It may be hard to believe that Sigmund Freud was a practicing psychoanalyst just 100 years ago. Freud’s time represented a major shift in the field of psychology and represented a turning point in the way we approach mental health.
What followed the Freudian era is a monumental leap in advances in the field as researchers learned more about the brain and behavior, making what was considered innovative practice just a century ago now feel outdated.
Just a century ago, treatments such as lobotomies and electroconvulsive therapy were not uncommon, but now we have access to more comfortable and safe treatment options.
Today you can find a variety of mental health treatment options such as cognitive behavioral therapy, psychopharmacology, and more — and the stigma of having a mental health condition is the weakest it’s ever been.
The advances listed below along with many others have led us to where we are at present — a world with more mental health good news than ever. We know more about the brain and behavior than we ever have, and we have access to the best treatment that history has allowed.
The 5 Most Meaningful Advances In Mental Health In The Last 100 Years:
1. Antidepressants
Modern antidepressants have been a game-changer — and even a life-saver — for millions of people.
The first antidepressant was accidentally discovered in the early 1950s. It was originally developed to treat tuberculosis, but physicians noticed that it had a significant mood-elevating effect and thought it could be used to treat depression. Today’s most commonly prescribed type of antidepressant, SSRIs, came to market in the 1980s.
For people who experience great difficulty getting out of bed, getting showered, or getting to work, antidepressants can be a lifeline and can relieve debilitating symptoms.
2. De-institutionalization
By the beginning of the 20th century, psychiatric institutions became seriously overcrowded. Asylums became notorious for poor living conditions, lack of hygiene, ill-treatment, and even abuse. Many of these institutions functioned much like prisons, and patients were isolated and neglected.
By later in the 20th century, many psychiatric hospitals had closed, and patients are now cared for at home, in halfway houses and clinics, or in regular hospitals.
In 1955, there were 558,239 severely mentally ill patients in the nation's public psychiatric hospitals. In 1994, this number had dropped to 71,619, according to PBS.
The deinstitutionalization movement was made possible by the discovery in the 1950s of psychiatric drugs, which could manage psychotic episodes and reduced the need for patients to be confined and restrained.
Another major impetus was a series of social and political movements that campaigned for patient freedom.
Now community services exist that include supportive housing, although more work is needed to ensure that those with severe mental health conditions can get the help they need rather than end up on the streets or in the criminal justice system.
3. Telemedicine
Virtual therapy and telemedicine started gaining traction in the 2000s, and by May 2020, health professionals — out of necessity — were seeing 50 to 175 times the number of patients via telehealth than they had prior to the pandemic, according to the American Medical Association.
It didn’t take long for mental health providers and patients to recognize telemedicine’s many upsides.
Teletherapy and telepsychiatry provide easier, private access to a broader base of patients, often at a lower cost.
It is especially valuable in rural areas, where access to mental health specialists is limited.
“Teletherapy is still the single most significant change I have seen during this time, at least in terms of potentially benefiting patients,” Jean Kim, clinical assistant professor of psychiatry at George Washington University, told Psycom.
4. Smartphone Apps
From the time IBM sold the first “smartphone” in 1994 to the launch of the iPhone in 2007 to the smart gadgets that now fill the pockets of millions of people around the world, smartphones have hugely impacted mental health.
While some effects have been negative, smartphones have also revolutionized how we access mental health information and support.
Having a smartphone has meant faster access to emergency hotlines, including the National Suicide Prevention Lifeline (introduced in 2005), the Crisis Text Line (introduced 2013), and officially launching in 2022, 988, the first federally designated universal telephone number for national suicide prevention and mental health crisis.
None of this is to mention the tens of thousands of mental health-related apps — such as Headspace, Happify, and Calm — that now potentially calm us with meditation, track our moods, allow us to text with a therapist, guide us with artificial-intelligence-directed chatbots, connect us with social media accounts making a difference, allow us to listen to mental health podcasts, and connect us with other mental health resources.
5. Equitable Insurance Coverage For Mental Illness And Substance Use Disorders
Passage of the Mental Health Parity & Addiction Equity Act in 2008 was a major step toward ending discriminatory practices of covering mental health and addiction treatment at lower levels than coverage for other medical and surgical care, Hannah Wesolowski, interim national director of government relations, policy, and advocacy at NAMI, told Psycom.
For many, this helped put an end to inequitable limits on provider visits and inpatient stays. Same for outsize copays, coinsurance, and deductibles for mental health treatment.
The act didn’t apply to individual and small-group plans and didn’t help the 48 million uninsured people in America, but it set precedent. And fast on its heels came the Affordable Care Act, which guaranteed mental health coverage for those with individual, small-group, and Medicaid expansion plans.
These advances are all worth celebrating, and the mental health landscape has improved significantly in the past century.
Stigma surrounding therapy and depression is dropping, more people are gaining access to affordable and effective treatment, the world is increasing its understanding of mental disorders, and conversations about mental health are more commonplace.
There’s still room for more solutions in the future, and we’re hopeful that the momentum can and will continue with sustained effort to improve and normalize mental health globally.
