13th Century: The Establishment Of Mental Institutions

Although the 19th century expansion of asylums in Europe and The United States was a movement initially based on moral principles, it led to significant negative implications for individuals, who were institutionalized as asylums became overcrowded, lacking hygiene, neglectful of patients and an overall place for poor living conditions (Wright, 1997). The rise in in-patient population in the early 19th century and patients’ inabilities to reintegrate into the community as a result of institutionalization have often been explained in terms of the mental health system and developments in psychology at the time. Sociologists on the other hand, have argued that these institutions have caused people to remain institutionalized. A compelling

In this article, the incarceration of the mentally ill is encouraged because it is safer than keeping them in mental institutions. It claims that mental institutions are extremely dangerous by their very nature and the nurses there are trained to treat the mentally ill, not to keep them from hurting themselves or other people. In prisons however, the

The article states that forty years before it written psychiatric hospitals were closed due to patients being kept too long and often without a good cause. There

The period of Enlightenment changed how scientists, philosophers, and society looked at the world. Psychiatry faced this new enlightened look, and moral treatment came out of it. According to Dr. James W Trent of Gordon College, before moral treatment people with psychiatric conditions were referred to as insane, and treated inhumanly (Link 1). Philippe Pinel of France at Bicetre hospital in Paris, advocated for moral treatment of the mentally ill (Link 1). In place of physical abuse, Pinel called for kindness and patience, which included recreation, walks, and pleasant conversation (Link 1). Pinel made this change out of reading, observation and reflection; rather then, a result of accident or experiment (Link 2).

Before the 1400s psychological issues, mental health problems, were viewed as a connection with the devil. The public viewed people with health problems as being possessed by a demon (Dualdiagnosis). Mental health wasn’t known in this time period, so people acting strange from the general public stood out. These people were treated in a few different ways: exorcism, murder, imprisonment, and trephining skulls; trephined skull is when a small hole is made in the skull to release spirits. (Lumen Learning). Everyone of these ways are very horrendous, but still very true to how mental ill people were treated. As a result, all of the treatments involved the mentally ill person dying or suffering. Mental ill people wasn’t understood at all in this

brain, or sending patients to institutions, doctor prescribed pills to try and treat mental conditions. In addition mental health patients were no longer being institutionalized due to the poor conditions in mental institutions (History of Mental Illness”)

Historians have traced mental health care back to as early as the 1500’s. At this time, families with mentally ill members kept them at home. They were treated as unwanted, out-of-place prisoners.

For the first time in America, mental health was finally being recognized in Pennsylvania where a section of a hospital was set aside for those who were mentally ill in 1752. It was not until 1773, thirteen years later, that a whole hospital was created and dedicated to treating mental health patients. Thus, creating the first insane asylum/madhouse. This hospital was called the, “Public Hospital for Persons of Insane and Disordered Minds,” in Williamsburg, Virginia. While the intentions of this hospital meant well, the stigma of mental health in the late 1770’s and 1800’s were that atypical behavior was a choice not an illness, resulting in the exile of those with mental health issues from society.

Evaluation and treatment of the mentally ill population has developed from confinement of the mad during colonial times, into the biomedical balancing of neurological impairment seen in these modern times. There were eras of mental health reform, medicalization, and deinstitutionalization sandwiched in between (Nies & McEwen, 2011). Regardless of the stage of understanding and development, communities have not been completely successful in dealing with and treating persons who are mentally unwell. Fortunately, treatment has become more compassionate; social and professional attitudes have morphed into more humanistic and

During the 1800s, treating individuals with psychological issues was a problematic and disturbing issue. Society didn’t understand mental illness very well, so the mentally ill individuals were sent to asylums primarily to get them off the streets. Patients in asylums were usually subjected to conditions that today we would consider horrific and inhumane due to the lack of knowledge on mental illnesses.

Institutional care was condemned, as in many cases patients’ mental conditions deteriorated, and institutions were not able to treat the individual in a holistic manner. In many state institutions, patients numerously outnumbered the poorly trained staff. Many patients were boarded in these facilities for extensive periods of time without receiving any services. By 1963, the average stay for an individual with a diagnosis of schizophrenia was eleven years. As the media and newspapers publicized the inhumane conditions that existed in many psychiatric hospitals, awareness grew and there was much public pressure to create improved treatment options (Young Minds Advocacy, 2016). .

What comes to mind when you hear the words “insane asylum”? Do such terms as lunatic, crazy, scary, or even haunted come to mind? More than likely these are the terminology that most of us would use to describe our perception of insane asylums. However, those in history that had a heart’s desire to treat the mentally ill compassionately and humanely had a different viewpoint. Insane asylums were known for their horrendous treatment of the mentally ill, but the ultimate purpose in the reformation of insane asylums in the nineteenth century was to improve the treatment for the mentally ill by providing a humane and caring environment for them to reside.

The mentally ill would have to attend church on a regular basis, as to even checking them into a general hospital so they would be left abandoned there. There began the establishment of Asylums, catholic nuns would run it and would care for the mentally ill. A lot of people believed that being “mad” was incurable and were put away in solitary confinement and would get harsh punishments if they didn’t comply with the rules. For a long time, asylums were not facilities to help the mentally ill, but instead it was a reformed penal institution where the families could abandon the mentally ill and be taken away from society which they were views as threats, or at sometimes they could be sentenced by law. Most of the staff were unqualified to even take care of the mentally ill. A case study describes that in a mental hospital in Paris, that they were treated like animals and patients shackled into small, cramped cells. Iron cuffs and collars allowed for them to have little movement but enough to feed themselves yet not enough movement to lay down; so they were forced to sleep upright. Other than that, the rooms were never cleaned and no visitors were allowed. The only person these patients would see is the person that would go deliver their food. These people would have no physical contact with anyone outside the

During the mid-1800’s the mentally ill were either homeless or locked in a cell under deplorable conditions. Introduction of asylums was a way to get the mentally ill better care and better- living conditions. Over a period of years, the admissions grew, but staff to take care of their needs did not. Asylums became overcrowded and treatments that were thought to cure, were basically medieval and unethical

The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and