Talk:History of psychiatric institutions
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As this is about history it will benefit from being organised primarily along a time line. Any observations about any regional differences can then be anchored to this temporal axis but I guess you knew that already.--Aspro (talk) 16:10, 29 November 2009 (UTC)
I agree and nice work. I think the Psychiatric hospital page could be pruned much more ruthlessly of historical material as well. All that is needed over there is one paragraph and then skip to the present day picture. Freekra (talk) 16:36, 29 November 2009 (UTC)
Now that I’ve had more time to think about it, as far as I’m concerned, just the link to the history would do. The reader will want just one or the other. Besides, what can one meaningfully say in just one paragraph! I have started a time line as an experiment, and so before I add any more to it, we really need to decide the most significant developments were. Also, it is not the only way of showing a time line. For example, it could be in the form of a flow chart showing new treatments branching out and continuing in parallel. For now though, getting the text in the articles sorted out seems more important. You seem to know what your doing, so it might be better if I step back and let you go-with-the-flow. I’ll be around still, in case you want to bounced ideas off me.--Aspro (talk) 19:04, 29 November 2009 (UTC)
I like the timeline, I've never seen one before and I couldn't resist playing with it I'm afraid. A flowchart might be useful but, as you've said, the text is the most important element. I'd rather you kept on editing with me though, I think it would make for a better article all round. Freekra (talk) 19:41, 29 November 2009 (UTC)
- I've removed the timeline, and moved its most salient points into the main timeline of psychiatry article. -- The Anome (talk) 20:27, 29 November 2009 (UTC)
- Note: I've also restored the "History" section in the psychiatric hospital article, replacing its previous text with a very short overview of this article. This follows standard Wikipedia house style when refactoring a section out of a overlarge article into its own "main" article. -- The Anome (talk) 02:27, 30 November 2009 (UTC)
Cut and paste of remnant from history section in Psych Hosp article
The history of psychiatric hospitals dates back to the creation of insane asylums in the 16th century. Whilst there are historically examples of older institutions for the confinement of those deemed mad, the institutionalisation of the "insane" on a wide scale began in the nineteenth century in Europe. Initially, the treatment of the inmates of insane asylums was brutal. Recognition of the brutality of these regimes by successive reformers led to more humane treatment of inmates, and as developments in psychiatry led to greater understanding of mental illness, further reforms were made.
Bethlem Royal Hospital (Bedlam) was the first known psychiatric hospital in Europe, founded in London in 1547. It soon became infamous for its treatment of the insane. In the eighteenth century, outsiders would pay a penny to come and watch their patients as a form of entertainment. In 1700, the "lunatics" were called "patients" for the first time. Within twenty years separate wards for the "curable" and "incurable" patients had been established. The institution was still a coercive and brutal regime when William Battie criticized its practices in his treatise in 1785. By 1815 thousands of visitors were still being permitted in to view the "unfortunates" as they were by then called. At this time there was minimal understanding of mental health issues and treatment methods were in the early stages of development. Patients were often given, what today would be considered ridiculous treatments, which often resulted in fatality or outstanding injury.
For wealthy families, the practice was often to employ a keeper to watch over the family member that was in crisis. An example from fiction gets has an important part in Charlotte Brontë Jane Eyre when Mr Rochester's places the care of ill wife Bertha under the watchful eye of Grace Poole. Alternatively, they may place their relative in the care of someone who makes a living by providing accommodation and care for the insane in private houses. These were simply known as "private asylums." The word "asylum" comes from the Greek for "refuge," because the place served as a refuge or sanctuary from the dangers that existed outside.
Phillipe Pinel (1793) is often credited as being the first in Europe to introduce more humane methods into the treatment of the mentally ill (which came to be known as moral treatment) as the superintendent of the Asylum de Bicêtre in Paris. A hospital employee of Asylum de Bicêtre, Jean-Baptiste Pussin, was actually the first one to remove patient restraints. Pussin influenced Pinel and they both served to spread reforms such as categorising the disorders, as well as observing and talking to patients as methods of cure.
In 1817, William Ellis was appointed as superintendent to the newly built West Riding Pauper Asylum at Wakefield. As a Methodist, he had strong religious convictions. With his wife as matron, they put into action those things they had learned from the Sculcoates Refuge in Hull which operated on a similar model as the York. After 13 years, as a result of their highly regarded reputation, they were invited to oversee the newly built first pauper asylum in Middlesex called the Hanwell Asylum. Accepting the posts, the asylum opened in May 1831. Here the Ellis's introduced their own brand of humane treatment and 'moral therapy' combined with 'therapeutic employment.' As its initial capacity was for 450 patients, it was already the largest asylum in the country and subject to even more building soon after. Therefore, the immediate and continuing success of humane therapy working on such a large scale, encouraged its adoption at other asylums. In recognition of all this work he received a knighthood. He continued to develop therapeutic treatments for mental disorders and always with moral treatment as the guiding principle.
Reformers, such as American Dorothea Dix began to advocate a more humane and progressive attitude towards the mentally ill. Some were motivated by a Christian Duty to mentally ill citizens. In the United States, for example, numerous states established state mental health systems paid for by taxpayer money (and often money from the relatives of those institutionalized inside them). These centralized institutions were often linked with loose governmental bodies, though oversight and quality consequently varied. They were generally geographically isolated as well, located away from urban areas because the land was cheap and there was less political opposition. Many state hospitals in the United States were built in the 1850s and 1860s on the Kirkbride Plan, an architectural style meant to have curative effect.
The development of psychosurgery in the mid 20th century was originally thought of as a humane advancement, but came to be regarded as a brutal and unneccesary treatment, leading to its abolition in the later part of the 20th century.
The late 20th century saw the introduction of new drug-based treatments, and futher reform movements that led to the introduction of a program of deinstitutionalization.
- Scarequotes provided because we're not necessarily dealing with the incarceration of people who would meet modern diagnostic criteria for mental illness. Scull, Andrew T. (1979). Museums of Madness.Palgrave Macmillan.
- Christine Stevenson, Medicine and Magnificence, passim.
- "Asylums and Care for the Insane". Catholic Encyclopedia. New York: Robert Appleton Company. 1913.
- Oxford DNB (2004) 'Ellis, Sir William Charles (1780-1839)' Oxford Uni. Press
- Yanni, Carla (2007). The Architecture of Madness: Insane Asylums in the United States. Minneapolis: Minnesota University Press.