HMH Blog

https://www.latimes.com/lifestyle/story/2021-10-04/what-is-involuntary-treatment-what-types-of-holds-exist

This article on involuntary mental health treatment(s) was very informative. The article discusses the various methods of classifying whether or not someone should be receiving involuntary mental health treatment, as well as the criteria/attributes they would have to show to be deemed eligible. In particular, Anuja Kumaria’s (Senior Attorney at the Law Foundation of Silicon Valley) quote stuck with me: “We understand that family is important; they are the support systems often,” “However, ultimately, when it comes to involuntary treatment, it’s the individual whose civil liberties will be jeopardized.” Kumaria acknowledges the importance of the family in the process of rehabilitation. Still, she maintains that there is a certain point where there should be outside intervention, which is where involuntary treatment comes into play. The article emphasizes that while the line of when it’s deemed appropriate to implement involuntary treatment methods has long been stained gray, there are methods and means of measuring the level of danger one poses to themself, and to others, and this is a main part of how psychiatrists determine if someone is in need of involuntary treatment. #histmental2023

As a quick point of reference, Of Mice and Men was one of my favorite books as a high schooler. It was the first high school-assigned book I can distinctly remember having a lasting impact on me. I believe we read it in my 9th-grade Honors English class. I can still remember the Socratic seminars about it and where I sat in the room, little details that I have forgotten for almost every other class. George and Lennie’s story of friendship and loyalty deeply resonated with me at a time in my life when I was trying to figure out who I was and who I wanted to be. Friendship is essential but far less so if not surrounded by the right kind of people. This is why, to this day, I prefer to have a small circle of friends with whom I know would do anything for me as I would for them. In my eyes, Real friendships are supposed to be an extension of one’s family.

Of Mice and Men is about George Milton and Lennie Small, two struggling ranch workers who migrate together throughout California (during the Great Depression era), looking out for work and for each other. From the onset, it becomes evident that Lennie has some kind of intellectual disability and that he is highly devoted and dependent on George. George seems to be frustrated at times by this guardianship kind of role he has with Lennie, but it is also apparent that George cares a great deal about Lennie. George and Lennie are hired to work at the ranch and meet two men, Candy, who is an older soft-spoken ranch hand, and Curley, who is the son of the ranch owner and extremely possessive over his wife. The two then meet a man named Slim, who has much influence on the ranch as a skilled mule driver. One day, Candy overhears George and Lennie’s plan to have their own ranch and live on their own terms. He is intrigued, and the three men decide to keep it a secret between them.

Lennie has always been fond of soft things and is given a puppy from Slim (whose dog just had puppies). This makes Lennie incredibly happy, but it is short-lived. A few days later, Lennie accidentally kills his dog and is inconsolable; overhearing Lennie’s cries, Curley’s wife tries to console Lennie. He tells her how he’s always liked soft things, to which she lets him feel her hair. Lennie grabs too tightly, and Curley’s wife screams out; in an effort to quiet her, Lennie accidentally breaks her neck, killing her. Realizing what he’s done, Lennie returns to the river pool, where he and George spent their first night before traveling to the ranch. The other ranchers find Curley’s wife’s body and assemble a lynch mob. George finds Lennie at the river. He isn’t angry with him but disturbed by what he feels he has to do. George begins to tell Lennie the story of the ranch they’d hoped to share; as the mob approaches and George tells Lennie about the rabbits he has always wanted, George shoots Lennie in the back of the head in an act of mercy.

Of Mice and Men provides a harrowing story of how mental illness was still very much taboo at the time that the story is set. (1920’s) It allows readers/viewers to see the way people with mental illnesses were marginalized and by most of general society, seen as burdens. George’s care of Lennie is by no means representative of how most people from that time would have handled someone with Lennie’s condition. George’s killing of Lennie serves as a final act of love for a friend that it seems only he ever really understood. He killed his friend because he knew that was going to be his fate one way or another, and he didn’t want Lennie’s last memories to be filled with agony, pain, and fear.

Of Mice and Men provides a compelling retrospective lens pointed toward the way/manners in which society treated people with mental illness. I hope readers/viewers today are as moved by Lennie and George’s story as I was/am as a 15-year-old and now at 22. I feel like, as a society, we need to emphasize stories like this to help keep us from reverting to such ill-considerate methods of care for those with mental illnesses.

