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Introduction
The rise of asylums in the United States started with early optimism and benevolent intent reflected in theory of moral treatment. However, the reality of overcrowding and the ineffectiveness of treatment quickly set in. Eugenics and draconian restraints followed.
Photo: Wikimedia Commons -
First Admitted Patients and Public Mental Hospital in U.S.
The Pennsylvania Hospital was established in Philadelphia in 1751 and part of the facility was used to admit mentally ill patients beginning in 1752. Eastern State Hospital was later founded in Virginia in 1768 under the name of the "Public Hospital for Persons of Insane and Disordered Minds,” becoming the first public mental institution in the United States.
Photo: http://www.benjamin-franklin-history.org/pennsylvania-hospital/ -
First Private Mental Hospital (Friends Hospital)
The Philadelphia Quakers constructed the first private psychiatric hospital in the United States, the Friends Asylum for the Relief of Persons Deprived of the Use of Their Reason, in 1813. They established a moral treatment methodology for the insane, using compassion, conversation, and occupation. This set a new standard for psychiatric care in the United States. Photo: https://www.loc.gov/item/2021670213/ -
Dorothea Dix
Dorothea Dix was an American activist who dedicated her life to improving conditions for the mentally ill. She advocated for the establishment of state-funded mental institutions and helped create dozens of them throughout the United States. Dix's work had a significant impact on the treatment of the mentally ill and helped reform the mental health community in a positive way. Photo: Encyclopaedia Britannica/UIG Vi -
Fernald State School Opens
The Fernald School was the Western hemisphere's oldest publicly funded institution for "feeble-minded" children in Massachusetts. Administrators at the school were early proponents of eugenics as their goal was to remove feeble-minded children from society and prevent them from reproducing, often times without inmates’ knowledge. Photo: https://sites.rootsweb.com/~asylums/fernald/index.html -
The Kirkbride Plan
Thomas Kirkbride designed over 70 hospitals between 1845 to 1910. These hospitals emphasized exposure to natural light and ventilation, two qualities he believed contributed to healing and comfort among mentally ill patients. His psychiatric theories and unique architectural design became known as the Kirkbride Plan. In the lithograph provided, you can see the common "bat wing" architecture. Photo: 1848 lithograph of the Kirkbride design of the Trenton State Hospital -
Nellie Bly
Nellie Bly, a writer for New York World, claims lunacy and is admitted to the Women’s Lunatic Asylum where she documents her appalling experiences in an expose. Her work prompts a grand jury investigation and leads to widespread reforms in the field of mental health. Bly helped pave the way for future investigative journalists. Photo: (Library of Congress) -
Sterilization Begins in Indiana
Indiana legalizes the sterilization of criminals and the mentally ill, inspiring 29 other states to do the same. Photo: Fort Wayne State School for Feeble Minded Youth
(IndianaCourts.com; available at http://www.in.gov/judiciary/citc/cle/eugenics/index.html) -
Indiana Sterilization Law Overruled
The Indiana Supreme Court ruled that the 1907 Indiana sterilization law was unconstitutional because it denied due process of the law granted by the Fourteenth Amendment. Reference: Williams et al. v. Smith, No. 23, 709, Supreme Court of Indiana, 190 Ind. 526; 131 N.E. 2; 1921 Ind. (B050826). Photo: https://www.pbs.org/independentlens/blog/unwanted-sterilization-and-eugenics-programs-in-the-united-states/ -
Indiana Sterilization Reinstated
By 1927, sterilization was reinstated by Indiana law. Approximately 2,500 people in state custody were sterilized at the time. A steep drop off in procedures occurred in the 1940s after horrific Nazi eugenics revelations. The law lasted nearly 50 years until Governor Otis R. Bowen approved the repeal of all sterilization legislation in 1974. Photo: https://eugenics.iupui.edu/events_Other.htm -
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New "Treatments" Arrive for Mental Illnesses
In 1936 the first prefrontal lobotomy was performed. In 1938, electroshock therapy was introduced by Italian neurologist Ugo Cerletti and became the primary treatment for schizophrenia and other mental illnesses. In the 1940s, chemical research began with medications such as lithium. Overall, the timeline represents the nascent orchestration of a modernizing approach to mental health and illustrates the importance of examining our practices in the modern day within such a perpetual industry. -