Horrors Of An Asylum: The History and Evolution of Asylums

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Before the evolution of asylums into the mental health hospitals and clinics we have today, being institutionalised for being mentally ill or unable to function in society meant being confined to an asylum. For centuries, people with a variety of mental health issues were trapped in asylums, frequently against their choice, in an attempt to “treat” them. Many books like those of Patricia Lubeck painted a picture of the horrors of these asylums.

Usually, the idea of being committed to an asylum was based on the belief that the individual had engaged in actions that were hazardous, abnormal, or interfered with the normal operation of society. As a result of significant changes in mental health conditions, ethics, and knowledge over time, there has been an evolution of asylums becoming less common in mental health care.

The History of Asylums

Although there was a drastic evolution of asylums in the 18th and 19th centuries, the practice of putting people with mental illness in institutions dates back to the 15th and 16th centuries. The understanding of mental health changed during the Enlightenment.

Before this time, people with mental illnesses were frequently viewed as demon-possessed or morally reprehensible, and they were subjected to severe treatment like starvation, torture, and chaining. The original idea behind asylums was to provide a haven from the harsh realities of society. Still, as time went on, they got overcrowded and became sites of cruelty, abuse, and neglect.

For instance, one of the first instances of a mental health facility was established in England in 1247 with the founding of the Bethlehem Royal Hospital, also called Bedlam. However, Bedlam quickly gained notoriety for its cruel treatment of patients, exposing the worst aspects of early institutional care.

Similarly, asylums started to spring up in the US in the early 1800s, with famous establishments including the New York State Lunatic Asylum. An important change in public attitudes was brought about by early asylum advocates, such as the reformer Dorothea Dix, who maintained that mental illness should be treated with compassion rather than punishment.

The 19th and 20th Centuries: The Evolution of Asylums

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The range of reasons for institutionalisation expanded along with the asylum system over the 19th and early 20th centuries. Asylum inmates were frequently diagnosed with what are today recognised as mental health conditions like depression, bipolar disorder, or schizophrenia.

However, not all of the requirements for admittance were medically sound. People who were merely rebellious, troubled, or non-conformist were frequently put to asylums, frequently without a formal diagnosis of a mental disorder.

Social and political considerations significantly influenced the process of institutionalisation. Immigrants and minority groups were also disproportionately sent to asylums, reflecting the prejudices and societal biases of the time. For instance, women were frequently sent to asylums for actions that were considered abnormal for the time, such as expressing anger or dissatisfaction with their lives—a practice that was once referred to as “hysteria.”

During this time, asylum conditions were often appalling. Frequently, the facilities were understaffed, underfunded, and overcrowded. Many patients did not receive the necessary care, and others experienced abuse and neglect. Lobotomies, electroshock therapy, and extended seclusion were among the cruel and scientifically unsupported therapies. The seclusion of people in asylums was exacerbated by the stigma associated with mental illness.

By the middle of the 20th century, mental health care had changed as a result of increased awareness of these cruel practices and the creation of more potent psychiatric drugs like antipsychotics and antidepressants.

As the “deinstitutionalisation” movement gained momentum, numerous asylums were shut down in the 1950s and 1960s. The goal of this movement was to shift from institutional care to community-based mental health treatment; however, there were several obstacles in its implementation, such as insufficient funding for alternative care facilities and a lack of assistance for patients once they were discharged into society.

Connection to the Present Time

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Even with the evolution of asylums, the asylum system’s legacy still has an impact on modern mental health treatment in a number of ways. On the one hand, a more compassionate, community-based approach to mental health treatment was made possible by the closure of asylums.

People with mental health disorders are no longer frequently institutionalised unless required, and medications and therapy are now widely accessible. Though they are not always well-funded or successful in addressing the needs of the most vulnerable, the emphasis has turned towards outpatient treatment, rehabilitation, and support networks that enable people to live in the community.

However, the deinstitutionalisation movement has brought up several difficulties, especially in light of the rise in the incarceration of people with mental health conditions. Nowadays, a large number of persons who would have previously been admitted to asylums are housed in jails or prisons, which are not prepared to offer mental health services. People with psychiatric disorders are marginalised and subjected to prejudice because of the ongoing stigma associated with mental illness.

The idea of being confined to an institution is seen as a thing of the past in the modern world. Yet, the fundamental problems with how society handles and cares for people with mental health disorders are still present. It is impossible to overestimate the significance of mental health awareness, appropriate treatment, and the eradication of stigma. The emphasis is on rehabilitation, inclusion, and creating support networks for individuals with mental health concerns instead of incarceration.

In conclusion, the history of asylums demonstrates the centuries-long change in society’s perceptions of mental disease. Asylums, which were first thought of as havens, have come to represent abuse and neglect. They left behind a complicated legacy that includes both significant injustices and improvements in mental health care.

Although institutionalization is no longer the norm for mental health care, the problems brought about by the history of asylums—such as stigma, subpar treatment, and systemic failure—continue to influence how society views mental health today. The past’s lessons highlight the importance of empathy, sufficient funding, and a dedication to enhancing the lives of those with mental illnesses. Interested in knowing the history Minnesota’s two oldest state hospitals and a glimpse into asylums of that time? Read Asylum Scandals: Abuse, Torture, Corruption and Murder in Minnesota’s State Hospitals.