I wrote a digitally enhanced essay about three different institutions for my Digital Project. The three institutions are Central State Hospital, Crownsville State Hospital, and Ionia State Hospital for the Criminally Insane. This essay aimed to take on more of a comparative-styled approach. I hope you enjoy the read, and I apologize for the long-winded tangents you may find scattered throughout.

With that being said here’s the link to my essay: https://mailumw-my.sharepoint.com/:w:/r/personal/jwelch2_mail_umw_edu/Documents/Digitally%20Enhanced%20Essay%20History%20471.docx?d=w5cfc9fc966cf4ded8ae300ba92775e1f&csf=1&web=1&e=N2YlBd

Please let me know if you have any issue accessing the essay through the link. (I also made sure to send it directly to your email.)

YouTube video about how Schizophrenia became a “Black Disease”.

This video provides an excellent summary from Metzl himself about how schizophrenia became increasingly identified within minority populations (specifically African-American men). He talks about how this was a systematic process that seeped through all facets of society.

https://freudfile.org/psychoanalysis/repression.html

I found this article to be very useful in helping me better understand Freud’s ideas/theories on repression and the role it played in patients’ conditions. From the article, I gathered the understanding that repression was not something that patients often did consciously, but rather, it usually was done subconsciously in order to protect them from an underlying experience of great magnitude or danger.

https://asylumprojects.org/index.php/Eastern_State_Hospital_Lexington

This article provides a rough overview of the Eastern State Lunatic Asylum. The article is chronologically organized for the most part, which would help in establishing an understanding of the institution’s evolution. The Eastern State Lunatic Asylum was one of, if not, the most influential institution in the 19th and 20th centuries.

https://asylumprojects.org/images/9/9e/petersburg21.png

This image is from the Central State Hospital in Petersburg, Virginia. (More commonly known as the Central Lunatic Asylum) This image shows several African American “insane patients” building a road. This picture struck me initially because I thought the patients were doing field/agricultural work, which was one of the main methods supervisors and attendants used to occupy patient’s time. Putting African-American insane patients to work was seen as one of the better courses of action by institutions because they were deemed to be inherently and genetically inferior.

Attached below is my proposal and annotated bibliography

Joey Welch

Hist 471 History of Mental Health in the US

Dr. McClurken

9/26/23

Proposal:

This research project focuses on several segregated and non-segregated asylums from the late nineteenth and early twentieth centuries. The central goals of the project are to examine the discrepancies in the institutions and asylum’s physical and social structures, their treatment methods, and patients’ overall experiences. This project sheds light on how the differences in many of these institutions were often strategically planned and racially motivated and how systemic racism in the field of medicine managed to seep through the 19th century into the 20th century. Various secondary and primary sources from the late 19th and early 20th centuries will support the project argument. Sources like Hughes’ “Labeling and Treating Black Mental Illness in Alabama, 1861-1910” helps to engage with the fact that a lot of the differences in methods and treatment for the African American mentally ill were extremely racially motivated and influenced. Articles like Jackson and Weidman’s “The Origins of Scientific Racism” will help further establish that racist ideologies and preconceptions had long been infesting the world of medicine. Nurridin’s “Psychiatric Jim Crow: The Desegregation Process at Crownsville State Hospital, 1948-1970.” should prove particularly informative to the project because it references how in many cases the efforts made by state officials and institutions to alleviate the discrepancies in the care and treatment of patients, often only exacerbated the problems and made care less accessible for minorities.

Annotated Bibliography

Bourque Kearin, Madeline. “‘As Syllable from Sound’: The Sonic Dimensions of Confinement at the State Hospital for the Insane at Worcester, Massachusetts.” History of Psychiatry 31, no. 1 (March 2020): 67–82. doi:10.1177/0957154X19879649.

In the article, Borque examines how senses such as sound were used as tools to control the moral structure of the asylums, as well as how patients interacted with the consistent silences and sounds of the institution. Throughout the text, Borque lists several ways in which aruality was used in the management and manipulation of patients. Borque focuses on how auditory and visual inputs were manipulated and controlled by the institutions and their staff as a means to keep patients subordinate and submissive.This article will contribute to the project as one of the main messages that can be implicitly drawn from it is how staff members were significant contributors to the depersonalization of their patients. 

