Tag Archives: moral treatment

Asylums Indeed

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A History of Rhode Island

A History of Rhode Island

Though insane asylums faced abuse charges after they became overcrowded, they were sanctuaries of peace measured against the care many insane patients had received in city-provided institutions. Cases written about in the book, State of Rhode Island and Providence Plantations at the End of the Century: A History (edited by Edward Field) is probably typical of treatment during the middle-1700s:

Rebecca Gibbs had been under the care of “the Towne of Newport” for 30 years and, “She seemed to be in a sense folded together, her lower limbs being drawn up to her breast so that her knees and her chin met and from this position there was never a change.” A physical deformity would have been bad enough, but Rebecca’s condition was caused by “her having been for several winters shut up in a cell without fire and without clothes, where she had drawn herself as compactly as possible together as a protection against the cold and had so continued till sinew and muscle were unable to relax.”

Thomas R. Hazard Wrote a Ground-Breaking Report on the Treatment of Rhode Island's Insane in 1851, courtsy Rhode Island Historical Society Library

Thomas R. Hazard Wrote a Ground-Breaking Report on the Treatment of Rhode Island’s Insane in 1851, courtesy Rhode Island Historical Society Library

In a different town, a man was chained and “so wrapped in bagging that when an apple was placed within his reach he could only gnaw it like an animal as it rolled about the floor and he rolled after it.”

Though some towns did treat the insane more kindly, that may have been the exception rather than the rule. Until the new idea of “moral treatment” based on kindness and retraining made its way to America in the 1830s, the insane could not expect comfort or help from society.

Rhode Island State Hospital for the Insane, Stone Hall, courtesy Rhode Island Department of State

Rhode Island State Hospital for the Insane, Stone Hall, courtesy Rhode Island Department of State

 

 

 

New Era, New Ideas

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Patient in Bethlem Royal Hospital, aka Bedlam, Before Moral Treatment

Patient at Bethlem Royal Hospital, aka Bedlam, in a Time Before Moral Treatment

Societies have always recognized mental illness–however they might define it–and early treatments for insanity were usually swift and somewhat brutal. As time went on most governing bodies realized that insane persons were not responsible for their actions; however, they found it difficult to do anything more than house patients somewhere until they either got better or died. These mentally ill people generally lived in harsh conditions at the mercy of their “keepers.” Even after so-called treatments for insanity became available, they remained largely unpleasant: bleeding, whipping, spinning, chaining, isolating from others, etc.

Male Ward at Athens Lunatic Asylum, courtesy Ohio University Libraries, University Archives

Male Ward at Athens Lunatic Asylum, courtesy Ohio University Libraries, University Archives

In the early 1800s, reformers such as Dr.  Philippe Pinel began to view the insane as people who had lost their reason because of exposure to severe stress or shocks. Victorians had terms like brain fever and shattered nerves to describe this kind of condition. Patients were seen as needing protection from society for a time so they could recover, and many alienists began using fewer restraints and stressful physical treatments. They believed that patients could be helped by moral treatments. These included friendly discussions of the patients’ problems, chores or occupations to discipline their time, and guidance for their interactions with others.

Glore Patients Out For a Stroll, 1902, courtesy Glore Psychiatric Museum

Glore Patients Out For a Stroll, 1902, courtesy Glore Psychiatric Museum

When the public began to see insane people recover, they finally discovered hope for their own loved ones. Asylums became less feared, and even the most reluctant families found them a blessing if a loved one had become violent or too difficult to treat at home. Unfortunately, the public’s embrace of asylums and their modern treatments caused overcrowding. In turn, this led to asylum under-staffing and a deterioration in the staff’s ability to give moral treatment. Soon, patients were merely being “kept” again.