Asylum from the modern world

prison_cage.jpgPBS have put an award winning documentary about the number of mentally ill people in America’s prisons online.

The programme recently won the Grand Prize in the Robert F. Kennedy Journalism Awards and asks difficult questions about why so many people with severe mental illness are inmates in the US prison system.

Fewer than 55,000 Americans currently receive treatment in psychiatric hospitals. Meanwhile, almost 10 times that number — nearly 500,000 — mentally ill men and women are serving time in U.S. jails and prisons. As sheriffs and prison wardens become the unexpected and often ill-equipped caretakers of this burgeoning population, they raise a troubling new concern: Have America’s jails and prisons become its new asylums?

The programme makes an interesting contrast to Diary Written in the Provincial Lunatic Asylum written in 1885 by Mary Huestis Pengilly, and now available online as a Project Gutenberg EBook.

Pengilly describes the experience of being treated like a prisoner in the asylum, which used handcuffs and restraints for the ‘patients’ resident there.

While a century ago, asylums were virtually prisons, it seems increasingly, that prisons are now becoming asylums.

Link to PBS show The New Asylums.
Link to Diary Written in the Provincial Lunatic Asylum (via Dana Leighton).

8 Comments

  1. Posted June 22, 2006 at 7:51 am | Permalink

    My bipolar nephew has ended up in jail a couple of times, fortunately so far they have realized he needed treatment and sent him to mental care facilities when he’s been picked up. But I think he’s one of the “lucky” ones.
    I would think most prisoners suffer from mental illness or psychosis of some sort.

  2. Kschltr
    Posted June 22, 2006 at 4:40 pm | Permalink

    The trend towards criminalization of our disabled population is not new. This is the reason the American version of “Ethical Treatment” and the creation of Public Mental Hospitals came about during the decades immediately post American Civil War. The huge numbers of wounded and traumatized veterans, many of whom were living in the streets and mugging folks etc… in order to support what would become one of America’s most serious public health problems, Opiate Addiction! The use of Opiates (Heroin specifically, as opposed to Laudanum) and the huge numbers of folks subjected to incredibly crude, but quick and effective battle field amputations, created a whole society of injured pain wracked veterans with no support services.
    Add to this the shear numbers of immigrants who had been steadily increasing in numbers and urgency to gain entry to the US during the years beginning BEFORE the American Civil War. The influx of Irish Immigrants was huge beginning in the 1850′s, the influx of German and French immigrants began increasing during the Franco – Prussian War which began in 1870. Of course, many people were attempting to come to America in the years following the American Civil War during the beginnings of the Industrialization for obvious reasons, and the US Census Bureau began taking more frequent census, also beginning to count or try to count heads in earnest in 1870.
    Dorothea Dix and a group of wealthy private citizens (Dorothea Dix was a Nurse/Social Worker who pioneered Veterans causes and also advocated for the masses of poor disenfranchised people on the streets during the post Civil War period)
    This group of private philanthropists, and volunteers developed the first STATE Mental Health Hospitals to provide education, vocational rehab, and ethical decent clean facilities for persons who would otherwise have languished and died in County Alms Houses (Poor Houses) or Jails and Prisons in New England.
    The first such “experiment” was Central Islip Hospital in Central Islip New York. It opened in 1884 and provided an atmosphere in which persons unable to sustain themselves due to perceived mental deficiencies, mental feebleness etc… who were not guilty of serious crimes against the public, were given clean clothes, a warm bed, educated to some degree, and worked on the grounds of the facility to grow crops, raise livestock, cook, clean, perform other maintenance labor, etc…
    It was a success and the New England State Hospital Systems began to operate. By the turn of the 20th C. The increasing numbers of unemployed, homeless, many non-english speaking immigrants, and the effectiveness of placing non-dangerous individuals in less restrictive envrironments than afforded by the Criminal Justice System, as well as the cost effectiveness of the Patients performing most of the labor was attractive.
    Larger and larger State Hospitals were built and more and more folks were COMMITTED TO THEM for just about any damned convenient reason or another for the next century…
    To be continued… I’m out of time for now!

