Drug Therapy

Sedative drugs, like bromides and barbitu­rates, and stimulating drugs, like ampheta­mine (Benzedrine), have long been effectively used in treating mental illness. The new 1950 ataraxic drugs (tranquilizers and brain stim­ulants) have given even more remarkable results. The first of these was reserpine, de­rived from Rauwolfia serpentina. This is the snakeroot plant, which has a long and ro­mantic history in the herbal medicine of In­dia, (Rauwolfia derivatives are also used in treating heart disease.)

The next important tranquilizing drug, discovered in France, was chlorpromazine. A young French doctor, conducting wounded soldiers back by plane from Indo-China, is credited with first observing its significant tranquilizing effect. Both these drugs proved of unexpected value in treating schizophre­nia, particularly in quieting and relaxing agitated patients. 

Scores of tranquilizers are now on the market and frantic research continues for newer and better ones, free of side reac­tions. Probably the best-known tranqui­lizer is the American discovery named "Mil-town" (meprobomate).

Such drugs should be taken only under medical supervision. They have been popu­larly called "don't give adamn pills" and they have raised the seriously interesting ques­tion: How tranquil can you get? Cerebral stimulants are drugs which elevate mood, which "cheer up" depressed patients the effect opposite to that of tranquilizers.

Some Other Psychiatric Treatments

Electroshock treatments, introduced about 1940, have also proved of great value in treating mental illness, particularly in depressed and melancholic patients. A mild electrical current is passed between the fron-tal lobes of the brain. Shock treatment is quite safe; millions of such treatments have been given with very few accidents or unto­ward reactions. A shock effect can also be produced by injections of insulin and metra-zol. The use of the new drugs has cut the need for shock treatment at least by half.

Hospitalization itself, in a properly run psychiatric hospital, is still another impor­tant form of treatment for mental illness. The essence of hospital treatment—in addition to the custody which prevents the patient from harming himself or others —is to relieve the patient temporarily of the stress of external re­ality and give a weakened ego a better chance to get control again of the unconscious mind. Some important progress has been made in recent years in improving the quality of the attendants at mental institutions. Unfailing kindness toward the disturbed patient is the proper rule. It is a far cry from the cruel Bed­lams of several centuries ago.

Community Menial Health Centers

Another forward step in providing im­proved care for the mentally ill in the United States is the development of comprehensive community mental health centers. Such cen­ters go a long way toward enabling the men­tally ill to stay at home, be treated at home, and recover at home. Federal grants-in-aid to finance up to two-thirds the cost of construc­tion of these new local mental health treat­ment centers were authorized in 1963. The development of these community centers is expected to be not only more effective but also less expensive in providing public hospital care for mental illness. Treatment will usu­ally begin earlier, when it is more intensive and effective; will avoid separation from fam­ily and commitment to a State hospital; and will offer the support of community resources following treatment.

Community mental health centers, as now visioned, embrace a new concept and a new challenge: comprehensive treatment provided in the community for all who need it. Services provided by the centers will include round-the-clock emergency services, short-term hospitalization, out-patient services, partial hospitalization in day or night treatment programs, aftercare, consultation, and educa­tion services for community agencies. Dr. Robert H. Felix, when Director of the U. S. P. H. S. National Institute of Mental Health, said: "Not since the creation of the National Institute of Mental Health in 1949 has such specific impetus been provided by the Federal government for the opening of a new era in dealing with problems of men­tal illness."