Patients Working in Laundry Room at Texas State Lunatic Asylum, 1898

How much attendants were paid (see last post) mattered a great deal to superintendents, and generally not for the right reasons. The public began to exert extraordinary pressure on institutions to accept their afflicted family members, which resulted in overcrowding at nearly every insane asylum in the country. Doctors couldn’t cure patients when they had too many to properly care for, and asylums began to lose their roles as sanctuaries and restorative institutions.

With cure rates down, superintendents had to look for other reasons the public should continue to endorse the use of asylums. One argument was that it was much cheaper to keep patients at an asylum than at home or in jails. Many superintendents prided themselves on how cheaply they could run their asylums, and often compared their rates with unfavorably high rates at other asylums. Salaries were nearly always the largest single expense  at asylums, so superintendents had an incentive to hire the cheapest staff they could find. Unfortunately, as Beers pointed out, one could expect very little from an attendant who would work for eighteen dollars a month.

Patients on Floor in Eloise Women's Mental Ward in Michigan

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