Category Archives: Insane Asylums

Insanity and Stereotypes

Patient With Acute Melancholia

Patient With Acute Melancholia

I believe that one reason insane asylums became popular–initially–is that they broke down traditional stereotypes about what it meant to be insane. For years, people viewed insanity as both incurable and hereditary. As views changed in the 1830s, hope became possible for families dealing with insanity. Alienists believed the condition could be cured, especially if it were nipped in the bud during what they called the acute phase. Asylums were looked upon as “hospitals for the mind” and alienists held out the possibility of curingĀ  diseases of the mind just as they did for diseases of the body.

At the same time, alienists began moving away from the idea that insanity was heredity. This belief shows itself in the many Victorian-era novels where heroes/heroines refuse to marry because of the “tainted blood” they might pass on. Alienists began to think that at most, heredity only gave a predisposition toward insanity, just as it might give a child a predisposition toward certain physical conditions. But, just as “weak lungs” might be prevented through fresh air and exercise, a predisposition toward melancholia, for example, might be thwarted by brisk mental activity, interesting hobbies, social involvement, and so on.

This new thinking was so encouraging for families who had a member with mental health issues!

What Next?

Trans-Allegheny Lunatic Asylum

Trans-Allegheny Lunatic Asylum

Writers need to keep busy with writing projects, even though there’s a lot out there to distract us. I’ve been wanting to write a book about insane asylums in general for a long time, and after Vanished In Hiawatha was published, got busy with an outline and some thoughts on how to present the information.

Next came a round of reading and researching, and then the re-immersion into the writing process. It can be a real chore to write again once you take a break from it, but I find that I always enjoy it once I make myself sit down and get started. I finished a couple of chapters and wrote a proposal, hoping to send it out with a quick turnaround–approved, of course!

That hasn’t happened yet, so I am staying busy with an e-book on insane asylums. This will be quite different from the history that I have in mind for a hardback, but it will still give readers a lot of interesting information. I’ve been writing a blog about the Canton Asylum for Insane Indians for several years, and I’ve included many snippets of information about insane asylums in general, their history, and some of the practices and routines followed by many alienists (early psychiatrists). I hope that many readers will gamble on exploring a new topic or diving more deeply into one they’re already interested in with this e-book, since this format is so inexpensive.

Here’s hoping!

The Incurable Insane

Chapin House at Willard Asylum for the Chronically Insane

Chapin House at Willard Asylum for the Chronically Insane

Alienists believed that early intervention in recent cases of insanity led to high cure rates–at least 40% and perhaps higher. However, patients who did not receive treatment until their cases were advanced or of long standing, were much less likely to recover. (See last post.) These latter were exactly the kind of patients that most families eventually wanted to turn over to asylums, and superintendents were eventually faced with the dilemma of how to use their limited resources most effectively.

Some of those who were interested in this growing problem suggested that special asylums just for the incurably insane be built. Caretaking for such individuals would be cheaper than including them in an establishment that were designed for more acute cases, and wouldn’t drain the staff manpower away from patients who stood a better chance of being cured. Though asylum superintendents didn’t like to spend their resources on the incurably insane, some of them were quite vocal about not building asylums just for these patients.

An article in the American Journal of Insanity (1844) made one superintendent’s position very plain:

— No one can predict which patients might be cured; of the people in that particular asylum, fully one-third couldn’t really be placed into one category or the other.

— Many incurables were simply “monomaniacs” (deranged only on one or two subjects) and sane on all others. Why should they be denied the comforts and amenities given to those who are hopeful of being cured?

— It would be impossible to make sure incurables weren’t abused or neglected. The author of the article said in particular: “In all Asylums, the fact that some are well and soon to leave the Asylum is the greatest safeguard against abuse.”

— If asylums for incurables didn’t have proper staffs of doctors and other appropriate caretakers, how would they be any better than poorhouses?

Others pointed out that to send someone to an asylum for incurables would destroy the individual’s last shred of hope and might well cause him or her to never be cured.

Cures and Controversy

Insane Asylums Could Be Beautiful, Architecturally

Insane Asylums Could Be Beautiful, Architecturally

Though it took years to make asylum care acceptable to the mainstream public, ordinary citizens did eventually begin to believe in the professionalism and experience provided by these institutions. After that, they began using asylums in increasing numbers. Asylums definitely relieved family members from the anxiety of caring for mentally ill loved ones, and took the drudgery and constant attendance that some patients required off family caretakers’ shoulders. Eventually insane asylums became popular enough to become overcrowded, and the question of how to manage “incurable” patients arose.

