History of
psychiatric institutions
Here's one
history from wikipedia.
The story of the rise of the lunatic asylum and its gradual transformation into, and eventual replacement by, the modern psychiatric hospital, is also the story of the rise of organized, institutional psychiatry. While there were earlier institutions that housed the 'insane,' the arrival at the answer of institutionalisation as the correct solution to the problem of madness was very much an event of the nineteenth century. To illustrate this with one regional example, in England at the beginning of the nineteenth century there were, perhaps, a few thousand "lunatics" housed in a variety of disparate institutions but by 1900 that figure had grown to about 100,000. That this growth should coincide with the growth of alienism, later known as psychiatry, as a medical specialism is not coincidental.[1]:14
Medieval era
In the Islamic
world, the Bimaristans were described by European travelers, who
wrote on their wonder at the care and kindness shown to lunatics. In 872, Ahmad
ibn Tulun built a hospital in Cairo that provided care to the insane.[2]
Nonetheless, medical historian Roy Porter cautions against idealising the role of
hospitals generally in medieval Islam stating that "They were a drop in
the ocean for the vast population that they had to serve, and their true
function lay in highlighting ideals of compassion and bringing together the
activities of the medical profession."[3]:105
In Europe
during the medieval era, a variety of settings were employed to house the small
subsection of the population of the mad who were housed in institutional
settings. Porter
gives examples of such locales where some of the insane were cared for, such as
in monasteries. A few towns had towers where madmen were kept (called Narrentürme
or fools' tower). The ancient Parisian hospital Hôtel-Dieu also had a small number of
cells set aside for lunatics, whilst the town of Elbing boasted a madhouse, Tollhaus,
attached to the Teutonic Knights' hospital.[4]
Other such institutions for the insane were established after the Christian Reconquista,
including hospitals in Valencia (1407), Zaragoza (1425), Seville (1436),
Barcelona (1481), and Toledo (1483).[3]:127
The Priory of Saint Mary of Bethlehem, which
later became known more notoriously as Bedlam, was founded in 1247. At the start of
the fifteenth century it housed just six insane men.[3]:127
The former lunatic asylum Het Dolhuys from the 16th century in Haarlem, the
Netherlands is now a museum of psychiatry with an overview of treatments from
the origins of the building up to the 1990s.
18th century
England
Domestic care
In England at
the beginning of the eighteenth-century the level of specialist institutional
provision for the care and control of the insane was extremely limited. Rather,
madness was still seen principally as a domestic problem, with families and
parish authorities central to regimens of care.[5]:439[1]:154
Various forms of outdoor relief were extended by the parish authorities to
families in these circumstances including financial support, the provision of
parish nurses and, where family care was not possible, lunatics might be
'boarded out' to other members of the local community or committed to private
madhouses.[5]:452–56[6]:299
Exceptionally, if those deemed mad were judged to be particularly disturbing or
violent, parish authorities might meet the not inconsiderable costs of their
confinement in charitable asylums such as Bethlem, in Houses of Correction or in
workhouses.[7]:30,
31–35, 39–43
Public asylums
At the start of
the eighteenth century London's historical Bethlem, which had been reopened in new
buildings at Moorfields in 1676 with a capacity for 100 inmates,[1]:155
was the only public asylum then operating in England.[8]:27
A second public charitable institution was opened in 1713, the Bethel in Norwich. It was a
small facility which generally housed between twenty and thirty inmates.[1]:166
In 1728 at Guy's Hospital, London, wards were established for chronic lunatics.[9]:11
From the mid-eighteenth century the number of public charitably funded asylums
expanded moderately with the opening of St Luke's Hospital in 1751 in Upper
Moorfields, London, the establishment in 1765 of the Hospital for Lunatics at Newcastle upon Tyne, the Manchester Lunatic
Hospital, which opened in 1766, the York Asylum in 1777 (not to be confused with the York
Retreat), the Leicester Lunatic Asylum (1794), and the Liverpool Lunatic
Asylum (1797).[8]:27
The trade in lunacy
Due, perhaps,
to the absence of a centralised state response to the social problem of madness
until the nineteenth-century, private madhouses proliferated in
eighteenth-century England on a scale unseen elsewhere.[1]:174
References to such institutions are limited for the seventeenth-century but it
is evident that by the start of the eighteenth-century the so-called 'trade in
