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.