There is a long history of maltreatment involving the mentally ill that has subsequently led to such legislation as Public Law 88-164 (Bloom, 1977). One of the oldest views of psychopathology was that mental illness was caused by supernatural powers. More specifically, it was believed that psychiatric disorders were the result of patients being invaded by evil spirits, thus making them evil beings (Bloom, 1977). Treatments at this time were designed to force out evil spirits. They consisted of various forms of punishment like 'trephining' or cutting out a section of the skull to let out evil spirits, beatings and burnings. Contrasting views were those of Hippocrates and other Greek physicians who held that mental disorders were similar to other diseases and had natural causes rather than supernatural. However, the treatments were no more humane and included purging, bleeding, blistering and administering vomit-inducing drugs (Bloom, 1977).

The debate of whether psychopathology was a disease of the body or the spirit raged on, as did how to best treat those afflicted. Health practitioners, or physicians supported a movement of treatment that advocated strengthening or restorative approaches as opposed to the depletive approaches of the past was born. Supporters of this movement encouraged treatments such as bed rest, providing the patient with good nutrition and placing the patient in a cheerful environment. Thus, the concept of the "restful retreat" was developed and supported by both clergymen and physicians- those who believed psychiatric disorders were diseases of the spirit and those who believed they were diseases of the body. The clergy supported "retreats" while physicians supported "hospitals". This time became known as the era of moral treatment (Bloom, 1977).

There were three developments that contributed to a shift in psychiatric care during the start of the 1950's. They were (1) the use of psychopharmacology (2) the development of the philosophy of the Therapeutic Community and (3) geographic decentralization in large state mental hospitals.