Norwich State Hospital for the Insane
Taxpayers today cry out against waste and unchecked expenses within the public health care system, and demand value for each health care dollar. It was the same a hundred years ago, and state insane asylums felt constant pressure to keep their expenses down. Care at that time was largely custodial, and patients eased their institution’s expenses somewhat by contributing labor in gardens, kitchens, and laundry rooms. Today’s strides in medical care and the curtailment of patient labor make comparisons between the eras difficult, but it is plain that life in an institution was never luxurious.
The average income a hundred years ago was $1,033. A gallon of gas cost seven cents, and a loaf of bread five cents; a medium-priced home was $2,750. The cost of living sounds great, but in 1912, Alabama insane asylums were confined to a per capita expenditure of $3.25 per week, or $169 per year. (In today’s dollars, that would be a little over $77 per week, or $4,004 per year.) That weekly $3.25 had to pay for food, clothing, entertainment, and medical treatment; wages for physicians, nurses, and attendants had to be covered; and utilities, equipment, tools, supplies, and repairs to the buildings also came from that sum.
The more patients in an asylum the lower the per capita costs. The Norwich State Hospital for the Insane in Connecticut began operations in 1905 with an average pf 77 patients and a weekly per capita cost of $6.58. By 1915, it had 1,109 patients and had dropped its weekly costs to $3.51. The Canton Asylum for Insane Indians, which held fewer than 100 patients, could not compete cost-effectively with larger institutions. Its superintendent faced the constant danger that Congress would decide to close the institution for financial reasons and disperse its patients to their respective state insane asylums.
Dairy Herd, State Lunatic Asylum No. 1, circa 1900, courtesy Missouri State Archives
Bryce Hospital for the Insane in Alabama
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I must refer to them with some term, and because I’m also discussing insane asylums in general, “patients” is the most flexible term to use. And, some of the people at Canton Asylum truly were patients who had debilitating physical problems as well as probable mental ones. Not all patients were sent to the asylum by whites or people in authority; some families implored the Commissioner of Indian Affairs to help their loved ones. It’s quite possible that many in this category received better care than their families could give, since they had limited resources and were sometimes emotionally and physically drained. Psychiatric care during this time period is fascinating partly because some of it was so bizarre and cruel, yet there are many instances where patients, themselves, thanked their doctors and the asylums that took them in.
I so appreciate your interest and involvement–let me know if any posts are particularly interesting to you.
How do you so easily call them patients? yet know the people were not.