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I hardly know anything about them and i want to know everything! First or second person experience preferred. This is what i DO know:
- Mentally Retarded people were often sterilized.
Typically only pre-1960s when the eugenics movement was discredited, and even then it wasn't "often" as much as "sometimes."
- Mentally Retarded and Mentally Ill were often in the same wards.
Not a particular issue in practice, as well as the obvious that some of the mentally ill were "retarded." Those who were mentally ill or "retarded" were more often than not very compassionate towards others.
The ones who acted out typically focused on staff.
- ECT and lobotomies against patient consent
Lobotomies fell out of favor once the thorazine and mellaril and other drugs were available. Different hospitals changed over at different times, but I don't recall ANY lobotomies being scheduled. ECT could only be used without consent on someone involuntarily committed. It wasn't common, but when used could be quite effective. It is still used today. (I remember one epileptic who was a voluntary commit who had nearly constant seizures. Three ECT sessions and lithium stabilized him to where he was able to go back to a normal life.)
- Husbands could "commit" their wives for treatment. Women were treated like children and/or property of husbands.
Highly sensationalized nonsense for the most part. ANY family member might be institutionalized by a family group (and remember that families could often be multi-generational in the same household) but a doctor would then evaluate and proceed based on his best judgment.
Here are some specific Qs i have but feel free to add ANY EDUCATIONAL INFO!
- How did someone get to a facility? Driven willingly?
- Could you just drop your wive and/or child off and never pick them up?
- Could you relinquish your parental duties this way?
- What if you had a "psychiatric emergency" at home? Who did you call then? (Today you usually call police or 911)
- Were there any psych units in general hospitals like there are today? Or were they all designated institutions?
- Who paid for this? (Today it's insurance at first, then taken over by state if institutionalization is needed.)
- What if someone had no place to go upon discharge? Did they just keep them??
- What are some reasons people were admitted for? (Today it's only for suicidality, homicitality or DANGEROUS hallucinations or delusions?)
- Were people ever sent to these facilities instead of jail or prison or for homelessness?
I worked in one around 1970.
- How did someone get to a facility? Driven willingly?
There were a few "categories" of patients
Someone who was committed under the "Baker Act" would be remanded by the courts or driven in by relatives, police or others.
Voluntary committals mostly were dropped off. Don't recall anyone driving themselves in, but it is possible.
- Could you just drop your wive and/or child off and never pick them up?
Not without good reason.
- Could you relinquish your parental duties this way?
Not without good reason. (although it was used as a threat by countless fathers)
- What if you had a "psychiatric emergency" at home? Who did you call then? (Today you usually call police or 911)
Generally the local police. The idea of guys in white coats with a paddy wagon is largely movie fiction that went out of style decades earlier.
- Were there any psych units in general hospitals like there are today? Or were they all designated institutions?
Yes, and there were hospital wards in the institutions.
- Who paid for this? (Today it's insurance at first, then taken over by state if institutionalization is needed.)
That gets complicated and there is no one answer. A capsule history is that colonial America had "poor farms" that cared for the elderly and mentally ill in exchange for a stipend from town taxes and the labor of those who lived there and could do any meaningful work, be it work on the farm, knitting, or whatever. Increasing costs and horrible abuse at some poor farms led to states banning them and taking the residents to a larger institution with doctors and somewhat trained staff. The residents still worked as therapy, and the institutions minimized costs by being self-sustaining food-wise. Abuse sometimes happened where a good worker who no longer had mental issues would not be released but forced to continue working for free. The government stepped in and mandated patients be paid for labor, ruining the farm system and increasing costs of operation. Other mandated requirements continued (and still continue) to be piled on, pushing states to abandon the institutional concept and mainstream patients.
In general, voluntary admits paid their own way and the costs of others were covered by the towns (initially) then the state.
- What if someone had no place to go upon discharge? Did they just keep them??
Rephrasing that - "were they allowed to stay" Yes and no. Some were allowed to move to dorms and get jobs on the grounds in the laundry and kitchen and other support positions. Increasingly, they were pushed out into halfway houses where they were subsidized until they found work.
- What are some reasons people were admitted for? (Today it's only for suicidality, homicitality or DANGEROUS hallucinations or delusions?)
You are naive - and those first two words don't exist. Psychosis, schizophrenia, dementia, severe epilepsy, syphilis, severe paranoia, organic mental defect, some Down's syndrome, and some minimal functioning seniors with health issues and no family capable of supporting them.
