The Deinstitutionalization of the Mentally Ill
The homeless- found on city park benches, street corners, and subway grates. Where did all of these people come from? One third, to one half of the homeless suffer from a mental illness. A lot is said about the homeless-mentally ill, but what their plight says about us may be more significant. We still have not found a place for those who are both poor and insane. Once there was a place for them; the asylum fulfilled the basic needs of thousands for decades, but now these institutions lay empty and in ruin. Has the hope to heal the mentally ill also been abandoned? Is there once again a need for the asylum? The disbandment of the asylum was the first step in ending segregation for those with mental illness, but we have yet to accomplish integration.
The concept of the asylum was originally meant to be a place of retreat for a sorely troubled individual. Appalled by the treatment of the insane, a woman by the name of Dorothea Dix set out to persuade legislature to establish thirty-two new asylums in several states across the country. This included the monumental government hospital, St. Elizabeth’s, in D.C. Dix believed that the most deranged individuals would recover from their illness if they were treated with kindness and dignity. These hospitals were set apart from the community and were made to provide a place of retreat from busy city life, a place for healing. The hospital grounds were peaceful and relaxing. With this environment and a structured day complete with evening entertainment it was thought that a patient would need only a few months to heal. The first patient arrived at St. Elizabeth’s in 1855. Dorothea Dix once said, “If the person’s insanity was detected soon enough and treated early with this moral treatment he would recover in months as if it were a cold or flu” (qtd. in Asylum: A History of the Mental Institution in America).
Unfortunately, asylum founders could only guess at the causes of insanity. Patient after patient was admitted into the state hospitals, but the cause of their disturbance was often a mystery. Many were inflicted with various organic diseases, like dementia, Huntington’s disease, brain tumors, and many were in the third stage of syphilis. With no treatments available, providing humane care was all that could be done. In the years following the civil war American cities boomed and the asylum began struggling to keep up. Soldiers, freed slaves, and immigrants were stranded in a strange land. The asylum became organized more like a factory or small town. There were upper and lower classman, bosses and workers, patients with nothing, and patients with privileges. Sarah Burrows, a schizophrenic and daughter of a wealthy doctor had a ten bedroom house that was built for her on the hospital grounds. Burrows home was just a stone’s throw away from the hospital’s west wing, where over sixty black women slept side by side. (Asylum: A History of the Mental...