lunacy' was well established.[9]:8–9
Daniel
Defoe, an ardent critic of private madhouses,[10]:118
estimated in 1724 that there were fifteen then operating in the London area.[11]:9
Defoe may have exaggerated but exact figures for private metropolitan madhouses
are only available from 1774 when licensing legislation was introduced and sixteen
institutions were recorded..[11]:9–10
At least two of these, Hoxton House and Wood's Close, Clerkenwell,
had been in operation since the seventeenth-century.[11]:10
By 1807, the number had only increased to seventeen.[11]:9
It is conjectured that this limited growth in the number of London madhouses is
likely to reflect the fact that vested interests, especially the College of Physicians, exercised
considerably control in preventing new entrants to the market.[11]:10–11
Thus, rather than a proliferation of private madhouses in London, existing
institutions tended to expand considerably in size.[11]:10
The establishments which increased most during the eighteenth-century, such as
Hoxton House, did so by accepting pauper
patients rather than private, middle-class, fee-paying patients.[11]:11
Significantly, pauper patients, unlike their private counterparts, were not
subject to inspection under the 1774 legislation.[11]:11
Fragmentary
evidence indicates that some provincial madhouses were in existence in England
from at least the seventeenth-century and possibly earlier.[1]:175[9]:8
A madhouse at Box, Wiltshire was opened during the
seventeenth-century.[1]:176[11]:11
Further locales of early businesses include one at Guildford in
Surrey which was accepting patients by 1700, one at Fonthill
Gifford in Wiltshire from 1718, another at Hook Norton
in Oxfordshire from about 1725, one at St Albans
dating from around 1740 and a madhouse at Fishponds in
Bristol from 1766.[1]:176[11]:11
It is likely that many of these provincial madhouses, as was the case with the
exclusive Ticehurst
House, may have evolved from householders who were boarding lunatics on behalf
of parochial authorities and later formalised this practice into a business
venture.[1]:176
The vast majority were small in scale with only seven asylums outside of London
with in excess of thirty patients by 1800 and somewhere between and ten and
twenty institutions had fewer patients than this.[1]:178
United States
In the United
States, the Pennsylvania Hospital was founded in 1751 as
a result of work begun in 1709 by the Religious Society of Friends. A
portion of this hospital was set apart for the mentally ill, and the first
patients were admitted in 1752.[12]
Virginia is
recognized as the first state to establish an institution for the mentally ill.[13]
Eastern State Hospital, located
in Williamsburg, was incorporated in 1768 under
the name of the “Public Hospital for Persons of Insane and Disordered Minds”
and its first patients were admitted in 1773.[12][14]
Along with the first institution in America, Virginia also founded the first
Colored Asylum in 1870.[15]
Their land was given to them by the House of Burgesses in 1769.[13]
Moral treatment
Phillipe
Pinel (1793) is often credited as being the first in Europe to introduce
more humane methods into the treatment of the mentally ill (which came to be
known as moral treatment) as the superintendent of the Bicêtre Hospital in Paris.[14]
Pinel credited his friend Jean-Baptiste Pussin, the Bicêtre's unschooled
manager, for removing patient shackles (though he occasionally used
straightjackets). Both spread reforms such as categorising disorders, as well
as methods of cure based on observing and talking to patients. Samuel
Hahnemann, a fellow medical translator now considered the founder of
homeopathic medicine, also lived in Paris at the time and advocated humane
treatment of the insane.[16]
Benjamin
Rush of Philadelphia also promoted humane treatment of the insane outside
dungeons and without iron restraints, as well as sought their reintegration
into society. In 1792 Rush successfully campaigned for a separate ward for the
insane at the Pennsylvania Hospital. His talk-based approach led to modern
occupational therapy and addiction medicine, although most of his physical
approaches have long been discredited, such as bleeding and purging (unlike
Pinel), hot and cold baths, mercury pills, a "tranquilizing chair"
and gyroscope. In Italy, Vincenzo
Chiarugi may also have banned chains before this time. Johann Jakob Guggenbühl
in 1840 started in Interlaken the first retreat for mentally disabled
children.[citation needed]
Around the same
time as Pussin and Pinel, British Quakers, particularly William
Tuke, pioneered an enlightened approach (moral
treatment) at the York Retreat which opened in 1796. The Retreat was not
a psychiatric hospital, and in fact abandoned medical approaches of the day in
favor of understanding, hope, moral responsibility and occupational therapy.[17]
The Brattleboro Retreat and the former Hartford Retreat were named after it.
