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A thoughtful survey of the history of psychiatry sheds light on a rich and intricate story of our evolving understanding, experience, and treatment of mental illness through time. These chronicles are at once a show of human curiosity for the mind-body connection, and an experiment in cruel and unusual treatment of illnesses that have proven difficult to quantify through both ancient and modern scientific means. It is the latter that makes an ethical study of the past so vital in a concerted effort to write a more just future for all patients. This paper provides a survey of the history of mental health and psychiatry from ancient Egypt to modern-day America, highlighting the injustices suffered by patients with mental illness throughout all times with a particular focus on the burden shouldered by vulnerable and underprivileged persons, minorities, and urban populations. Through an analysis of landmark American cases, it examines the establishment of civil rights for psychiatric patients in the areas of: the right to treatment, right to refuse treatment, and civil commitment. Drawing upon these precedents and historical contexts, this paper explores how the principles of bioethics can be applied to the future of psychiatry with respect to emerging trends like the use of social media, telehealth, gene editing, and AI/VR in medicine. By thoughtfully reflecting on the past and applying the lessons we have gleaned to the future, this thesis aims to promote a more ethical and equitable approach to mental healthcare, one that protects and actively fosters the empowerment of all patients, regardless of background, mental status, or socioeconomic status. / Urban Bioethics

A thoughtful survey of the history of psychiatry sheds light on a rich and intricate story of our evolving understanding, experience, and treatment of mental illness through time. These chronicles are at once a show of human curiosity for the mind-body connection, and an experiment in cruel and unusual treatment of illnesses that have proven difficult to quantify through both ancient and modern scientific means. It is the latter that makes an ethical study of the past so vital in a concerted effort to write a more just future for all patients. This paper provides a survey of the history of mental health and psychiatry from ancient Egypt to modern-day America, highlighting the injustices suffered by patients with mental illness throughout all times with a particular focus on the burden shouldered by vulnerable and underprivileged persons, minorities, and urban populations. Through an analysis of landmark American cases, it examines the establishment of civil rights for psychiatric patients in the areas of: the right to treatment, right to refuse treatment, and civil commitment. Drawing upon these precedents and historical contexts, this paper explores how the principles of bioethics can be applied to the future of psychiatry with respect to emerging trends like the use of social media, telehealth, gene editing, and AI/VR in medicine. By thoughtfully reflecting on the past and applying the lessons we have gleaned to the future, this thesis aims to promote a more ethical and equitable approach to mental healthcare, one that protects and actively fosters the empowerment of all patients, regardless of background, mental status, or socioeconomic status. / Urban Bioethics