- Were people ever sent to these facilities instead of jail or prison or for homelessness?
There were criminal wards, where the courts had decided that the person was legally criminally insane and a threat to society. There is no abrupt cut-off between criminal acts and violent acts by those with mental issues. There are some homeless people that have been pushed out of institutions who would function better in an open campus institutional setting. Part of the reasons why this isn't done is cost, part is liability, part is public perception (who scream at the mention of even a small halfway house near them), and part is fear that making such an option would result in a LOT of people taking advantage of it.
If you go to the Project Gutenberg website, there are a couple of eBooks by people who were institutionalized prior to 1930. The changes that occurred in mental institutions over the years were monumental and experiences cannot be conflated together into one narrative.
I'm mostly curious about personal experiences or second person experiences so i guess this would mostly be last century, any country.
In the 1960s, a close relative of mine was diagnosed with "paranoid schizophrenia" but never got treatment for it. Based on the small amount of time i spent with him in the 1990s, i don't think that this was an accurate diagnosis at all. He was a "high functioning" tradesman with a wife and 4 kids.
They also told his wife after the diagnosis that "personalities don't change." But "paranoid schizophrenia" is in no way a "personality disorder." I can see that he might have had some "paranoia" to his personality (or "Paranoid Personality Disorder") but "schizophrenia" is a *usually* a debilitating illness with hallucinations.
So one of my personal observations is that the word "schizophrenia" was thrown around a lot during those days. (Maybe even to Frances Farmer?) Paranoid Personality Disorder was a diagnosis way back to at least the 1920s so why would they use the term "schizophrenia" so much?
That's just one specific question i have but i'm interested in any and all of the last 50-100 years.
(And i'm sure FF did NOT have a lobotomy since most people basically turned into vegetables after that.)
Diagnosis criteria changes, some psychiatrists are more accurate than others, and sometimes what is observed by bystanders is only a minor part of what really is going on. From your previous post, it is obvious that you are not qualified in making any meaningful diagnosis or second guessing an existing one other than to question it and ask a professional for a second opinion.
There are high-functioning schizophrenics. If you want to take the term and diagnosis to an extreme, EVERYONE is schizophrenic to some extent, since we all interpret reality and sometimes interpret wrong.
I'm mostly curious about personal experiences or second person experiences
Not exactly what you want perhaps, but still:
In the mid-60's a guy I knew was arrested for drug possession. The judge gave him 3 choices: prison, the Army (and potentially a trip to Vietnam), or the state mental hospital. He chose the hospital, which was at that time home to patients who had lived there for decades. Almost all of them were floridly psychotic, some potentially violent, so he pretended to believe all their ravings and go along with the program. He even let one of them do a tattoo on his leg of an alien who this wild patient believed took him up to the spaceship every night. My friend was there for 6 months. He was 17 at the time.
I once cared for a man who had undergone a leucotomy decades earlier in the early 1950's, which is a bit different from a lobotomy. The surgery was described to me as putting small egg beaters in the brain and breaking up the nerve connections. The man had 2 circular scars on his forehead. He had no personality, perfectly bland guy. What is the difference between lobotomy and leucotomy
This might be of interest.... a lovely girl who ended up like a baby due to her father and his embarrassment at his daughter or so its said. The Tragic Life of JFK's Sister
Then we had the Lock Asylums for women only, sometimes girls too who society deemed too flirty or outrageous to be out among the public.. Magdalene Institution
Read five lines from the bottom of this article to see the hypocrisy of the time.
A LIBRARIAN'S research has pieced together the history of one of Glasgow's best kept secrets, the Lock Hospital for ''dangerous females'' with sexually transmitted diseases. For five years, Mrs Anna Forrest poured in vain over Glasgow's borough records, the city planning office notes, and records of the city's hospitals, before concluding her account of the ''non-existent'' place.
