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LANDING OR HOME PAGE

Over the past 200 years in the United States, a tension has existed between care and custody as responses to mental health. Throughout this history, the actions of physicians, advocates, and government agencies have all shaped mental health policies.

In the 19th century, dozens of states constructed asylums in rural settings where people were treated with sedative drugs, hydrotherapy, and work regimens.

Families often committed their relatives to these institutions when their behaviors made them unable to work or carried a risk of violence, removing them from their homes and communities.

The growth of cities and wage labor made it harder for families, particularly ones from working‐class and immigrant backgrounds, to care for their family members who could not work. Overcrowding became a major issue and people housed in asylums often lived in cramped quarters, worked without pay, or experienced violence.

A series of asylum exposés after World War II led policymakers in the 1950s to question large‐scale institutional care. New developments in psychotherapy and drug treatments made it easier to deliver medical treatment in local settings. Advocates argued for a more inclusive society and challenged the practice of involuntary confinement. As a result, mental hospitals dramatically reduced their number of beds, a process called “deinstitutionalization.”

People who could not access adequate social services and medical care often became vulnerable to arrest in a new era of mass incarceration. Many people with mental health conditions increasingly went to jail for misdemeanors and drug offenses. State officials began to build psychiatric wards in prisons and jails and many states converted closing mental hospitals into prisons. New issues of custody re‐emerged in mental health.

Today, breaking the cycle of incarcerating people with mental health conditions involves multiple stakeholders. Police departments have conducted trainings to foster a better understanding of mental health conditions. Local governments have created mental health and drug courts to provide community‐based treatment, not confinement.

Many activists called for a voice and a choice in their recovery and worked to ensure self‐determination, peer supports, and access to holistic health approaches.

Other advocates called for access to medical treatments in the community and behind bars, and the reduction of incarceration rates overall.

QUOTE BOXES:

How has society moved away from custodial forms of treatment for people with mental health conditions?

How have people sought a more inclusive society?

(385 words)

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OB12784

OB12794

OB12810

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EXHIBITION COLLECTION

EXPLORE

Over the past 200 years, physicians, advocates, and government agencies have all shaped mental health policies. These stakeholders have often taken different approaches and a tension has existed between care and custody as responses to people with mental health conditions. As you explore this history, consider these different responses and the ways in which people have struggled to create a more inclusive society.

OB# Image Image Alt Tag Title Description Detail Transcript

Digital Record Link and/or MedlinePlus Link

OB12791

Portrait of a white woman.

Dorothea Dix, ca.

19th century

Courtesy National Library of Medicine

Dorothea Dix, a teacher and author, became a strong advocate for asylums. During the 19th century, Dix helped found over 30 asylums around the country to prevent people deemed insane from being jailed or placed in poorhouses.

Full Item:

https://collections.nlm.nih.gov/catalog/nlm:nlmui d‐101413738‐img

OB12788

Painting of a building. Design proposal of the Sheppard Asylum near Baltimore, MD by Calvert Vaux, 1860

Calvert Vaux, architect and landscape designer, drew this initial proposal for the Sheppard Asylum with large bay windows

C. VAUX. ARCHT Full Item:

https://collections.nlm.nih.gov/catalog/nlm:nlmui d‐101575485‐img for fresh air and sunlight. This “Kirkbride” plan was a popular design in the mid‐19th century.

The design aimed to cure people of their mental ailments through sunlight, privacy, and tranquility in a rural setting.

OB12787

Painting of a crowd, mostly standing, looking at a man breaking chains from the wrist of a seated figure on the ground.

Pinel Unchains the Insane, illustration by Robert A. Thom, This illustration shows French physician Phillipe Pinel observing while asylum superintendent Jean‐Baptiste Pussin removes chains from people at an asylum in Paris, 1795.

Pinel believed insanity was curable and rejected the use of physical restraints. Instead, he emphasized moral treatment which sought to heal people through self‐discipline and the rigid environment of the asylum.

