Nineteenth-century asylums evoke terrible images of dark and dirty cells, shrieking lunatics, horrible experiments, and abusive doctors. The disturbing nature of these impressions is not unfounded. Abuse and poor conditions in the United States of America mental institutions have been well documented. Former patients often published sensational exposés to reveal the dark and horrid nature of these secret places. However, for most of the nineteenth-century, the asylum was also conceived of as a beacon of human rights, an enlightened institution to protect and cure the mentally ill. This saintly image was occasionally upheld by the patients themselves, through periodical literature published from within the asylums. The most prolific of these, ‘The Opal’ was written, edited, and printed by patients in the New York State Lunatic Asylum at Utica, and sold to the public for a profit.
Asylum periodicals and exposés are markedly different forms of literature, both in style and in a message. Periodicals worked to advocate the benevolent mission of the asylum, whereas exposés claimed to reveal their hidden corruption. Asylum periodicals and exposés provided important commentary on insanity and mental institutions themselves and were part of the larger social and political discussions of the nineteenth-century. The institutionalized had lost many of their rights as humans and as United States of America citizens. Patients were seen as mentally and socially defective, even after they had been released, and were largely ignored as individuals. By publishing within the framework of institutional periodicals and sensational novels, these men and women created a public forum in which they could discuss serious issues and have their voices heard. Through their literature, mental patients in the nineteenth-century were able to shed light on how the United States of America asylums deprived citizens of their liberties and human rights through forceful imprisonment and unwarranted abuse.
Asylums, as they existed during the mid-nineteenth-century, were unique within the larger history of mental institutions in the United States of America. In the early colonial era, communities were small and closely-knit, so the few “distracted” people, as they were known at the time, were dealt with informally by family or neighbours. Insanity was considered more of a social and religious problem than a medical one. People saw mental illness as an outward expression of sin or a punishment from God. However, negative these religious suspicions may seem, there is no indication that the colonists treated most mentally ill people cruelly. A tolerant and often generous outlook was due in part to the small size of the communities, as well as the Puritan emphasis on charity. A number of developments gradually altered public opinion over the eighteenth-century, and toleration of the insane in the United States of America proved to be short-lived.
As the population of the colonies grew in the eighteenth-century, there was a significant increase in the number of insane or otherwise dependent people. Before this point, confinement or exclusion was rarely resorted to and was only utilized in response to the violently insane that posed a danger to the community. The more dependents there were, however, the less the community could care for them. Increasingly, the insane as a whole came to be seen as dangerous because of their uselessness and the burden they placed on society. Along with the population growth, the initial influence of the era of Enlightenment reached the colonies in the eighteenth-century, which drastically altered many people’s perceptions of the world. Its emphasis on reason reduced the supernatural explanation for madness and introduced the concept of insanity as a disease. However, many people still believed that this particular disease was the fault of the ill person, a result of their poor lifestyle. Furthermore, the Enlightenment’s idea that to be human meant to be reasonable had the unfortunate result of classifying the mentally ill, who were without reason, as less than human. These ideas led to the overwhelming practice of confinement in response to the mentally ill. People saw the mad as inhuman, dangerous, diseased, and a threat to human reason. As such, the insane were no longer cared for as members of the community, but were isolated, out of sight.
Most people with mental illnesses were kept shut up in almshouses, poor houses, jails, and hospitals for much of the late eighteenth and early nineteenth centuries. Although many of these institutions were charitable in nature and provided guardianship for their charges, the public impression of them was negative. These establishments served simply to keep the insane out of society, rather than to provide any kind of medical care, either physical or mental. The conditions were very poor. The inmates or patients were kept chained in cells or pens and were physically abused. Hospital wards for the insane were damp, cold, and unclean, and caused the deaths of many patients. While these custodial and often inhumane facilities were being utilized to remove the insane from the public eye, a number of social movements changed the asylums yet again.
By the nineteenth-century, the Enlightenment was embraced for its optimism about the human spirit and mind, as well as the capacity for human perfectibility through reason. Enlightenment thinkers believed that all deviant humans, such as criminals or the mentally ill, could be cured and moulded back into useful and reasonable citizens. Unlike in earlier years, when the Enlightenment had a negative effect on the public opinion of the insane, its effects in the nineteenth-century were more positive. This was in part because of the renewed religious spirit of the Second Great Awakening in the early nineteenth-century. The main change that this movement brought was a rejection of the Puritan belief in the inherent sinfulness of man in favour of man’s internal goodness and a kinder, more forgiving God and insanity was no longer seen as an expression of evil, nor was disease a divine punishment. A kind God would wish for people to treat the mentally ill with love and empathy rather than fear.
Changes came in the world of mental health as well. Philippe Pinel, a French philosopher and asylum doctor, famously unchained his patients in 1793 and created a new system of caring for the mentally ill. This was called the “moral treatment,” a theory which posited that insanity was curable not by locking the mad up in chains and punishing them, but through kindness, conversation, and the close attention of a physician. By the 1830s and 1840s, most asylums in the United States of America were being built and operated to fit this treatment style, which became the earliest form of psychiatry. The new asylums were seen as humanitarian institutions, providing moral care for the mentally ill who had been so abused by the previous system. Those who founded and reformed asylums during this period had tremendous optimism about the curability of the mind.
Within the moral asylums of the mid-nineteenth-century, doctors believed that mental illness could be cured given the proper, controlled environment. Since many associated insanities had negative and dangerous connotations, the asylums operated on the idea that, provided with healthy and moral surroundings, the insane could be returned to sanity, and therefore humanity. Superintendents stressed the necessity of occupational activities for the health of the patient’s mind. Many asylums had workshops where the patients could build practical skills, such as sewing, farming, blacksmithing, and printing. Asylums became centres of cultural activity, where the work of patients could include theatre, photography, and writing. One such activity encouraged by doctors was the creation of patient periodicals. Writing could help cure diseased minds, and at the same time provide good public relations for the asylum.