The 48-year-old librarian at Glasgow's Royal College of Physicians and Surgeons says she wants to give a voice to those so called dangerous women who were made scapegoats for the spread of venereal diseases, which were as virulent killers as cholera and typhus. ''When I first started looking, I was told that the hospital never existed,'' she said. ''It became a mission to find out more and let the public know what happened to these women and young girls.'' Polite society did not want to know when the proposal to open a VD clinic for females was considered in 1805, a feeling reflected in the lack of documentation about the building. It was called Lock. The name was thought to either derive from the old English word loke, associated with a leper house, or the French loque which was a bandage used for leprosy. Like lepers, those with VD were shunned. Initially, arguments on whether it should be built at all raged between the Glaswegian medical profession, the clergy, and traders of the time. Just as HIV has spread fear and prejudice through society of the late twentieth century, syphilis was seen as a punishment from God. Women were called the carriers and spreaders of disease, but there were no health provisions made for them. Indeed, throughout the 1700s, it was thought finding a cure would only encourage them to go out and sin again. In 1598, the Glasgow kirk session and town councils of the time had ordered drastic quarantine measures. Men and women who were sick were rounded up in Glasgow Green. They were sent outside the city walls and ordered never to return. As females were considered the carriers, their shame was burned on to their faces with branding irons. There was no medical provision for either sex until 1733, when Glasgow's Town Hospital in Clyde Street was established: but only for the ''deserving poor'', which meant no one with the pox, or VD - or women. The Town Hospital was eventually used as an insane asylum, overrun by men in the last stages of syphilis. By 1790, a small unit for women was set up in Glasgow at the university, but it admitted only pregnant women. There were still no health provisions for women with VD. When the Napoleonic war broke out, the Gallowgate Barracks were established in the city and Glasgow Royal Infirmary was opened. Such was the consequent spread of disease due to soldiers sleeping with the ''sporting ladies'' of the town that certain wards were used only to treat the military. GRI was still not taking in pregnant or diseased women or children. After much debate, the Lock Hospital for women was established in 1805. The dwelling house opened at 151 Rottenrow Lane with 11 beds, but did not exist in the medical establishment records of the time. It used mercury as a treatment - popular at the time but ultimately toxic to the patient. Many women entering the Lock were never seen again and those entering were not allowed to leave until their treatment, often lasting for months, was over. Many tried to break out. Some were moved eventually to the nearby insane asylum as syphilitic madness and mercury poisoning ravaged their bodies. It was 1807 before the city officially recognised the Lock. By 1846, the hospital was moved to new premises at 41 Rottenrow. Child victims of abuse and incest were being discovered in larger and larger numbers but Victorian society found the fact impossible to admit. One Lock doctor is on record as saying a seven-year-old girl had ''given the illness to herself''. But from 1925, new treatment centres were opening up for venereal disease patients. Medicines were improving and in 1940 the Lock Hospitals annual reports showed the number of patients on the decline. Seven years later the building's funds were transferred to the Royal College of Physicians and Surgeons of Glasgow. It was 1955 when the Lock was finally demolished and the walls which held the secrets and pain of thousands of Scots women were gone forever.
scotia
I knew an RN who in 1953 was involved in the first US clinical trial of Thorazine. Her job was at a Philadelphia inpatient psych hospital where most of the patients were psychotics and some had been catatonic (no talking or interacting with others) for years. Most of the staff had caring relationships with the patients due to the years-long residency of both the patients and the staff (in those days, nurses, the attendants and many doctors lived on hospital grounds).
The doctors and nurses began the trial on a Monday, she recalled. When she came to work on Friday she was alarmed. Most if not all of the doctors and nurses were crying. She thought a tragedy had occurred. But no! They were crying with joy and awe: catatonic patients who had not spoken or made eye contact for decades were chatting with them, and psychotic patients were suddenly making sense. They all considered Thorazine a miracle drug, and even then they realized it would herald the end of lobotomy and other psychosurgery, electroconvulsive (shock) therapy, insulin shocking, packing (in cold, wet sheets), and other available treatments.
Thank you ALL so much all for the references and stories!!
Harry Chickpea,
I'm interested in where you worked in the 70s- Florida? What state and was it a psych facility in a general hospital or a state run facility?
As grateful as i am for your input, this was an unnecessary insult: "From your previous post, it is obvious that you are not qualified in making any meaningful diagnosis or second guessing an existing one other than to question it and ask a professional for a second opinion."
You must have been missing my point which is that the word "schizophrenia" seemed to have been bantered about more than today. I of course recognize that all mental disorders are on a spectrum and happy to hear from another person who does as well. Most people do not and only use the word "spectrum" in regards to Autism.
"Personality Disorders" (previously called "Axis II" disorders) are not currently, or formerly from what i've researched, the same as Organic Mental Disorders (previously called "Axis I disorders.") So someone in the 1960s giving a diagnosis of "paranoid schizophrenia" but then advising family that "personalities don't change," is making an incongruent statement. "Schizophrenia" is not a "personality disorder" and never has been.