Full Item:

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OB12790

Illustration of a woman being carried by two men onto a train to the left. On the right is a large crowd.

Illustration from Modern persecution;

or, Insane asylums unveiled, Elizabeth P.

W. Packard, 1873

In front of a crowd of onlookers, a sheriff forced Elizabeth Packard onto a train bound for an asylum in Jacksonville, Illinois. Packard’s husband had her committed because of her differing views on religion. After her release, Packard campaigned nationwide for the legal protection of people in asylums.

No. 1 No. 2

BEALE, DES. CHICAGO

CHAMBERLINE,

ENG.N.Y.

Kidnapping Mrs.

Packard “Is there no man in this crowd to protect this woman!” See page 59.

No. 1 – “And this is the protection you promised me Mother!

What is your gas worth to me!” See page 61.

No. 2 – “I will get my dear Mamma out of prison! My Mamma shan’t be locked up in a prison!” See page 62.

The full book will be digitized and added to Digital Collections.

[Full Item link here]

MedlinePlus:

https://medlineplus.gov/patientrights.html

OB12784

A woman sits in a rocking chair.

A patient at St.

Elizabeths Hospital, Washington, D.C., St. Elizabeths Hospital was a federally funded mental hospital. It reached its peak population of 7,529 people in 1955, one of the largest in the country.

In the 1950s, mental health advocacy and changes in psychiatry led groups like the American Psychiatric Association and the National Institute of Mental Health to call for alternatives to institutions like St. Elizabeths. They proposed outpatient clinics and community mental health centers.

OB12793

A man in distress in a hot bathtub.

Illustration from The Chicago Tribune, March 16th, 1896

Staff negligence at the Illinois State Hospital caused Julian Grabowski, who was paralytic, to die from scalding water in a bathtub.

As asylums grew, journalists and physicians exposed abuses that included violence, lack of clothing and food, and the use of physical restraints.

FATALLY SCALDED

MedlinePlus:

https://medlineplus.gov/patientsafety.html

Full Item:

https://collections.nlm.nih.gov/bookviewer?PID=n lm:nlmuid‐2933036RX32‐leaf#page/1/mode/1up

OB12794

Groups of African Americans sitting in at several tables

African American Ward at St.

Elizabeths Hospital, Washington D.C., ca.

Courtesy National Archives and Records Administration

Asylums regularly denied admissions to many African Americans or placed them in separate and inferior wards.

This is a dining hall at St.

Elizabeths Hospital in https://medlineplus.gov/healthdisparities.html

Washington, D.C. designated for African American residents.

OB12818

Men standing on a street holding signs.

Eugenics demonstration on Wall Street, photograph by Underwood & Underwood, 1915

Courtesy Wisconsin Historical Society

In this photo, men hired by a medical journal hold signs in 1915 fostering fears that mental health conditions were dangerous.

This public attitude reinforced beliefs at the time that asylums should protect society from people with mental health conditions.

I am a burden to myself and the state.

Should I be allowed to Propagate?

I must drink alcohol to sustain life Shall I transfer the craving to others?

Would the prisons and asylums be filled if my kind had no children?

I cannot read this

SIGN

By what right have I children?

OB12798

Several women standing in a room.

Psychopathic Ward, lithograph by Robert Riggs, 1945

This illustration shows women in a locked ward of the Philadelphia State Hospital in 1945. Investigations into this hospital led reformers to critique mental hospitals as prison‐like, with bars on the windows and little treatment.

Full Item:

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OB12797 Portrait of a white man.

Clifford Beers, ca.

20th century

Clifford Beers founded an advocacy organization that became Mental Health America.

In his 1907 book, A Mind That Found Itself, Beers described his experience as a patient at an asylum. He critiqued the physical abuse he experienced there, the institution’s untrained attendants, and the use of physical restraints and seclusion.

