Straitjackets. Sedatives. Bars on the windows. In 1900, patients at mental hospitals in the United States faced inhumane treatment, often because doctors could not identify the cause of their melancholy or mania. Officials at psychiatric hospitals in the 1900s, known at the time as lunatic asylums or insane asylums, locked patients up against their will, with few ideas on how to properly treat their problems. As Nellie Bly witnessed when she went undercover at Bellevue Hospital in New York, patients were beaten and choked, and their living quarters often looked more like prison cells than hospital rooms.
In one institution, new patients who tested positive for syphilis were intentionally infected with malaria, once considered an effective treatment for the sexually transmitted infection. Halls were often filled with screaming and crying. Conditions at asylums in the 1900s were terrible, even before doctors began using treatments like the lobotomy and electric shock therapy. Patients quickly learned to simply parrot back what doctors wanted to hear in the hopes of leaving the facility.
The truth about what life was like at a historic mental institution will appall you.
In the early days of mental hospitals, not everyone chose to enter one. Up until the 1960s, the majority of asylum patients in the US were admitted involuntarily to institutions. By contrast, about 71% of people in psychiatric institutions today are voluntary patients.
Laws allowed families to commit their relatives with little supporting evidence. In 1860, for example, based on an Illinois law, Elizabeth Packard landed in an asylum for three years only because she practiced a different religion from her husband.
Parents also committed their children to mental institutions. In 1883, Henry Frazier was sent to an asylum in New Orleans because his mother called him uncontrollable, saying that "he masturbates himself to complete exhaustion."
Families could even "purchase" confinement for relatives they didn't want to deal with. And patients might stay in psychiatric institutions for extended periods. By 1904, only 27.8% of asylum patients in the US had been institutionalized for a year or less, with the vast majority being long-term cases.
Some people with mental health issues tried to hide their condition to avoid being sent to an asylum. A firsthand account from a patient at the Oregon State Hospital warned that peculiar behavior could land people in the hospital against their will:
They'll put you out at the end of Center street if you don't watch out. They'll put you out in the bughouse with the rest of the nuts.
In 1887, journalist Nellie Bly agreed to go undercover in a mental asylum to record the conditions inside. She reported horrific treatment from doctors, including hair pulling and solitary confinement. Bly also decried the way patients were treated like prisoners:
I could not sleep, so I lay in bed picturing to myself the horrors in case a fire should break out in the asylum. Every door is locked separately and the windows are heavily barred, so that escape is impossible. In the one building alone there are, I think Dr. Ingram told me, some 300 women. They are locked, one to 10 in a room. It is impossible to get out unless these doors are unlocked.
By the early 20th century, many mental hospitals tested patients for syphilis. At the Oregon State Hospital, doctors used "malarial treatment" for people newly infected with the disease, which was incurable before antibiotics. Doctors who used the treatment, first advocated by Dr. Julius Wagner-Jauregg, intentionally injected malaria germs into a patient's bloodstream based on the theory that malarial fever could kill syphilis.
Wagner-Jauregg's research showed that approximately half of these patients saw a reduction in syphilis symptoms after the malaria infection, but at least 15% died from the treatment. One patient in Oregon reported, "Right now, four or five patients on the ward are in bed with malaria."
The earliest treatments for mental illness were often brutal. In the early 19th century, asylums in England used a wheel to spin patients at a high speed. Other treatments, still used at the end of the 19th century, included harnessing patients and swinging them, or branding a patient with hot irons in an attempt to "bring him to his senses."
Improvements in technology didn't always mean better treatment. By the 1930s, doctors began to experiment with new, troubling methods of treating mental illness, including lobotomies and electric shock therapy.
Patients soon learned the only way to get out of the insane asylum was to fake it. "You do just what the doctor says if you want to get out of here," one patient said. The same patient later died by suicide.