Who got committed?

March 20, 2010 8:10 AM

It's the mid 20th century. You're a 40 or 50-something, poor, married immigrant mother who barely speaks English, has been accused by your husband of infidelity....and has just been committed to a state hospital for the "insane." How mentally ill are you likely to be, by today's standards?

An uncovered death certificate about a relative everyone is mum about, revealed a sad surprise: the death occurred (at an elderly age) at a "state hospital for the insane." Commitment was probably sometime between 1940 and 1970. Just how "crazy" were most residents of these mammoth state facilities? How low was the bar set for committal? Where can I read more (on or offline) about these hospitals, and the state of dignosis/care?

[There is a very garden variety history of moderate depression along the various branches of the family tree, but nothing like bipolar or schizophrenia among her literally dozens of direct descendants. There is a history of thyroid problems, but I'm wondering if "myxedema madness" was a thing of the past at that point because doctors knew to test thyroid levels?]

posted by anonymous to Health & Fitness (11 answers total)

The great but very disturbing PBS special called The Lobotomist touches on some of these issues. I don't know enough about the subject to speak with confidence, but my impression is that patients then (especially closer to the 1940s) ranged from very likely to considered mentally ill by today's standards to not at all likely to be considered mentally ill by today's standards; the people fitting the latter category were admitted for a variety of reasons, but were often vulnerable in a way that made them easy to control, and your details fit that--poor, accused of a moral failing like infidelity, immigrant, female (vulnerable in terms of social and legal status then), non-English speaking.
posted by sallybrown at 8:22 AM on March 20, 2010 [1 favorite]

For further reading, take a look at the work of Andrew Scull and Gerald Grob, two of the leading historians of mental illness in America.

As for your particular relative, its very difficult to generalize. At most we can say that the bar was set "low" by our present-day standards, in the sense that diagnostic categories were not as refined, standardized, and codified as they are today. However, many critics of psychiatry argues that people who are in some way socially deviant have long been (and continue to be) classified as "mentally ill."
posted by googly at 8:28 AM on March 20, 2010 [1 favorite]

Oh and this is a good New York Times article and slide show about various women who ended up at the Willard Psychiatric Center, seen through the suitcases they brought and never got a chance to take home.

Suffering from TB herself, and stressed over a series of illnesses and deaths among her loved ones, [Margaret] was brought to Willard in 1941 without ever having seen a psychiatrist on the basis of complaints that she “annoys people” and felt persecuted. On her way to the ward Margaret, 48, said she felt “like a fly in a spider web.” She died there 32 years later.

Like many of the women who ended up in this hospital, Ms. Penney said, Margaret was an immigrant and had little or no family nearby. The patients were definitely troubled, she added, but the cause was often an immediate crisis like a death in the family or the loss of a job, something that would rarely need lifelong commitment.

“A lot of these folks happened to be in the wrong place at the wrong time and said the wrong thing to the wrong person,” Ms. Penney said.

For more information see suitcaseexhibit.org.
posted by sallybrown at 8:30 AM on March 20, 2010 [10 favorites]

Her age may suggest something like Huntington's, but that's a real stab in the dark.

But, hey, she was female, so it may well have been good (okay, not so much), old-fashioned hysteria. The accusation of infidelity may be the clincher there.

Really, though, it could have been anything. Would it be possible to go digging around in some old records?
posted by Sys Rq at 9:06 AM on March 20, 2010

Your state historical society archives might have some records for mental institutions. I came across some old ledgers in the archives at my local historical society while doing research on an entirely different subject. The ledger was called "Book of the Insane" and was from the early 1900s. Some of the entries for patients included descriptions of alcoholism, "hysteria" and things that seemed like garden variety OCD and depression. I understand that it used to be somewhat easy to have a family member committed to an institution against their will.
posted by pluckysparrow at 9:14 AM on March 20, 2010

The range went from very insane to completely sane. Edmund Wilson is said to have committed Mary McCarthy to a psychiatric facility basically because she was getting on his nerves. Mary McCarthy was not insane.
posted by OmieWise at 10:26 AM on March 20, 2010

I suspect that it was a state facility makes it more likely that there was some real aspect of disability. There used to be a network of local public and private asylums and these had less stringent standards, especially the latter.

Sexism was an issue. Dysfunctional males could become hobos or hermits and as long as they didn't bother anyone, they were left alone. Dysfunctional women in a patriarchal society were potentially at the mercy of their husbands or if unmarried faced serious societal disapproval, especially if they bore children.

Ken Kesey's One Flew Over the Cuckoo's Nest is based on his own experiences as an orderly and documents at least one radical perspective on the 1950s institutional environment, which is pretty alien by today's standards (and was already obsolete in many ways by the time the film was made in 1975). It stands as a marker of changing ideas about what constituted insanity in this period. Although mental illness in general is something that comes with a social definition and is subject to historical variation, I don't know of a period in our history when attitudes changed so much so quickly.

Rather than try to speculate from general statistics, though, I would try to dig deeper into your own relative's case. Find out what privacy laws your state has and see what records you can obtain. Ask for newspaper records through a genealogy research service, in case there are any recorded arrests. Contact relatives outside your immediate circle who may be more willing to talk. Above all, don't torture yourself. Even if your relative would not have been institutionalized today, it's probably not productive to develop a narrative of unjust commitment without a lot more knowledge of her situation. Everyone involved may have had utterly compassionate and contemporarily justified motives.
posted by dhartung at 11:26 AM on March 20, 2010

I don't know how it worked in the United States, but at that time period it was very common in South America for husbands to commit their wives as a way of getting rid of them (and having full access to their money), very little burden of proof required - meaning they weren't insane. Many times they became insane in those institutions because of how they were treated. Think The Yellow Wallpaper.
posted by Neekee at 12:23 PM on March 20, 2010

An excellent book, Women of the Asylum, tells the stories of women committed because they were "inconvenient" to a family or husband. Some were depressed, or stole things, but the majority were just in the way and didn't have anyone willing to speak up for them. A woman who bore an out-of-wedlock child might, indeed, have embarrassed her family to the point where they put her into confinement.

A gripping fiction read on the same subject (set in England): The Vanishing Act of Esme Lennox. Without spoilering the book/ending, the protagonist, Esme Lennox, is disliked by her mother and somewhat eccentric and this, in addition to another factor, leads her family to commit her to an asylum, where her niece finds her many years later.
posted by Rosie M. Banks at 4:07 PM on March 20, 2010

There are people who would have been institutionalised fifty years ago, but cope very well today with the aid of medication. So even though the correct answer may be that she would not have been institutionalised today, that doesn't mean it was the wrong decision back then.
posted by Joe in Australia at 4:40 PM on March 20, 2010

Note that homosexuality/lesbianism was considered to be a psychological disease until fairly recently. One of the men in Kesey's "One Flew Over the Cuckoo's Nest" is in the asylum because he is gay, as is at least one of the girls in Susanna Kaysen's "Girl, Interrupted" (also based on a true story) was sent there for being, basically, too butch.
posted by Asparagirl at 6:01 PM on March 20, 2010