Public and Private Asylums
After seeing the success of the York Retreat, public and private asylums began to pop up across the United States with Philadelphia Quakers leading the way by opening their own asylum in 1817. By 1841 there were 16 private and public asylums with the first public asylum in Worcester, MA opening in 1833 (Whitaker, 2009). Asylums were not only growing and devloping in the U.S. but were also being established in other countries, mostly as charitable institutions. Broadmoor Asylum was opened in England in 1863 but soon became overcrowded (Parry-Jones, 1987).
There were strict rules created for the development of asylums:
Location: in the country
- Small facility, could not have more than 250 patients
- There must be flowerbeds and gardens outside to provide patients with fresh air
- Architecturally pleasing building, both inside and out
- A kind, loving superintendent
- Tasks for patients to complete, such as: education, gardening, reading, sewing, games.
30-80% of all admitted patients discharged within a year for these asylums were seen as “cured” (Whitaker, 2009); it was of the opinion of many superintendents of the asylums that the majority of the insane population could be cured if they were institutionalized as soon as possible after developing their mental illness (Grob, 1991).
Re-admittance and Success Rates in America
Psychiatrists believed that patients who were re-admitted to asylums were not re-admitted for the a continuation of the same illness, but for a new illness that they were inflicted with. It was widely believed that because people could have many respiratory illnesses then the same could be true for mental illnesses: it is the same illness, but in a slightly different form than the last time. Thus, they could still include episodic treatments as successful, even if the person was re-admitted at a later date (Grob, 1991).
Many asylums had high success rates in terms of treating their patients and ridding them of the mental illnesses. The Worcester State Hospital in Massachusetts reported in 1842, after a decade of operation, that 46.4% of it’s patients were undergoing treatment for less than a year, and only 13.2% had been undergoing treatment for 5 or more years. The same rates could be found at other asylums across the United States, most notably Virginia Western Lunatic Asylum had 41.4% of patients hospitalized for less than a year and 29.6% hospitalized for 5 or more years, and the California Insane Asylum had 40.2% of patients hospitalized for less than a year, and .1% had been hospitalized for 5 or more years (Grob, 1991).
1808 Lunatics Act
The Lunatics Act gave counties permission to set up asylums and collect rates for them. In 1845, the provision became mandatory (Dickinson, 1990).
Dickinson, E. (1990). From madness to mental health: A brief history of psychiatric treatments in the UK from 1800 to the present. The British Journal of Occupational Therapy, 53, 419-424.
Grob, G. N. (1991). The chronic mentally ill in America: The historical context. In V. Fransen (Ed.) Mental health services in the United States and England: Struggling for Change, (pp. 3-17). Princeton, N.J., US: Robert Wood Johnson Foundation.
Parry-Jones, W. L. (1987). Asylum for the mentally ill in historical perspective. Bulletin of the Royal College of Psychiatrists, 12, 407-410.
Whitaker, R. (2009). Deinstitutionalization and neuroleptics. In Y. O. Alanen, G. dC. Manuel, A. S. Silver, & B. Martindale (Eds.) Psychotherapeutic Approaches to Schizophrenia Psychoses: Past, Present, and Future, (pp. 346-356). New York, NY, US: Routledge/Taylor and Francis Group.
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