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present dissertation has a mixed methods research design combined with a documental feature. From the legal proceedings for involuntary commitment of crack cocaine users, this piece of work aims at reflecting on the interactions of certain institutions (such as family, Unified Health System (SUS), welfare, Judiciary, etc.) in the process of health care provision to drug users. From this general objective, we produced two specific aims, which are the focus of the present dissertation: (a) to analyze academic and legal documents related to the topic of involuntary commitment, and, (b) to build a social and epidemiological listing of the legal proceedings (involuntary commitment requests) involving users of crack cocaine, received in 2013. We produced a social and epidemiological listing of the legal proceedings (involuntary commitment requests) involving drug users received by the 4th Regional Health Division (RHD) in 2013. The analysis of the documents gathered in the 4th RHD was based on descriptive statistical analysis, performed using software IBM SPSS, version 21. Furthermore, this research used Critical Social Psychology and Theories of Social Representation as theoretical and methodological foundations. The present research also used the body of knowledge from authors who focus on the issues related to mental health, drug users (more specifically crack cocaine users) and involuntary commitment. After presenting our methodological choices, the dissertation is organized in four chapters: the first one is entitled: Social representation and drugs ; the second chapter, Brazilian Policies on drugs: what kind of care do I need? ; the third chapter is entitled Involuntary commitment for crack cocaine users ; and the fourth and last chapter s title is Social and Epidemiological listing of legal proceeding of the 4th CRS: results and discussion . We concluded that the discourses contained in the legal proceedings are from people other than the crack cocaine users. Therefore we emphasize the necessity of listening to drug users. It is from their experiences and knowledge that health care will be planned and put into execution. The singular therapeutic project will be effectuated from a warm welcome and a listening without prejudices. / A presente dissertação, com design quali-quantitativo e de caráter documental, busca descrever a partir dos processos judicias para internação compulsória de pessoas que fazem uso de crack, como certas instituições família, Sistema Único de Saúde (SUS), Assistência Social, Judiciário, etc. interatuam na produção de cuidado em saúde. Desse objetivo, geramos dois objetivos específicos: (a) analisar documentos acadêmicos e jurídicos relativos ao tema da internação compulsória e (b) realizar um levantamento sócio epidemiológico dos processos judiciais (pedidos para internação compulsória) recebidos em 2013, de pessoas que fazem uso de crack. Foi realizado um levantamento sócio epidemiológico dos processos judiciais (pedidos para internação compulsória), recebidos pela 4ª Coordenadoria Regional de saúde em 2013, de pessoas que fazem uso de drogas. Os documentos levantados na 4ª CRS foram analisados com base na análise estatística descritiva, realizada com o auxílio do software IBM SPSS Statistcs, versão 21. Além disso, esta pesquisa tem como base teórica e metodológica os pressupostos da Psicologia Social Crítica e da Teoria das Representações Sociais, bem como, foi utilizado o corpo teórico de autores que enfocam as temáticas referentes à saúde mental, pessoas que fazem uso de drogas, mais especificamente, a droga crack e internação compulsória. Após apresentar as incursões metodológicas, organizamos a dissertação em quatro capítulos: o primeiro capítulo é intitulado Representações Sociais e drogas ; o segundo capítulo, Políticas sobre drogas no Brasil: qual o cuidado que eu preciso? ; terceiro capítulo, intitulado Internação compulsória de pessoas que fazem uso de crack e o quarto e último capítulo, possui como título Levantamento sócio epidemiológico dos processos judiciais na 4ª Coordenadoria Regional de Saúde: resultados e discussão . Concluiu-se que os processos possuem discursos sobre esses sujeitos, a partir de outras vozes que não a sua. Dessa forma, enfatizamos que as vozes dessas pessoas devem ser escutadas. É a partir das suas experiências e de saberes que o cuidado em saúde vai ser desenhado. A partir do acolhimento e de uma escuta sem preconceitos que o Projeto Terapêutico Singular se efetivará.

Background: Psychiatric hospitalization of children and adolescents can be carried out either voluntarily or involuntarily. The aim of this form of inpatient hospitalization is to provide treatment for those who cannot manage the symptoms of their mental illnesses on their own. However, psychiatric hospitalizations of children and adolescents are costly and could lead to outcomes such as worsened mental state in former patients and distrust of the system in caregivers. It is crucial to have a solid understanding of specific components that lead to the hospitalization. Purpose: To identify potential trends in patient admission data through the analysis of admission characteristics in children and adolescents placed under involuntary and voluntary status in a psychiatric facility. Methods: An extensive literature review was conducted using the CINAHL, MEDLINE, and APA PsycINFO databases. Articles that were eligible for inclusion in this review of literature were those written in English, published from 2000-2024, and contained a population of subjects aged 3-17. A total of nine articles were utilized for the review after the search was completed. Results: Of the nine articles, a majority of them found correlations between involuntary admission and psychotic symptoms and disorders, manic behaviors, older age, female gender, and psychosocial burden. As for voluntary admission, behavioral or mood disorders, symptoms of depression and suicidal thoughts, and younger age were found to be primary contributing factors. Conclusion: More research should be completed on patient demographics that are lesser noted, such as sexual orientation, race, and ethnicity, in order to enhance the quality of care children and adolescents receive under inpatient psychiatric hospitalization. Additionally, with the identification of these trends related to legal placement status, future research should be conducted on long-term outcomes of and satisfaction with psychiatric hospitalization in former patients with the aforementioned demographics.