(Researching the history of psychology is a hobby of mine so I also own all DSMs so i can search stuff like this that i can't find on-line.)
But even though this is the "official" medical information, subtle lingo, implications and nuances fascinate me. I wonder if some/all psychiatrists still thought of all psych disorders as "personality disorders?" Seems likely that many did and even highly trained mental health workers still blamed the patients for their illnesses. . . . .
One of the many helpful bits of info i took from your post, which i guess should not surprise me, is how the laws still differed from state to state. For example, "The Baker Act" is not used in New England but i'm familiar with it. (We have our own versions here.) The way it has been explained to me by people familiar with current psychiatric hold laws is that "The Baker Act gives families' input more input into the hospitalization" but i haven't researched the laws so that is just one person's opinion.
Other states have different versions of the "Baker Act" with slightly different legal implications. In California it's called a "5150," in MA it's "Section 12" and RI and many others its merely called "Certification." (Which i'm guessing is where the slang "certifiable" comes from.)
The words "suicidality and homicidality" do indeed "exist" today:
Quote:
Examples of situations where a Section 12 might be appropriate include:
Suicidality
Homicidality
Markedly impaired judgment due to mental illness to such an extent that a person is unable to protect himself/herself.
But that did answer my question regarding the "reasons" for admitting people. It seems like from what you are saying, in the 1970s, a diagnosis alone and/or lack of caretakers was enough to admit someone. That would not fly today as there needs to be "eminent risk" to self or others. No doubt this is connected to deinstitutionalization and "managed care" (otherwise, any high functioning schizophrenic may be at risk of being admitted based on diagnosis alone. )
I remember in the early 1950s hearing my mother and others whisper about a young girl of about fourteen who was PUT AWAY as they said, sounded like a criminal to me back then..... and had St Vitus Dance...I never saw this girl.. she never got out of wherever she was staying... I asked an old aunt a few years ago about this girl, and she said that Mary was a little hyper, always singing and was caught kissing a boy up an alley....Now Ive since looked up about St Vitus Dance and cant see any reason for this girl being put in a mental asylum, if in fact it was this illness...Mary died in her twenties https://en.wikipedia.org/wiki/Sydenham%27s_chorea
I'm interested in where you worked in the 70s- Florida? What state and was it a psych facility in a general hospital or a state run facility?
Vermont State Hospital, state run primarily psych.
As grateful as i am for your input, this was an unnecessary insult: "From your previous post, it is obvious that you are not qualified in making any meaningful diagnosis or second guessing an existing one other than to question it and ask a professional for a second opinion."
That wasn't an insult. You were second guessing a medical professional based on your assessment of a casual acquaintance who had been diagnosed. That was an over-reach and I called you on it. Years after working at the hospital I had an excellent manager of a very busy theatre working for me. (switching to neutral gender now to protect privacy) In casual conversation with this person, it was mentioned by them that their tv talked to them. Subsequent conversation confirmed this person as schizophrenic, but unless that one subject area was broached, one would never know it. I bring this up to show that unless you have the training and contact in the right setting, a correct assessment is very difficult.
You must have been missing my point which is that the word "schizophrenia" seemed to have been bantered about more than today. I of course recognize that all mental disorders are on a spectrum and happy to hear from another person who does as well. Most people do not and only use the word "spectrum" in regards to Autism.
Mmmnn, not really. The general public resorted to the more colloquial terms now regarded as insensitive insults. Words of four syllables or more like schizophrenia weren't commonly used. In point of fact, diagnosis often wasn't brought up in day to day care unless something unusual was going on.
"Personality Disorders" (previously called "Axis II" disorders) are not currently, or formerly from what i've researched, the same as Organic Mental Disorders (previously called "Axis I disorders.") So someone in the 1960s giving a diagnosis of "paranoid schizophrenia" but then advising family that "personalities don't change," is making an incongruent statement. "Schizophrenia" is not a "personality disorder" and never has been.
(Researching the history of psychology is a hobby of mine so I also own all DSMs so i can search stuff like this that i can't find on-line.)
The closest thing to a DSM is the manual that car repair shops use to fix a flat rate charge for fixing your car. If you have more than one, then you are probably aware of the battles that go on concerning what gets included and what doesn't. One of the standard statements for psych 101 classes is that all students are expected to learn that they are totally messed up and in need of therapy by the end of the first semester. The DSM and current standard therapy are guided less by science, common sense, and compassion than by insurance companies wanting diagnosis codes to fit into their spreadsheets.
