TREATMENT OF THE MENTALLY ILL
The mentally ill in early America were regarded as sub-human: they were hanged, imprisoned, tortured, chained, caged, or left to wander. The government was more concerned with the person’s property than it was with helping the person heal. Even in so late a year as 1830, the mentally ill would be dressed in straitjackets and put in a dark cell. If this did not calm them, they could be subjected to starvation or other forms of torture.
“Out of sight, out of mind” seemed to be the general wisdom.
We like to pretend that what we think of as “history” happened a long time ago. We like to say that treatment of the mentally ill has come a long way and things aren’t nearly as bad as they used to be. We have a tendency to forget that many gross injustices crept into the 20th century. We tend to forget that we, or older people we know, were actually alive when awful, inhumane things were happening.
Handmade clubs were used to quiet the patients at St. Joseph State Hospital as recently as 1950.
Read that sentence again and make sure you are exhibiting the proper amount of horror.
Also (and unsurprisingly) during the mid-20th century, patients (when not working or participating in therapy) were expected to sit in rocking chairs that were lined up against the walls and be silent, making no demands on staff. No doubt these “good” patients were able to meet such expectations only because they were drugged into complacency. We still prefer our patients to be drugged to the point that they present no problems, but we have at the very least started arranging the furniture to encourage socialization.
Unfortunately, throughout the majority of history, to have the mentally ill left ignored in a rocking chair would have been kind in comparison to the kind of treatment they were usually subjected to.
Restraint rings set into dungeon walls: this is an image that evokes horror. The person was chained to the ring, or multiple rings, and thus restrained. When we think of such things, we think of the long-dead past. But the restraint ring pictured above came from the basement of the hospital in St. Joseph, Missouri. The hospital opened in 1874. We do not know when the practice was abandoned there. Regardless, it was not so long ago.
“Out of sight, out of mind.” What a horrific pun.
But there has always been more than one way to restrain a person. One can imagine that the restraining devices of the 16th and 17th centuries were quite crude, and they were. The museum gave us two examples. In the first, the prisoner (the term “patient” is not even applicable) was put into a straitjacket and bound to the wall, with his feet placed inside a wicker container so he could not kick his “caretakers.” In the second example, the person is enclosed in cloth that covers his entire body except for his feet. According to the museum, patients sometimes suffocated in this particular restraint.
The most alarming part of the Glore Psychiatric Museum (and no doubt what attracts a majority of its visitors) is its extensive collection of restraint and treatment devices (both originals and reproductions).
The tranquilizer chair was developed near the end of the 18th century by Benjamin Rush. The patient could be restrained into complete immobility and then subjected to “treatment” such as bloodletting or exposure to extreme heat or cold.
The lunatic box (also known as the English booth, the coffin, or the clock case) was used in the 18th and 19th centuries. The victim was forced to remain standing, eventually in their own excrement. The opening in front of the face could be covered, leaving the person in darkness.
Restraint cages like those pictured above were very common. Why this would be preferable to simple shackling is beyond my contemplation. Perhaps the clear message of “you are no better than an animal” had something to do with their popularity.
Recent methods of restraint are less objectionable, and perhaps easier to stomach when they come in cheerful country kitchen patterns.
The ways in which the mentally ill were “dealt with” are awful enough. Unsurprisingly, methods of “treatment” were no better.
A bath of surprise was a 17th century device in which a patient was dropped suddenly through a trapdoor into a tub of cold water. The violent shock was meant to break the person’s chain of delusional ideas.
“Douching” was a common treatment for melancholy, agitation, rage, and other things during the 18th and 19th centuries. The patient was put into ice cold water and would have additional cold water splashed into their face. This was meant to awaken the individual to reality.
The hollow wheel was created by German psychiatrist Johann Reil in the late 18th century. The patient was imprisoned in the wheel and forced to either run forward/backward or remain completely motionless. A person outside of the wheel could also set it in motion, forcing the patient to run. Use of the hollow wheel was abandoned in the early 19th century.
You may look at these archaic instruments and marvel at how our ideas have evolved away from such mercilessness. But each report of patient abuse and every story of the callousness or cruelty of our care providers only highlights the link between our past and present.
The past is not so far away, after all.
Our trip to the Glore Psychiatric Museum was an emotional and emotionally draining experience. It was a lot to take in, and by the end of it (the devices shown above were our last stop) I was lightheaded and ready to faint. We had gone in knowing what to expect, but the experience was nevertheless visceral.
This four-part series took more than six days to compile, and I know it is lacking. I would like to discuss many of these things further, but it will have to wait until a later time. I simply do not have the energy.
If you are interested in psychiatry, or injustice, the Glore Psychiatric Museum is undoubtedly worth a visit. If you happen to find yourself in Missouri, we highly recommend you drop by. At only $5 per person, it’s an absolute bargain.
All images were taken with permission at the museum and should not be reproduced. All information included in this essay was taken from museum exhibits and museum publications unless otherwise stated.