19th century
United States
In 1806 an
authorization to a hospital in New
York City was granted to erect additions and provide suitable apartments
adapted to the various forms and degrees of mental illness. Other important
dates in the early part of the 19th century were: the opening of an institution
for the care of the mentally ill at Frankfort, Pennsylvania,
by the Society of Friends in 1817, the founding of the Hartford
Retreat, in Hartford, Connecticut, in 1824, the opening
of the South Carolina State Hospital for the Insane in 1824, of the Eastern State Hospital at Lexington,
Kentucky, in 1824, of the Western State Hospital at Staunton, Virginia, in 1828, of one of the
buildings of the Blockley Almshouse for the dependent insane in Philadelphia
from 1830 to 1834, the Maryland Hospital for the Insane
in 1832, and the New Hampshire State Hospital for the Insane at Concord in 1842.[12]
From this
period on, the erection of state hospitals went rapidly forward in the
different states. The first law for the creation of a state hospital in New
York was passed in 1842. The Utica State Hospital was opened approximately
in 1850. The creation of this hospital, as of many others, was largely the work
of Dorothea Lynde Dix, whose philanthrophic efforts
extended over many states, and in Europe as far as Constantinople.
It was through her efforts that institutions were erected in Massachusetts,
Pennsylvania, New Jersey, Rhode Island, North Carolina and the District of
Columbia. According to her biographers, some 30 institutions in the United
States owe their existence, in whole or in part, to her efforts.[12]
Trends
Reformers such
as Dix began to advocate a more humane and progressive attitude towards the
mentally ill. Some were motivated by a Christian duty to mentally ill citizens.
In the United States, for example, the numerous state mental health systems
established were paid for by taxpayer money, and often money from the relatives
of those institutionalized inside them. These centralized institutions were
often linked with loose governmental bodies, though oversight and quality
consequently varied. They were generally geographically isolated as well,
located away from urban areas because the land was cheap and there was less
political opposition.
Many state
hospitals in the United States were built in the 1850s and 1860s on the Kirkbride
Plan, an architectural style meant to have curative effect.[18]
States made large outlays on architecture that often resembled the palaces of
Europe, although operating funding for ongoing programs was more scarce. Many
patients objected to transfers from private hospitals to state facilities. Some
Brattleboro Retreat patients tried to hide when state officials arrived to
transfer them to the new Waterbury State Hospital. This decline in patient
census led to the collapse of many private institutions, which still accepted
indigent patients even when state reimbursement for private hospitals dropped
in the face of rising state hospital costs.[citation needed]
In the 1800s
middle-class facilities became more common, replacing private care for
wealthier persons. However, facilities in this period were largely
oversubscribed. Individuals were referred to facilities either by the community
or by the criminal justice system. Dangerous or violent cases were usually
given precedence for admission. A survey taken in 1891 in Cape Town,
South Africa shows the distribution between different facilities. Out of 2046
persons surveryed, 1,281 were in private dwellings, 120 in jails, and 645 in
asylua, with men representing nearly two thirds of the number surveyed. In
situations of scarcity of accommodation, preference was given to white men and
black men (who's insanity threatened white society by disrupting employment relations
and the tabooed sexual contact with white women).[19]
Defining
someone as insane was a necessary prerequisite for being admitted to a
facility. A doctor was only called after someone was labelled insane on social
terms and had become socially or economically problematic. Until the 1890s,
little distinction existed between the lunatic and criminal lunatic. The term
was often used to police vagrancy
as well as paupers and the insane. In the 1858–59, the Lunacy Panic occurred in
Victorian England that medical doctors were declaring people "insane"
that were actually sane. These people were perhaps awkward or embarrassing to
families, thus meriting convenient disposal into asylums. This sensationalism
was pronounced in novels such as The Woman in White.[19][20]
Non-restraint movement
In Lincoln (Lincolnshire,
England) Robert Gardiner Hill, with the support of
Edward Parker Charlesworth, developed a mode of treatment that suited 'all
types' of patients, whereby the reliance on mechanical restraints and coercion
could be made obsolete altogether – a situation he finally achieved in 1838. By
the following year of 1839 Sergeant John Adams and Dr. John
Conolly were so impressed by the work of Hill, that they immediately
introduced the method into their Hanwell
Asylum, which was by then the largest in the kingdom. The greater size
required Hill's system to be developed and refined. This was necessary as it
was beyond Conolly to be able to supervise each attendant as closely as Hill
had done. By September 1839, mechanical restraint was no longer required for
any patient.[21][22]
20th century
Radical politics
In February
1919, the first soviet in the British
