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Education Blog

Mental Health and "Moral Treatment"

By 

Mütter EDU Staff

July 27, 2018

Greetings and salutations, fellow historico-medico afficionados, and welcome to another installment of , our semi-regular segment on the unusual and interesting aspects of medical history. Past articles have covered a variety of topics, from to to the .

Today's issue is the first in a three-part series of guest articles written by students in the . The KJF Program is a three-year after-school and summer internship for Philadelphia high school students from historically excluded communities who have an interest in careers in healthcare and medicine. These two wrote these articles as part of a two-week summer internship wherein they worked closely with staff in the and conducted original research on a topic of their choice. First up is Yazmeen Robinson, who chose to research "moral treatment," a 19th century mental health practice.

Take it away, Yazmeen!  --KI

Psychiatric hospitals were built for those who were suffering from mental illness and could somehow recover from it. During the nineteenth-century in the United States, there were new European ideas about the treatment of people who were mentally ill. These ideas were called “moral treatment” which promised treatment for those with mental illness in an asylum. During the 19th century, they thought that by treating the patients more like children rather than an animal, patients would have a better chance at recovering. Treating the patients as individuals and helping them to gain control of themselves was very important. Moral treatment at the asylum was connected with occupational therapy, religion, and their community. Moral treatment usually didn’t include traditional treatments like physical restraints.

The moral treatment of the insane refused to associate with the disruptive behavior of mentally ill individuals. Some people with mental illness were too violent or disruptive to stay at their homes or in their communities. Some people with mental illness received treatment at home other than a hospital.

Friends Asylum was established by Philadelphia’s Quaker community in 1814, which was the first institute designed to perform the full program of moral treatment. The Friends Asylum wasn’t run by physicians. It was run by lay staff, which made it unique. Private hospitals were more available to wealthier families to care for their mentally ill family member.

At Taunton Hospital in Massachusetts, there was a lower story that was built and designed for patients that were uncontrollable or considered "filthy.” The (1854-1868) has 240 entries with patients’ names, mental states, family histories, and financial status. These records contained information about patients’ profession, lineage, time in America, ships sailed on, and whether their taxes had been paid.

Here are two patient records that I found interesting:

pg. 101:

Weigandt, Louis, 41, admitted April 3,1860, Boston
Hopeless and quiet
German in Boston, 12 years, wife lives at 70 Crystal Palace, Luicida St.
Mr. Nash reports Weigandt born in Germany, landed in New York how long ago unknown. Parents never in U.S.; Weigandt had lived mostly in Boston.
Wife Jane born in Marblehead, no doubt has a set[?] there
Is cousins with cashier of Marblehead Bank
Mr. Locke says wife [?] care of [?] Crystal Palace

pg. 96:

Copeland, John, 29, admitted Feburary 24, 1860 North Bedford
Doubtful and troublesome; now has been very [?]; fugitive slave; can go as far as health is concerned
Mr. Locke says [Copeland] born in Newburn, North Carolina
Feb 23rd 1863: He [Copeland] says does not know where he was born first found himself in Newburn. Then to Duplin County, there 4 years, came to Philadelphia in 1855 from Wilmington, thence to New York and Albany. 2 years in Albany, then to Wilton County, 9 months there, then to North Bedford, 2 months there. Send to Philadelphia.

Today there are only a few psychiatric hospitals that exist. Psychiatric care is now delivered through other services, such as crisis service. Doctors today gives patients psychiatric medications, such as, antidepressants, anti-anxiety medications, and mood-stabilizing medications, which help treat, but do not completely cure, mental illness. Depending on how severe the patient’s mental illness is, the treatment that will be given could be a mixed treatment. Today there is a treatment team that helps with a patient’s unique recovery plan, which includes educational programs, support groups, and counseling.

Thanks, Yazmeen! Be sure to check back, dear reader, for our second installment soon. Until next time. Catch you on the strange side!

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