Full Item:

https://collections.nlm.nih.gov/catalog/nlm:nlmui d‐101435399‐img

OB12800

Several white men and one woman standing behind another man at a desk signing a paper.

Bill Signing – S. 1576, Mental Retardation Facilities and Community Mental Health Center Construction Act, photograph by Abbie Rowe, 1963

Courtesy John F. Kennedy Presidential Library and Museum

President John F. Kennedy signed legislation in 1963 that allocated funds for new community mental health centers.

https://medlineplus.gov/healthfacilities.html ?

OB12802

An African American man sitting on a bench outside.

George Elder in the Philadelphia Evening Bulletin, photograph by Nelson Martinez, Courtesy Special Collections Research Center, Temple University Libraries

In 1942, two doctors certified George Elder as insane and a judge committed him to the Philadelphia State Hospital.

Elder remained at the hospital until 1970, but when he moved into the community, he had few resources to support himself.

Stories like his caused policymakers to work to provide social services alongside mental health care.

OB12967

A white man at a podium giving a speech.

Bertram S. Brown, M.D. giving a speech to the National Association for Mental Health in Los Angeles, CA, 1970

Bertram Brown, the director of the National Institute of Mental Health (NIMH) from 1970 to 1977, was a key figure in the national effort to redefine and expand mental health services.

Brown’s work at NIMH addressed mental health conditions and substance abuse by means of community support services and mental health centers.

The National Association for Mental Health

Douglas Waterstreet Irving Chase Mr. Chapman Bertram Brown James E. O’Connell

National Association for Mental Health

OB12966

A page of text. Introductory remarks, Bertram S.

Brown, M.D., Director of National Institute of Mental Health (NIMH), 1977

In 1977, the NIMH held a press conference introducing the Community Support Program.

This initiative called for more social supports to help recovery in people’s home communities.

It became core to the National Plan for the Chronically Mentally Ill, which over time caused many states to work towards better integrating mental health and social services.

INTRODUCTORY

REMARKS

Bertram S. Brown, M.D.

Director, NIMH November 15, 1977

Community Support Program press conference DHEW Bldg., Washington, D.C.

Good afternoon. On behalf of my colleagues from the National Institute of Mental Health and the Department of HEW, I am pleased to welcome you to this press briefing. As you know, Secretary Califano could not be here because he is in Europe studying health financing systems in England and West Germany.

Our purpose today is to highlight the activities and goals of a new program, one that we view as a direct and much needed response to a nationwide problem that all of you are familiar with. The code‐word for the problem is “deinstitutionalization ,” and it is popularly understood to mean the plight of mental patients who have been discharged from hospitals, most often to fend for themselves. The response that we will be describing is the Community Support Program. CSP is a multi‐agency initiative; we are here because the NIMH is taking a lead role in its development.

I can assure you at the outset that the CSP does involve complex partnerships among Federal, State, and local government agencies and among numerous service programs in mental health and human or social services. Many of the details are spelled out in the kits that were made available to you; also, to the extent that your time permits, we plan to answer questions directly. As for format, I’d like to give a brief introductory statement, I’ll give my partners an opportunity to comment, and then we will open for questions.

OB12799

A Native American man escaping a building from a window.

Still from One Flew Over the Cuckoo’s Nest, directed by Miloš Forman, 1975

Courtesy The Saul Zaentz Company, © 1975, 2008

At the end of One Flew Over the Cuckoo’s Nest, the character Chief Bromden broke through the locked windows of the mental hospital and ran towards freedom.

This movie, adapted from Ken Kesey’s 1963 novel of the same name, prompted more people to think of mental hospitals as restrictive of people’s freedom.

This concept became central as the courts established new civil rights for people in mental hospitals, making it more difficult to confine people against their will.

OB12807

woman.

Judi Chamberlin, ca.

Courtesy Special Collections and University Archives, University of Massachusetts at Amherst

Judi Chamberlin was an activist who fought against the coercive treatment of people with psychiatric histories. Her experience of confinement at the Rockland State Hospital in New York led her to write On Our Own in 1978.

