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In the 19th and 20th centuries, reformers in the United States and Europe built asylums in response to a range of social issues including disability - mental health, and alcoholism. These documents and images from the NLM Digital Collections bring to life the day to day experiences of people at these sites: the conditions of the asylums and the limits on liberty that many people in them experienced.
Letter stitched in cloth by Anna B. Kuster Welty, 1877
Courtesy National Library of Medicine
Anna Welty stitched this letter in German asking for her release from the California Insane Asylum in Stockton. She had been hospitalized for mania for four years when she created this piece. Like many people, Anna Welty experienced asylums as restricting their liberty, particularly if they had been placed there involuntarily. She did not gain release and instead escaped in 1884 and drowned accidentally the day after leaving.
Architectural drawing of the Sheppard Asylum’s fourth floor, by British-American landscape architect Calvert Vaux , ca. 1860
Courtesy National Library of Medicine
Often, servants and attendants lived on the grounds of asylums, as reflected in these servants’ quarters rooms. Room and board were part of the staff’s salaries. Superintendents often lived on the asylum grounds as well in their own separate houses.
Bird’s eye view of the Willard Asylum for the Insane in Ovid, NY, 1888
Courtesy National Library of Medicine
In 1890, the Willard Asylum held over 2,000 people as patients, the largest institution in the country at the time. Patients arrived by steamship at the dock and the campus was comprised of a number of detached buildings. Many asylums like Willard resembled small towns due to their size.
Earlswood Asylum, T. S. Crowther, ca. 1800s
Courtesy National Library of Medicine
The Earlswood Asylum in Redhill, England was the first institution for people with intellectual and developmental disabilities in Britain. Administrators often imposed strict work regimes on individuals there in the belief that it would make them into productive citizens in society and would benefit the asylum.
The New York State Inebriate Asylum, Harper’s Weekly, 1869
Courtesy National Library of Medicine
The New York State Inebriate Asylum in Binghamton was the first hospital to treat alcoholism as a disease. It reflected the belief at the time that removing people from their communities and placing them in asylums could fix a host of social disorders in the 19th century. Due to graft and mismanagement, the inebriate hospital closed and later became the Binghamton Asylum for the Chronic Insane.
Side view of an asylum van, ca. 1890
Courtesy National Library of Medicine
This van was used by a New Jersey town to convey people to and from the asylum. The bars on the windows prevented passengers from leaving the van without permission and reflected the widespread use of security measures to keep people from leaving asylums without permission. Escapes were still a common occurrence, however.
Bird’s eye view of the State Asylum for the Insane, Morristown, NJ, ca. 1850
Courtesy National Library of Medicine
This illustration shows a popular asylum design named the Kirkbride Plan, which centered the administrative functions of the hospital in the central core of the building. Patients were then housed in the wings that emanated from the core and were divided by gender and the type of mental health condition.
Boys using shower at New York Juvenile Asylum, Dietetic Gazette, May 1891
Courtesy National Library of Medicine
The physician Simon Baruch created one of the first institutional shower baths in the New York Juvenile Asylum as a public health measure.
The Asylum was founded in 1851 and took in children who committed petty crimes or who came from impoverished or abusive families. The asylum sought to reform these children through moral, religious, and vocational training.
Patient ball at the Insane Asylum on Blackwell’s Island, illustration by W.H. Davenport, NY, Harper’s Weekly, 1865
Courtesy National Library of Medicine
Often, officials at asylums worked to rehabilitate people with social and recreational activities such as sports, concerts, theater, and dances.
Letter from Mrs. A. Schmitt to the Asylum Investigating Committee of the Citizen’s Association of Chicago, November 13, 1884
Courtesy National Library of Medicine
In this letter, Mrs. Schmitt, the wife of an engineer at the asylum, writes how the superintendent Dr. J. C. Spray threatened her family with a pistol. She wrote the letter to an investigating committee, which in 1884 looked into charges of neglect and political corruption at the Insane Asylum of Cook County, Illinois.
Letter from Robert Bruce, Manager of the Detective Police Agency, to Dr. Shobal Clevenger, March 7, 1887
Courtesy National Library of Medicine
Dr. Shobal Clevenger investigated conditions at the Cook County Asylum, after working there in the 1880s. A man tried to assault him as an intimidation tactic. This letter reported the findings of a detective that Clevenger hired to investigate the matter.
Letter from Hana Pickard to the Asylum Investigating Committee of the Citizen’s Association of Chicago, November 14, 1884
Courtesy National Library of Medicine
In this letter, an employee at the Cook County Asylum outlines the abuses she experienced while working there in the 1880s. She describes how the superintendent had “a bad temper” and “that his threat to shoot and whip others were common.” She ended the letter with hope that conditions would change.
Letter from Otto L. Schmidt, M.D., to the Asylum Investigating Committee of the Citizen’s Association of Chicago, November 14, 1884
Courtesy National Library of Medicine
In 1884, the Insane Asylum of Cook County, Illinois came under investigation for neglect and political corruption. In this letter, Otto L. Schmidt, a prominent physician, stated that “politics was the principle interest of the place and that medicine and the care of the patients were decidedly subordinate.” He revealed this information with the hope that the the investigation would spark change.
