Tag Archives: Willard Asylum for the Chronic Insane

Time and Tasking

Family Life Could Be Ovewhelming, While Still Not Comparable to Caring for Adults in an Asylum

Family Life Could Be Ovewhelming, While Still Not Comparable to Caring for Adults in an Asylum

Ward attendants were the backbone of patient care in asylums, and their attitudes and skills could make or break a patient’s experience (see last post). At the Canton Asylum for Insane Indians, attendants were never trained and very likely relied on their home experiences with raising children or being around perhaps difficult family members. The stress and tempo of caring for several children at home might mimic some of the tasks of attendants, but it made a difference that attendants were usually dealing with adults rather than children. Carrying a small child to a bath–even an unwilling one–might be stressful, but a parent would prevail. That might not be so true in the asylum setting. Here are just some of the routine tasks male attendants were expected to complete for ten or more patients each day:

— wake patients up (6:00 a.m.) and see that each patient washes his face and hand, and combs his hair

— attend the morning cleaning, bedmaking and tidying of the ward

— see that the lavatories, tubs, toilets and urinals are in good working order and not leaking. Fixtures are to be washed whenever necessary and scrubbed with a cleaning powder at least once daily. All faucets are to be polished whenever necessary

— all wood work is to be rubbed down once daily with an oiled cloth

Willard Asylum Patients Working in the Sewing Room. Structured Activities Made Supervision Easier for Attendants

Willard Asylum Patients Working in the Sewing Room. Structured Activities Made Supervision Easier for Attendants

In addition to these duties, attendants had to take patients to the dining room, feed those who could not feed themselves, bathe and change the clothing (or at least clean and change) patients who soiled themselves, take each able-bodied patient outdoors for exercise at least twice daily, shave them once a week, give them haircuts and trim their nails, and on and on. Patients were always to be supervised, and attendants were never to leave their wards except if duty required. Before doing that, they had to make sure no patient had a lighted pipe or cigarette, etc.

Agnews Insane Asylum Patients Eating Lunch, courtesy Detroit Public Library Digital Collections

Agnews Insane Asylum Patients Eating Lunch, courtesy Detroit Public Library Digital Collections

It is little wonder that being an attendant was not an attractive job, and didn’t usually draw people who could get easier work with better pay, elsewhere.

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Part-Time Physicians

Doctor with Horse and Buggy, 1894

Doctor with Horse and Buggy, 1894

Early physicians were prepared to handle a variety of medical cases, and rural practitioners often took on mental illness as well, if their territories were too far away from asylums for treatment. They had a difficult and uncertain occupation, however, that didn’t necessarily provide a good living. We may be used to seeing doctors earning comfortable salaries today, but that wasn’t always the case.

 

View of Taunton State Hospital, Interior

View of Taunton State Hospital, Interior

Rural doctors could not set extraordinarily high fees for their work or they wouldn’t have been able to find and keep patients. But, the time-consuming trips they made to see patients (during the age of house calls) prevented them from seeing many patients on any given day. Few patients, of course, meant meager salaries. Earnings were all too often along the lines of the doctor in 1849 who billed a patient $12 for services–but then deducted two dollars in exchange for two bushels of buckwheat.

Because it was so difficult to earn a living as a full-time physician, many doctors took on second jobs. During the early 1800s in Burke County, North Carolina, doctors held second jobs ranging from Superior Court clerk, to school teacher, to hotel operator, to farmer, in order to supplement their wages as physicians.

Doctor's Parlor, Willard Asylum for the Chronic Insane

Doctor’s Parlor, Willard Asylum for the Chronic Insane

It is no wonder that a position as an asylum superintendent would be so attractive to medical men, and so jealously guarded by physicians who were alienists. Because they could squeeze out competition, asylum superintendents enjoyed decent salaries and pleasant places to live. Though they didn’t own the homes or living areas they received on the asylum’s grounds, the buildings were grand and elegant (at least at first), and the grounds beautifully landscaped. Such a situation was much better than the salaries and living arrangements available to many other physicians outside the field.

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Grimes Was Not Impressed

Morningside Hospital Patient Ward, circa 1935

When Dr. John Maurice Grimes inspected mental institutions in the U.S. (see last two posts), he discovered that the federal asylum in Washington, DC, (St. Elizabeths) was overcrowded. Continue reading

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The Insane as News Items

Doctor's Parlor, Willard Asylum for the Chronic Insane

Doctor’s Parlor, Willard Asylum

Though early alienists did a great deal to de-stigmatize insanity and help families feel better about seeking help for their mentally ill members, insanity was still a delicate subject that most families preferred to keep private. Asylum superintendents understood this. Continue reading

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The Chronic Insane

Outagamie County Asylum for the Chronic Insane, Wisconsin, circa 1889

Outagamie County Asylum for the Chronic Insane, Wisconsin, circa 1889

Alienists stressed that the prompt treatment of insanity was imperative to a cure. They cautioned the public that it was far wiser to bring an afflicted person to an asylum for a cure as soon as possible, rather than let the patient languish at home for years until an asylum became a last resort. By that point, the disease might have too strong a hold and never be shaken. Continue reading

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Care For the Body as Well as the Mind

Buffalo State Asylum for the Insane

Buffalo State Asylum for the Insane

Though insanity had been recognized since the country was founded and asylums (both private and state-funded) had been around for almost a hundred years, doctors had not instituted any systematic training for asylum attendants. Attendants were the front line resource for any asylum, and their interaction with patients could greatly contribute to their comfort and recovery–or to their misery and mental distress. Many doctors, of course, made individual efforts, but training could be particularly haphazard at state institutions. One main problem was that there was little status attached to being an attendant, the work was hard, and the pay low. Many times, asylums could only get the type of worker no one else would employ, particularly since able-bodied men typically had a number of other choices.

Women had fewer choices, and it was likely easier for asylums to find female workers of good quality. In 1883, the Buffalo State Asylum began a general course of instruction for women, mainly pertaining to the rules of the institution, with some specifics on caring for the insane. The training was given as an experiment at first, but was successful enough that the asylum’s Board of Managers offered the course formally. Students had to pass a state civil service exam and successfully pass a test after the course. They then received a certificate. A male attendants’ course began in 1885 when the formal program began.

Male Attendants at Willard Asylum for the Chronic Insane, courtesy inmatesofwillard.com

Male Attendants at Willard Asylum for the Chronic Insane, courtesy inmatesofwillard.com

Group of Physicians and Attendants at Willard Asylum for the Chronic Insane, courtesy inmatesofwillard.com

Group of Physicians and Attendants at Willard Asylum for the Chronic Insane, courtesy inmatesofwillard.com

 

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