history of the american asylum
Looking back at hospitals and institutions that are now left abandoned not only show us how far the medical and mental health field has come but also why it has come so far. The majority of abandoned institutions are mental hospitals for the mentally ill and state schools for the mentally and physically disabled; both of which have an equally heartbreaking past. Their past, filled with public unawareness of overcrowding, neglect and abuse, should be known in order to prevent history like this from ever repeating itself.
Caring for the mentally ill, developmentally and physically disabled was done by family members up until the mid 1700s when families began putting their loved ones into almshouses. Between 1773 and 1800 small state hospitals were being constructed in hopes of creating a place for the mentally ill and disabled individuals to receive treatment and care as opposed to be thrown into jails since that had been the alternative for those who could not afford other care. Once state institutions and state schools were constructed and in operation, the association of superintendents would determine the main requirements while each institution made the rest of their decisions accordingly.
Image taken from the National Library of Medicine of ASMAII members
At the 1866 Association of Medical Superintendents of American Institutions for the Insane (ASMAII) annual meeting, the members allowed hospitals to house 600 patients in a single building instead of the 250 patients it had previously agreed on. The number of patients in an institution, and the number of staff members varied based on whether it was a linear or cottage plan asylum, a congregate asylum or a state school and hospital. Regardless of the design, this change in increased patient housing created the downward spiral of overcrowding and poor conditions for patients everywhere.
By the 19th century, these facilities were developing at a rapid rate with every state having one or more public institutions. Who was considered to be "mentally ill" was expanding as the mere existence of these hospitals inspired families to institutionalize their relatives. With the admittance of more and more individuals into these asylums for rather ridiculous reasons, social categories were created without a second thought. Women with postpartum depression were institutionalized, teenagers entering the years of rebellion and mood swings, children with epilepsy and autism, the elderly who faced alzheimer's or dementia and even people who couldn't speak english well enough.
More than questionable treatment practices such as electroshock therapy, insulin therapy, and lobotomies were no stranger to many of these state hospitals and schools but the ongoing abuse and neglect that went on in these places created with good intention ultimately led to their closure. Between the 1970s and 1990s states all over the country were closing their public institutions one by one in part because of the movement towards deinstitutionalization but also because of media exposés that went inside some of these well-known facilities. To read more about these individual asylums/hospitals, and state schools, visit the locations tab.
Image taken from the Library of Congress
Aldrich, C K. "Deinstitutionalization. University of Virginia Newsletter. 211985.
"Cultural History of Madness, Psychiatry and Mental Health." Mental Health Worldwide,
"MENTAL HOSPITALS: NEW YORK." Journal of the American Medical Association, vol. 137, no. 4, 1948, p. 385.
Van Der Velde, Matt. Abandoned Asylums. Editions Jonglez, 2016.
Yanni, Carla. The Architecture of Madness: Insane Asylums in the United States. U of Minnesota P, 2007.
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All photos taken by Sami Fego unless stated otherwise