Diana, Martha Louis. “Black Women’s Psychiatric Incarceration at Georgia Lunatic Asylum in the Nineteenth Century.” Journal of Women’s History 34, no. 1 (Spring, 2022): 26-48. doi:https://doi-org.umw.idm.oclc.org/10.1353/jowh.2022.0008. https://umw.idm.oclc.org/login?url=https://www-proquest-com.umw.idm.oclc.org/scholarly-journals/black-women-s-psychiatric-incarceration-at/docview/2811716628/se-2. 

In this article, Louis asserts that post-slavery psychiatric practices combined with social realities such as racism and poverty led to attempts at distinguishing black women’s experiences with insanity. Louis supports her claims by examining the lives of five black women in the Georgia Lunatic Asylum. This article would fit well into the project because it focuses on the issue of mental illness, specifically among black women during the late nineteenth century. One of the project’s main goals is to examine how and why minorities, specifically African-American mentally ill patients, were treated differently and, in many cases, with less care than white patients.

Goffman, Erving. “Asylums: Essays on the Social Situation of Mental Patients and Other Inmates” (1st ed.). Routledge. (2007). https://doi-org.umw.idm.oclc.org/10.4324/9781351327763

In his text, Erving focuses on the inmates and their experiences. He takes on the task of attempting to understand the social situation of the mentally ill and other inmates. He supports his claims with essays fixated upon the inmate’s situation from an institutional standpoint while diversifying his sociological source base. This article fits nicely into the project because it aims to understand the social structures used to confine and manipulate the mentally ill. 

Gambino, Matthew. “Erving Goffman’s Asylums and Institutional Culture in the Mid-Twentieth-Century United States.” Harvard Review of Psychiatry 21, no. 1 (2013): 52–57. https://doi.org/10.1097/HRP.0b013e31827d7df4.

Gambino contends that Erving’s essays argue that “large-scale” asylums and mental hospitals would be best labeled “total institutions” similar to prisons and concentration camps. The essays written by Goffman indicate mass amounts of mistreatment of inmates and mental patients. This article fits into the project similarly to the Goffman source above in that they both take a sociological approach to understanding the institutions.

Foucault, Michel. History of Madness. London: Taylor & Francis Group, 2006. Accessed September 22, 2023. ProQuest Ebook Central.

In his text, Foucault analyzes “madness” in a history of its own and as an everchanging creation of societal and cultural influences. Focault supports his argument by dividing madnessess’ changing interpretations across three eras, including the Middle Ages Renaissance, the Classical Age in the seventeenth century, and the modern experience of the madness era, which started at the end of the eighteenth century. Focault’s text will inform the project because it addresses how knowledge and the motivations behind psychiatric treatment changed over time and shaped how institutionalization was perceived.

Hughes, John S. “Labeling and Treating Black Mental Illness in Alabama, 1861-1910.” The Journal of Southern History 58, no. 3 (1992): 435–60. https://doi.org/10.2307/2210163.

In Hughes’ article, he argues how the care and treatment of the black mentally ill population in the south, more specifically Alabama, was greatly influenced by white superintendents like Peter Bryce, whose beliefs were founded from ideologies such as pro-slavery and social Darwinism. Hughes supports his argument throughout the article by mentioning several different institutions and case studies throughout the South in which black mentally ill patients were subjected to much harsher treatments, living conditions, and expectations than the white mentally ill populations. This article will help supplement the project’s argument that there were racial correlations between the discrepancies in the institutions themselves, treatment methods, and the overall patient experiences.

Jackson, John P., and Nadine M. Weidman. “The Origins of Scientific Racism.” The Journal of Blacks in Higher Education 50, no. 50 (2005): 66–79.

This article asserts that Darwin’s Origin of the Species was one of the leading motivators in the emergence of concepts such as racial inferiority. Jackson supports these claims throughout the text by engaging with how intellectuals like Francis Galton and Charles B. Davenport interacted and adapted to their understandings of evolution. This article will help provide the project with a basis better to understand the racial motivations behind evolutionary thoughts and conceptions. 

