A History of Public Mental Health Care in Pennsylvania
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i 9 ' and the Politician A History of Public Mental Health Care in Pennsylvania ■ A l i \ * i i Ernest Morrison HI- $' ► u \ ;>{ 1 I •i i i 1 JSf { > The Physician, the Philanthropist, and the Politician ■5 A History of Public Mental Health Care in Pennsylvania * Ernest Morrison W-s 1 2 Commonwealth of Pennsylvania *. ^1 Pennsylvania Historical and Museum Commission fl for j The Historical Committee of the Harrisburg State Hospital , I 2001 i I i fe a . •;? V.. .• JS Commonwealth of Pennsylvania Tom Ridge, Governor Pennsylvania Department of Public Welfare Feather Houstoun. Secretary Pennsylvania Historical and Museum Commission Janet S. Klein, Chairman < Brent D. Glass, Executive Director c < l % C The Historical Committee of the Harrisburg State Hospital was established in X June 1982 to collect and preserve the records , artifacts and story of <; Pennsylvania ’s first State Hospital , which first opened in 1851 in Harrisburg . < Today the committee seeks to promote a better understanding of the state hospital « system and its role in providing for the Commonwealth ’s mentally ill. This book < has been written as part of the committee ’s efforts to commemorate the one hun dred fiftieth anniversary of the establishment of the state ’s first mental hospital at Harrisburg . i \ < < < c € >> < -< A * \ <S C i 5 t © 2001 Historical Committee of the Harrisburg State Hospital Printed in the United States of America c c Published and distributed by < The Historical Commttee of the Harrisburg State Hospital * P. O. Box 61260 Harrisburg, PA 17106-1260 ISBN 0-89271-101-9 i <4 a — ■ . A to lift the curtain of popular misconception which unfortunately long has existed with regard to mental institutions. Sophia M. R. O’Hara i r i., vv -v i. i Table of Contents Foreword .Vll Colonial America 1 William Penn’s Great Law .... 1 Madness in Colonial America 1 Pennsylvania Hospital .......... 1 Benjamin Rush ....................... 3 The Asylum Building Era 5 The Frankford Asylum and “Moral ” Treatment ................. 5 Thomas S. Kirkbride................................................................. 6 A Kirkbride Asylum.................................................................... .8 The Legislative Sessions of 1838 and 1841 .......................... 10 Thomas Pym Cope ...................................................................... 11 Dorothea Lynde Dix ’s Memorial ............................................. 12 Dorothea L. Dix .......................................................................... 14 Founding of the American Psychiatric Association ............ 15 Construction of the First Pennsylvania Asylum................. 16 Joseph Konigmacher ................................................................. 16 Asylum Life................................................................................. 17 Restraints and Therapies ........................................................ 19 John Curwen............................................................................... .20 Dixmont ........................................................................................ .22 Origins of Insanity...................................................................... .24 The Civil War............................................................................... ,25 Danville ....................................................................................... ,27 Habeas Corpus ............................................................................ 30 Asylum Architects...................................................................... 30 The Board of Public Charities ................................................ 33 “Insane Asylum Warfare” ........................................................ 36 “Life Among the Insane”—The Story of Adriana Brinckle 38 The Cottage Plan .44 Norristown State Hospital ................. ,44 Hiram Corson ......................................... .46 Search for New Measures................... ,48 Warren State Hospital ....................... ,48 Asylum Afflictions: Fire and Disease 50 Wernersville State Hospital .............. 52 Blacks and the Asylum....................... 55 Poor Farms............................................. .57 vi The Twentieth Century 59 Allentown and Farview State Hospitals 59 The Mental Hygiene Movement ............. 60 The Haviland Survey ............................... 61 Torrance ....................................................... 66 The Department of Welfare .................... 67 Wernersville and Act 272 ........................ 68 First Pennsylvania Mental Health Act . 69 Western State Psychiatric Hospital ....... 70 Shock Therapy............................................ 70 “Full State Care ” 74 Byberry and the “Full State Care” Act.................. 74 Mayview and Retreat ............................................... 75 State Hospital System at Its Peak........................ 77 The Philadelphia Mental Health Survey Report. 78 “Crazy Harry” ............................................................ 78 American Psychiatric Association Study of 1955 79 Citizen’s Mental Health Groups ............................. .81 Return to the Commnity .......................................... 82 Staff Needs.................................................................. 83 Arthur P. Noyes: “Mr. Psychiatry”........................ .84 Community Mental Health 86 The Scranton Administration and Mental Health 86 The Unit System.......................................................... .88 Psychiatric Nursing ..................................................... 89 Wyatt vs. Stickney........................................................ 91 The State Hospital as “City”...................................... 92 Vecchione vs. Wohlgemuth ........................................ 95 Patient Abuse................................................................ 95 Mental Health Plans................................................... 96 Closing of Byberry....................................................... 98 The Schizophrenic Mind............................................ 100 Not Guilty by Reason of Insanity............................. 102 A New Century ................. 103 Appendices 106 Mental Health Care Acts of the Pennsylvania General Assembly 106 State Hospital System at its peak—1947 ......................................... 110 Bibliography .............................................................................................. 111 - Foreword Moreover, the volume of legislative vii acts in the 150 years since 1851 —which Around a chandelier in the main read number in the hundreds—is evidence of ing room of the Pennsylvania State the concern for and the commitment of the Library in Harrisburg a motto is inscribed legislature to providing for the mentally that reads: “Thought never ripens into ill. truth except through action. ” Although it The reader should keep two points in is Emersonian in character, it is accompa mind throughout. Regardless of the past nied by no attribution. And search as I shifts in public mental-health policy — may, I have never found it in any diction whether at a given moment a community, ary of quotations, although there are county, or state system was preferred—the dozens of quotations that convey the same concern was always for the indigent, not basic idea. those who could afford to pay. The latter Thought and action do go together usually went to private hospitals or were (despite a widespread belief that individu cared for at home. This was true even als are either thinking or acting, but sel though many of the state facilities admit dom both), and significant actions are ted some paying patients during much of invariably preceded by thoughts. their history. The policy behind establish As much as the actions themselves, ing and maintaining both the county and the ideas are what this book is about — the state schemes was to provide for the ideas that led to the acts of the legislature, poor. the erection of buildings, and the evolution Second, the choice of which type of in Pennsylvania’s treatment of the mental facility—community, county, or state—was ly ill. Its underlying theme, then, traces in favor at any point was determined not the shifts in “public policy ” in Pennsyl only by the perceived quality of the care vania’s treatment of its mentally ill that the mentally ill might receive in one or the grew out of this thinking. other class of institution, but also by who Each act of the legislature, the erec should pay for the indigent ’s care. tion of each new hospital building, the Today, regardless of whether an indi implementation of each improvement in vidual stays in a state or a community medical regimen came about as the result mental health center, those who can pay of some new idea, which often emerged invariably do so with insurance reim from or led to changes in the public ’s per bursements, while the indigent are largely ception —the “public policy ” climate—of provided for with federal funds (Medicare the manner in which the Commonwealth or Medicaid). The state, of course, furnish should provide for its less fortunate citi es facilities, staff, and training at the state zens, including its mentally ill. hospitals it continues to maintain. This trend is quite apparent, for exam While a people ’s greatness is usually ple, in the acts of the legislature. Between measured by the wars it wages, the 1868 and 1873 the acts that established notable cities it erects