Her work inspired a new vision of self‐help and peer‐support services run by people with psychiatric histories.

FREE ALL PSYCHIATRIC

INMATES!

MedlinePlus:

https://medlineplus.gov/patientrights.html

OB12816

Two men injured lie on the ground while others surround them. One man standing in front holds a gun and looks on to the right.

Chaos outside the Washington Hilton Hotel after the assassination attempt on President Reagan, photograph by Michael Evans, Courtesy Ronald Reagan Presidential Library and Museum

Many were wounded on the ground outside the Washington Hilton Hotel after John Hinckley Jr. attempted to assassinate President Ronald Reagan in 1981.

The jury found Hinckley “not guilty by reason of insanity” and the court committed him to St.

Elizabeths Hospital in Washington, D.C. The case fueled legal changes that made it easier to incarcerate people with mental health conditions for crimes, rather than place them in mental hospitals.

OB12803

A man and woman stand speaking to one another outside a prison cell.

U.S. Public Health Service (PHS) physician and nurse at the entrance to a locked area at a prison facility, ca.

1970s

PHS staff provided medical care in federal prisons. As the number of people with mental health conditions in jails grew, medical personnel across the country increasingly provided psychiatric services behind bars.

Full Item:

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OB13374

Infographic with two female icons, small and large, and two male icons, small and large surrounded by text.

Statistics from On Life Support: Public Health in the Age of Mass Incarceration, Vera Institute of Justice, 2014

Courtesy Vera Institute of Justice

People with mental health conditions increasingly went to jail for misdemeanors and drug offenses. These trends worsened as lawmakers made cuts to the welfare system.

People with mental health conditions who struggled to access housing, employment, and medical services became

WOMEN DIAGNOSED

WITH SERIOUS

MENTAL HEALTH

CONDITIONS

31% IN JAIL

4.9% IN GENERAL

POPULATION

MEN DIAGNOSED

WITH SERIOUS

MENTAL HEALTH

CONDITIONS

14.5% IN JAIL

more vulnerable to the growing criminal legal system.

3.2% IN GENERAL

POPULATION

72% of people with a serious mental health illness in jail also have a substance abuse disorder.

OB12810

Two African American men lying in a room with the word “Recovery” on the wall.

A mental health division in the Cook County Jail in Chicago, IL, photograph by Lili Kobielski

Courtesy Lili Kobielski

At one time, the Cook County Jail held 9,000 people each day and about one‐third of them had a mental health condition.

RECOVERY

OB12804

Portrait of an African American man.

And then I got busted, poster featuring Mercury Morris, National Institute on Drug Abuse, ca. 1980s

Former professional football player Mercury Morris became a spokesman for substance abuse recovery. In 1982, he was sentenced to 20 years in prison for drug trafficking. The courts later overturned his sentence.

The War on Drugs brought harsh sentences for drug offenses like this one, which disproportionately affected African American communities.

These new laws further criminalized substance abuse, MERCURY MORRIS

AND THEN I GOT

BUSTED.

There was this guy, a nationally known sports hero. And then I got busted, As a result of my lust for cocaine, I bypassed high and went straight to messed up. I mean zoom—there was no stopping. Some of you know exactly what I’m talking about because you’re taking the exact same ride. A phone call could help

Full Item:

https://collections.nlm.nih.gov/catalog/nlm:nlmui d‐101444703‐img

MedlinePlus:

https://medlineplus.gov/druguseandaddiction.ht ml which often coincided with mental health diagnoses.

you. It took prison to help me.

COCAINE. THE BIG LIE.

CALL 1‐800‐662‐HELP.

A Public Service of the National Institute on Drug Abuse Department of Health and Human Services Ad Council

OB12808

Text surrounded by the tops of heads.

Postcard for World Mental Health Day,

ca. 1990s

Mental health advocacy organizations have fought against the discrimination of people with mental health conditions in housing, employment, and the criminal legal system.

