Treatment replaces mental hospitals

File In 1979, the state of Illinois closed what was once called the Northern Hospital for the Insane in East Moline. More than 5,000 resided there. Today, treatment and drugs have replaced such hospitals. Above is the infirmary at the former state hopital, below is the administration building. File

Erratic behavior and illusions once blamed on the devil today can be fixed with drugs.

During the Middle Ages, Europeans viewed mental problems as symptoms of satanic possession, which could only be exorcised by moral and spiritual treatment. The insane were shunned, frequently chained and cast into dungeons.

Until as late of the middle of the 18th century, mildly insane people wandered homeless through the country. Others, feared as a menace to the community, were sent to prison to live beside criminals.

Until the 1950s, barbiturates and bromides were used to calm patients, according to Dr. Eric Ritterhoff, medical director at Robert Young Center for Community Mental Health. Their use varied widely, because no one was clear how much to prescribe or why they worked.

Insulin coma therapy also was tricky, he said. Too much insulin resulted in brain damage.

Lithium, a metallic chemical element discovered in 1817, also was used in the late 1800s and early 1900s as a calmative.

As late as the mid-1950s, jails in this country were a stopping place between home and state mental hospitals. Without treatment, people often slid into permanent states of regression.

At the time, the East Moline Mental Health Center housed up to 5,000 patients. Gov. James Thompson closed it in 1979, as the state consolidated its treatment centers. The days of torture and straitjackets to control people in asylums had given way to pharmaceuticals people can take in their homes.

In the early '50s Reserpine and Thorazine were the first true pharmaceuticals used to treat mental illness, Dr. Ritterhoff said. Modifications soon followed, including tricyclics in the early 1960s. Later, selective seratonin reuptable inhibitors, including Prozac, became popular.

A breakthroughs came with Clozaril, a tranquilizer outside the Thorazine class, he said.

Those who do not respond to medication may need shock treatment or psychosurgery, Dr. Ritterhoff said. Psychosurgery has become more sophisticated since lobotomies, which if badly performed turned people into vegetables.

Today, people with mental illness no longer spend the rest of their lives in hospitals. Instead, they can become free of symptoms and participate in daily life.

``We've seen the steady decline of hospitalized patients and the length of their stays,'' Dr. Ritterhoff said. ``Our treatments are much more rapid and effective.''