Wiki for Dr. McClurkens Courses

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1. I found the comparisons Shorter makes between the French and Germans regarding their effectiveness and level of care toward the mentally ill to be very striking. Shorter believes their political structure was the main contributing factor to the discrepancies between the two countries. Germany, being a decentralized country, allowed for the expansion of their mental health efforts across the country, unlike in France, where due to a lack of care from the likes of the Ministry of the Interior and psychiatric leaders like Esquirol, efforts for reformation of the treatment of the mentally ill rarely escaped outside the walls of Paris. I was left wondering why. Why were the French so content in neglecting those outside their capital the proper and humane treatment that was becoming second nature in many other parts of Europe? -Joey Welch

1. Although Reil is supposed to have had very limited contact with patients, he makes some interesting points including talking about how he feels doctors have an ability to help and make a difference here in the field of psychiatry. He does say that there are very few psychiatrists and this is one of the reasons he is promoting the idea of an institution where patients go for this specifically. Is this what begins to separate psychiatry from the practice of medicine as a specialization? The fact that few doctors are interested in it and separate facilities for patients exist? (12-14) 
— Ruth Curran

2. The distinction made between “nervous disorders” and “pyschiatric illness is interesting here (25). They clearly both involve issues with the mind and are altering the person’s ability to function but they are both treated differently and even by different doctors, what is the distinction here that is keeping them from being classified together? (25)
—Ruth Curran

1. It is interesting to see the paradoxes listed in the reading as it was stated that Rush in particular proclaimed one thing in his textbook, yet he practiced another at his hospital. Was this common throughout psychiatric treatment when it was becoming more mainstream? And do we see similar patterns of this today?-Margie Jones

2. The contrast between the neurological and situational cause of mental illness is a complex pattern to follow in the reading. I am curious how we have reached today's seemingly even distribution of cause of mental illness.-Margie Jones

1) Shorter mentions in History of Psychiatry that in European asylums have been around since the middle ages. While obviously they have not always been referred to as asylums or in language that is more common in our time, there have been systems in place to house those with mental disorders regardless of whether or not they were helpful. I think it would be interesting to look into treatment/housing of those with mental disorders prior to the 19th century and look into how they compare to early asylums in the US.

2) Madness and Civilization briefly mentions “positivism”(?) and how it leads the patient to believe the psychiatrist has skills beyond science, comparable to divine power or magic. This made me curious about any connections between mental health and religion during this time period. - NG

1. Shorter pointed out that the US did not have much of a pre-modern madhouse phase, unlike in Europe, as well as that the US did not go through the same reform European countries did until later. What impact might these differences have had on the history of mental health care in the US moving forward? - Morgan Kelley

2. Shortner addressed a number of explanations for the increased number of asylum patients in the 19th century and concluded that the most likely reason was a genuine increase in the number of people who required care and wider changes in who was responsible for that care. One thing that he did not address that I had wondered about was how increased legitimacy of asylums as an institution and psychiatry as a field might have made that sort of care more desirable to those who might have once been weary of the new practices; could this have been a reason for the increase as well? - Morgan Kelley

1. "What do these many founders of modern psychiatry have in common? How about the Foucaldian notion that psychiatry was born in some kind of fiendish alliance between capitalism and the central state, enlisting psychiatrists in the larger game of confining deviant individuals in order to instill work discipline into an unmotivated traditional population" (Shorter,16).

How true does this quote stand in the bigger picture? -RJD

2. Confinement at home is discussed at the beginning of Shorter's book. The mentally unwell were obviously not being treated well at home, versus in institutions later on. Accounting for anomalies in treatment, was a one size fits all approach to mental health even possible? -RJD

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