Psychiatric Institutions - History

History

Modern psychiatric hospitals evolved from, and eventually replaced the older lunatic asylums. The development of the modern psychiatric hospital is also the story of the rise of organised, institutional psychiatry. While there were earlier institutions that housed the "insane" the arrival of institutionalisation as a solution to the problem of madness was very much an event of the nineteenth century. To illustrate this with one regional example, in England at the beginning of the nineteenth century there were, perhaps, a few thousand "lunatics" housed in a variety of disparate institutions but by 1900 that figure had grown to about 100,000. That this growth coincided with the growth of alienism, later known as psychiatry, as a medical specialism is not coincidental. In the late 19th and early 20th centuries, terms such as "madness," "lunacy" or "insanity" -- all of which assumed a unitary psychosis -- were split into numerous "mental diseases," of which dementia, praecox, and schizophrenia were the most common in psychiatric institutions.

The treatment of inmates in early lunatic asylums was sometimes brutal and focused on containment and restraint. With successive waves of reform, and the introduction of effective evidence-based treatments, modern psychiatric hospitals provide a primary emphasis on treatment, and attempt where possible to help patients control their own lives in the outside world, with the use of a combination of psychiatric drugs and psychotherapy. These treatments can be involuntary. Involuntary treatments are among the many psychiatric practices which are questioned by the Anti-Psychiatric movement. Involuntary treatment is emphatically opposed by the mental patient liberation movement, but this movement does not have any issue with any psychiatric treatment that is consensual, provided that both parties are free to withdraw consent at any time.

Most psychiatric hospitals now restrict internet access and any device that can take photos.