Isles was established at Monaghan Lunatic Asylum,
in Monaghan,
Ireland. This led to the claim by Joseph
Devlin in the House of Commons that
"that the only successfully conducted institutions in Ireland are the
lunatic asylums"[23]
Physical therapies
A series of
radical physical therapies were developed in central and continental Europe in
the late 1910s, the 1920s and, most particularly, the 1930s. Among these we may
note the Austrian psychiatrist Julius Wagner-Jauregg's malarial therapy for general paresis of the insane (or neurosyphilis)
first used in 1917, and for which he won a Nobel Prize in 1927.[24]
This treatment heralded the beginning of a radical and experimental era in
psychiatric medicine that increasingly broke with an asylum based culture of
therapeutic nihilism in the treatment of chronic psychiatric disorders,[25]
most particularly dementia praecox (increasingly known as schizophrenia
from the 1910s, although the two terms were used more or less interchangeably
until at least the end of the 1930s), which were typically regarded as hereditary
degenerative disorders and therefore unamenable to any therapeutic
intervention.[26]
Malarial therapy was followed in 1920 by barbiturate
induced deep sleep therapy to treat dementia
praecox, which was popularized by the Swiss psychiatrist Jakob
Klaesi. In 1933 the Viennese based psychiatrist Manfred
Sakel introduced insulin shock therapy and in August 1934 Ladislas J. Meduna, a Hungarian neuropathologist
and psychiatrist working in Budapest, introduced cardiazol
shock therapy (cardiazol is the tradename of the chemical compound pentylenetetrazol,
known by the tradename metrazol in the United States), which was the first
convulsive or seizure therapy for a psychiatric disorder. Again, both of these
therapies were initially targeted at curing dementia
praecox. Cardiazol
shock therapy, founded on the theoretical notion that there existed a
biological antagonism between schizophrenia
and epilepsy
and that therefore inducing epiletiform fits in schizophrenic patients might
effect a cure, was superseded by electroconvulsive therapy (ECT), invented
by the Italian neurologist Ugo Cerletti in 1938.[27]
In 1935 the Portuguese neurologist Egas Moniz
devised the leucotomy, a surgical procedure targeting the brain's frontal
lobes. This was shortly thereafter adapted by Walter Freeman and James W. Watts in
what is known as Freeman-Watts procedure or the standard prefrontal lobotomy. From
1946, Freeman developed the transorbital lobotomy, using a device akin to an
ice-pick. This was an "office" procedure which did not have to be
performed in a surgical theatre and took as little as fifteen minutes to
complete. Freeman is credited with the popularisation of the technique in the
United States. In 1949, 5074 lobotomies were carried out in the United States
and by 1951 18,608 people had undergone the controversial procedure in that
country.[28]
In modern
times, insulin shock therapy and lobotomies are viewed as being almost as
barbaric as the Bedlam "treatments", although the insulin shock
therapy was still seen as the only option which produced any noticeable effect
on patients. ECT is still used in the West, but it is seen as a last resort for
treatment of mood disorders, and is administered much more safely than in the
past.[29]
Elsewhere, particularly in India, use of ECT is reportedly increasing, as a
cost-effective alternative to drug treatment. The effect of a shock on an
overly excitable patient often allowed these patients to be discharged to their
homes, which was seen by administrators (and often guardians) as a preferable
solution to institutionalization. Lobotomies were performed in the hundreds
from the 1930s to the 1950s, and were ultimately replaced with modern
psychotropic drugs.
Eugenics movement
Compulsory sterilization of the "feeble-minded"
The eugenics
movement of the early 20th century led to a number of countries enacting laws
for the compulsory sterilization of the "feeble minded", which
resulted in the forced sterilization of numerous psychiatric inmates.[citation needed] As late as the
1950s, laws in Japan allowed the forcible sterilization of patients with
psychiatric illnesses.[citation needed]
Germany and occupied Europe: Nazi euthanasia program
Under Nazi
Germany, the Aktion T4 euthanasia
program resulted in the killings of thousands of the mentally ill housed in
state institutions. In 1939, the Nazis secretly began to exterminate the
mentally ill in a euthanasia campaign. Around 6,000 disabled babies, children
and teenagers were murdered by starvation or lethal injection.[30]
Drugs
The twentieth
century saw the development of the first effective psychiatric
drugs.
The first antipsychotic
drug, chlorpromazine (known under the trade name Largactil in
Europe and Thorazine
in the United States), was first synthesised in France in 1950. Pierre
Deniker, a psychiatrist of the Saint-Anne Psychiatric Centre in Paris, is
credited with first recognising the specificity of action of the drug in
psychosis in 1952. Deniker travelled with a colleague to the United States and
Canada promoting the drug at medical conferences in 1954. The first publication
regarding its use in North America was made in the same year by the Canadian psychiatrist
Heinz
Lehmann, who was based in Montreal. Also in 1954 another antipsychotic, reserpine,
was first used by an American psychiatrist based in New York, Nathan S. Kline.
