Tag Archives: cure rates at insane asylums

Could Healthy Bodies Lead to Healthy Minds?

Broughton Hospital, courtesy the University of North Carolina

Broughton Hospital, courtesy the University of North Carolina

Early specialists in mental health (alienists) firmly believed that patients’ physical environment impacted their minds. Asylum superintendents tried to site their institutions in the countryside (thought to be healthier than cities) and advocated for buildings that were spacious, well-ventilated, and accessible to clean water. They urged patients to spend time outdoors working if possible, or simply strolling through landscaped grounds if they could or would not work. Before asylums became too overcrowded for this routine to continue, superintendents seemed to get results with this idea of fresh air and a restful environment.

An 1891 article about Broughton Hospital in Morganton, NC extolled the benefits of its country environment. “The present year shows the number of its cures to be fifty per cent. of it’s [sic] admissions, which last numbered 148 persons,” the writer proclaimed. Even more astounding was the institution’s death rate of only four per cent–half the death rate at most other institutions. “No better testimonial can be offered as to the unrivaled excellence of the Piedmont climate than these simple figures furnish.”

Fire Brigade at Broughton Hospial, Staffed by Patients and Employees, courtesy Broughton Hospital Public Safety

Fire Brigade at Broughton Hospial, Staffed by Patients and Employees, courtesy Broughton Hospital Public Safety

The writer went on to say that though the managers of the Hospital used the “most advanced and scientific methods known to the moderns and utterly discard the wretched system of physical restraint,” they did not attribute their impressive success from “any marked superiority in their treatment over all the rest of their professional brethren.”

Post Card of Broughton State Mental Hospital

Post Card of Broughton State Mental Hospital

Instead, the “eloquent figures” quoted (particularly the death rate) showed “what this pure atmosphere will do for men, half dead when they come here.”

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Early Problems Providing Mental Health Care

Civil War Soldier Angelo Crapsey, 1861, Who Committed Suicide in 1864 After a Period of Mental Illness, courtesy Kutztown University of Pennsylvania

Civil War Soldier Angelo Crapsey, 1861, Who Committed Suicide in 1864 After a Period of Mental Illness, courtesy Kutztown University of Pennsylvania

Leaders in many states recognized early on that they needed to provide treatment for mental illness at public expense. The North Carolina Hospital (Raleigh) opened in 1856, but an influx of patients after the Civil War forced the state to find other places for care, such as in private homes. It is likely that this increased need for care occurred just as families were hurting for cash: Fraud became so widespread that the stateĀ  had to pass laws requiring counties to care for the insane, instead.

Early care in North Carolina’s asylum consisted primarily of rest, occupational therapy, and treatment for physical problems. Cure rates during this period were in the neighborhood of 30 – 40 percent. Though high, these cure rates may be accurate. After the trauma of fighting during the Civil War, patients who were former soldiers may have been truly helped by a stay in a calm, well-regulated environment where not much was demanded of them.

North Carolina’s constitution mandated that the state care for all of its “insane, blind, and deaf-mute persons.” However, there was still a great deal of stigma attached to insanity and public acknowledgement of it by families. By 1884, the general population–though it recognized the need for care–wanted it provided at home. Consequently, many family physicians found it necessary to study insanity so they could at least recognize and provide some sort of treatment for it among their patients.

Peaceful Scene at North Carolina Hospital, 1924

Peaceful Scene at North Carolina Hospital, 1924

 

Drug Room at North Carolina Hospital, 1924

Drug Room at North Carolina Hospital, 1924

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