ANGER FEAR

persecution stigma World Mental Health Day

POOR HOUSING

unemployment loneliness depression alienation misunderstanding

Full Item:

https://collections.nlm.nih.gov/catalog/nlm:nlmui d‐101459127‐img

MedlinePlus:

https://medlineplus.gov/mentaldisorders.html

OB12968

Two police officers looking at a person on the left whose hand sticks out from behind a wall.

Police officers with a Crisis Intervention Team in Memphis speaking with a person involved in a complaint, photograph by Stan Carroll, featured in The Commercial Appeal

Courtesy The Commercial Appeal/USA Today

Crisis Intervention Team members received training in de‐escalation techniques for mental health emergencies.

Police departments nationwide have implemented this model and agencies such as the National Institute of Mental Health have studied its effectiveness.

OB12969

A page of text from a book.

Principles of Community‐based Behavioral Health Services for Justice‐ Involved Individuals, Substance Abuse and Mental Health Services Administration

(SAMHSA)

Courtesy Substance Abuse and Mental Health Services Administration

SAMHSA published this report on ways that mental health providers could support people with mental health conditions involved in the criminal legal system.

The National Institute of Mental Health has also studied programs that support people’s re‐entry to the community after prison. This research has sought to break the cycle of imprisonment that many people with mental health conditions faced.

Principles of Community‐based Behavioral Health Services for Justice‐ involved Individuals: A Research‐based Guide A bridge to the possible

Department of Health & Human Services

USA

SAMHSA

Substance Abuse and Mental Health Services Administration

MedlinePlus Link:

https://medlineplus.gov/druguseandaddiction.ht ml

OB12821 A woman holding a hand‐made sign.

Unidentified protester at an American Psychiatric Association conference, photograph by Tom Olin

Courtesy © Tom Olin ‐ Tom Olin Collection

Activists have called for a voice and a choice in their recovery.

They have worked to protect the rights of people with mental health conditions.

Dysphoric It’s MY BODY It’s MY BRAIN It’s MY MIND It’s MY LIFE

DIGITAL GALLERY

Document

OB12826 Letter stitched in cloth by Anna B. Kuster Welty, 1877

Anna Welty stitched this letter in German asking for her release from the California Insane Asylum in Stockton. She had been hospitalized for mania for four years when she created this piece. Like many people, Anna Welty experienced asylums as restricting their liberty, particularly if they had been placed there involuntarily. She did not gain release and instead escaped in 1884 and drowned accidentally the day after leaving.

Courtesy National Library of Medicine

Sheet of cloth with hand‐stitched text.

https://collections.nlm.

nih.gov/catalog/nlm:nl muid‐2932238R‐bk

2 Graphic

OB12828 Architectural drawing of the Sheppard Asylum’s fourth floor, by British‐American landscape architect Calvert Vaux , ca. 1860

Often, servants and attendants lived on the grounds of asylums, as reflected in these servants’ quarters rooms. Room and board were part of the staff’s salaries. Superintendents often lived on the asylum grounds as well in their own separate houses.

Courtesy National Library of Medicine

An architectural drawing.

https://collections.nlm.

nih.gov/catalog/nlm:nl muid‐101583568‐img

OB12829 Bird’s‐eye view of the Willard Asylum for the Insane in Ovid, NY, 1888

In 1890, the Willard Asylum held over 2,000 people as patients, the largest institution in the country at the time.

Patients arrived by steamship at the dock and the campus was comprised of a number of detached buildings.

Many asylums like Willard resembled small towns due to their size.

Courtesy National Library of Medicine

Illustration of a landscape with buildings and streets from bird’s eye view.

https://collections.nlm.

nih.gov/catalog/nlm:nl muid‐101449066‐img

4 Graphic

OB12830 Earlswood Asylum, T. S.