McKinnon, Susan. “The American Eugenics Record Office: Technologies for Terminating ‘Degenerate’ Family Lines and Purifying the Nation.” Social Analysis 65, no. 4 (2021): 23–48. https://doi.org/10.3167/sa.2021.650402.

McKinnon’s article argues that concepts like  “degenerate families” were strategically, methodically, and scientifically justified in their aims to purify the nation. This led to national regulations on marriage immigration, and led to the sterilization of thousands of Americans. This article will contribute to the argument that racial biases have had  a significant influence on society and institutional care.

McGrath, Patrick. “Nonelective Surgery: In the Early 20th Century, Trenton State Hospital was the Scene of Unspeakable Experimental Treatments.” New York Times (1923-), May 29, 2005. https://umw.idm.oclc.org/login?url=https://www-proquest-com.umw.idm.oclc.org/historical-newspapers/nonelective-surgery/docview/92902465/se-2.

McGrath addresses doctors like Henry Cottons, whose unusual and inhumane treatments ended in an incredible number of deaths and mutilations of the mentally ill at his Trenton State Hospital. Similarly to the McKinnon article, McGrath emphasizes that instances like the horrors at Trenton State Hospital can directly correlate to systematic social and scientific negligence. This article helps further inform the concept that psychiatrists in the late nineteenth and twentieth centuries, especially, were so fixated on developing “cures” for mental illness rather than a greater understanding of the various causes.

Norris, Caroline. “A History of Madness: Four Venerable Virginia Lunatic Asylums.” The Virginia Magazine of History and Biography 125, no. 2 (2017): 138–82. http://www.jstor.org/stable/26322605.

This article argues that progress has been made regarding treating mental illnesses. Norris draws upon four distinctive yet very different Virginia state asylums as her case studies in examining the changes in institutionalization and its effects on patients. This article will prove useful for the project as it provides a more optimistic retrospective outlook on how far the care for the mentally ill has come over the years. 

Nuriddin, Ayah. “Psychiatric Jim Crow: Desegregation at the Crownsville State Hospital, 1948–1970.” Journal of the History of Medicine & Allied Sciences 74, no. 1 (January 2019): 85–106. doi:10.1093/jhmas/jry025.

This article argues that while improvements came out of the desegregation process at the Crownsville State Hospital, the preceding deinstitutionalization movement negated a lot of the progress that had been made because it limited those most vulnerable in terms of their means of accessing care. Nurriddin supports her assertions through institutional reports, patient records, and oral histories. This article will likely contribute heavily toward the research project because it emphasizes that reforms meant to alleviate the discrepancies in the care and treatment of black mentally ill patients only increased the divide between the access and quality of treatment available to them.

Oswald, Frances. “Eugenical Sterilization in the United States.” American Journal of Sociology 36, no. 1 (1930): 65–73. http://www.jstor.org/stable/2767224.

This article argues in favor of using sterilization upon the mentally ill to eliminate their ability to procreate. Oswald supports this theory because the procedures themselves are on large part voluntary, although in many states, it is required by law as well. This article fits nicely into the project because it emphasizes the level of deception and coercion used by states and institutions alike.

Payne, Christopher., and Oliver. Sacks. Asylum : Inside the Closed World of State Mental Hospitals. 1st ed. Cambridge: MIT Press, 2009.

Payne and Sacks argue retrospectively that mental institutions and their staff, by in large, were motivated toward healing their patients. The authors suggest that a few select instances of maltreatment and practice coupled with the expansion of medicinal options outside institutions and the period of deinstitutionalization combined to ultimately collapse the asylum’s credibility and its previous clientele pool. This text is similar to the Norris article in that both authors chose to take on optimistic standpoints in their arguments and analyses of asylums and state mental hospitals. This text could serve well in helping form counterarguments in favor of the efforts of the institutions and their staff.

Pumphrey, Shelby. “Curiously Cured by Sterilization.” Southern Cultures 29, no. 1 (2023): 74–105.

