Tag Archives: Elizabeth Packard

Model Law for Commitment of the Insane

Mrs. Packard Was a Well-Known Victim of Coerced Commitment

Mrs. Packard Was a Well-Known Victim of Coerced Commitment

One of the great tragedies for people judged insane was the ease with which they could be committed to institutions. During certain periods in some states, all it took was the word of family members or “respectable citizens” to commit people to asylums–a practice certain to be abused for personal gain, spite, or control. In 1876, Dr. Alexander E. MacDonald, superintendent of the New York City Asylum for the Insane, explained the way that the state of New York had improved its commitment laws.

Referencing other states that didn’t require physicians to examine the person in question, or only required one doctor to determine insanity, MacDonald cited New York’s requirement that two reputable physicians had to testify that the person was insane and “unfit to be at large.” The latter provision was to protect “harmless” lunatics and chronic cases who weren’t endangering themselves and others. Additionally, the doctors called in to make the examination had to have been in practice at least three years. Though neither of these requirements could curtail all unjust commitments, they seemed to be a step in the right direction.

Illustration from Nellie Bly's Ten Days in a Mad-House

Illustration from Nellie Bly’s Ten Days in a Mad-House

Furthermore, the form physicians completed required them to state their reasons for determining that the person in question was insane. Theoretically, this forced doctors to give a somewhat in-depth examination to back up their opinions, and additionally, their remarks would help the doctor at the asylum decide what initial course of treatment to begin.

Hammond May Have Been an Alcoholic or Heavily Medicated

Hammond May Have Been an Alcoholic or Heavily Medicated

Though any of these requirements seem both obvious and fundamental, they came at a time when many doctors simply rubber-stamped family decisions for commitment. Any obstacles to easy, painless commitments had to be a good thing for the helpless people who were often shipped off to asylums for convenience.

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How to Commit

Elizabeth Packard Being Taken to an Asylum Against Her Will, courtesy National Library of Medicine

Elizabeth Packard Being Taken to an Asylum Against Her Will, courtesy National Library of Medicine

Few patients went to insane asylums voluntarily; most were committed by physicians called in once concerned family members decided a patient’s behavior had reached some sort of tipping point. Committing a patient to an asylum should have been a very serious affair, but it is evident that it was not always done with professionalism and discernment. In an article* published by the American Journal of Insanity (1876), Dr. A. E. MacDonald gave medical students some sound advice about how to examine a patient and determine whether or not to propose commitment.

Dr. Abraham Myerson, Dr. I Veron Brigg, and Dr. Earl K. Holt Examine Defendants, 1934

Dr. Abraham Myerson, Dr. I Veron Brigg, and Dr. Earl K. Holt Examine Defendants, 1934

Many states required the concurrence of two or more physicians to commit a person to an asylum. MacDonald noted that many times a physician–perhaps at the invitation of the family’s physician–was asked to commit a patient to an asylum, rather than to examine a patient. He likened the situation to that of a physician called in to prescribe medicine to a patient without examining him first to see if the medicine were needed. Families would seldom do such a thing, yet with a presumably insane patient, the verdict was often presupposed and the physician essentially called in to rubber-stamp the decision. MacDonald cautioned students to be careful, though, and to examine such a patient thoroughly with an eye to defending himself in a court of law should the patient later sue.

MacDonald went on to say that physicians often encountered two groups within the family: those who wanted the patient committed, and those who didn’t. He also emphasized that much of what he would hear concerning the patient from these family members would be either useless or untrue. He tried to give students a road map of pertinent questions to ask and a systematic way to approach the situation so they could assess a patient objectively.

He also had this bit of advice: “I advise you to make sure of being able at once to recognize your patient from those who may surround him, by learning before you enter the room, some particulars as to his dress or appearance. It is not a little awkward and embarrassing to address yourself to a bystander, under the impression that he is the patient, but it is a mistake that has happened, and might happen again.”

Ambulance Outside Bellevue Psychiatric Hospital, 1895

Ambulance Outside Bellevue Psychiatric Hospital, 1895

*From a lecture delivered before the students of the University of the City of New York, Medical Department, March 10, 1876.

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Arbitrary Commitment

Elizabeth Packard Being Taken to an Asylum Against Her Will, courtesy National Library of Medicine

Elizabeth Packard Being Taken to an Asylum Against Her Will, courtesy National Library of Medicine

Alienists were notorious for their self-confident belief that they knew what was best for anyone with mental illness. In an essay from the July,1868 issue of the American Journal of Insanity, the (anonymous) author makes a case for doing away with legal procedures for commitment: “. . . other diseases, except those of a highly contagious type, do not call for civil interference nor court publicity.