At a Paris based colloquium on neuroleptics
(antipsychotics) in 1955 a series of psychiatric studies were presented by,
among others, Hans
Hoff (Vienna), Aksel[who?] (Istanbul), Felix Labarth
(Basle), Linford Rees (London), Sarro[who?] (Barcelona), Manfred
Bleuler (Zurich), William Mayer-Gross
(Birmingham), Winford[who?] (Washington) and
Denber[who?] (New York) attesting
to the effective and concordant action of the new drugs in the treatment of
psychosis.[citation needed]
The new
antipsychotics had an immense impact on the lives of psychiatrists and
patients. For instance, Henry Ey, a French psychiatrist at
Bonneval, related that between 1921 and 1937 only 6 per cent of patients
suffering from schizophrenia and chronic delirium were discharged from his
institution. The comparable figure for the period from 1955 to 1967, after the
introduction of chlorpromazine, was 67 per cent. Between 1955 and 1968 the
residential psychiatric population in the United States dropped by 30 per cent.[31]
Newly developed antidepressants were used to treat cases of depression, and the introduction of muscle
relaxants allowed ECT to be used in a modified form for the
treatment of severe depression and a few other disorders.[citation needed]
The discovery
of the mood stabilizing effect of lithium
carbonate by John Cade in 1948 would eventually revolutionize the
treatment of bipolar disorder, although its use was banned in
the United States until the 1970s.[citation needed]
The use of psychosurgery
was narrowed to a very small number of people for specific indications.[which?][citation needed] New treatments
led to reductions in the number of patients in mental hospitals.[citation needed]
Country-specific/regional events
United States: Reform in the 1940s
From 1942 to
1947, conscientious objectors in the US assigned
to psychiatric hospitals under Civilian Public Service exposed abuses
throughout the psychiatric care system and were instrumental in reforms of the
1940s and 1950s. The CPS reformers were especially active at the Philadelphia State Hospital where four Quakers initiated The Attendant magazine
as a way to communicate ideas and promote reform. This periodical later became The
Psychiatric Aide, a professional journal for mental health workers. On 6
May 1946, Life magazine printed an exposé of the
psychiatric system by Albert Q. Maisel based on
the reports of COs.[32]
Another effort of CPS, namely the Mental Hygiene Project, became the National Mental
Health Foundation. Initially skeptical about the value of Civilian Public
Service, Eleanor Roosevelt, impressed by the changes
introduced by COs in the mental health system, became a sponsor of the
National Mental Health Foundation and actively inspired other prominent
citizens including Owen J. Roberts, Pearl Buck
and Harry Emerson Fosdick to join her in
advancing the organization's objectives of reform and humane treatment of
patients.[citation needed]
Psychiatric internment as a political device
Psychiatrists
around the world have been involved in the suppression of individual rights by
states wherein the definitions of mental disease had been expanded to include
political disobedience.[33]:6
Nowadays, in many countries, political prisoners are sometimes confined to
mental institutions and abused therein.[34]:3
Psychiatry possesses a built-in capacity for abuse which is greater than in
other areas of medicine.[35]:65
The diagnosis of mental disease can serve as proxy for the designation of
social dissidents, allowing the state to hold persons against their will and to
insist upon therapies that work in favour of ideological conformity and in the
broader interests of society.[35]:65
In a monolithic state, psychiatry can be used to bypass standard legal
procedures for establishing guilt or innocence and allow political
incarceration without the ordinary odium attaching to such political trials.[35]:65
In Nazi
Germany in the 1940s, the 'duty to care' was violated on an enormous scale:
A reported 300,000 individuals were sterilized and 100,000 killed in Germany
alone, as were many thousands further afield, mainly in eastern Europe.[36]
From the 1960s up to 1986, political abuse of psychiatry was
reported to be systematic in the Soviet
Union, and to surface on occasion in other Eastern European countries such
as Romania, Hungary, Czechoslovakia, and Yugoslavia.[35]:66
A "mental health genocide" reminiscent of the Nazi aberrations has
been located in the history of South African oppression during the apartheid
era.[37]
A continued misappropriation of the discipline was subsequently attributed to
the People's Republic of China.[38]
Deinstitutionalization
Main article: Deinstitutionalization
By the
beginning of the 20th century, ever-increasing admissions had resulted in
serious overcrowding. Funding was often cut, especially during periods of
economic decline, and during wartime in particular many patients starved to
death. Asylums became notorious for poor living conditions, lack of hygiene,
overcrowding, and ill-treatment and abuse
of patients.[39]
The first community-based
alternatives were suggested and tentatively implemented in the 1920s and 1930s,
although asylum numbers continued to increase up to the 1950s. The movement for
deinstitutionalization came to the fore in various countries in the 1950s and
1960s.
