases that went undiagnosed, untreated, or mistreated due to the use of the term hysteria. Women who were diagnosed were often advised to use methods of treatment that did little to nothing to aid their suffering and treat their symptoms. Some physicians prescribed methods of treatment such as high power showers, pelvic massages, and the use of vibrators while others prescribed marriage as a cure. These recommended treatments rarely improved the condition of the women who were receiving them. This lack of feminine care highlights the oppression of women that is so prominent in the nineteenth century. 

The short story, The Yellow Wallpaper by Charlotte Perkins Gilman, clearly exemplifies the neglect and disconcern for the mental health of women in the nineteenth century, as described above. Although it is not stated in the text that John diagnoses his wife with hysteria, the reader can observe the nonchalant manner in which her symptoms are addressed. The symptoms the narrator of The Yellow Wallpaper feels are somewhat disregarded and assumed to be “woman” problems. In addition to the blatant disregard of most of her symptoms, her physician husband orders treatments that are ineffective and seemingly more harmful than helpful. 

Due to medical and technological advances over the last century, the treatment and diagnostics surrounding mental health has improved drastically. In contrast to practice in the nineteenth century, information about mental health issues has been compiled, reviewed, and made easily accessible. This has made treatment and care for those who are mentally ill much more effective and attainable. Overall, physicians today know more about how to properly assess and treat those with mental disorders. Awareness and discussion surrounding mental illness has also changed drastically since the nineteenth century. Mental illness has gained a new level of importance in society. According to article Mental Health in the 21st Century by Gro Harlem Brundtland, “worldwide, mental disorders [account] for approximately 12% of all disability-adjusted life years lost in 1998,” (411). This type of knowledge being available to the public has allowed for the contribution of money and other resources dedicated to improving the treatment and care of those who are mentally ill. 

Although there are many mental illnesses that do not have cures, there is a much heavier focus by physicians than there has been in the past to use other alternatives. These alternatives include varying courses of medication and forms of therapy that have been found to help manage the symptoms of patients. It is very rare that patients are sent away to an asylum where they receive only the most basic forms of care. Patient’s conditions are taken much more seriously today. In addition to advances in caring for those who are directly affected by mental illness, there are intervention groups established in communities to help support families and patients both morally and financially. 

Advances in both the scientific side of medicine, as well as awareness and education regarding mental health has allowed for a system of care that is much more beneficial to those who are plagued by mental illnesses. The treatment and study of mental health has come a long way, and will continue to expand over the future years to come.
