MENTAL
INSTITUTIONS
in
AMERICA
MENTAL
INSTITUTIONS
in
AMERICA
SOCIAL
POLICY
TO
1875
GERALD N. GROB
With a new introduction by the author
Originally published in 1973 by the Free Press
Published 2008 by Transaction Publishers
Published 2017 by Routledge
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Library of Congress Catalog Number: 2008028350
Library of Congress Cataloging-in-Publication
Grob, Gerald N., 1931
Mental institutions in America : social policy to 1875 / Gerald N. Grob.
p. ; cm.
Reprint. Originally published: New York : Free Press, c1973.
Includes bibliographical references and index.
ISBN 978-1-4128-0850-7 (alk. paper)
1. Mental health policyUnited StatesHistory. 2. Psychiatric hospitalsUnited StatesHistory. I. Title.
[DNLM: 1. Hospitals, PsychiatrichistoryUnited States.
2. Health PolicyUnited States. 3. History, 18th CenturyUnited States. 4. History, 19th CenturyUnited States. WM 27 AA1 G9m 1973a]
RA790.5.G76 2008
362.2'1dc22
2008028350
ISBN 13: 978-1-4128-0850-7 (pbk)
FOR
GEORGE A. BILLIAS
Contents
List of Illustrations
1. The House of Employment, Almshouse, and Pennsylvania Hospital
2. Virginia Eastern Lunatic Asylum (Williamsburg)
3. McLean Asylum for the Insane
4. Hartford Retreat for the Insane
5. Bloomingdale Asylum
6. Horace Mann
7. Samuel B. Woodward
8. Dorothea Lynde Dix
9. Worcester State Lunatic Hospital
10. Utica State Lunatic Asylum
11. New York City Lunatic Asylum, BlackwelPs Island
12. Thomas S. Kirkbride
13. Isaac Ray
14. John P. Gray
15. Pliny Earle
16. Three Years in a Mad-House!
17. Mrs. E. P. W. Packard
18. Willard Asylum for the Insane
For an author to take a retrospective view of a book published more than three decades earlier is somewhat discomforting. The passage of time as well as additional information, after all, has the potential to alter interpretations that at the time of publication appeared reasonable. Be fore suggesting how I view some of the major interpretations of Mental Institutions in America as well as themes that required modifi cation, I should like to sketch out the elements that shaped my thinking about the evolution of mental health policy in the United States.
Like many American historians, I shared the social democratic ethos that dominated the discipline in the post-World War II decades. I was born in 1931 at the beginning of the Great Depression. My parents were Polish Jews who had migrated to the United States a decade earlier in order to escape from an environment in which anti-Semitism was endemic. Married in 1929, they lacked formal education and struggled for much of their lives. Yet they instilled in my sister and me an almost naive faith in the redemptive authority of education quite apart from its role in enhancing career opportunities. Their Judaism, poverty, and liberal outlook made them staunch supporters of Franklin Delano Roosevelts New Deal.
My commitment to the social democratic left was further strength ened during my years at the City College of New York, a bastion of liberal if not radical thinking. The student body included many com mitted to Marxist ideals, which in their eyes provided an alternative to what appeared to be a rapacious capitalism. Although I was not un sympathetic to campus Marxists, their single-mindedness and hostility to alternative ideas proved unacceptable, and my allegiance remained with the liberal and social democratic left.
My faith in a liberal political ideology and its promise of progress, nevertheless, was always tempered by recognition that human beings were neither completely rational nor moral. Too young to serve in World War II, I was increasingly aware of the horrors of Nazism and the Holocaust. Part of my family had remained in Poland. With but a single exception, those who remainedincluding my grandfatherwere murdered by the Germans. The Holocaust left me with an abiding sense of tragedy and a recognition of human frailty. My approach to history, therefore, refl ected a number of contradictory tendencies: a commit ment to social democratic principles, a belief in the fallibility of human nature, a faith in the ability of individuals to make genuine choices that were in part independent of the forces operating upon them, and hostility to any overarching historical explanations bordering on deter minism. Nor was I persuaded that all phenomena were linked or that it was possible to apply all-encompassing theories to human behavior and society. When introduced to the writings of Reinhold Niebuhr in the early 1950s, I immediately felt an affi nity for the manner in which he combined conservative theology and radical politics while simul taneously warning of the dangers and pitfalls presented by the allure of power. Niebuhr employed irony and paradox without sanctifying or legitimating the claims of both the extreme left and right.
After graduating from City College in 1951, I briefl y attended Columbia University, where I received an M.A. in 1952. I did not like Columbia, largely because of the factory-like atmosphere characteristic of its approach to graduate education. Through a circuitous route I ended up at Northwestern University and received my Ph.D. in 1958. My dissertation (published in 1961) dealt with the late nineteenth-century American labor movement, a subject that had interested me since my undergraduate days at City College.
Following two years of military service in the mid-1950s, I accepted my fi rst teaching position at Clark University in Worcester, Massachu setts in 1957. At that time Clark was a small institution but one with a rich intellectual tradition. With a total faculty of no more than seventy, friendships transcended disciplinary affi liation. In 1959, a colleague in psychology with extraordinarily broad interests suggested that I set a graduate student to work on a history of an old state hospital in Worcester. Upon familiarizing myself with Worcester State Hospital, I found that it had played a signifi cant role in the history of the care and treatment of persons with severe mental illnesses. I also found that a large mass of manuscript material had survived, including every single patient case history since its formal opening in 1833 (which by the 1960s exceeded 70,000). I decided, therefore, to undertake a study of the hospitals history.
In retrospect, my decision to pursue research on the history of psychiatry and institutional care was somewhat presumptuous. My knowledge of the subject was nonexistent, nor was I even remotely familiar with a large social and behavioral science literature on the subject. Ignorance and fear of the unknown, however, did not prevail over what only can be described as a youthful hubris.