The prevailing
public arguments, time of onset, and pace of reforms varied by country.[39]
Class action lawsuits in the United States,
and the scrutiny of institutions through disability activism and antipsychiatry,
helped expose the poor conditions and treatment. Sociologists and others argued
that such institutions maintained or created dependency, passivity, exclusion
and disability, causing people to be institutionalized.
There was an
argument that community services would be cheaper. It was suggested that new
psychiatric medications made it more feasible to release people into the
community.[40]
There were
differing views on deinstitutionalization, however, in groups such as mental
health professionals, public officials, families, advocacy groups, public
citizens, and unions.[41]
21st century
Asia
In Japan, the
number of hospital beds has risen steadily over the last few decades.[39]
In Hong Kong, a
number of residential care services such as half-way houses, long-stay care
homes, and supported hostels are provided for the discharged patients. In
addition, a number of community support services such as Community
Rehabilitation Day Services, Community Mental Health Link, Community Mental
Health Care, etc. have been launched to facilitate the re-integration of
patients into the community.
New Zealand
New Zealand
established a reconciliation initiative in
2005 in the context of ongoing compensation payouts to ex-patients of state-run mental
institutions in the 1970s to 1990s. The forum heard of poor reasons for
admissions; unsanitary and overcrowded conditions; lack of communication to
patients and family members; physical violence and sexual misconduct and abuse;
inadequate complaints mechanisms; pressures and difficulties for staff, within
an authoritarian
psychiatric
hierarchy based on containment; fear and humiliation in the misuse of seclusion;
over-use and abuse of ECT, psychiatric medication and other
treatments/punishments, including group
therapy, with continued adverse
effects; lack of support on discharge; interrupted lives and lost
potential; and continued stigma, prejudice and emotional distress and trauma.
There were some
references to instances of helpful aspects or kindnesses despite the system.
Participants were offered counseling to help them deal with their experiences,
and advice on their rights, including access to records and legal redress.[42]
Africa
- Uganda has
one psychiatric hospital.[39]
- South
Africa has several psychiatric hospitals. These hospitals are spread
throughout the country. Some of the most well-known institutions are:
Weskoppies Psychiatric Hospital Weskoppies Psychiatric Hospital,
colloquially known as Groendakkies ("Little Green Roofs") and
Denmar Psychiatric Hospital Denmar Psychiatric Hospital in
Pretoria, TARA [2]
in Johannesburg, and Valkenberg Valkenberg Hospita in
Cape Town.
Europe
Countries where
deinstitutionalization has happened may be experiencing a process of
"re-institutionalization" or relocation to different institutions, as
evidenced by increases in the number of supported
housing facilities, forensic psychiatric beds and rising numbers in
the prison population.[43]
Some developing
European countries still rely on asylums.
United States
The United
States has experienced two waves of deinstitutionalization. Wave one began in the
1950s and targeted people with mental illness.[44]
The second wave began roughly fifteen years after and focused on individuals
who had been diagnosed with a developmental disability (e.g. mentally
impaired).[44]
Although these waves began over fifty years ago, deinstitutionalization
continues today; however, these waves are growing smaller as fewer people are
sent to institutions.
A process of
indirect cost-shifting may have led to a form of
"re-institutionalization" through the increased use of jail detention
for those with mental disorders deemed unmanageable and noncompliant.[45]
In Summer 2009, author and columnist Heather Mac Donald stated in City Journal, "jails have become
society’s primary mental institutions, though few have the funding or expertise
to carry out that role properly... at Rikers, 28 percent
of the inmates require mental health services, a number that rises each
year."[46]
South America
In several South
American countries, the total number of beds in asylum-type institutions
has decreased, replaced by psychiatric inpatient units in general hospitals and
other local settings.[39]
References
1.
^ a
b
c
d
e
f
g
h
i
j Porter, Roy
(2006). Madmen: A Social History of Madhouses, Mad-Doctors & Lunatics
(Ill. ed. [originally published 1987] ed.). Stroud: Tempus. ISBN 9780752437309.
2.
^ Koenig, Harold
George (2005). Faith and mental health: religious resources for healing.
Templeton Foundation Press. ISBN 1-932031-91-X.
3.
^ a
b
c Porter, Roy
(1997). The Greatest Benefit to Mankind: A Medical History of Humanity from
Antiquity to the Present. London: Fontana Press. ISBN 0006374549.