Crowther, ca. 1800s

The Earlswood Asylum in Redhill, England was the first institution for people with intellectual and developmental disabilities in Britain.

Administrators often imposed strict work regimes on individuals there in the belief that it would make them into productive citizens in society and would benefit the asylum.

Courtesy National Library of Medicine

Comic‐style illustration of rooms and buildings with people in an asylum.

https://collections.nlm.

muid‐101395921‐img

5 Graphic

OB12831 The New York State Inebriate Asylum, Harper’s Weekly, 1869

The New York State Inebriate Asylum in Binghamton was the first hospital to treat alcoholism as a disease. It reflected the belief at the time that removing people from their communities and placing them in asylums could fix a host of social disorders in the 19th century. Due to graft and mismanagement, the inebriate hospital closed and later became the Binghamton Asylum for the Chronic Insane.

Comic‐style illustration of rooms and buildings with people in an asylum.

https://collections.nlm.

muid‐101435836‐img

6 Graphic

OB12832 Side view of an asylum van, ca.

This van was used by a New Jersey town to convey people to and from the asylum. The bars on the windows prevented passengers from leaving the van without permission and reflected the widespread use of security measures to keep people from leaving asylums without permission. Escapes were still a common occurrence, however.

Courtesy National Library of Medicine

Illustration of a carriage.

https://collections.nlm.

muid‐101406628‐img

7 Graphic

OB12833 Bird’s‐eye view of the State Asylum for the Insane, Morristown, NJ, ca. 1850

This illustration shows a popular asylum design named the Kirkbride Plan, which centered the administrative functions of the hospital in the central core of the building. Patients were then housed in the wings that emanated from the core and were divided by gender and the type of mental health condition.

Courtesy National Library of Medicine

Illustration of a landscape with a large building from bird’s eye view.

https://collections.nlm.

muid‐101403962‐img

8 Graphic

OB12834 Boys using shower at New York Juvenile Asylum, Dietetic Gazette, May 1891

The physician Simon Baruch created one of the first institutional shower baths in the New York Juvenile Asylum as a public health measure.

The Asylum was founded in 1851 and took in children who committed petty crimes or who came from impoverished or abusive families. The asylum sought to reform these children through moral, religious, and vocational training.

Courtesy National Library of Medicine

Illustration of a figure looking at a group of young children washing under large showers.

https://collections.nlm.

nih.gov/catalog/nlm:nl muid‐101435514‐img

OB12836 Patient ball at the Insane Asylum on Blackwell’s Island, illustration by W.H. Davenport, NY, Harper’s Weekly, 1865

Often, officials at asylums worked to rehabilitate people with social and recreational activities such as sports, concerts, theater, and dances.

Courtesy National Library of Medicine

An illustration of people dancing https://collections.nlm.

muid‐101435140‐img

10 Document

OB12825 Letter from Mrs. A. Schmitt to the Asylum Investigating Committee of the Citizen’s Association of Chicago, November 13, 1884

In this letter, Mrs. Schmitt, the wife of an engineer at the asylum, writes how the superintendent Dr. J. C. Spray threatened her family with a pistol.

She wrote the letter to an investigating committee, which in 1884 looked into charges of neglect and political corruption at the Insane Asylum of Cook County, Illinois.

Courtesy National Library of Medicine

A handwritten letter. https://collections.nlm.

nih.gov/bookviewer?PI D=nlm:nlmuid‐

2933036RX3‐

leaf#page/6/mode/1up

OB12838 Letter from Robert Bruce, Manager of the Detective Police Agency, to Dr. Shobal Clevenger, March 7, 1887

Dr. Shobal Clevenger investigated conditions at the Cook County Asylum, after working there in the 1880s. A man tried to assault him as an intimidation tactic. This letter reported the findings of a detective that Clevenger hired to investigate the matter.

