My working thesis is “this paper will argue American society forced mental health facilities to become long term care facilities.” The first place to look for that is how “insane” people were viewed by the majority of Americans during the nineteenth and twentieth centuries. As cities became more populated throughout America citizens became less likely to take care of mentally ill family members. These people were seen as burdens not only to the families but by the community. This led to mental health facilities becoming somewhat of a “dumping ground” for unwanted individuals. This can be seen in the broad spectrum of things that got people sent to these facilities as well as the seemingly instant increase in the elderly population. Once communities filled mental asylums they then put little or no money into any facet of the hospitals. Leading to serious problems of overpopulation and abuse. This is in serious contrast to the original purpose of these facilities. The goal for all of these facilities was to cure individuals to a point where they could return to society. But since society viewed the individuals so poorly the hospitals never had a true chance. The idea of moral treatment was what every hospital in America was built on. The issue of overcrowding is the main reason these hospitals became care facilities. Simply put the hospitals never had the knowledge and resources to individually work with patients. Funding also plays a huge role in this. It is mentioned multiple times that Kirkbride and other operators had to beg for money to keep running their hospitals. Which really harkens back to how society viewed “insane” individuals. As they were willing to send them there but not willing to ensure their safety.
Sources
Grob, Gerald N. 2011. Mad among Us : A History of the Care of America’s Mentally Ill. Editora: New York: Free Press.
Grob argues that American hospitals were made with good intentions but societal factors led to its eventual downfall. Grobs discusses how the development of these hospitals coincided with growing societal beliefs. For my project it discusses the growing displeasure that Americans had about the mentally Ill.
Tomes, Nancy. 1994. The Art of Asylum-Keeping.
The main argument that Tomes is making is that Kirkbrides asylum philosophy lost appeal because of “new social realities.” It follows Thomas Kirkbride and his ideal facility which was never able to come to fruition. This source is useful because it talks about moral treatment in theory and in action and gives a unique perspective that most head physicians shared.
Tone, Andrea. 2009. The Age of Anxiety : A History of America’s Turbulent Affair with
Tranquilizers. New York: Basic Books.
The author discusses the issues with feeding humans pills to help deal with mental illness. She points to the use of tranquilizers to remedy anxiety. This shows the willingness of modern doctors to prescribe heavy medication, showing how treatment has never really changed overtime.
Shorter, Edward. 1998. A History of Psychiatry: From the Era of the Asylum to the Age
of Prozac. New York ; Chichester: Wiley.
Shorter argues against the “revisionist” history of psychiatric care that took place in the 1960s. Shorter mentions how the work done in the sixties discredited mental illness and their true effects. This touches on the evolution of Psychiatric hospitals be that physically or in the public eye up until the modern day.
Magennis, A.L. “Lives Forgotten; Morbidity and Mortality in the Late 19th Century
Colorado Insane Asylum.” American Journal of Physical Anthropology, 2003, 144–.
The article emphasizes the poor treatment that the patients faced. Magennis discusses the examinations of patients’ skeletal remains, noting that many of them suffered violent deaths. This is a good piece to help expand on the idea that Americans used hospitals as a dumping ground.
Jimenez, Mary Ann. Changing Faces of Madness : Early American Attitudes and
Treatment of the Insane. Hanover, NH: Published for Brandeis University Press by University
Press of New England, 1987.
Mary Ann Jimenez makes the case that as society developed there became a need to care for these individuals. Mainly she points at the growing need running along side Americas industrialization This adds context to show societies changing views as their life styles began to change.
Sutton, John R. “The Political Economy of Madness: The Expansion of the Asylum in
Progressive America.” American Sociological Review 56, no. 5 (1991): 665–78.
https://doi.org/10.2307/2096087.
This article argues that in the late 1890s-1940s it was the governments responsibility to take care of these individuals. Sutton points to a political split which ultimately only hurt the people who needed help. The government showed little support to these facilities yet everyone reaped in the benefits.
Riddle, Bryan Justin. “Treatment, Warehousing, and Dispersion: Mt. Pleasant Insane
Asylum, 1844-1980.” ProQuest Dissertations Publishing, 2010.
This author argues that Iowas government was ultimately the downfall of Mount Pleasant Insane Asylum. He notes how Iowa did not give the proper resources to the asylum so it ultimately spiraled into a disaster. This article is a perfect example of how society let down these individuals and never gave the hospitals a real opportunity to work.
Holt, Anna Kate. “Seeking Voices in Dark Places: The History of the Tennessee
Asylum for the Insane.” ProQuest Dissertations Publishing, 2023.