5.
^ a
b Suzuki, Akihito
(1991). "Lunacy, in Seventeenth- and Eighteenth-Century England: Analysis
of Quarter Sessions Records Part I". History of Psychiatry 2
(8): 437–56.
6.
^ Andrews,
Jonathan (2004). "The Rise of the Asylum". In Deborah Brunton. Medicine
Transformed: Health, Disease & Society in Europe, 1800–1930.
Manchester: The Open University. pp. 298–330. ISBN 0719067359.
7.
^ Suzuki, Akihito
(1992). "Lunacy, in Seventeenth- and Eighteenth-Century England: Analysis
of Quarter Sessions Records Part II". History of Psychiatry 3
(8): 29–44.
8.
^ a
b Winston, Mark
(1994). "The Bethel at Norwich: An Eighteenth-Century Hospital for
Lunatics". Medical History 38 (1): 27–51.
9.
^ a
b
c Parry-Jones,
William Ll. (1972). The Trade in Lunacy: A Study of Private Madhouses in
England in the Eighteenth and Nineteenth Centuries. London: Routledge.
10.
^ Noll, Richard
(2007). The Encyclopedia of Schizophrenia and Other Psychotic Disorders
(3rd ed.). New York: Facts on File. ISBN 0816064059.
11.
^ a
b
c
d
e
f
g
h
i
j MacKenzie,
Charlotte (1992). Psychiatry for the Rich: A History of Ticehurst Private
Asylum. London: Routledge. ISBN 0415099917.
12.
^ a
b
c
d 
William A. White (1920). "Insane,
Institutional Care of the, in the United States". Encyclopedia Americana.
William A. White (1920). "Insane,
Institutional Care of the, in the United States". Encyclopedia Americana.
13.
^ a
b "THE
FIRST INSANE ASYLUM.; To Virginia Belongs the Credit in This Country.".
New York Times. 16 July 1900. Retrieved 2009-11-01.
14.
^ a
b James J. Walsh (1913). "Asylums
and Care for the Insane". Catholic Encyclopedia. New York: Robert
Appleton Company.
James J. Walsh (1913). "Asylums
and Care for the Insane". Catholic Encyclopedia. New York: Robert
Appleton Company.
16.
^ Samuel
Hahnemann (1796). "Description
of Klockenbring During his Insanity". The lesser writings of Samuel
Hahnemann. pp. 243–249. OCLC 3440881.
17.
^ Digby, Anne
(1985). Madness, morality, and medicine: a study of the York Retreat,
1796–1914. Cambridge: Cambridge University Press. ISBN 0-521-26067-1.
18.
^ Yanni, Carla
(2007). The
Architecture of Madness: Insane Asylums in the United States.
Minneapolis: Minnesota University Press. ISBN 978-0-8166-4939-6.
19.
^ a
b Roy Porter;
David Wright (7 August 2003). The Confinement of the
Insane: International Perspectives, 1800–1965. Cambridge University
Press. ISBN 978-0-521-80206-2. Retrieved
11 August 2012.
21.
^ Suzuki, Akihto
(January 1995). "The
politics and ideology of non-restraint: the case of the Hanwell Asylum.".
Medical History (183 Euston Road, London NWI 2BE.: Wellcome Institute) 39
(1): 1–17. PMC 1036935. PMID 7877402.
22.
^ Edited
by:Bynum,W.F;Porter,Roy;Shepherd,Michael (1988) The Anatomy of Madness: Essays
in the history of psychiatry. Vol.3.The Asylum and its psychiatry. Routledge.
London EC4
24.
^ Brown Edward M
(2000). "Why Wagner-Jauregg won the Nobel Prize for discovering malaria
therapy for General Paresis of the Insane". History of Psychiatry 11
(44): 371–382. doi:10.1177/0957154X0001104403.
25.
^ Ugo Cerletti,
for instance, described psychiatry during the interwar period as a
"funereal science". Quoted in Shorter, Edward (1997). A History of
Psychiatry: From the Era of the Asylum to the Age of Prozac. Wiley: p. 218
26.
^ Hoenig J
(1995). "Schizophrenia. In Berrios, German and Porter, Roy (Eds.), A
History of Clinical Psychiatry. Athlone: p. 337; Meduna, L.J. (1985).
Autobiography of L.J. Meduna". Convulsive Therapy 1 (1): 53.
28.
^ Shorter, Edward
(1997).A History of Psychiatry: From the Era of the Asylum to the Age of
Prozac. Wiley: pp. 226–229.
29.
^ Yanni, Carla.
