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

Bibliographic Data

ID21257386
AuthorsPreethy George (Westat (United States), corresponding author), Nev Jones (0000-0002-4177-0621, University of Pittsburgh), Howard H Goldman (0000-0002-7899-4936, University of Maryland, Baltimore), Howard Goldman, Abram Rosenblatt (Westat (United States))
Year2023
Volume3
Pages100205
Publication date2023-12-01
Open AccessYes
TypeARTICLE
VenueSSM - Mental Health (JOURNAL)
Journal identifiersISSN: 2666-5603 • E-ISSN: 2666-5603
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.ssmmh.2023.100205
PMID37388405
OpenAlexW4353094445
LanguageEN
Citations received5
References cited52

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

Mental health · Psychiatry · Psychosis · Psychosocial · Medicine · Mental Health and Patient Involvement · Mental Health and Psychiatry · Psychology · Schizophrenia research and treatment

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Citations per year1.67
Citation span2023 - 2026 (4)
Highly citedNo

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