The first hospital in the U.S. opened its doors in 1753 in Philadelphia. While it treated a variety of patients, six of its first patients suffered from mental illness. In fact, Pennsylvania Hospital would have a pivotal impact on psychiatry.
Benjamin Rush, a physician who has been referred to as “the father of modern psychiatry” largely due to his book, Medical Inquiries and Observations on the Diseases of the Mind, worked at the hospital. He believed in treating mentally ill patients with bloodletting, a treatment that was used by Ancient civilizations. He dismissed demonic theories behind mental illness, and instead thought that psychiatric disorders originated from “hypertension in the brain’s blood vessels” (as cited in Goodwin, 1999).
It was thought that removing blood from the body would help to ease the tension. Patients would indeed typically calm down after a bloodletting, but that was mainly because they were just too weak.
Today, such treatments seem incredibly cruel. But during earlier times, professionals genuinely believed that they were helping patients.
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I work in a state mental health institution and battle every day against the stigma that people have against mental illness and institutions. A great percentage of our patients’ families are fearful when their relatives come here, and then when it’s time to go they don’t want them to leave.
We have been in existence since the 1880s, which is long for the midwest. At one time our institute was a sustainable community with its own farm, water system, electrical system, and medical hospital. The head psychiatrist lived on the grounds.
The people who work here are top-notch and work with recovery and the whole person in mind.
—No doubt many readers are familiar with the horrific treatment of patients in mental asylums. However, the first group of institutions was different. Not only did they have good intentions to help individuals with mental illness, they were also smaller and offered individualized care.
History does not confrim the above. It is a kind of “romantic” retelling. For a more accurate view, see “The Discovery of the Asylum,” By Rothman. “Asylum” is employed ironically.
“Asylum” is itself a curious word, becoming, through lived experience, its own antonym, a place of safety/ a place of horror.
Harold A. Maio, retired Mental Health Editor
khmaio@earthlink.net
I believe that what still goes on in psychiatric hospitals today is incredibly cruel. The disrespect, the threats to gain compliance, the take downs for people being legitimately angry and not even threatening anyone, patients having to earn basic human rights – like access to fresh air, etc. It’s wrong. I am too afraid to ever see a psychiatrist again after being inpatient. They treated patients like dirt.
I agree with you, Denise. Many men would commit wives who disagreed with them. I believe my grandmother suffered such a fate when Henry C. Hearn was caught flagrante delicto with Pauline Paeskes, the housekeeper of my grandmother and Henry, also called Harry Hearn. He committed my grandmother and assumed the role of husband to the hustler Pauline Paeskes who then became known as Pauline Hearn and she had two sons from a previous union, Ira C. Fulk aka Leland Fulk and George Fulk. Pauline Paeskes was married to a man named Fulk before she decided to sleep with Harry Hearn. He was a cold brute from my early remembrances of him. When Pauline and he babysat my sister Kathy, they had inflicted cigarette burns on Kathy. They should have been beaten within an inch of their lives. I would cross the street to avoid them if they were still alive or perhaps think about arranging their quiet extermination.
One comment here is positive about psych wards and the other negative. What have others experienced?
My experience was 98% negative. Locked up, no fresh air, minimal activities, no psychotherapy, threats to achieve compliance with drugs, long term stays, and lack of empathy or respect by doctors.
What say others?
Psychiatry and psychology are pseudo-science at best. Psychiatrists are drug pushers. I agree, that they do not have your best interest at heart. Avoid them at all costs. Choose God as your counselor.
If my memory is correct in 1783 London all attempts of treatment were stopped. The patients were only confined and fed. The mentally ill recovered anyway. Where are those spontaneous remissions today?
Without knowledge of the cause of behaviors we call mental illness those attempting treatment cannot know if they are doing something to prolong the mental distress.
When mental breaks appeared in office workers using the first prototypes of close-spaced workstations engineers and designers were able to solve the problem within four years. Doctors and psychiatrists have been arguing among them selves for decades. In fact they don’t know of the 1960′s accidental discovery. No one has evaluated Subliminal Distraction for the source of bizarre behavior.
I have only had positive or neutral experiences in hospitals. The neutral experience was in a community mental health hospital. It was basically a holding tank for people on 72 hour holds. The food was good, staff was nice but there was no treatment other than dispensing existing medications. When I was taken there, following a suicide attempt and a night in a general hospital on a heart monitor, police came to get me put me in handcuffs with a chain around my waist. I was still out of it enough that it didn’t phase me but now I think of the experience with embarrassment.
My other experiences in psych wards of general hospitals have been completely positive. The staff was positive and involved, certainly no threats but stated consequences such as if you stay isolated in your room all day we won’t be able to see if you are nearing stability and release. The psychiatrist saw me every day. I had a physical exam upon entering the hospital. Yes, the ward was locked, for safety reasons. Things that were removed or supplied were given/taken because of safety – no shoe laces, ties in pants, phones with cameras (patient privacy) and plastic utensils to eat with. There was some therapy, both counseling and OT. One place had more therapy in their program than the other. However they were all the same in one way — they provide a safe environment in which to treat you enough so that you are not a danger to yourself or others. When I go inpatient, I am usually relieved because I don’t have to fight the urges to suicide.
