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Society's approach to the treatment of mental illness has changed radically over the centuries. It has evolved across cultures and time as the understanding of the human condition has changed along with advances in science, medicine, and psychology. The history and evolution of mental health and treatment has often been shocking, and it explains a great deal about the current landscape of mental health care today.

Want to discover more about the history of mental health treatments? Then check out the gallery.

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Mental illness might seem like a recent phenomenon, but it has been observed throughout history. The term “mental hygiene” spread in the medical field starting in the 19th century. Prior to this, there wasn’t an official term to describe it.

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Historians and mental health professionals have evidence of the history of mental illness through documented cases. Disorders now known as depression, post-traumatic stress disorder (PTSD), and bipolar disorder have had names such as hysteria, psychosis, and even demonic possession.

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Ancient theories about mental illness were often the result of belief in the supernatural, such as demonic possession or curses. Anthropological discoveries dating as far back as 5000 BCE showed evidence of trephining, which is a process of a hole being bored into the skull.

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It was believed that opening up a hole in the skull would allow the evil spirit, or spirits, that inhabited the head to be released. Surprisingly, as it wasn't a fatal procedure, trephining went on for centuries.

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Priest-doctors, like those in ancient Mesopotamia, and shamans would use rituals based on religion and superstition since they believed that demonic possession was the reason behind mental disturbances.

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The ancient Egyptian civilization was notably advanced for its time in the field of medicine and recommended that patients engage in recreational activities such as music, dancing, or painting, to relieve symptoms of mental illness.

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It was a standard belief in ancient societies that mental illness had a supernatural origin. However, somewhere between the 5th and 3rd centuries BCE, the Greek physician Hippocrates rejected this idea, and wrote that imbalances in thinking and behavior were from natural occurrences in the body, in particular, the brain.

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Hippocrates, Galen, and Socrates, each developed the idea of there being four essential elements to the human body: blood, bile, black bile, and phlegm. Known as the humors, when they were out of balance, mental illness was the result. This belief persisted through the Middle Ages.

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Doctors of the time would give patients laxatives, leeches, and cupping therapy to restore the body’s proportions of humors. Tobacco imported from the Americas was used to make patients vomit out the excess humors. Other treatments saw doctors extracting blood from the forehead to drain the guilty humors away from the brain.

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Outside interventions and facilities for residential treatment were rare. However, it wasn’t until 792 CE in Baghdad that the first psychiatric hospital was founded.

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Meanwhile, in Europe, families saw their mentally ill relatives as a source of shame and humiliation. Many families resorted to hiding their loved ones in cellars, sometimes caging them, and even beating them as a form of reprisal for their antisocial and undesired behavior.

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Some options beyond family care did surge during the Middle Ages. A common solution was to send the mentally ill to workhouses, public institutions where the poorest people were given basic room and board in return for work. Others were checked into general hospitals, but were often abandoned and ignored.

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However, these facilities did not offer real treatment and comfort to the mentally ill, forcing patients to live in inhuman conditions and subjecting them to cruel abuse.

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As word spread of the horrible environments within asylums, a call for reform arose in the 19th century. An example of this took place at an asylum in Devon, England, which abandoned methods of treatment based on restraint.

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However, it was in Paris in 1792 that physician Philippe Pinel made one of the most important reforms in the treatment of mental health. Pinel developed a hypothesis that mentally unhealthy patients needed care and kindness in order for their conditions to improve

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Moral treatment was highly effective, but it died out during the 19th century. Critics argued that the method did not really treat patients, but made them instead dependent on their doctors and the asylum staff. In the 20th century, historians and contemporary doctors argued that the moral method simply substituted one form of control for another.

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A major step forward in the treatment of mental health illness came with the career of Austrian neurologist and psychiatrist Sigmund Freud. He is best known for his theory of psychoanalysis. This gave rise to the practice of "talking cures" and free association, encouraging patients to talk about whatever came to mind.

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Freud’s theory was that conversation would open a door to the patient’s unconscious mind, granting access to any kind of repressed thoughts and feelings that might have caused the mental instability.

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Mainstream psychology didn't think much of psychoanalysis, however, attention to Freud's work opened other doors to mental health treatments, such as electroconvulsive therapy. This is because the treatment originated from the biological model of mental illness, which stated that mental health problems were caused by biochemical imbalances in the body.

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Electroshock therapy proved promising at first, but was quickly abandoned because the convulsions it induced in patients were so severe that they became too scared to willfully participate. Rumors of abuse and torture spread, of doctors and administrators threatening to use electroconvulsive therapy on uncooperative patients.

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First developed in the 1930s, a patient would be put into a coma, after which a doctor would hammer a medical instrument through the top of both eye sockets. The process would cut the nerves that connected the frontal lobes, which regulate behavior and personality, to the centers of the inner brain that regulate emotion.

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The idea behind lobotomies was to calm patients who were uncontrollably hysterical or emotional, especially in conditions like schizophrenia and bipolar disorder. The procedure was largely discontinued after the first psychiatric medications were created in the 1950s.

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Introduced in 1927 and continued until the 1960s, insulin coma therapy would put the patient into a low blood sugar coma because it was believed large fluctuations in insulin levels could alter how the brain functioned. Insulin comas could last one to four hours, but risks included prolonged coma.

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In metrazol therapy, physicians introduced seizures using a stimulant medication. Seizures began roughly a minute after the patient received the injection and could result in fractured bones, torn muscles, and other adverse effects. While this treatment was dangerous and ineffective, seizure therapy was the precursor to electroconvulsive therapy.

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In 1949 an Australian psychiatrist introduced the drug Lithium into the market. The drug didn't cure psychosis, but proved better at controlling the symptoms than any other previous method.

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As lithium became the standard for mental health treatment, other drugs like Valium and Prozac became household names during the 20th century. These became some of the most prescribed drugs for depression across the world.

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With the rise of drugs, dedicated facilities to house mentally ill people declined. While this indicated a positive trend, it also created a problem for people with severe mental health problems, particularly those with no social or family network to support their recovery. This also includes those who can't afford the fees or insurance plans for rehabilitation.

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Today, the stigma surrounding mental illness has decreased with new knowledge of the subject. This has stemmed from mental health advocates and public figures raising awareness.

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Treatment for mental illness has come a long way, even in recent history. However, with many falling prey to addiction and with major cracks in modern healthcare systems, there's still a lot of work to be done.

Sources: (Sunrise House) (CSP) (Baton Rouge Behavioral Hospital)