Many alienists believed that if they could intervene in a case of insanity soon after it manifested (an acute case), they stood a good chance of curing it. However, when families kept mentally ill members at home until they ran out of time, money, or the physical ability to continue providing care, the situation was less hopeful. These long-standing cases, alienists feared, were incurable.

What should be done with such patients? Superintendents hated to divert money and time from their more acute (and therefore curable) patients to the chronically insane who were nearly impossible to cure. Yet, these long-term patients still needed care. The idea of special asylums for “incurables” soon came up for consideration. My next post will discuss the position that many in the profession took toward asylums for the incurably insane.

Considered With Care

County Asylum for the Insane, Appleton, Wisconsin

County Asylum for the Insane, Appleton, Wisconsin

When asylums first became accepted in the U.S., all aspects of their construction came under review. Experts looked for designs that gave good ventilation, access to sunlight, and provided safety. They also considered the asylum’s location very important. Alienists–men trained in mental health care–were convinced that city living contributed to the rise of insanity in the population. They believed that siting an asylum in the calm, restful countryside would help patients get well. It was important, then, that windows in bedrooms or sitting rooms look out on lovely, peaceful views.

Though it’s true that some patients came to asylums simply because it was convenient for their families, many other patients truly needed help of some kind. For women who were distraught or overwhelmed with the care of eight to ten children and all the physical work that fell to housewives in that day, a stay in a country setting might be very beneficial. Patients who were mildly depressed (melancholy) were often helped by a change of scenery and some of the light occupation an asylum offered. Others who had become stressed to the point of mental breakdown by the cares of business or family could get away from the source of their turmoil.

Asylum superintendents came to feel strongly that proper architecture and a small patient population would allow doctors to provide the kind of individual care that would help patients most. Sadly, asylums just got bigger and bigger, and the personal touch began to fade. Asylums turned into warehouses rather than “hospitals for the mind.”

No End to the Sentence

elizabeth-packard-being-taken-to-an-asylum-against-her-will-courtesy-national-library-of-medicine

Elizabeth Packard Being Taken to an Asylum Against Her Will, courtesy National Library of Medicine

After researching insane asylums for many years, I’ve come to the conclusion that they have been–and still are–a necessary evil. I went into this topic simply fascinated by the history of asylums and how they came to be. (This is also the subject of the book I’m currently writing.) I could see how humane they were in comparison to what had come before. Patients who had previously been locked in unheated outhouses, basements, or thrown into jail–often without adequate food or clothing–could now rest in rooms that were warm and clean. Prior to the 1830s, life was dismal indeed for anyone considered insane.

But the reality of life in an asylum is terrible to consider. Imagine going for a carriage ride with a spouse or friends to take tea with a new acquaintance, only to find that you have arrived at an insane asylum and are going to be kept there. Or, imagine appearing before a judge to explain or justify some sort of irrational behavior (and who hasn’t acted irrationally at some point?) only to be judged insane and “sentenced” to an insane asylum. The scariest part of either scenario was the open-endedness of the sentence. If that same person had committed a crime, he or she would spend a definite amount of time in jail and then get out. Not so with the insane patient . . . his or her fate depended upon the discretion/personality/judgment of the asylum’s superintendent!

Birth of a Book

Front-View-of-Canton-Asylum-courtesy-National-Institutes-of-Health

The Front View of the Canton Asylum for Insane Indians, Canton, South Dakota, U.S.

A new book is exciting, even after you’ve read your manuscript a hundred times, proofed it over and over, and scrutinized it for errors and typos until you feel you could recite entire chapters in your sleep! Vanished in Hiawatha: The Story of the Canton Asylum for Insane Indians was published June 1, 2016, after literally years of research and writing.

In 2008 I was in writing limbo–I had finished a short biography for teens and wasn’t sure about my next topic. I knew I wanted to write historical material, but what? I began toying with the idea of a young adult novel that involved insane asylums . . . perhaps the main character’s father had been sent to one so his evil relatives could gain control of his fortune . . . perhaps the main character would be sent to one . . . the possibilities were intriguing. For some reason, I had associated insane asylums with England, but my beginning research showed that they had also been well-represented in the United States. Just as I began to get excited about fictional situations, I ran across a reference to the Canton Asylum for Insane Indians.

What!? An asylum just for Indians? Could this be real? I almost thought it wasn’t, until I dug around enough to understand that this institution had really existed. After that, I couldn’t get the place out of my mind and I began to put out feelers for additional information. Soon, I was digging deeper and starting to shape a book that would keep me interested and amazed for the next eight years.