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The History of
Mental
Asylums in
the United
States
How have mental asylums evolved throughout the course of U.S.
history?




By: Ranier Ford
Table of Contents:

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Project Proposal_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Pages 3-5
Critical Reactions to Sources_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Pages 6-11
Responses to Research Questions_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Pages 12-14
Questions Developed During Research_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Page 15
Works Cited_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Page 16











Project Proposal
Historical Event:

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What historical event are you choosing to focus on? I am focusing on the evolution of mental
asylums in the U.S. The idea of a psychiatric hospital was introduced to the U.S. in the late
1700s and conditions seemed to be hellish no matter where or by whom the asylum was run.
There have been many reports of barbaric treatments such as electroshock therapy, lobotomy and
other techniques that had been used to cure the inmates.
Why did you choose this event? I want to research this further because there is a very sinister
stigma associated with mental asylums. My understanding of them is extremely vague and what I
have heard about the asylums is not appealing. I want to find out if they are in fact as bad as the
stories that I have heard and if so, have they gotten more efficient and better for the patients as
time has progressed.
Research Questions:
1) How has the qualification for admittance changed throughout history?
2) How have the treatments for mental illness changed?
3) At what point was the brutality of the asylums unveiled and was immediate action taken?
4) Why is there such apparent intolerance towards insanity overall?
5) Does the general idea of an insane asylum still exist today? If so, how big is the average
asylum and are patients treated in a humane way?
6) Essential Question: How is the history we tell revealing of our truths? To what extent is
the United States history subjective? How does knowing and understanding the complexities of
US history create a better understanding of todays society?

How does the Independent Study Relate:
My research of insane asylums relates to themes that we are studying this semester
because it is important to show how the U.S. has made decisions similar to other countries
around the world. There are thousands of years of history regarding mental illness and it is
interesting to see if/how the U.S. handled insanity different that other places. By understanding
the ins and outs of treatment for the mentally ill throughout history, it will help me begin to
learn how things such as our prison and health systems work.

Sources:
Fiction Novel:

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One Flew Over the Cuckoos Nest by Ken Kesey: This novel takes place in a mental
asylum and is narrated by a thought-to-be deaf and mute Native American. The way that
the story is written is in a way that makes it seem as though it is not those inside of the
asylum that are crazy, but those outside of it.

3-5 Articles:
The History of Mental Illness by Kimberly Luepo: This article discusses the three
revolutions throughout the progression of mental asylums.
Evolution of Treatment of Mental Illness by PBS: This article provides a basic
understanding of every recorded case for the treatment of mental illness, starting in 400
B.C.
Brief History of Mental Health Care in the U.S by Unite for Sight: This article
covers the rudimentary yet necessary knowledge required for understanding the grand
scheme of the USs perspective on mental health care.
Hiawatha Diary: This is a website about the Hiawatha asylum which purely housed
Native Americans with mental illnesses. It discusses why the asylum shut down as well as
names and stories of every patient buried there.

2 Primary Sources:
Insane Asylums Unveiled: This website accounts tales from a patient who was in an
asylum during the year 1860. After the patient had been released from the asylum, she
wrote about everything that she had experienced and reveals shocking information.
Mad in America by Robert Whitaker: Whitaker unveiled secrets about psychiatric
mistreatment that had been hidden from the public for close to two centuries. Whitaker
was able to achieve having mental asylum patients reveal their personal experience with
electroshock, neuroleptic drugs, insulin coma therapy, and lobotomy.









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Critical Reactions to Sources
The History of Mental Illness
By: Kimberley Luepo
Summary: Often times, people tend to overlook the fact that mental institutions are fairly new to
our culture. It should be noted though, that here have been many different techniques of taking
care of mentally unstable people throughout world history. In Colonial America, those who
suffered from mental illness were often thought of as being lunatics. During this time in history,
it was believed that these lunatics obtained their insanity due to being born during a full moon
or that it transpired when a baby slept under the light of a full moon. Colonists viewed insanity
as possession by the devil so, often times, those who suffered from it were locked away from
society. These were the initial events that helped spark the idea of mental asylums and dealing
with insanity in the U.S. As time progressed, there came three revolutions of mental illness. The
first was Hospitalization, the second was Moral Management, and the third was Society
Cooperation and Interaction.
Reaction: After finishing this article, I find that it was very difficult to differentiate the three
revolutions in the way that it was written. I think that the author should have created more