Holt argues that other authors do not cover the racism that was regularly apart of hospitals. She points to the Tennesse Asylum to show the how racism effected not only this asylum but similar ones across the nation.The fact that racism was so prevalent amongst these facilities speaks volumes to societal problems.
Lanzoni, Susan. “The Asylum in Context: An Essay Review.” Journal of the History of
Medicine and Allied Sciences 60, no. 4 (2005): 499–505. https://doi.org/10.1093/jhmas/jri070.
This review argues that the issue of overcrowding was a variety of factors. Early in the article the author discusses the role that families play however in the end, Lanzoni mentions that “lax procedures” on commiting individuals is what did the most damages. This article shows a couple of different views that add perspectives on the family side, political side, and the institution side.
Kemp, Donna R. Mental Health in America : a Reference Handbook. Santa Barbara,
Calif: ABC-CLIO, 2007.
Kemp argues that the ever changing definition of mental illness makes it difficult for individuals to find adequate treatment. It covers the changing definitions and treatments of a varies of different illnesses. Speaks to the terrible treatment that patients recieved and the fields sort of Guinea pig approach to mental illness.
FEE, Elizabeth, and Theodore M BROWN. “Freeing the Insane.” American Journal of
Public Health (1971) 96, no. 10 (2006): 1743–1743. https://doi.org/10.2105/AJPH.2006.095448.
This article argues that the treatment in the 1800s was a major step in the right direction for the world of mental health. Points to use of “moral treatment” that occurred in America and other countries compared to treatment during the 1700s. As my paper will focus on the negative it is important to understand that leaps were made during this time period.
Geloso, Vincent, and Raymond J. March. “Rent Seeking for Madness: The Political
Economy of Mental Asylums in the United States, 1870 to 1910.” Public Choice 189, no. 3-4
(2021): 375–404. https://doi.org/10.1007/s11127-021-00890-1.
This piece argues that “stronger political influence from mental healthcare providers contributed to the rise in institutionalization.” They point to the rising level of rates from 1870-1910. A perfect example of policies that allowed for the neglect of patients and hospitals alike.
Yanni, Carla. 2007. The Architecture of Madness : Insane Asylums in the United States.
Minneapolis: University Of Minnesota Press.
This author argues that the architecture of insane asylums has evolved overtime. They had to change from the kirkbride model in order to better suit patients. It is also mentioned that hospitals now prefer open spaces with art which shows the evolution of American hospitals.
Ryan, Madeline Kearin. “The Smell of the Insane: Disciplining the Olfactory Domain in
the Nineteenth-Century Asylum.” Historical Archaeology 56, no. 4 (2022): 722–39.
https://doi.org/10.1007/s41636-022-00378-9.
This article focuses on the failure of the facilities to keep patients properly taken care of. TH articles paints this a top down problem.For my paper it talks about the failures of asylum operators to successfully implement proper regiments for patients.
Deitz, Charles. “‘A Tomb for the Living’: An Analysis of Late 19th-Century United States
Newspaper Reporting on the Insane Asylum.” ProQuest Dissertations Publishing, 2018.
Deitz’ argues that newspapers helped to push negative narratives about mental illness. While also promoting false narratives about asylums. This works perfectly with my other sources to display growing societal views.
Braslow, Joel. Mental Ills and Bodily Cures : Psychiatric Treatment in the First Half of
the Twentieth Century. Reprint 2019. Berkeley, CA: University of California Press, 1997.
https://doi.org/10.1525/9780520917934.
This piece argues that doctors went to extreme lengths for these tests. Which violated the rights of individuals and went unknown to families. This article speaks to the poor treatment that patients had to undergo in these facilities and further strengths the idea that patients were test subjects.
Grob, Gerald N. Mental Institutions in America : Social Policy to 1875. London:Routledge Publisher, 2017
In this piece Grob argues that mental institutions are unable to produce results. This drastically impacts the amount of support they receive from the public. For my paper it shows where societies expectations and reality just didn’t line up.
Grob, Gerald N. “Review: John C. Burnham, ‘Mental Institutions in America: Social Policy to 1875’ (Book Review).” Journal of Social History. Berkeley, Calif: University of California Press Books Division, 1975.
This source agrees that Grob is right, and that it was social policy that was the largest factor in hospitals failures. For my paper it solidifies some of what I had found and my overall thesis.
Lambe, Jennifer. “Memory Politics: Psychiatric Critique, Cultural Protest, and One Flew Over the Cuckoo’s Nest.” Literature and Medicine 37, no. 2 (2019): 298–324. https://doi.org/10.1353/lm.2019.0014.
This article covers a form of popular media but flips it in a way to reflect upon current America’s treatment of those with mental illness. It really works to show how patients are often ignored by society. For my paper this shows some of the more general preconceived notions that American society held.