The question of whether schizophrenia is organic or personality is still in debate, as are questions on individual diagnoses being accurate. If you dig around, you'll find reference to the "Kingship Myth" and spiritual emergency, where the first major psychotic break in schizophrenia has been played out and reframed successfully. In other cultures, people we would call schizophrenic are considered as potential shamans.
It seems that we are dancing around what may be your real issue, that you are uncomfortable with one particular diagnosis and have a need to dispute it. Discussing that with strangers on the internet might seem somewhat satisfying, but may not resolve your need as well as direct discussion with the parties involved and other professionals. My point is that we here cannot say that the original diagnosis was correct or incorrect. There is no way that we would have anywhere near enough data, and Monday morning quarterbacking isn't going to change that. You could be right, you could be wrong. At this point you have a semi-informed opinion and the way to become more informed is better achieved by direct discussion with the people involved or a second diagnosis.
If the person was misdiagnosed or mistreated, the real responsibility for correction lies with that person if he is able, or his medical ombudsman. As a casual observer, privacy laws will shut you out and make your opinion irrelevant. Anyone who has been involved with care for more than a short period of time can relate incidents where care was insufficient, diagnosis off-the-mark, and an individual has suffered as a result. Sometimes you just have to step back and let the course of events unfold.
But even though this is the "official" medical information, subtle lingo, implications and nuances fascinate me. I wonder if some/all psychiatrists still thought of all psych disorders as "personality disorders?" Seems likely that many did and even highly trained mental health workers still blamed the patients for their illnesses. . . . .
Mental health workers and psychiatrists are people, and just like anyone have their own skill levels and idiosyncrasies. I've seen psychologists that I wouldn't trust to do therapy with anything more intelligent than a chihuahua. I've read some that simply astound me with their brilliance. "Blaming" was never even anything that crossed my mind while working. It would have served no purpose, and the tasks at hand were difficult enough as it stood. There was one syphilitic patient who pretty obviously was responsible for his own condition, but so what? It didn't mean he needed any less care or deserved less.
One of the many helpful bits of info i took from your post, which i guess should not surprise me, is how the laws still differed from state to state. For example, "The Baker Act" is not used in New England but i'm familiar with it. (We have our own versions here.) The way it has been explained to me by people familiar with current psychiatric hold laws is that "The Baker Act gives families' input more input into the hospitalization" but i haven't researched the laws so that is just one person's opinion.
Other states have different versions of the "Baker Act" with slightly different legal implications. In California it's called a "5150," in MA it's "Section 12" and RI and many others its merely called "Certification." (Which i'm guessing is where the slang "certifiable" comes from.)
I use the term generically, as most people recognize it and it is easier to say and write than to quote chapter and verse.
The words "suicidality and homicidality" do indeed "exist" today:
Psychobabble designed by lawyers, the worst of both worlds.
Suicidality - The likelihood of an individual completing suicide
Dinnerality - The likelihood of eating dinner
Driverality - The likelihood of driving a car
sticking an -ality at the end of an existing word ought to be listed somewhere in the personality disorder section of the DSM as terminal language stupidity.
But that did answer my question regarding the "reasons" for admitting people. It seems like from what you are saying, in the 1970s, a diagnosis alone and/or lack of caretakers was enough to admit someone. That would not fly today as there needs to be "eminent risk" to self or others. No doubt this is connected to deinstitutionalization and "managed care" (otherwise, any high functioning schizophrenic may be at risk of being admitted based on diagnosis alone. )
Never underestimate a society's ability to incarcerate or institutionalize ANYONE perversely. Kill a rat that has been digging in your garbage can, and if you use a gun you can be incarcerated for "animal cruelty." Take an offensive flag from a flagpole and you can be arrested. You don't need to be schizophrenic to play those games.
I would agree with that and would be curious on how that would relate to the social issue of handling mental illness.
A few decades ago the rise of psychotropic drugs and the influence of 'managed care' became part of the way society dealt with the issue of how to provide care to patients and their families. I believe there were successes on the drug side because patients indeed seemed to function better on a day to day basis with the drugs. However on the 'managed care' side I'd be curious on overall opinions about that.
With 'managed care' decisions were made on whether to institutionalize or not based on a number of variables. I am a bit biased on managed care and think it didn't work as well it should have. Really I saw its geVe failure in a particular instance. Just wondering how professionals or those in the field think about it.
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