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obvious indicators that it was discussing a new revolution because of how important that aspect
is.
Other than that though, I was very interested about the information that the article
provided; especially the piece that discussed lobotomy. A result of my interest in lobotomy was
that I wanted to explore more about the specifics regarding the results of the procedure. What is
found out from an article in the Encyclopedia Britannica is that, the procedure formerly was
used as a radical therapeutic measure to help grossly disturbed patients with schizophrenia,
manic depression and mania (bipolar disorder), and other mental illnesses which is why it
became such a common technique in mental institutes. It was not intended to revive the patient
back to sanity, but it was a convenient way to bring them to a state of calm by removing certain
parts of the brain cortex.
Also, at one point during my research, I stumbled across a site that had to do with
Psychotherapy. A key component from that article that stood out to me was something called
Chemical Lobotomy. The article revealed that when antipsychotics are taken, the neuroleptic
drugs become essentially indistinguishable from the effects of a real lobotomy. Drugs such as
Thorazine and Haldol can virtually disrupt brain functions and change patients thoughts,
emotions, memory, and basic personality. A questions that was brought up for me after reading
the article was whether or not people were actually testing the drugs that were being
administered to patients. Were they aware of potential side effects or was it just an experimental
process?

Mad in America
By Robert Whitaker
Summary: In the novel, Mad in America, author Robert Whitaker unveiled secrets about
psychiatric mistreatment that had been hidden from the public for close to two centuries.
Whitaker was able to achieve discussions with mental asylum patients about their experiences
with electroshock, neuroleptic drugs, insulin coma therapy, and lobotomy. Mad in America
provided an insight into asylum institutions in a way that made me feel I had been in the asylum
experiencing the pain with the patients.
Reaction: Quite frankly, reading Mad in America by Robert Whitaker made me sick. I had never
realized the level of intolerance there is when it comes to insanity. The father of American
psychiatry, Benjamin Rush had once stated that insanity was caused by morbid qualities in the
blood and in order to fix that, up to four-fifths of the blood should be drawn away in hopes of
cleansing. Not only is there intolerance, but insanity created an epidemic of fear throughout the
U.S. Agateophobia is the phobia of insanity and it became extremely prevalent in the 1800s due
to the drastic upswing of mental institutions and sudden awareness about insanity.
I took a particular interest in Benjamin Rush and chose to research him further. What I
discovered is that Rush is more of a barbarian than he is a doctor. Just a few of his techniques for
curing mentally ill people were; strapping patients to a board while spinning them around at
high speeds, or strapping them to a chair that immobilized every part of their body for long
periods of time and blocked their site with a wooden shroud all the while dousing them in ice-
cold water. Also, due to his opinion that an insane persons blood is morbid, at one point during

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his career, Rush bled a patient 47 times, removing a total of four gallons of blood over time.
Learning this information made me curious as to whether or not doctors challenged each others
theories during that time period. I am aware that the amount of doctors in that time period was
much lower, so I am wondering if they just allowed the best to do whatever he/she pleased and
then followed in their footsteps.








Insane Asylums Unveiled
By: Elizabeth Packard
Summary: In, Insane Asylums Unveiled, the haunting stories of a patient that was released
from an asylum in Jacksonville, Illinois are told from her perspective. She was sent there by her
husband and as soon as she got out she wrote detailed stories about her experiences. The patient
was a woman named Mrs. Packard and she began her narrative by saying that:
As to medical treatment, I received none at all, either from himself, or his
subordinates. And the same may be said with equal truth, of all the inmates. This
is the general rule; those few cases where they receive any kind of medical
treatment, are the exceptions.
A little ale occasionally is the principal part of the medical treatment which these
patients receive, unless his medical treatment consists in the laying on of hands,
for this treatment is almost universally bestowed. But the manner in which this
was practiced, varied very much in different cases.
Starting off the story in this way was an interesting way of drawing a reading in with the
knowledge that that they were about to read was going to be sickening yet extremely
informative. Insane Asylums Unveiled is everything that its name cuts
Reaction: Primary sources are generally supposed to come from reliable people. On the outside,
this article seems reliable because it was written by a woman who experienced being in an
asylum first hand. But, once I started to think about it, I began to wonder how reliable this source
actually is. Packard was in the asylum for a reason, whether it was unjust or needed, we will
never know because it is just her word with nobody to back it up. An insane person could
easily imagine scenarios and believe them to be real. But regardless of the question of reliability,
I still found that this article provided insight into the sinister atmosphere of an asylum; especially
the stories about medical treatment. Packards comments about the medical treatment was
shocking to me because the asylums were intended to heal. They were meant to be a place of