“Asylum Deaths: List of Unnatural Endings of Patients Sent by the Coroner to Gov. Lowden to Aid Inquiry,” The Chicago Daily Tribune, December 4, 1918
Courtesy National Library of Medicine
In 1918 the coroner sent a list of unnatural deaths at the Chicago State Hospital for the Insane to the Governor asking him to investigate. “Hundreds of relatives and friends of inmates are making inquiry concerning the place.” This list documents people dying from suicide, escape attempts, and violence.
Shobal Vail Clevenger, 1892
Courtesy National Library of Medicine
The psychiatrist Dr. Shobal Clevenger fought neglect and corruption at public asylums in Illinois. His advocacy led to criminal convictions and some reforms. He faced death threats because of this investigation and eventually left the asylum field altogether.
The Insane in Foreign Countries, William Pryor Letchworth, 1889
Courtesy National Library of Medicine
Social reformers in the United States studied the practices of asylums in Europe and brought their ideas back to America. William Letchworth’s book The Insane in Foreign Countries became a reference text that documented the treatment of people diagnosed with mental health conditions in Europe in the 19th century.
Report of the Chairman of the Board of Directors for the Asylum for the Colored Insane, J.W. Vick, ca. 1881
Courtesy National Library of Medicine
In 1880, North Carolina opened an asylum for African Americans only. This report documents how the institution was built in a rural area of the state. The result was that people housed at the asylum often lived far from their homes in this remote setting.
U.S. Asylum for Insane Indians Annual Report and Census, 1926
Courtesy National Library of Medicine
In 1898, Congress created the first asylum for Native Americans. Over the next three decades, people from reservations across North America were removed from their families and homes and placed in the Canton Asylum in South Dakota.
“Senate Scene in Springfield, Illinois” from Modern Persecution; or, Insane Asylums Unveiled, Elizabeth P.W. Packard, 1873, reprinted 1973
Courtesy National Library of Medicine
Elizabeth Packard, an author who herself had been wrongfully committed, lobbied the Illinois legislature about the rights of patients in asylums. As a result, the state passed a law requiring that people have a public hearing before being committed to a hospital.
Packard campaigned nationwide for that reform and for the legal protection of people in asylums.
“Dr. McFarland punishing One-Armed Wyant” from Modern Persecution; or, Insane Asylums Unveiled, Elizabeth P.W. Packard, 1873, reprinted 1973
Courtesy National Library of Medicine
Mr. Wyant was a patient at an asylum when he struck an attendant. As punishment, the administration forced him into a shower bath. Shower baths were considered a therapeutic measure for mania and melancholia, but people also experienced them as punishments.
Memorial to the Legislature of Massachusetts, Dorothea L. Dix, 1843
Courtesy National Library of Medicine
Author and social reformer Dorothea Dix protested against the confinement of people with mental health conditions in prisons and almshouses in this address to the Massachusetts State Legislature. She took her campaign nationwide and worked to expose the widespread use of confinement in response to insanity. She took her findings to state legislatures across the country, using them as evidence to justify the creation of asylums.
The True Cause of Insanity Explained, or, The Terrible Experiences of an Insane, Related by Himself: The Life of a Patient in an Insane Asylum, Francis Delilez, 1888
Courtesy National Library of Medicine
Francis Delilez wrote this account in which he described his experience of insanity, which he said caused him to murder his brother. The police arrested Delilez and took him to the Northern Wisconsin Hospital in Winnebago. This book describes the conditions at this institution in the 19th century.
Two Years and Three Months in the New York Lunatic Asylum at Utica: Together with the Outlines of Twenty Year’s Peregrinations in Syracuse, Phebe B. Davis, 1855
Courtesy National Library of Medicine
Phebe Davis was hospitalized at the New York Lunatic Asylum from 1850 to 1853. After she left, she wrote critically about her experience and stated that her confinement in the asylum stemmed from stepping outside the bounds of socially acceptable behavior. This theme appeared in a number of writings by women housed in asylums in the 19th century.
Am I a lunatic?, or, Dr. Henry T. Helmbold's exposure of his personal experience in the lunatic asylums of Europe and America, Henry T. Hembold, 1877
Courtesy National Library of Medicine
Henry Hembold was a successful retail druggist who was confined to asylums in the United States and France during the 1870s. In this book, he described the different treatments he received while a patient at various institutions, offering an interesting transnational perspective.
Report Relative to an Asylum for Lunatics, New Jersey Legislature Joint Committee on Asylum for Lunatics, 1841
Courtesy National Library of Medicine
In the 19th century, many social reformers found that people deemed insane were in jails and poorhouses or faced homelessness. In this report, legislators in New Jersey called for the creation of an asylum. In 1848, the state opened the New Jersey State Hospital, its first public asylum.
How to Care for the Insane: A Manual for Attendants in Insane Asylums, William D. Granger, M.D., 1886
Courtesy National Library of Medicine
Dr. Granger, a physician at the Buffalo State Asylum wrote this manual in order to train people for work as attendants in asylums. In it, he outlines the various types of nervous functions and types of insanity. Granger also trained the staff in how to respond to people in asylums, with kindness, observation, and strict discipline, and the different forms of treatment such as sedatives and hydrotherapy.
Asylum inmates, 54 Photographs of Inmates at an Imbecile Asylum, Joseph Parrish, 1886
Courtesy National Library of Medicine
This collection of photographs by Dr. Joseph Parrish capture, for a moment in a time, the people most affected by the asylum movement. Dr. Parrish likely took these photographs as a way to classify the people, a common practice at the time as people’s physical appearances was thought to be tied to their underlying ailments.
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