A handwritten letter. https://collections.nlm.

nih.gov/bookviewer?PI

D=nlm:nlmuid‐

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leaf#page/5/mode/1up

12 Document

OB12839 Letter from Hana Pickard to the Asylum Investigating Committee of the Citizen’s Association of Chicago, November 14, 1884

In this letter, an employee at the Cook County Asylum outlines the abuses she experienced while working there in the 1880s. She describes how the superintendent had “a bad temper” and “that his threat to shoot and whip others were common.” She ended the letter with hope that conditions would change.

D=nlm:nlmuid‐ leaf#page/4/mode/1up

13 Document OB12840 Letter from Otto L. Schmidt, M.D., to the Asylum Investigating Committee of the Citizen’s Association of Chicago, November 14, 1884

In 1884, the Insane Asylum of Cook County, Illinois came under investigation for neglect and political corruption. In this letter, Otto L.

Schmidt, a prominent physician, stated that “politics was the principle interest of the place and that medicine and the care of the patients were decidedly subordinate.” He revealed this information with the hope that the the investigation would spark change.

D=nlm:nlmuid‐ leaf#page/1/mode/1up

14 Document

OB12842 “Asylum Deaths: List of Unnatural Endings of Patients Sent by the Coroner to Gov.

Lowden to Aid Inquiry,” The Chicago Daily Tribune, December 4, 1918

In 1918 the coroner sent a list of unnatural deaths at the Chicago State Hospital for the Insane to the Governor asking him to investigate.

“Hundreds of relatives and friends of inmates are making inquiry concerning the place.” This list documents people dying from suicide, escape attempts, and violence.

A newspaper clipping. https://collections.nlm.

D=nlm:nlmuid‐

2933036RX29‐

leaf#page/1/mode/1up

15 Graphic

OB12847 Shobal Vail Clevenger, 1892 The psychiatrist Dr. Shobal Clevenger fought neglect and corruption at public asylums in Illinois. His advocacy led to criminal convictions and some reforms. He faced death threats because of this investigation and eventually left the asylum field altogether.

man.

https://collections.nlm.

nih.gov/bookviewer?PI D=nlm:nlmuid‐

2933036RX40‐

leaf#page/3/mode/1up

16 Book

OB13337 The Insane in Foreign Countries, William Pryor Letchworth, 1889

Social reformers in the United States studied the practices of asylums in Europe and brought their ideas back to America. William Letchworth’s book The Insane in Foreign Countries became a reference text that documented the treatment of people diagnosed with mental health conditions in Europe in the 19th century.

Page of text. https://collections.nlm.

muid‐66520040R‐bk

17 Document

OB12990 Report of the Chairman of the Board of Directors for the Asylum for the Colored Insane, J.W. Vick, ca. 1881

In 1880, North Carolina opened an asylum for African Americans only.

This report documents how the institution was built in a rural area of the state. The result was that people housed at the asylum often lived far from their homes in this remote setting.

nih.gov/ext/dw/10160

1131/PDF/101601131.

pdf

18 Document

OB12850 U.S. Asylum for Insane Indians Annual Report and Census, In 1898, Congress created the first asylum for Native Americans. Over the next three decades, people from reservations across North America were removed from their families and homes and placed in the Canton Asylum in South Dakota.

Descendants today gather each year to honor their ancestors and the traumas they experienced at the asylum.

Courtesy National Library of Medicine

Page of text. https://collections.nlm.

nih.gov/catalog/nlm:nl muid‐2934010R‐ root?leaf=2934010RX1

19 Graphic

OB12855 “Senate Scene in Springfield, Illinois” from Modern Persecution; or, Insane Asylums Unveiled, Elizabeth P.W.

Packard, 1873, reprinted 1973

Elizabeth Packard, an author who herself had been wrongfully committed, lobbied the Illinois legislature about the rights of patients in asylums. As a result, the state passed a law requiring that people have a public hearing before being committed to a hospital.

Packard campaigned nationwide for that reform and for the legal protection of people in asylums.

