The History of Asylums in the 1800s

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  • 0:00 Asylums
  • 0:32 European Outlook
  • 1:59 American Perspective
  • 4:15 Dorothea Dix
  • 5:54 Lesson Summary
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Lesson Transcript
Instructor: Cirrelia Thaxton

Cirrelia is an educator who has taught K-12 and has a doctorate in education.

During the 1800s, treating individuals with psychological issues was a problematic and disturbing issue. These patients were maintained in places called asylums, and were usually subjected to conditions that today we would consider horrific and inhumane.


In the 1800s, asylums were an institution where the mentally ill were held. These facilities witnessed much ineffective and cruel treatment of those who were hospitalized within them. In both Europe and America, these facilities were in need of reform. Patients with severe mental problems, also called lunatics in the medical profession at the time, were routinely subject to brutal techniques, such as ice baths and electric shock.

European Outlook

Around this time, Europeans began to use a method called moral management. The idea behind moral management was that the environment had a major effect on a patients' well being. Doctors realized that patients were mentally ill, not criminals. They did away with the use of shackles and straightjackets, and focused on the beautification of the living environment, using furniture and artworks that were aesthetically pleasing. Making the asylum interior resemble home was a primary goal of this movement, as it sought to calm lunatics rather than antagonize them. Moral management practiced constant surveillance to ensure order and safety among the asylum residents.

However, moral management had repercussions, as patients became difficult to control without restraints. Many European hospitals sought to develop recreational activities that would give patients social skills and help them find more constructive ways to occupy their time. With advances in biomedical science, the moral management movement began to decline in the late 1800's due to the emphasis on drugs and psychotherapy. Moreover, leaders of moral management lost prominence because they failed to train other practitioners properly. They also failed to realize that increasing the size of asylums could lead to overextension of facilities, overcrowded patient rooms and understaffed workers.

American Perspective

In America, mental conditions such as depression, mania or melancholy could cause one to be admitted to a mental institution. These places resembled private madhouses rather than hospitals. Due to poor organizational structure and lack of quality services to patients, these madhouses left few, if any, records. To manage unruly patients, physical restraints were used. These places were obviously disastrous for all those who desperately needed psychiatric attention. Americans began to protest against patient abuse, and a call for reform rang out across the country.

One man famous for his work in the advancement of moral treatment of the mentally ill was Dr. Thomas Story Kirkbride. From the mid to late 1800's, Dr. Kirkbride insisted that patients who were confined to overcrowded jails and almshouses should be housed in facilities that had environments conducive to their well being and comfort. His magnificent architectural designs for asylums offered physical comforts never seen before. They had well-ventilated rooms and beautiful landscaping, and gave patients physical and social activities to occupy their time. One of his best buildings was the Athens Asylum for the Insane, in Athens, Ohio. The doors to this state-supported facility were opened in January of 1874, and the site featured Kirkbride's trademark ornate structural design along with two patient wings extending from a central building for medical staff. Kirkbride created this functional design to keep unruly patients in the wings, while the clinical staff was housed in the middle building for administrative duty.

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