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safety, not torture. Not only that, but it became obvious to me while reading this article that
patients were treated like animals without any sort of awareness of the kind of care that each
individual needed to help their mental state.
Mrs. Packard for example, I assume that she was somebody who could think and function
normaly, but she was placed in something known as the eighth ward. The eighth ward was
considered the worst ward in that particular asylum. In this specific section of the asylum, the
patients were the lowest of prisoners. They could take care of themselves no better than infants
and a result was the patients wallowing in their filth due to lack of care from the doctors and
nurses. I find it very obvious from this article that the asylum employees were not giving the
patients the sort of attention and care that they needed. If somebody who can remember
everything is stuck with people who were the most unstable out of everybody in the asylum,
there are some key indicators that attention was not being paid. This passage of the article made
me wonder if that is a common occurrence in modern-day hospitals. According to Wikipedia,
there is still evidence of this inhumane care today, such as patients getting expelled from the
hospital if they cant afford treatment, no matter what their health situation is. Granted,
treatments are modified for each patient, but money plays a huge role in what kind of treatments
are provided. After reading both the Wikipedia article, and Mrs. Packards story, I became
curious if modern day hospitals ever look into the past of asylums to compare what is being done
now to what was being done then.





















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Evolution of Treatment of Mental Illness
By: PBS
Summary: This PBS article is valuable to my research because it gives a brief overview of
treatment for the mentally ill beginning at 400 B.C. and going through 1992. Something that I
found interesting about the information that this article contained was that it seems as though
treatments fluctuated from fair to inhumane at each new time period mentioned. For example,
during the 1600s in Europe, it became an increasingly common practice to isolate people
suffering from mental illness. According to the Evolution of Treatment of Mental Illness
article, they were often housed with handicapped people, vagrants, and delinquents. All the
while, they were being treated in increasingly inhumane ways such as being kept in dungeons
and chained to walls. The next turn of the century though, the French physician Phillippe Pinel
expressed growing concern about treatment of the mentally ill and began reforming the institutes.
He took over the Bictre insane asylum and prohibited the use of chains and shackles. Pinel also
removed patients from dungeons and in place he provided sunny rooms and exercise.
Reactions: After reading this article, it is apparent to me that since as early as 400 B.C,
treatments for people with mental illnesses have constantly been an experiment. While reading
the article, I noticed many fluctuations in treatments, so it brought up the question for me of
whether or not that is still occurring. What I discovered is that, according to the Treatment
Advocacy Center, there are more mentally ill people in prison than there are in hospitals. At least
16 percent of inmates in jail have a serious mental illness in comparison to the 6.4 percent in
1983. That means that in less than three decades, that percentage has almost tripled.
In the nineteenth century, mentally ill people filled prisons until a reform movement was
started by Dorothea Dix. If you compare the nineteen hundreds to now, the numbers of mentally
ill inmates then would be very similar to the number now.
I find this situation very similar to Packards. Packard had not been evaluated enough to
realize that she was not placed where would be most beneficial to her, and that is what is
happening with the inmates. It surprises me because I always assume that the U.S. automatically
learns from our past but it seems to me that when it comes to the mentally ill, that is the last
thing that we are doing.





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One Flew Over the Cuckoos Nest
By: Ken Kesey
Summary: One Flew Over the Cuckoos Nest is a story that was written in 1962 and details
what went on in a mental asylum in a seemingly abstract way. The story is told through Chief
Bromdens eyes, a character who is thought to be deaf and mute. Throughout the progression of
the story, we see the antics of a character known as Randle Patrick McMurphy essentially
destroy the order that had once existed in the asylum. The narrator is thought to be mute and
deaf, providing an interesting aspect on the way that the other characters in the book treat him.
At no point do they suspect him of being able to think his way out of the asylum, which is why
the story ends so properly. In my opinion, the sly addition of wit made the book wrap up well.
Reaction: Initially, I disliked this book. But as I finished it, I found that there was a creative
metaphor laying beneath the words of a mental asylum patient. It seems to me that Kesey was
writing a novel about the depersonalization of an individual who cannot provide to society. The
whole time, Chief Bromden had been subjected to the scrutiny of an overall indoctrinated
society. Indoctrination is the idea that when somebody is told things relentlessly, they can
essentially be brainwashed into believing whatever it is they are being told. I believe that this is
what created the overall anti-insanity approach around the U.S. As an asylum patient,
Bromden and the others were treated like animals due to being different. If they had been
valuable in society, they would not have been subjected to such brutal and inhumane
treatment. In modern day times, ranking peoples importance depending on what they provide to
society often occurs. Doctors are placed on a pedestal because they are helping society while
janitors are often treated with little respect. If there is somebody who does not have the
capability to provide, they will be locked away as a method of dealing with them. This has been
seen in many cases with elderly people. In most cases, an elderly person is put into a nursing
home where they will reside until their death. It is a trend that has become acceptable and
common in our society. This connection makes me wonder if the trend of depersonalization
happens among other cultures- in regards to both sanity and the elderly.







