Patients outside the Asylum Doors: Changes in Psychiatric Views and Treatment at the Michigan Asylum for the Insane during the Late Nineteenth Century

Abstract

During the late nineteenth century, the Michigan Asylum for the Insane in Kalamazoo, Michigan, underwent significant changes in the treatment and living conditions offered to patients. Michigan founded the asylum in 1854 and built it to resemble other mid-nineteenth century insane asylums. The typical mid-nineteenth century state insane asylum was a massive building set in the countryside, where insane patients were able to simplify their lives and get in better touch with the spiritual world. These institutions were setup in the Kirkbride style, a layout where a massive, ornate, gender-segregated building was arranged in the middle of acres of land available for walks, recreational activities and gardening. The Michigan state government had their insane asylum built in the popular in the Kirkbride style, the embodiment of moral treatment. Moral treatment helped the insane patients “live at the highest level of humanity for them” by treating them like sane adults through a regimen of exercise, work, and amusement. However, as time went on, the Michigan Asylum for the Insane became overcrowded, which prevented the asylum from applying moral treatment properly. Overcrowding led the insane asylum to become little more than a holding cell for the mentally insane. The underlying problems and issues with conditions at the Michigan Asylum for the Insane were brought to light by the media and by the state judicial system in the 1870s and 1880s. This constant negative attention lavished on the psychiatric care at the asylum helped push the asylum to update and change the types of treatments and living conditions for patients to match psychiatric views in the late nineteenth century. Views of psychiatric treatment and mental illness in the late nineteenth century were evolving, as the Victorian notion of spirituality as the source of illnesses was being replaced by scientific explanation. The Victorian notion of mystical spirituality defined insanity as a product of sin and evil, a disruption of the spirit. Newer scientific notions explained disturbances of the mind through genetics and simple overworking of the mind. During this evolution of psychiatric views, two groups of thinking emerged: the old asylum superintendents who championed moral treatment and the neurologists who founded their treatments on science and logic. These two groups engaged in a protracted debate over diagnosing, defining, and treating mental illness. Compounding the debate were concerns about anxiety and overcivilization that troubled Americans. Americans, especially the middle class, looked for an unambiguous definition, diagnoses, and treatment of insanity because of their fear of the rise of a cultural problem of anxiety and nervhousness. Their concerns about overcivilization made Americans yearn for the days of the early American republic, especially its simple, natural aesthetics and farming. As views on psychiatric treatment changed and the debate between scientific neurologists and traditional superintendents raged on at the national level, treatment and conditions changed within the Michigan Asylum for the Insane. By the late-1870s, conditions within the asylum failed to meet the standards it promised at its founding. The asylum was not in a good position as it was overcrowded with not enough room for patients’ exercise and entertainment. Murmurings of abuse and mismanagement rippled beneath the surface. A court case, Newcomer v. Van Deusen (1876), filed by a former Michigan Asylum for the Insane patient against the superintendent. The trial was for misdiagnosis and unlawful detainment, and it eventually reached the Michigan Supreme Court. The final verdict of the first hearing, in favor for Mrs. Newcomwer, was delivered in the last few months of 1878. Regional newspapers followed the trial, and days after a second hearing of the case was called for in January 1879, the story of another Michigan Asylum for the Insane patient rendering her horrific experience within the asylum walls was published. The Michigan legislature quickly put together a joint committee to investigate the conditions and management of the Michigan Asylum for the Insane. The 1879 abuse investigation examined both former and present patients, staff members, and people in the community who had daily or weekly contact with the institution. The need for the state to look into the management of the asylum cast a negative light upon the institution and reflected Americans’ growing distrust of asylum treatment. With the burden of a negative image and a failing moral treatment system, the Michigan Asylum for the Insane sought to recreate itself by ushering in a new treatment system: colony farming. The colony farm system embodied the new ideals of simplicity and desire to go back to the earlier, idealized days of agriculture. Furthermore, it helped with the growing issue of overcrowding, chronic and aging patients, and treatment for the saner, less violent patients. Financially, the new treatment system helped the asylum. It produced milk, grain, fruit and vegetables for the asylum. Patients worked on the colony farm, but the work was neither intensive nor exploitive. Farming in the fresh, clean air strengthened the patients. Patients learned skills they could use to support themselves after they were released from the asylum. Moreover, the colony farm system produced a homelike environment as the patients were housed in cottages with little supervision, lending a sense of freedom and self-control. The colony farm system saved the asylum money, gave it fresh produce, occupied patients, and dealt with its overcrowding issue, all while helping the asylum stay current.