Tag Archives: investigations into insane asylums

Inspection Results

State Lunatic Asylum in Lincoln, Nebraska

State Lunatic Asylum in Lincoln, Nebraska

The two federal institutions for the insane (St. Elizabeths and the Canton Asylum for Insane Indians) were investigated several times. In 1926, the comptroller general of the United States listed his findings concerning the investigation into St. Elizabeths. They included the following:

— The laws under which persons …are committed to the hospital are not adequate or sufficiently definite.

— There are too many patients in some of the wards, resulting in a crowded and unhealthy condition.

— Dining rooms, sitting rooms, toilets, baths, and other facilities of some of the wards are quite inadequate and most unsatisfactory.

— The fire hazard in certain wards is too great, and there does not appear to be sufficient fire fighting equipment.

— Several findings concerned the proper accounting of patients’ monies and valuables, including the need for a place to safeguard them.

Some of these 1926 findings were similar to those at Canton Asylum (overcrowding, inadequate facilities, and fire hazards). However, St. Elizabeths had 4,340 patients in June 1926, well over 50 times the number of patients at the Canton Asylum. The facility was not perfect, but by no means did it have 50 times the problems of its sister asylum. Undoubtedly St. Elizabeths’ leadership had something to do with its better performance.

Asylums were frequently inspected and investigated, and most had similar problems. Appropriations were generally set for a certain time period and included set numbers of personnel positions. Because funding wasn’t based on actual patient populations or patient to staff ratios, overcrowding could set off a cascade of problems. Facilities became inadequate and attendants became overburdened. In turn, stressed attendants probably lost patience or reacted less professionally with difficult patients. A new (and possibly sufficient) cycle of funding may have given an institution a chance to catch its figurative breath, but a new cycle of overcrowding was almost certain to begin shortly thereafter. As the public became more comfortable using insane asylums, their demands on these institutions created perpetual overcrowding. Insane asylums were often victims of their own success.

Overcrowding at Byberry (Philadelphia State Hospital) from a 1946 Department of Welfare Report

Overcrowding at Byberry (Philadelphia State Hospital) from a 1946 Department of Welfare Report

Patients Had to Sleep in Chairs at the Camarillo Mental Hospital

Patients Had to Sleep in Chairs at the Camarillo Mental Hospital, courtesy Camarillo State Hospital Historical Society

 

 

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Asylum Comparisons

St. Elizabeths Hospital for the Insane of the Army, Navy, and District of Columbia

St. Elizabeths Hospital for the Insane of the Army, Navy, and District of Columbia

St. Elizabeths and the Canton Asylum for Insane Indians were investigated a number of times during the early twentieth century. Both were federal insane asylums, but they were also quite different. St. Elizabeths was very much a medical facility, while the Canton Asylum was run along Indian boarding school lines. In 1927:

— St. Elizabeths had an amusement hall (Hitchcock Hall) for patients; Canton Asylum did not.

— St. Elizabeths had specialized buildings like cottages for tubercular patients and quarantine buildings; Canton Asylum did not.

St. Elizabeths had a 10,000 volume library and subscribed to 35 periodicals; in 1925 the Congressional Library began to send its surplus magazines to the asylum (about 1,000 a month); Canton Asylum received subscriptions to about half a dozen magazines.

St. Elizabeths had a furlough program which allowed patients to go home on trial visits; a social worker followed up on patients during these short visits; Canton Asylum actively discouraged furloughs for any reason. St. Elizabeths created an out-patient department for veterans who had been discharged from the military shortly after commitment. This department helped some patients find employment and tried to help them find a home so that they would not be overwhelmed when they were released. Canton Asylum did not help its patients this way.

A typical menu for a Tuesday midday meal at St. Elizabeths showed: bean soup, beef pot roast, gravy, browned potatoes, cucumbers, bread, oleo, and tapioca cream pudding. A menu for Canton Asylum (from the 1928 Meriam Report) showed: a stew of meat and carrots, with more fat and bones than anything else, thin apple sauce, bread, and coffee.

St. Elizabeths was significantly larger than the Canton Asylum, which gave it justification for some of its specialized facilities. However, its placement in Washington, DC and its patient population (veterans and citizens of the District of Columbia) also mattered. The American Red Cross, veterans’ groups, and the Knights of Columbus, as well as other civic organizations had easy access for volunteer work and aid of various kinds; the Canton Asylum had to depend on the kindness of small-town organizations like volunteer ministers and the Canton Band to help its patients.

However, both organizations had areas of weakness that investigations brought to light.

Dining Room at McLean Asylum for the Insane

Dining Room at McLean Asylum for the Insane

Bear Cubs at St. Elizabeths' Zoological Gardens

Bear Cubs at St. Elizabeths’ Zoological Gardens

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