Responses to Research Questions

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1) Does the general idea of an insane asylum still exist today? If so, how do they aid in the
rehabilitation of patients?
Even though the traditional psychiatric hospital with hundreds of rooms and cold stone
rooms have been diminished, there are still psychiatric hospitals that care for people who suffer
from major mood and anxiety disorders. Often times, they are known as Intensive Outpatient
Programs and are generally joined with a hospital. For example, Porter Adventist Hospital has an
Intensive treatment program that primarily serves people with chronic depression, bipolar
disorder, and OCD. It also treats patients with disorders such as schizophrenia or schizoaffective
disorder.
At the Porter Adventist Hospital, there are very gentle methods of treatments. When
dealing with behavioral health, they have clinical therapists focus on skill-based programs such
as Dialectical Behavior and Cognitive Behavior during group therapy sessions. Another
treatment that is used is Electroconvulsive Therapy. This is not a technique that is used often,
and when it is, it is only in special cases. ECT is used when patients are unresponsive to other
treatments, pose an immediate danger to themselves or others and are not good candidates for
medication. It is generally used on patients that are severely depressed, suicidal or have a bipolar
disorder with depression or mania.
There is much attentiveness when it comes to doctors choosing the right kind of
rehabilitation for patients. They analyze reactions to medications, therapy and other forms of
treatments and then create a program to help heal the patient based on his/her personal needs.
Treatments are much more personalized and effective than ones in the past and people with
disabilities are treated as humans rather than animals.
2) How have the treatments for mental illness changed?
The introduction of psychopharmacology is potentially the most significant change to
mental illness treatment. Though the introduction of medication was arguably the most
significant change, it was not necessarily the best during its initial establishment. In the 1900s, a
common belief was that all illnesses would be completely managed with medication, and that it
would be available to people who were mentally ill in a convenient and efficient manner. In
1960, a movement of deinstitutionalization of the asylum patients spread around the U.S. The
movement meant that thousands of patients were discharged from institutions and often times
they were incapable of living independently. Many discharged people became homeless; in the
1980s and estimated one-third of all homeless individuals in America were considered mentally
ill (New).
Even though psychotropic drugs can help heal somebody who suffers from a mental
illness, they are often not enough to overcome the problem fully. The drugs typically work by
changing the amount of chemicals in the brain known as neurotransmitters. They will either
increase or decrease the amount of neurotransmitters in the brain depending on the illness. It is
paramount that people on psychotropic drugs have social support through friends and family,

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lifestyle, and therapy. If there is a lack of social support, it reveals the underlying problem with
psychotropic medication; it has allowed individuals to avoid direct confrontation of their mental
health issues. Relentless stigmatism of mental illness has influenced individuals finding it easier
to avoid the shame associated with being mentally disabled rather than directly confronting
their issue through something such as therapy.
Despite the complications with psychotropic medication, treatments for mental illness
have become drastically more humane and less severe. Lobotomy and electroshock therapy are
no longer an option, and the treatments that we are using now provide an opportunity of
rehabilitation and being healthy once again to people who suffer from mental illness.
3) Why is there such apparent intolerance towards insanity overall?
In a world dominated by religion, it makes sense that a statement in any sort of religious
scripture would cause uneasiness among religious devotees. In the Bible for example, it was
thought that insane people were possessed by demons due to the strange behaviors they would
often exhibit. There are only two passages that use the word lunatic in the bible, but they were
enough to spread an epidemic of fear. In Mathew 4:24 it was stated that, The news about Him
spread throughout all Syria; and they brought to Him all who were ill, those suffering with
various diseases and pains, demoniacs, epileptics (lunatics), paralytics; and He healed them.
The second passage that talked about demon possession causing lunatic behaviors was:
Lunatic demon possession of a boy since childhood: Mt 17:14-18; Mk 9:17-18;
Luke 9:37-42 a lunatic, very ill, often falls into fire and water, a spirit seized,
suddenly screams, throws into convulsions, foaming mouth, grinds teeth, slams
him to the ground and starts rolling around, mauls him, stiffens out. Jesus said: You
deaf and mute spirit, I command you, come out of him.
Religion is a sense of community. Community occurs by reason of mutual experience and
preferences with others. Where there is a religious sense of community there is a power to form
collective beliefs. Imagine that somebody is a part of a community, and the vast majority of
those he/she trusts are under the same impression that being a lunatic is caused by demonic
possession. It is highly probably that they would develop a similar mentality as well. Both word
of mouth and religion are powerful things. They both have influence over peoples perspectives
and can drastically influence common knowledge. Religion has the potential to contribute to the
holistic development of people on a bio-pyscho-social-spiritual level (Merwe, 2010). It can be
expected that people will not think through their own intellectual diligence and general
knowledge but rather mold their perspectives to match a religious leaders.
In the event of a religious leader exhibiting the belief of demonic possession causing
mental illness, the basic psychologic needs of humans will overcome the basic intellectual
diligence that could convince otherwise. With constant rhetoric against mental illness among
many religions throughout the world, it makes sense that such an extreme level of intolerance
was created through the progression of time.

