As both an A-level biology teacher and a doctoral student specialising in the well-being of post-secondary students, I approach the subject of mental health with a dual lens: scientific curiosity and professional responsibility.
Some students still seem reluctant to talk about mental health, while others speak openly about their struggles with anxiety or other psychological difficulties. This striking contrast compels me to reflect not only on the present-day complexities of mental health but also on the historical narratives that continue to influence contemporary attitudes.
As educators, we must avoid reinforcing stigma while also ensuring that openness is treated with utmost respect and dignity.
Education about mental health should foster safe, respectful spaces where students can see psychological difficulties not as weakness or taboo but as a natural aspect of human experience shaped by biology, nurtured by culture, and sustained through resilience and community.
Looking across history, one can see how the treatment of mental health has evolved from superstition and inhumane treatment to evidence-based, person-centred care. Yet the legacy of past stigma remains visible in today’s classrooms.
The history of mental health care reflects a complex interplay between biology, culture and belief. In the ancient world, explanations often focused on the balance of the four humours: blood, phlegm, yellow bile, and black bile, as described by Hippocrates.
Education about mental health should foster safe, respectful spaces where students can see psychological difficulties not as weakness or taboo but as a natural aspect of human experience shaped by biology, nurtured by culture, and sustained through resilience and community
Indian Ayurvedic medicine also used humoral principles, together with diet, massage, and yoga, while Chinese traditions employed yin and yang to understand balance. Mesoamerican practices were much more drastic, involving skull perforation and psychotropic substances. However, they also highlighted the religious and communal aspects of healing, which are still relevant in today’s discussions of mindfulness, meditation, and spiritual support.
In Christian societies, mental illness was sometimes associated with demonic possession, leading to the use of exorcism. By contrast, medieval Islamic medicine combined scientific and spiritual practices, including baths, diet, cupping, and even theatre as forms of treatment.
Asylums started opening up in the 19th century. Conditions were often inhumane, and treatments could be extreme, such as hydrotherapy, insulin shock therapy, and electroconvulsive therapy. Emil Kraepelin’s 1883 classification of mental disorders marked an important step toward systematic diagnosis. Yet stigma persisted.
A major turning point came in the 1950s with the work of Nigerian psychiatrist Thomas Adeoye Lambo, who pioneered outpatient and community treatment models. This approach shifted the focus from confinement to rehabilitation, a philosophy later reinforced by organisations such as the Singapore Association for Mental Health (1968).
The devastation of war also shaped psychiatry, with trauma care and psychometric testing becoming central to post-war practice.
The emergence of psychological theories in the late 19th and 20th centuries broadened understandings of mental illness.
Sigmund Freud’s psychodynamic theory emphasised the unconscious mind, unresolved motives, and the interplay of id, ego, and superego. His successors ‒ Carl Jung, Alfred Adler, Melanie Klein, Anna Freud, and Erik Erikson ‒ elaborated on this framework, highlighting developmental, relational, and symbolic aspects of psychological life.
In contrast, behaviourism, pioneered by Ivan Pavlov, John Watson, and B.F. Skinner, rejected introspection and focused on observable behaviour and conditioning.
Later, the biopsychosocial model, developed by George Engel and John Romano in the 1970s, was pivotal in recognising the interplay of biological, psychological, and social factors. Its strength lies in acknowledging complexity; its limitation, as critics note, is that it often ignores cultural and spiritual dimensions that profoundly shape help-seeking behaviour and symptom expression.
The recovery model, building on community psychiatry, has been equally influential. It is based on principles of hope, empowerment, and identity reconstruction, embodied in the CHIME framework (connectedness, hope, identity, meaning, empowerment). It reframes recovery as personal, directed by individuals themselves rather than imposed by institutions.
The Substance Abuse and Mental Health Services Administration (SAMHSA)’s four dimensions of recovery – health, home, purpose, and community – mirror this holistic approach.
Community psychology, particularly through Bronfenbrenner’s ecological systems theory, emphasises that individuals exist within interconnected systems: microsystems of family and peers, mesosystems of institutions such as schools and macrosystems of cultural and ideological contexts, and the chronosystem of historical time. This ecological framing is particularly relevant in multicultural classrooms where the meaning of words like “depressed” can vary significantly depending on cultural background.
But perhaps the most transformative development has been the rise of neuroscience. From Edwin Smith’s surgical papyrus in ancient Egypt, to Santiago Ramón y Cajal’s discovery of neurons in the 1890s, to the establishment of neuroscience as a discipline in the 20th century, our understanding of the brain has expanded dramatically. Discoveries about neurotransmitters, synaptic plasticity, and brain imaging have revealed the biological underpinnings of mental illness, providing both diagnostic clarity and therapeutic innovation.
Josephine Ebejer Grech is a doctoral candidate specialising in the neuroscience, neuroplasticity, metacognition, well-being and academic resilience of post-secondary students.