Insane or Misunderstood?

    In the 19th century, insane asylums were a new concept that evolved, creating a monumental shift towards the perception of mental illness and the medicine/treatments correlated with recovery. Insane asylums are also commonly known as "lunatic asylums", which acted as institutions that were established in order to better understand the mind of a "mad-man." This concept is one that many people are familiar with in modern society, adopting a more sensitive identification of psychiatric hospitals in today's world. Societal culture has constructed a very presumptuous idea about the common exposure of knowledge that molds people's perceptions about what these institutions were and how they were run. The reputation of these institutions proceeds itself, particularly in the 19th century--a time that marked the rise of experimental and methodical scientific curiosity fueled by medical inquiry (7). These institutions were placed all around the world and were horrific establishments that administered many inhumane procedures and treatments fueled by many misconceptions on mental illness and to what extent it was misunderstood. 

The Rise of Insane Asylums 

Though insane asylums weren't a new concept at the time, it was in the 19th century when they gained a lot more traction and popularity as a form of isolation from the mass population of society, and presented a new era of reform (7). Asylums were developed with the intent of providing care for those who can not care for themselves and to offer a wide range of support, community, and safety for those who found themselves in these unfortunate mental circumstances. Still, with the forced perception and persona of these institutions being something that is needed, "asylums were regarded as prisons disguised as hospitals" (6). Within the 19th century came extensive expansion over North America and Europe (7), similar in geographic terms as to where the institution is placed on Bram Stoker's novel, "Dracula." As the acceptance and demand for insane asylums grew, so did the need for physical space in order to fit the mass amounts of incoming patients. This growth was motivated legally as the County Asylum / Lunacy Act was passed that practically forced the obligation of admission of those with mental deficiencies. After the act was passed between the mid to late 1800s, close to 100 new asylums were built and opened (6). 

Treatments and Conditions

Trans-Allegheny Lunatic Asylum reasons for admission (8)

Treatments and conditions of these insane asylums are the main form of controversy surrounded by these institutions. When the normal everyday person thinks of insane asylums, their thoughts go straight to the inhumane, strict, and horrific methods of treatment and immoral perceptions of the patients there. Well-known treatments consist of lobotomies, electro-convulsive therapy, hydrotherapy, restraintment, confinement, and a plethora of other so called "cures" (3). Along with the appalling treatments, space within these institutions was scarce due to the continual admission of patients because of the rising popularity and accessibility. Sanitation was an afterthought within these institutions, again, due to the immense shift of continual enrollment and blatant apathy for the patients honest well being and genuine recovery (1). 

Admission of women has highly more common due to the weighted judgement and misogyny around this time period. Similar to the patriarchal structures in the novel "Dracula" with the women being perceived as either innocent and pure or insane and seductive. Some of the reasons for admission were valid such as loss of loved ones or abuse. But, women were often admitted purely on the insinuation of hysteria which was commonly correlated with menstrual cycles, uterine problems, nymphomania, or breaking through the expectations of women hood in this time period. These reasons were relatively subjective to the personal judgement of the one doing the admitting which was heavily and effortlessly abused. Women and men were strictly segregated in asylums and often times so segregated that they would be in completely different buildings. Patients were given jobs while they were there, men having more labor intensive outdoor jobs such as farming and women were being kept indoors to do laundry or employed in the needle room. As time went on, regimented days and employment began to relax and patients were encouraged to spend time outside because as research continued, scientists came to the conclusion that the environment in which you live has a heavy impact on your mental well being (6).  

Architectural Design

Kirkbride design blueprint of Trenton State Hospital 1848 (9)

The first large asylum was constructed in the 1800s as the traction of relieving the burden of the mentally ill people from their families and society grew in popularity, architects had no choice but to grow with the acceptance of these institutions. Dr. Thomas Story Kirkbride constructed a blueprint outline of the widely known presentation of asylums society portrays. The Kirkbride Plan evolved with the promotion of healthier and more humane treatments of the mentally ill by advocating for orderliness and exposure to nature (4). Constructing an environment that correlates with the treatments for patients plays an active role in the recovery process because patients feel more connected to their environment when they aren't feeling restricted or isolated. Humans are highly affected by the physical location they are exposed to, so when the architecture of the buildings started to conform to humanistic desires, there was seen to be an increase in patient recovery (2). These blueprints and designs were famous for their astounding size and emphasis on the subordinate approach to moral management. Structurally, this plan was designed for patients mental process progress by stressing natural light exposure, beautiful and rural views, along with better air circulation. 

Sources

(1) "A Victorian Mental Asylum." Science Museum, 2018, https://www.sciencemuseum.org.uk/objects-and-stories/medicine/victorian-mental-asylum. 

(2) Cooksey, Elizabeth C. "CONTAINING THE MAD: Moral Architecture and the Nineteenth-Century Asylum." Research in the Sociology of Health Care, EBSCOhost, vol.8, 1989, pp. 253-71.

(3) MacRae, Meghan. Horrifying Psychiatric Treatments From The Age of Reason. CVLT Nation, 2020, https://cvltnation.com/horrifying-psychiatric-treatments-from-the-age-of-reason/. 

(4) McElory, Ethan. The Buildings. Kirkbridge Buildings, https://www.kirkbridebuildings.com/buildings/. 

(5) Into the Shadows. "The Horrors of Historical Mental Asylums." YouTube, 2024, https://www.youtube.com/watch?v=h9bXornp-WA.  

(6) McBeath, VL. Victorian Era Lunatic Asylums. Historical Sagas and Mysteries, https://www.valmcbeath.com/books/the-ambition-destiny-series/. 

(7) Sims, Andrew C.P., Yudofsky, Stuart C., et all. Treatment of mental disorders, Britannica, 2025, https://www.britannica.com/science/mental-disorder/Treatment-of-mental-disorders.

(8) Reasons for Admission. 1800s, Trans-Allegheny Lunatic Asylum.

(9) Trenton State Hospital. 1848, Kirkbride Lithograph, https://en.wikipedia.org/wiki/Kirkbride_Plan#/media/File:Trenton_State_Hospital_-_Kirkbride_Lithograph_1848.jpg.