Courtesy National Library of Medicine

Illustration of a seated crown at tables surrounding a stage where one standing figure holds up slips of paper and another sits behind at a table.

20 Graphic

OB12856 “Dr. McFarland punishing One‐ Armed Wyant” from Elizabeth P.W. Packard, Modern Persecution; or, Insane Asylums Unveiled, 1873, reprinted 1973

Mr. Wyant was a patient at an asylum when he struck an attendant. As punishment, the administration forced him into a shower bath. Shower baths were considered a therapeutic measure for mania and melancholia, but people also experienced them as punishments.

Courtesy National Library of Medicine

Illustration of a man and other figure standing looking on as two boys hold down another inside a shower.

21 Book

OB12991 Memorial to the Legislature of Massachusetts, Dorothea L.

Dix, 1843

Author and social reformer Dorothea Dix protested against the confinement of people with mental health conditions in prisons and almshouses in this address to the Massachusetts State Legislature. She took her campaign nationwide and worked to expose the widespread use of confinement in response to insanity.

She took her findings to state legislatures across the country, using them as evidence to justify the creation of asylums.

Courtesy National Library of Medicine

Page of text. https://collections.nlm.

muid‐7703963‐bk

22 Book

OB12992

The True Cause of Insanity Explained, or, The Terrible Experiences of an Insane, Related by Himself: The Life of a Patient in an Insane Asylum, Francis Delilez, 1888

Francis Delilez wrote this account in which he described his experience of insanity, which he said caused him to murder his brother. The police arrested Delilez and took him the Northern Wisconsin Hospital in Winnebago. This book describes the conditions at this institution in the 19th muid‐0006504‐bk

23 Book

OB12993

Two Years and Three Months in the New York Lunatic Asylum at Utica: Together with the Outlines of Twenty Year’s Peregrinations in Syracuse, Phebe B. Davis, 1855

Phebe Davis was hospitalized at the New York Lunatic Asylum from 1850 to 1853. After she left, she wrote critically about her experience and stated that her confinement in the asylum stemmed from stepping outside the bounds of socially acceptable behavior. This theme appeared in a number of writings by women housed in asylums in the 19th

Cover of a book. https://collections.nlm.

muid‐101173345‐bk

24 Book

OB12994

Am I a lunatic?, or, Dr. Henry T.

Helmbold's exposure of his personal experience in the lunatic asylums of Europe and America, Henry T. Hembold, Henry Hembold was a successful retail druggist who was confined to asylums in the United States and France during the 1870s. In this book, he described the different treatments he received while a patient at various institutions, offering an interesting transnational perspective.

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25 Book

OB12995 Report Relative to an Asylum for Lunatics, New Jersey Legislature Joint Committee on Asylum for Lunatics, 1841

In the 19th century, many social reformers found that people deemed insane were in jails and poorhouses, or faced homelessness. In this report, legislators in New Jersey called for the creation of an asylum. In 1848, the state opened the New Jersey State Hospital, its first public asylum.

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26 Book OB13338 How to Care for the Insane: A Manual for Attendants in Insane Asylums, William D.

Granger, M.D., 1886

Dr. Granger, a physician at the Buffalo State Asylum wrote this manual in order to train people for work as attendants in asylums. In it, he outlines the various types of nervous functions and types of insanity.

Granger also trained the staff in how to respond to people in asylums, with kindness, observation, and strict discipline, and the different forms of treatment such as sedatives and hydrotherapy.

Cover of a book. https://collections.nlm.

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27 Image

OB13339 Asylum inmates, 54 Photographs of Inmates at an Imbecile Asylum, Joseph Parrish, 1886

This collection of photographs by Dr.

Joseph Parrish capture, for a moment in a time, the people most affected by the asylum movement. Dr. Parrish likely took these photographs as a way to classify the people, a common practice at the time as people’s physical appearances was thought to be tied to their underlying ailments.

Portrait of three white girls and a white women standing together in dresses.

https://collections.nlm.

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