Civil War Soldier Angelo Crapsey, 1861, Who Committed Suicide in 1864 After a Period of Mental Illness, courtesy Kutztown University of Pennsylvania

Leaders in many states recognized early on that they needed to provide treatment for mental illness at public expense. The North Carolina Hospital (Raleigh) opened in 1856, but an influx of patients after the Civil War forced the state to find other places for care, such as in private homes. It is likely that this increased need for care occurred just as families were hurting for cash: Fraud became so widespread that the state  had to pass laws requiring counties to care for the insane, instead.

Early care in North Carolina’s asylum consisted primarily of rest, occupational therapy, and treatment for physical problems. Cure rates during this period were in the neighborhood of 30 – 40 percent. Though high, these cure rates may be accurate. After the trauma of fighting during the Civil War, patients who were former soldiers may have been truly helped by a stay in a calm, well-regulated environment where not much was demanded of them.

North Carolina’s constitution mandated that the state care for all of its “insane, blind, and deaf-mute persons.” However, there was still a great deal of stigma attached to insanity and public acknowledgement of it by families. By 1884, the general population–though it recognized the need for care–wanted it provided at home. Consequently, many family physicians found it necessary to study insanity so they could at least recognize and provide some sort of treatment for it among their patients.

Peaceful Scene at North Carolina Hospital, 1924

Drug Room at North Carolina Hospital, 1924