It must have been hell for anyone who became mentally ill for the anyone “committed” to the old time prisons called asylums. Now they are called hospitals and in many cases are true treatment centers rather than mean a lifetime confinement with conditions worse than most of the prisons at the time.
Well, my experience is that it’s still hell to be in a psych hospital, and I use the term “hospital” quite loosely. I would rather be dead than ever go back to a psych ward. In Texas there are next to no hiring standards. I think it’s a minimum of a GED for psych techs, and that’s who patients spend the majority of their time with. Very little interaction with the nurses, they rarely left the front desk.
People were forced to strip in front of a staff member. One woman was prohibited from mailing a letter. People are falling over asleep in groups because they’re so drugged, but you better believe they’re still billing insurance companies and the government for therapy. Group therapy is a joke but they’ll threaten patients who don’t go, because if you don’t go they can’t bill for it. Treatment usually entails coloring pictures or other childish activities and you better comply or it’s a sign that you’re really ill. Heaven forbid you try to stand up for yourself and retain a tiny fragment of dignity. I guess the theory is that the moment you get diagnosed with a mental illness you’re iq drops to that of a preschooler.
The day rarely went by when they weren’t doing a take down or threatening to do one. Yeah, it’s a great place to go to be treated for depression. Very helpful.
But, oddly enough, even though the place was eventually shut down for its crappy care when I was there there were people who didn’t want to leave.
Depriving people of sunlight, lack of fresh air, rude staff, use of threats, depressing environment, infantalising activities, fatty greasy cafeteria food, etc. does not lead to mental health no matter how glossy the brochure.
Oops, I meant “your iq”
I went two different times to the same facility, which meant that alot changed in ten years. But my facility was part of a regular hospital, and I did not go to a state institution. That made a great deal of difference. Also the psychiatrist in charge of supervising all the treatments was knowledgeable and dedicated. Been seeing him for almost 30 years. I wish that everyone could find the treatment they need.
My family and friends were allowed an hour or two to support me every day, and they brought me what the hospital could not provide. They were not afraid to visit. Not all hospitals are that ‘non-threatening’. The community can make changes if they decide to learn more, relax, and get to know people who are suffering.
Ms. Tartakovsky,
This is a very interesting post about the establishment of the first mental hospital in U.S. and the many components and issues the institutions faced. I was immediately drawn to your post due to the fact, that I am a student studying psychology and plan to have a career in the field. After reading your discussion I enjoyed some additional commentary on the Pennsylvania Hospital as well as others centers. What I found interesting were the types of treatment that patients received when diagnosed as mentally ill. Although I am familiar with other techniques such as lobotomy, shock therapy, and trepanning I was unaware that bloodletting was once practiced. With further research I found that doctors induced patients into comas using large doses of insulin and metrozol. I do agree that some of these techniques were practiced with good intention for the patients, however in modern society they are seen as immoral procedures giving the field of psychology a negative stigma. Do you feel there are techniques that modern professionals use today that would be claimed immoral such as over prescribing medication for example? What surprised me is that because of the increase in population, hospitals became over-crowded with patients who employees then were abused and neglected. Before the growth, do you think there were people that were mentally sound who acted as though they were suffering from an illness in order to have a place to stay?
In your post you specified that in the early period institution used moral therapy as a treated which allowed patients to participate in anything, “from exercise and religion training to lessons on good hygiene and [even] activities that were tailored to each person’s interests, such as writing or music.” Through some digging I found that this type of therapy was produced by Dr. Kirkbride who designed hospital buildings with the intent of patients in a stimulating environment in the hopes that they will become more stable. What is your opinion on this type of design? Do you think its intentions helped cure the sick? Something I found interesting in your post was that the figure who fought for an expansion in funding intuitions was a woman. It was intriguing to know that Dorothea Dix, a female activist, argument was taken seriously enough to create funding for hospitals where conditions were no doubt inhumane for the patients. Overall I very much enjoyed reading your post and increasing my knowledge in the psychiatric field.
As a child of 6 or so, I had to visit one of these “snake pits” to see a relative with my parents.This was in the late thirties. It left a terrible fear in my mind about ever being “committed” to a Mental “asylum”. It was a horrible fear that I got from that visit.
I am now 82 and have not suffered that kind of disaster but the very fear of it never left me.
I wonder how many children subjected to such an experience developed some kind of Post Traumatic Event Syndrome. Perhaps even to the point that they finally suffered a mental breakdown.
I have followed the progress in the treatment of and societal view toward “nervous breakdowns” and I am delighted to say EVERYTHING about the subject has improved. However we need more improvement and it does seem to be headed in that direction.
Thanks to the new rapid and widespread communication of science and knowledge, the world gets better all the time.
In the past, people did not care about mentally ill patients. This would explain the horrible conditions mentioned. Today I hope it is better.
It’s really sad how they treated their patients,and why?