Tag Archives: Pennsylvania Hospital for the Insane

Impossible Tasks?

Supervisor-in-Chief, Attendants & Employees, Detached Building No. 4, Willard Asylum

Supervisor-in-Chief, Attendants & Employees, Detached Building No. 4, Willard Asylum

Though superintendents and other professional staff were inherently in charge of insane asylums, attendants were the true backbones of them. What attendants did or did not do, the way they treated patients, and their attitudes in general could provide some sort of therapeutic benefit or make a patient’s stay as miserable as possible.

At the Canton Asylum for Insane Indians, attendants were never trained. They likely watched what other attendants did and followed suit, also bringing in their own attitudes and experience to patient care. There were guidelines for attendants–provided after inspectors discovered that the asylum’s first superintendent (Oscar Gifford) had never disseminated them to staff–but they would have been difficult to follow due to the asylum’s perpetual short-staffing. In fact, any number of subsequent inspections showed that most guidelines obviously were not followed. The government did make its priorities clear, however:

A Group of the Asylum Staff, Willard Asylum

A Group of the Asylum Staff, Willard Asylum

“In the event of a fire, your first duty is to save the lives of all the patients under your charge. Your second duty is to save government property. Your third duty is to yourself. These duties are always to be considered in this order.”

Attendants at Pennsylvania Hospital for the Insane

Attendants at Pennsylvania Hospital for the Insane

Clearly, human staff were of least value to the Bureau of Indian Affairs. It is little wonder that the agency allowed its one asylum to fall into neglect simply because it would not provide enough people to adequately care for their charges.

My next post will discuss the enormity of attendants’ responsibilities.

 

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Payrolls

Attendants at Central Islip Psychiatric Hospital, 1910, courtesy Minnesota Governor's Council on Developmental Disabilities

Insane asylums were important to local economies. Local men were needed for construction work or repairs, and businesses could count on meeting at least some of an asylum’s supply needs. Perhaps more importantly, insane asylums provided steady work for locals. From 1900 to 1907, the Canton Asylum for Insane Indians spent $54,896.78 on maintenance, some of which found its way into local pockets. It spent almost as much on wages, though–which was probably far more important. The payroll went from a bare $2,080 at the end of 1902 to $11,340 by 1907.

The first salary list included: a superintendent and assistant superintendent, a financial clerk, an attendant, three laborers, and a night watch (8 total). By 1909, the list included: a superintendent and assistant superintendent, clerk, matron, seamstress, laundress, cook, dining room girl, engineer, two male and two female attendants, three laborers, a night watchman, and a laborer (18 total). As buildings and the patient population went up, the asylum pumped more and more money into Canton and the surrounding area. It’s little wonder that the townspeople had a soft spot in their hearts for the facility and considered it a valuable resource.

Graduation Class of Nurses at Utica State Insane Asylum, 1899, courtesy Minnesota Governor's Council on Developmental Disabilities

Woman Attendants With Dumb Bells at the Pennsylvania Hospital for the Insane, early 1860s, courtesy Minnesota Governor's Council on Developmental Disabilities

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Employee Grievances

Pennsylvania Hospital for the Insane, 1870, Male Staff at Entrance, courtesy Brenner Collection, Brynmawr

Though it is easy to blame attendants for being frustrated and unkind to the patients in their care, attendants were often frustrated themselves. Mary J. Smith (see last post) told an investigator about her workday: “Her work in the morning is as follows, 6 patients to dress before breakfast–2 paralytics, 1 spastic deplegia, and three that are so crazy they do not know enough to put their clothes on; that she has to wait on tables then after breakfast gives medicine to from 6 to 12 patients, four she has to take to closets (bathroom)–that she has to make 11 beds herself.”

In addition to this daily morning routine, on Wednesday mornings, Smith had to scrub 5 small rooms, one large room, one large hall, three short halls, and a pair of steps. On Thursdays, she had to put the clothing from the laundry away. There were 28 patients in the female ward in 1908, and Smith had charge of 15 of them.

Though there could never be an excuse for mistreating patients, Smithwas undoubtedly harried and overburdened. It would have been tempting to just lock up patients so she could give her attention to some of her additional duties. One consequences of the inspection was that the asylum was authorized to add two attendant postions, one female and one male. Unfortunately, to do so, it had to abolish two laborer positions.

Buggy Used at the Colorado Insane Asylum, 1879-1899

Agnew State Insane Asylum (Santa Clara) after 1906 Earthquake

 

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Punishing the Insane

Douche Bath in Pennsylvania Hospital for the Insane, 1868, courtesy cournellpsychiatry.org

Douche Bath in Pennsylvania Hospital for the Insane, 1868, courtesy cournellpsychiatry.org

Some asylum superintendents treated their patients like naughty children or criminals, imposing punishment upon those who were unruly or uncooperative.

Doctors forced patients to take hyoscyamine (an alkaloid found in henbane that has a very bitter, nasty taste) or to drink disgusting concoctions. Another popular punishment was the plunge bath, in which patients were repeatedly dunked in ice-cold water.

Hyoscyamine (Henbane)

Hyoscyamine (Henbane)

Patients who were able to work, but refused to do so, were especially irritating. Doctors might try to humiliate or degrade them by forcing these patients to wear ragged clothes, or by cutting their hair off.

Other doctors noted that these punishments seldom worked, and called for humane treatment. In their opinion, the insanity itself was the cause of a patient’s misbehavior. These doctors felt it was pointless to punish someone who couldn’t control his behavior or had lost his moral sense through the disease of insanity.

Surprise Bath, courtesy cornellpsychiatry.org

Surprise Bath, courtesy cornellpsychiatry.org

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