Institutions to house the mentally ill began in the Middle Ages. The word “bedlam” is derived from the nearly 800-year-old Bethlem Royal Hospital, which is still in operation.
In the 21st century, unfortunately, there is a stigma about mental illness. One hundred years ago, however, being mentally ill meant more than being judged and stereotyped. It meant you could be locked up for life and usually without your consent.
The Victorian View on Mental Illness
By the Victorian era, it was accepted that mental illness was indeed a disease, and this meant it was treatable.
What was considered a mental disorder, though, was not fully understood in the Victorian era. People often were committed for conditions that had nothing to do with mental illness.
Reasons that could get a person committed included:
- Learning disabilities
- Being an unruly or opinionated woman
- Being dangerous or violent
- Being suicidal
- Mental exhaustion
- Giving birth to an illegitimate child
- Post-partum depression
- Shell shock
Many patients were forgotten by their families, and abuse was common.
The number of people who were committed increased over the course of the 19th century. By the dawn of the 20th century, asylums were overcrowded and understaffed, despite laws that regulated how they should be run.
Treatments for mental illness were nothing more than torture. These “cures” included:
- Cold baths
- Withholding food
- Mercury pills
- Inducing vomiting
Many patients didn’t survive their treatment and were buried on the asylum grounds.
Not all treatments, however, were inhumane. Patients at the better institutions were allowed some measure of autonomy and were rewarded for good behavior.
More effective treatments included:
- Art therapy
- Occupational therapy
Champions of Change
In the late 19th century, reformers began advocating for change.
Former asylum patient Elizabeth Packard wrote three books on her experiences. She was committed by her husband, a minister, for disagreeing with him on theology in 1860.
Illinois state law stated a person must have a public hearing before he or she could be committed. The exception to the law was a wife; she could be committed by her husband without question.
Packard was released three years later and eventually took her husband to court. She later went on to become a champion of women’s rights and human rights.
Reporter Nellie Bly, considered a pioneer of investigative journalism, voluntarily committed herself in 1887 to investigate the treatment patients receive in asylums.
Her book Ten Days in a Mad-House is based on her New York World articles.
Bly’s investigation led to an inquiry by a New York assistant district attorney as well as changes to the Department of Public Charities and Corrections which funded New York City’s asylums.
The work of these women and others, in addition to new medical discoveries, helped changed conditions at insane asylums.
Updated: 23 October 2020