The Sordid History of the Asylum

 

The old New Brunswick Asylum

Modern psychiatry considers all major forms of “mental illness” incurable, including chronic depression. All they can do is prescribe pills to reduce the “symptoms.” 

Yet the early mental hospitals, circa the first half of the 19th century claimed cure rates up to 82% (C.M. McGovern, The Masters of Madness: Social Origins of the American Psychiatric Profession. 1985, Hanover Press: University Press of New England.)

What went wrong?

A history of the local asylum here in Saint John, N.B., is instructive. Founded in 1835, it was the first in what later became Canada.

Based on the success of such model asylums as York, England, and Worcester, Massachusetts, the plan was to get the patients away from whatever was causing them disorientation, stress or grief, in a calm and relaxing atmosphere. Dr. Waddell, an early superintendent, wrote that when “the cause of excitement no longer exists and they are confined to one scene and one set of companions, improvements are made.” And not just any scene. There were set principles for asylums: “Every hospital for the insane should be in the country, and within less than two miles of a large town.” “No hospital for the insane, however limited its capacity, should have less than fifty acres of land devoted to gardens and pleasure grounds for its patients. At least one hundred acres … for two hundred patients.”

So when a permanent site was sought for the provincial asylum, the site chosen was one that had previously been used for a summer resort, overlooking a major tourist attraction, the Reversing Falls. At the time, it was a mile outside the city, “commanding a magnificent view of the harbour and city.” “Varied scenery, but near enough to the active and changing scenes of life to arrest the attention and amuse the inmates.”

“The sound caused by rushing water is the music of nature, and is always in harmony with, and soothing in its effects on, the nervous organism.”(Waddell, 1874)

So how did we lose this seemingly effective model?

One mistake was putting these hospitals too close to the cities. Inevitably, the nearby city grew and spread to and beyond the hospital gates. The land reserved for outdoor activities became too valuable and was sold off. No more peaceful natural surroundings. At the same time, with growing populations, the hospitals became overcrowded. Giving out pills and sending them home, back to the conditions that caused their upset, was cheaper.

And there was a second mistake. The early successful asylums were generally run by religious organizations. Or else they were run by romantic idealists with a sense of mission. Staff were often themselves former patients.

Given that the primary cause of “mental illness” is a sense of loss of meaning and purpose, this religious element was probably critical to their success. And it prevented an obvious problem with staffing. Once the state took over, it was just a job. 

And a job likely to attract a certain type of person: someone who likes preying on the vulnerable. For who is more vulnerable than a psychiatric patient?

The first supervisor of the asylum, Dr. George Peters, resigned under a cloud. Seven female employees had accused him of “violating their person,” and having “illicit intercourse” with patients.

This has been a recurring problem, it seems, for psychiatry.

A patient committed in 1868 recorded his experiences. The admitting clerk would not address him, but spoke of him in the third person. “I was searched with as little ceremony and feeling as if they had been examining a horse.” He was then, throughout his stay, “ordered about like a dog.” 

“The keepers,” he writes, “are all very ignorant men and are selected purposely for their brutal and cruel disposition.” He could not of course know this, could not know on what basis employees were chosen. I am sure his assumption is wrong. But lacking any control, bullies would naturally self-select for such a job.  “They are, without exception, the most unfeeling, heatless wretches I have ever met.”

And so the cure for mental illness was lost. Obviously, if, as is currently understood, most or all mental illness is caused by abuse, especially in childhood, the mental hospital as it came to be constituted was in fact the perfect prescription for making the problem incurable. 

And so, supposedly wanting to reform this situation, we now send the unwell off to die on the streets. Causing our “homeless crisis.” The Saint John Asylum was torn down in 1998, and the site is now a popular park.

But have you noticed how much the original, successful asylum concept resembles a Christian or Buddhist monastery? Which were historically not just self-sustaining, but financially highly successful.

You have your solution.

How to Really Stop Mass Shootings

All right, banning more guns is going to do nothing to prevent incidents like the recent Connecticut shooting. What will?

One idea is to lock up anyone who is mentally ill and shows violent tendencies. The problem with this is that professional psychiatrists and psychologists have demonstrated no ability whatsoever to identify who is and who is not a threat of violence. In fact, studies suggest they are worse at this than the general population.

But this may not be a problem. Most of the mentally ill, let alone the violently mentally ill, do not want to live in society. Living in the community is the last thing they want to do. The community has driven them crazy. I bet they would voluntarily remove themselves from the community, given half a chance.

They don’t so it now, firstly, because they are not allowed to, and second, because the asylums have for some mad reason generally been designed to be like prisons. Instead, a lot of them die on the street.

Portrait of an Insane Woman, 1854

The trick is to design an asylum that is not too attractive to an ordinary, simply lazy person, gives the (perhaps violently) insane what they want, and separates them from the rest of society.

In a country like the US or Canada, with lots of land, there does seem to be a simple solution: offer the self-selected “mentally ill” free accommodation in small communities remote from the rest of us. An abandoned mining town, for example, where accommodations would be cheap. Offer no entertainment, no TV, internet, radio, or movies; the insane will not care, while those not insane will miss it enough for this to be a deterrent. The non-insane will also be deterred by separation from their families, friends, and familiar social networks; this will be an attraction for the insane.

If this sounds a bit familiar, it should. I’m describing something a lot like a monastery. There is a good reason for that.

Most of the mentally ill probably most need time to think, and time to deal with the spirits who are trying to communicate with them. Our current practice does everything we can to prevent this. Allow it, and I suspect most of the mentally ill will be able to cure themselves, most fairly quickly.

One of our biggest mistakes is in trying to coerce the mentally ill. Why do we do this? Probably because of the universal human urge to bully the weak. The runt gets pecked to death by the pack. But if the “mentally ill” are living apart, there is no longer any real need to force anyone to take medicine. Let them do it if they want, not do it if they want. Let them wander freely; into the woods away from everyone if they prefer.

The town would need most of the facilities of any small town: a restaurant for those who cannot manage to cook for themselves, a laundry for those who cannot manage to clean. A police force to keep people from eating one another. A doctor; ministers and churches. Postal service. But for the most part, treat these people as adults who know what is best for themselves, and have the right to decide things for themselves, while reducing stress where possible.

Besides preventing people from going off and shooting everyone in sight, this would almost certainly be far cheaper than what we do now for the “mentally ill.” Far more humane. And far more effective.