We do not demand a commission or an inquest to decide whether a man has a fever raging into delirium, or whether he has a general paralysis, or whether a surgeon shall be permitted to amputate his limbs or trepan his skull.”

The writer went on to point out that if anyone saw a person sick or wounded in the street, “we take him forthwith to the nearest hospital, without stopping to canvass our legal right to restrain him of his liberty.”

Charles Guiteau Said He Was Temporarily Insane When He Assassinated President Garfield

Charles Guiteau Said He Was Temporarily Insane When He Assassinated President Garfield

The author lamented that a patient stricken with insanity was sometimes met with a suspicious relative who wasn’t convinced of his illness even though his other relatives were. Because of this suspicion, the patient, “against the wishes and judgment of the rest,” was then liable to the “questioning of the law and its ministers.” This then led to publicity, which might be detrimental to the patient’s recovery.

Though She Had a Trial, Mary Todd Lincoln Was Involuntarily Committed to an Asylum

Though She Had a Trial, Mary Todd Lincoln Was Involuntarily Committed to an Asylum

 

Most people, of course, would not want to be committed involuntarily to an insane asylum, and welcomed legal safeguards to prevent it. It is amazing to consider how differently alienists and laypeople considered the matter–it almost certainly boiled down to who was in control of the situation.

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Employee Frustration

Unruly Patients at Blackwell's Island, from Harper's Magazine, 1860

Employees at the Canton Asylum for Insane Indians didn’t always get along, and the institution’s first big inspection proved that. Dr. Turner had a beef with superintendent Gifford (see last post), but some employees had a beef with Turner.

One attendant in particular, Mary J. Smith, found her work difficult in part because of Turner’s instructions. He did not like to use restraints and wouldn’t often authorize them, but Smith said that she couldn’t do all of her work unless she locked certain patients in their rooms. Her 1908 affidavit stated:

“Doctor had forbidden her to lock certain patients up without his permission . . . ‘he told me if I was doing my duty I would have her (Mary LeBeaux) outside instead of locked in her room, at that time I had locked her in for throwing a cuspidor at me’.” The inspector taking the statement said that “she has marks on her body where the patient has bitten her and has thrown cuspidors at her repeatedly.”

This kind of situation was a quandary for attendants at all asylums: how to handle violent patients without resorting to restraints or reciprical violence. One solution was to call in enough attendants so that the patient could be safely restrained by humans until he/she calmed down. Unfortunately, Canton Asylum had too few attendants for this to be a feasible solution.

Woman Forced Into Cold Shower, from Elizabeth Packard's book Modern Persecution, or Asylums Revealed

Child Patient in Restraints, Georgia State Hospital for the Insane (1940s), courtesy Georgia State University

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Another Side to the Story

Book by Elizabeth Packard

Book by Elizabeth Packard

Elizabeth Packard had been imprisoned in her home by her husband, who considered her insane because she did not obey him and agree with his philosophy. (See 11/12/10 post). During her sanity trial, her husband sold their home and took their children out of state.

Elizabeth, an assertive and independent woman, wrote several books about her experiences. Modern Persecution or Married Woman’s Liabilities was published in 1873.  In this work, she had the satisfaction of venting her anger about the injustices her husband had committed, while striking a blow for women’s helplessness under current laws.

Kidnapping Mrs. Packard

Kidnapping Mrs. Packard

Elizabeth became influential through her books and lectures, and was able to make an independent living. Her lobbying efforts for stricter commitment laws and rights for the insane were largely successful, though they were opposed by the psychiatric community.

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Alarming Testimony

Elizabeth Packard

Elizabeth Packard

Several people who were committed to insane asylums wrote about their experiences. Nellie Bly’s expose as a reporter was shocking, but her stay was temporary and her release secure. Real patients who survived commitments also offered shocking testimony, which made a great impact on the public.

Elizabeth Packard, married to Reverend Theophilus Packard, did not always fall in with her husband’s way of thinking on theology. He decided to have her committed to an insane asylum in Jacksonville, Illinois. After three years he allowed her release, but then decided to confine her to their home. He locked her in a room and nailed the windows shut. Elizabeth managed to drop a letter out the window to a friend, who alerted a judge.

The Packards' Home

The Packards' Home

Judge Charles R. Starr issued a writ of habeas corpus and then interviewed Elizabeth in his chambers. He allowed her a jury trial to determine her sanity. The prosecution’s testimony centered on Elizabeth’s rebellion against her husband and his doctrine, while her defense showed that she was, nevertheless, a devout Christian. Doctors testified both for and against her, pronouncing her both insane and perfectly rational.

The jury took seven minutes to reach a verdict that Elizabeth Packard was sane.

Insane Asylum, Jacksonville, Illinois

Insane Asylum, Jacksonville, Illinois

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