(12 April 2007). The
Architecture of Madness: Insane Asylums in the United States (Architecture,
Landscape and Amer Culture) (1 ed.). University of Minnesota Press.
pp. 53–62. ISBN 978-0-8166-4940-2.
30.
^ Torrey E.F.,
Yolken R.H. (16 September 2009). "Psychiatric
Genocide: Nazi Attempts to Eradicate Schizophrenia". Schizophrenia Bulletin 36 (1):
1–7. doi:10.1093/schbul/sbp097. PMC 2800142. PMID 19759092.
31.
^ Thuillier, Jean
(1999). Ten Years that Changed the Face of Mental Illness. Trans. Gordon
Hickish. Martin Dunitz: pp. 110,114, 121–123, 130. ISBN
1-85317-886-1
33.
^ Semple, David;
Smyth, Roger; Burns, Jonathan (2005). Oxford
handbook of psychiatry. Oxford: Oxford University Press. p. 6. ISBN 0-19-852783-7.
34.
^ Noll, Richard
(2007). The
encyclopedia of schizophrenia and other psychotic disorders. Infobase
Publishing. p. 3. ISBN 0-8160-6405-9.
35.
^ a
b
c
d Medicine
betrayed: the participation of doctors in human rights abuses. Zed
Books. 1992. p. 65. ISBN 1-85649-104-8.
36.
^ Birley, J. L.
T. (January 2000). "Political abuse of psychiatry". Acta Psychiatrica Scandinavica 101
(399): 13–15. doi:10.1111/j.0902-4441.2000.007s020[dash]3.x.
PMID 10794019. edit
37.
^ "Press
conference exposes mental health genocide during apartheid, 14 June 1997".
South African Government Information. Retrieved 16 January 2012.
38.
^ van Voren,
Robert (January 2010). "Political Abuse
of Psychiatry—An Historical Overview". Schizophrenia Bulletin 36 (1):
33–35. doi:10.1093/schbul/sbp119. PMC 2800147. PMID 19892821.
39.
^ a
b
c
d
e Fakhourya W,
Priebea S (August 2007). "Deinstitutionalization
and reinstitutionalization: major changes in the provision of mental
healthcare". Psychiatry 6 (8): 313–316. doi:10.1016/j.mppsy.2007.05.008.
40.
^ Rochefort DA
(Spring 1984). "Origins
of the "Third psychiatric revolution": the Community Mental Health
Centers Act of 1963". J Health Polit Policy Law 9 (1):
1–30. doi:10.1215/03616878-9-1-1. PMID 6736594.
41.
^ Scherl DJ,
Macht LB (September 1979). "Deinstitutionalization
in the absence of consensus". Hosp Community Psychiatry 30
(9): 599–604. PMID 223959.
42.
^ Dept of
Internal Affairs, New Zealand Government. Te Āiotanga: Report of the
Confidential Forum for Former In-Patients of Psychiatric Hospitals June
2007
43.
^ Priebe S,
Badesconyi A, Fioritti A et al. (January 2005). "Reinstitutionalisation
in mental health care: comparison of data on service provision from six
European countries". BMJ 330 (7483): 123–6. doi:10.1136/bmj.38296.611215.AE.
PMC 544427. PMID 15567803.
44.
^ a
b Stroman, Duane.
2003. “The Disability Rights Movement: From Deinstitutionalization to
Self-determination. University Press of America.
45.
^ Domino ME,
Norton EC, Morrissey JP, Thakur N (October 2004). "Cost shifting
to jails after a change to managed mental health care". Health Serv
Res 39 (5): 1379–401. doi:10.1111/j.1475-6773.2004.00295.x.
PMC 1361075. PMID 15333114.
The entire
article is located at:
http://en.wikipedia.org/wiki/History_of_psychiatric_institutions
And all I want
to do is take care of our mentally deficient people, which we all know happens
to some of our Families.
Said another
way, catastrophe insurance, is not a bad idea for government to get in involved
in as regards people like Aunt Lucy or Cousin Theo. Said even another way, we
should all help our less fortunate, as best we can.
I have the
advantage of knowing the other alternatives since I am old enough to know what
used to exist. And what I know is that we can treat our mentally deficient
people better than we usually treat our dogs, like in a kennel; or even as we
do today, like our homeless people, or even those living under bridges, with human poop
all around. That is a sad state of affairs.
Now I also know
and admit that our ancestors could have done better, like in orphanages and mental
sanitariums.
If you buy this
line, then now is the time for us to make things better this time around.
Life is tough,
but we are all obligated to take care of all us, as best we can.
No comments:
Post a Comment