Asylums Attacked as Jails

The “History Notes” article by Lucy Ozarin, M.D., in the June 1 issue was too brief to completely convey relations between American neurologists and psychiatrists toward the end of the 19th century. One item she did not discuss was the moral issue that divided Weir Mitchell from his psychiatric colleagues—the prison function of the mental hospital. Books on the history of psychiatry regularly omit the following passage from Mitchell's lecture to the “asylum doctors” (as psychiatrists were then called):

“You quietly submit to having hospitals called asylums; you are labeled as medical superintendents.... You should urge in every report the stupid folly of this. You.. .conduct a huge boarding house—what has been called a monastery of the mad... .I presume that you have, through habit, lost the sense of jail and jailor which troubles me when I walk behind one of you and he unlocks door after door.... You have for too long maintained the fiction that there is some mysterious therapeutic influence to be found behind your walls and locked doors. We hold the reverse opinion... .Your hospitals are not our hospitals; your ways are not our ways.”

The above is quoted from Mitchell's “Address Before the Fiftieth Annual Meeting of the American Medico-Psychological Association, held in Philadelphia, May 16th, 1894,” which was published in the July 1894 Journal of Nervous and Mental Disease. For a full account, see my book, Coercion as Cure: A Critical History of Psychiatry (Transaction Publishers, July 2007).