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4) Essential Question: How is the history we tell revealing of our truths? To what
extent is the United States history subjective? How does knowing and understanding the
complexities of US history create a better understanding of todays society?
In the case of mental asylums, the Unites Statess history is extremely subjective based
purely on the fact of who is involved. On one hand, we are gathering information from patients
who were placed in a psychiatric institution and retelling what they endured based on their
memories. The other side are doctors and nurses who were subjecting the patients to cruelty, so it
is likely that they toned down the extremity of the treatments. The only purely fact based
evidence that we have to go off of are the words of the few people who went into an asylum and
retold their experience about it.
Despite the sketchiness of the reliability of information, we have a general, if not completely
accurate, knowledge of what occurred inside of asylums. Using this knowledge we can learn
from the mistakes made and apply that to modern day treatments for mental illnesses. We can
learn to conquer intolerance towards mental illness by understanding that it is not a supernatural
occurrence and that essentially anybody can be subjected to it. Having the asylums in our history
can help us make decisions that will prevent recreating the past.





Questions Developed During Research:
1) Were people were actually testing the drugs that were being administered to patients. Were
they aware of potential side effects or was it just an experimental process?
2) Did doctors allow the best to do whatever he/she pleased and then followed in their
footsteps or was there pushback to claims that various doctors made by others?
3) Do modern day hospitals research the past of asylums to compare what is being done now
versus what was being done then?







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Works Cited:
"Casting the Demon out of the Lunatic Boy." Bible.org. N.p., n.d. Web. 26 May 2014.

"Electroconvulsive Therapy (ECT)." ECT. Porter Adventist Hospital, n.d. Web. 26 May 2014.

"Find the Right Therapist." Psychotropic Medication for Depression, Anxiety & Other Therapy
Issues. Goodtherapy.org, n.d. Web. 26 May 2014.

Harper, Charles L., and Bryan F. LeBeau. "SOCIAL CHANGE AND RELIGION: THINKING
BEYOND SECULARIZATION PERSPECTIVES." SOCIAL CHANGE AND RELIGION:
THINKING BEYOND SECULARIZATION PERSPECTIVES. Creighton University, n.d. Web. 26
May 2014.

"Hiawatha Asylum." Hiawatha Diary. N.p., 2007. Web.

"Intensive Outpatient Treatment Program." Mental Health. Porter Adventist Hospital, n.d. Web.
26 May 2014.

Kesey, Ken. One Flew over the Cuckoo's Nest, a Novel. New York: Viking, 1962. Print.


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Luepo, Kimberely. "The History of Mental Illness." The History of Mental Illness. N.p., n.d.
Web. 26 May 2014.

"New Releases." The Prevalence and Treatment of Mental Illness Today. Harvard Health
Publications, n.d. Web. 23 May 2014.

Mann, Emilt. "Insane Asylums Unveiled." Mrs. Packard. McCarter.org, 4 May 2007. Web. 26
May 2014.

Merwe, Karen Van Der. "A Psychological Perspective on the Source and Function of Religion."
Theological Studies. Aosis Open Journals, 22 Nov. 2010. Web. 24 May 2014.

"Module 2: A Brief History of Mental Illness and the U.S. Mental Health Care System." A Brief
History of Mental Illness and the U.S. Mental Health Care System. Unite for Sight, n.d. Web. 26
May 2014.

"Timeline: Treatments for Mental Illness." American Experience. PBS, n.d. Web.

"21st Century Treatment for Mental Illness." Nineteenth Century Insane Asylums. Wordpress, 1
May 2013. Web.