Although mental illness has been observed and documented for hundreds of years, the major advances in psychiatric treatment came in the latter part of the 19th century. Emil Kraepelin, a German psychiatrist, made an important contribution when he developed a classification system for mental illnesses that is still used for diagnosis. Sigmund Freud, the famous Viennese psychiatrist, developed techniques for analyzing human behavior that have strongly influenced the practice of modern psychiatry.
In the 20th century, the practice of psychiatry underwent another major advancement with the development of medications that could be used in treating psychiatric conditions, such as depression and anxiety. Since then, great strides have been made in this area, and medication is very often a component of psychiatric treatment.
The past several decades have seen new challenges emerge in the field, especially in regard to the elderly and their mental health. Medical, industrial, and technological breakthroughs have brought a substantial increase in Americans' life spans; in the 20th century, the average life expectancy increased from approximately 50 years to more than 75 years. This increase means we have a growing elderly population. The U.S. Census Bureau predicts that the population age 65 and over will more than double by 2030 (increasing from approximately 35 million in 2000 to 77 million in 2034).
Of those elderly who live in nursing homes, it is estimated that a significant percentage have a mental illness and/or are depressed. Currently, though, most are not getting proper psychiatric treatment; in fact, the vast majority of the elderly with mental illness are not receiving psychiatric attention at all. Nursing homes were designed to treat people's physical, not mental, problems, and until fairly recently the mental health issues of elderly people were not even recognized by most people, even physicians. Professional recognition for the field of geriatric psychiatry was obtained in 1991 when it was formally recognized as a subspecialty of psychiatry and in 1998 when the American Psychological Association voted to recognize that clinical practice with the elderly requires special training, expertise, and skill.
The growing number of senior citizens in the United States and the proliferation and recognition of Alzheimer's disease, dementia, depression, and other mental diseases and disorders of the elderly clearly point to the need for geriatric psychiatrists.
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