Pumphrey’s article addresses Virginian African American men who were forcibly sterilized in the early twentieth century, and she examines the roles that disability, race, and gender played. Pumphrey supports her arguments by considering the experimental works of Dr. Charles Carrington and the experiences of Hiram Steele, Frank Baylor, and Richard Mills, three institutionalized African-American men. This article will help inform the project in that it examines how African American men, specifically, were marginalized by state institutions and those responsible for the care of the mentally ill.

Reiss, Benjamin. Theaters of Madness Insane Asylums and Nineteenth-Century American Culture. Chicago: University of Chicago Press, 2008. https://doi.org/10.7208/9780226709659.

Reiss asserts that the efforts made by doctors and staff of institutions were made urgently and creatively to resolve the rapidly increasing insane population. Reiss supports this assertion by navigating the lives of patients and doctors and their relationships. This article will help inform the project because it provides a more positive retrospective analysis than many other sources, and it could help create counterarguments. 

Royer, Steven Leigh. Allentown State Hospital. Mount Pleasant, South Carolina: Arcadia Publishing, 2020.

This text covers the Allentown State Hospital, the first homeopathic state hospital for the mentally ill in Pennsylvania. Royer and Smith assert that Allentown helped to set the precedent for alternative treatment methods in mental institutions, moving away from the archaic forms of restraint and subduction predominant in many of the asylums of the nineteenth century. This article will help contribute the basis for counterarguments in favor of the reforms being made to the care of the mentally ill in the early twentieth century.

Stuckey, Zosha. “Race, Apology, and Public Memory at Maryland’s Hospital for the ‘Negro’ Insane.” Disability Studies Quarterly 37, no. 1 (2017). https://doi.org/10.18061/dsq.v37i1.5392.

In this article, Stuckey examines to what extent racism acted as a motivating factor towards the creation of the Marylands Hospital for ‘Negro’ Insane. He supports his argument through the analysis of 14 categories of conditions. He compares the Maryland Hospital for the ‘Negro’ Insane against the nearby white asylum over a period of seven years. This article should prove significantly informative in demonstrating how racist ideologies and preconceptions influenced the creation of segregated institutions like the Maryland Hospital for the ‘Negro’ Insane. 

Summers, Martin Anthony. Madness in the City of Magnificent Intentions : a History of Race and Mental Illness in the Nation’s Capital. New York, NY: Oxford University Press, 2019.

Summers argues that St. Elizabeth’s should be a part of the narrative when discussing the institutionalization of mentally ill African Americans. Summers supports his argument by examining the relationship between the African-American community and St. Elizabeth’s Hospital and how it evolved. Summers also delves into how African Americans started to challenge the discriminatory and racist assumptions of the medicinal field of the time. Summers’ text contributes a narrative to understand the context of African American institutionalization and how their community sought to navigate the marginalization and systematic discrimination in the healthcare field.

Summers, Martin. “‘Suitable Care of the African When Afflicted With Insanity’: Race, Madness, and Social Order in Comparative Perspective.” Bulletin of the History of Medicine 84, no. 1 (2010): 58–91. https://doi.org/10.1353/bhm.0.0320.

Similarly to his text above, Summers uses this article to understand better the formation process of racist hierarchies and theories that subjugated mentally ill African Americans to vastly different standards of care than white populations. Summers supports this argument by analyzing St. Elizabeth’s Hospital as a case study of how these ideologies and theories were implemented. This article proves helpful toward the project in that it contributes to the idea that race in the period of asylums can best be understood by looking back within the history and historiography of psychiatry.

https://kentuckyhistoricinstitutions.files.wordpress.com/2021/06/1-1.jpg

The picture above shows several patients at Eastern State Hospital in Lexington, Kentucky, and a restraint device known as the coercion chair being used on one of the patients. This picture, in particular, stuck out to me because of how the restrained patient sits with their head in their hands. This picture fits the theme of the increase of asylums’ use of restraint, even among those like Kirkbride who seemed to have difficulty implementing such strategies genuinely. #histmental2023

https://docs.google.com/document/d/1K7cO41Gb9pul82pQbHxXIeLMQq_vUj97gxkAe9HvBfg/edit?usp=sharing

Attached above is my Project Topic and Initial Bibliography. #histmental2023