We’ve come a long way as far as cultural perception and stigma surrounding mental illness are concerned. As far back as ancient Egypt, Greece, and Rome, mental illness was viewed as divine punishment or unholy possession, and this perception continued on through the Middle Ages. In America, by the time the 18th century rolled around the perceptions had changed but the stigma had not. Although supernatural factors were no longer believed to be the common cause of mental illnesses, the lack of understanding and preconceived ideas about mental illnesses perpetuated the desire for the confinement of these individuals.
The first major move in the treatment of mental illness in America came from Dorothea Dix, an American teacher and author turned activist who sought to expose and change the horrific conditions of the mental institutions that existed throughout the nation. In the 1800s, the stipulations for institutionalization were vast and arbitrary. On top of the horrific terms on which people could be committed, the conditions in these places were shockingly terrible. One example of this occurred at Auburn Prison in 1821where the majority of 80 male patients in solitary confinement either broke down mentally or committed suicide. Dorothea saw the injustices these people faced — in her words, being kept “in cages, closets, cellars, stalls, pens! Chained, naked, beaten with rods, and lashed into obedience!” —and pledged to help them the best she could.
Over a 40-year period, Dorothea was directly responsible for the United States government’s funding of 32 state psychiatric hospitals across the country. While her work did wonders for the advancement of people who are mentally ill, it also lead to mass institutionalization where any people seen as public nuisances or were viewed as dangerous were committed to these institutions.
The early 1900s offered some strides as well as some fallbacks. The use of electroshock therapy became widespread in the treatment of mental illness, often without the use of anesthesia. Patients were also subjected to frontal lobotomies and hydrotherapy where patients were submerged in or blasted with water as means of treatment. However, in the 1950s, new medications that could help stabilize unstable patients mixed with funding cuts to large, scandal-ridden state hospitals lead to deinstitutionalization which dramatically reduced the number of patients being held at these centers.
Stay tuned for Part 2 in the series of Mental Illness in America.