I did my psychiatric nurse training & my aunt ran the geriatrics building at one of our state psych hospitals. At one point the hospital was the largest hospital in the world. Not the largest psych hospital…the largest hospital. It had its own post office, zip code, train station and a farm that produced all the vegetables, milk, butter, eggs and some ham via pigs.
The hospital wasn’t bad at all. It was one of 3 huge psych hospitals within a 50 mile radius . In 1930s there was a fourth psych hospital in the area . Plus there was a criminal psychiatric hospital in the next county.
The hospitals were built in the countryside because it was believed that city life was crowded, noisy, stressful and unhealthy. It was also believed that a lot of people needed to get away from their home environment. Families were larger in those days. People were so poor that families were often malnourished. Domestic abuse wasn’t a thing…men could beat their wives, parents could beat their children and nobody would do anything about it.
A severely psychotic patient could ruin a family … the family could get evicted because of bad behavior on the part of one family member.
There were lots of reasons why people needed to be placed outside the home/family. There was no psychotherapy, no medication. Also, drug addicts didn’t go to jail - they were put in psych hospitals.
So some families needed protection from disturbed family members.
Some people needed protection from their whole families.
Unfortunately, women were targeted by husbands and could be placed in mental hospitals for life because of post partum depression and menopause. Sometimes the husband just found another woman and gaslighted his wife. Men were in charge. The doctors were all male. Husbands would go to Dr and accuse wife of all kinds of craziness. Dr would commit the woman.
Psych hospitals started out fine. But as time went on they became restrictive. Patients used to work on the farm, in the laundry, in kitchens. Civil rights organizations said it was slave labor, so all of that went away. Lots of patients had enjoyed doing farm work. It gave them something to do and they felt they were in fresh air and sunshine.
Some people were simply homeless and didn’t have the smarts to get a decent job and make the rent. We all know someone like that in our families.
States were being accused of malpractice & false imprisonment. By 1970s our state was CONSTANTLY having surprise inspections as well as JCAHO inspections. Newspapers would blast “Violations found at state mental hospital!” when it was just record keeping/clerical errors. Snake pits were down south……