4 Mental health care and treatment

During the twentieth century, care and treatment of the mentally ill developed from an institutional system based in large mental hospitals to a largely community-based care system. The old mental hospitals provided custodial care, which required patients/inmates to live in a self-contained hospital community, supervised by a separate community of doctors, nurses and other service workers, such as an upholsterer, head gardener and cobbler. Today’s community care has most service users living independently, in small groups or with their own families, in the same community where the rest of us live.

Care and treatment has also evolved. The introduction of effective medication in the 1950s led to the gradual closure of the old hospitals and less need for constant supervision of individuals with serious mental health problems. Concurrently, new talking therapies were introduced that helped individuals to cope with life’s stresses. Today there is a range of effective medication that is used to treat mental health problems from schizophrenia to depression. Whereas at one time the goal was containment and alleviation of symptoms, today the goal of treatment is recovery.