Medical illustration from 1838 shows restraints in use in France, something which sadly did not change much over the years. Via/ Wellcome Images
Oregon State Hospital courtyard, 1905. Via/ Wiki Commons
Mental patient with depressive catalepsy. Via/ Wellcome Images

In 1887 there were in England more than 80,000 insane asylum patients in the various types of facilities (workhouses, pauper asylums, private asylums and hospitals, as well military and criminal insane asylums). In the U.S. in 1880 there were 232,473 people in asylums, workhouses, juvenile detention centers, and homes for the blind and deaf. Despite well-intentioned methods of treatment (which included restraints and hydrotherapy), even improvements made around the turn of the century left segments of asylum populations vulnerable to mistreatment and misdiagnosis.

Cold water spray was used to treat mania and psychotic episodes. Via/ Internet Archive
Brookwood Mental Hospital, England, 1890s. Via/ Internet Archive
Men’s ward at a St. Louis mental hospital, 1904. Via/ St. Louis Public Library
Women’s ward in same facility, 1904. Via/ St. Louis Public Library

Patients in asylums could be suffering from diseases (like syphilis, epilepsy, or alcoholism) or even from extreme grief. Sometimes the elderly and those with senility ended up in insane asylums. While we would today consider these medical ailments or matters for family, the lack of successful treatments and knowledge of disease meant that in many cases patients/inmates would have been incarcerated for life.

This restrained woman was diagnosed with having “hysteria-induced narcolepsy.” Via/ Wellcome Images
Women’s ward in England, clearly a very nice facility compared to many institutions of the era. Via/ Wellcome Images
Civil War military hospital, mental ward. Via/ Wellcome Images

Staff were advised to bribe them with food, and to coerce, or punish patientswho often had little control in their lives – and this was at facilities where the staff believed they were giving good treatment to the inmates! Some facilities offered little to no treatment or discussion of care. On the other hand some facilities offered occupational or distractive therapy, one of the few steps towards humane treatment of mental patients at the time.

Sewing room on women’s ward, St. Louis, 1904. Via/ St. Louis Public Library
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