Sunday, March 30, 2014

Some Intellectual Disability Hospitalization History

Phillip N. Thomas. Harrisburg State Hospital: Pennsylvania’s First Public Asylum. Charleston, S.C.: Arcadia Publishing, 2013.

In 1845, the Pennsylvania legislature and the Governor signed a law to create the state government’s first mental health hospital. It was to be called the Pennsylvania State Lunatic Hospital and Union Asylum for the Insane. This resulted from the Moral Treatment movement that believe those with intellectual disabilities could be treated in hospital settings. Prior, the mentally ill were “warehoused” and lived together with no treatment programs.

Benjamin Rush was a leader in the moral treatment movement. He treated mentally ill patients in a private Philadelphia facility, the Pennsylvania Hospital. In 1792, he began a campaign to create a ward just for mentally ill patients.

In 1835, Pennsylvania Hospital opened a separate facility, the Pennsylvania Hospital for the Insane. It was first directed by Dr. Thomas Story Kirkbride. Kirkbride published a design for constructing mental health hospitals that guided the construction of several subsequent facilities including the Harrisburg State Hospital.

Dorothea Dix led a nationwide movement to construct mental health hospitals. Her presentation in 1845 before the Pennsylvania legislature helped persuade legislators to create a state-owned facility.

The 130 acres Sales Farm in Harrisburg was purchased for the site. “Union Asylum” was removed from the name. It was designed for 250 patients. It opened in 1851. There were 37 patients (24 male, 13 female) by the end of that year. There were 182 patients at the end of 1853.

Some patients worked in agriculture positions. This was meant to give them self-confidence and to keep them active.

The hospital also served war wounded patients during the Civil War.

Several additions were made to the hospital to serve more patients. Overcrowding became a common problem during the 19th century with some rooms designed for four patients having up to ten patients. In 1898, there were 907 patients in facilities meant to house 700 patients.

In 1893, the legislature appropriated $100,000 for construction a new administrative section located within the Main Building. The legislature refused additional requests for funds for expansion in 1898. In 1899, the legislature agreed to the construction of a new building. In 1901, the legislature appropriated $253,000 for four new buildings. Further expansions were made through 1922.

The hospital had 1,319 patients in 1921 in facilities designed for 1,000. Part of this overcrowding was that homeless and elderly were sometimes sent to the hospital even though they did not appear to be mentally ill. This continued growth in patients led to an expansion project in the 1930s followed by more expansion in the 1950s. This included a building for tuberculosis patients opening in 1938.

The hospital was designed for 3,000 patients in the 1950s.

Among treatment methods used were hydrotherapy, where patients were placed into tubs of water; rain baths, where patients were sprayed with water; and wet packs, where patients were constrained for long periods wrapped in wet sheets. In 1941, it became on of the first hospitals to use electroshock therapy. In 1952, it began using insulin shock therapy.

Towards the end of the 20th century, there were movements to move mentally ill patients into community settings or home settings. The hospital had 450 patients as of 1992. The average stay was for six months. In 1996, the hospital closed.


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