  3. Kschltr
    Posted June 23, 2006 at 1:04 am | Permalink

    Continued…
    As non-english speaking immigrants crowded Brooklyn, NY after passing through Ellis Island, the streets were filled with homeless persons, the unemployed, and many who turned to crime and/or alcoholism for relief and to survive. The merchants in New York City’s Borough of Brooklyn (Kings County) acquired a large tract of land which became known as KINGS PARK on the North Shore of Long Island’s Suffolk County which they then agreed to “lease” in exchange for In Kind Services or some such thing, if the State would construct a Mental Hospital to hold the undesireables who cluttered their business district sidewalks and could not be kept in NYC Jails or Deported. These undesireables were shipped to the State of New York’s KINGS PARK FACILITY and retained. This occured during the first decade of the 20th Century. Kings Park was not established as an ethical or humane alternative to poor houses, or death from mental deficiencies. It was established to hold the homeless, the unemployed, and those who were non-criminals and could not be disuaded from remaining in their neighborhoods despite their lack or resources, housing or due to behaviors considered disruptive. Treating the mentally ill, providing vocational training or hospital based employment was now a secondary consideration.
    Other facilities dotted the landscape in the State of New York from North Western New York’s Buffalo Facility, Binghampton, Albany, etc…
    Prisons were expensive and labor intensive as the criminal element was not always manageable or pliant like the mentally ill and could not be relied upon to function in staff multiplier or “TRUSTEE” roles. It was cheaper and safer to put the non-criminals in the Mental Health System where the courts did not hear appeals and the evolution of Mental Hygeine Law as distinguished from Criminal Code, and Corrections or Penal Law afforded family members and communities the ability to have disruptive members of their society locked up indefinitely without anything in the way what would be considered due process.
    This continued throughout the 20th Century here in New York State until 1954 when the first of a radical new type of Psychoactive Neuroleptic came into use. THORAZINE! Thorazine was considered a wonder drug, as Lobotomies and Electro Convulsive Therapy (without benefit of modern anesthetics, muscle relaxants, and other modifications caused deaths, brain injury, but primarilly spontaneous fractures from the electrically induced Grand Mal Seizures which caused such spastic tonic clonic contractions of skeletal muscles as to cause teeth to break off without a well fitting bite block, palettes to spontaneously fracture, Spines and Cervical injuries resulting in paralysis and death were not uncommon. AND they used higher voltages unnecessarilly and applied electrodes bilaterally to the cranium causing brain damage and burns in many cases.
    An alternative was Insulin Shock Therapy, during which a patient was brought to a severe HYPOGLYCEMIC STATE and rendered unconscious, nearly comatose, and could be kept under control in this condition using Dextrose and crude Blood Sugar Monitoring. This too resulted in brain injury and death for many poorly supervised patients.
    Chains and Paraldehyde were about all the staff had to subdue violently out of control patients until the 50′s when THORAZINE was heralded as a MIRACLE DRUG.
    THORAZINE was given to just about anybody in massive doses to control their behavior was used as a CHEMICAL RESTRAINT vs. for any other legitimate therapeutic purpose. The more the better.
    In 1954 there were approximately 97,000 in patients in the State of New Yorks Mental Hospitals. 35,000 were located at the original CENTRAL ISLIP, KINGS PARK and PILGRIM HOSPITAL, all in rural SUFFOLK COUNTY.
    Pilgrim was built during the FDR administration and used WPA/NRA funding. It’s constuction was a high priority since the GREAT CRASH and subsequent DEPRESSION of 1929 drone thousands to depression, suicide, homelessness, and vagrancy. We needed a new holding facility. So PILGRIM was built in what is now BRENTWOOD NY.
    PILGRIM was touted as the biggest and most modern PSYCHIATRIC HOSPITAL in the WORLD. The exposition in 1933, the same year Adolph Hitler was made Chancellor of Germany, was attended by Neurologists, Psychologists and Psychiatrists from around the world. The French were prominently present and praised the effort as it was a French Physician, Pinot, who approched the Revolutionary Council immediately after the fall of the Aristocracy and the Bastille who requested he be granted permission to treat the Prisoners in the DUNGEONS BELOW THE DUNGEONS who were chained to the walls, kept in cages and other torture devices as they were Mentally Ill.
    This pioneering French Physician encouraged the council to consider the poor wretches CITIZENS and was granted permission to take possession of Le Bicetre’ and utilize to experiment with TREATING the INSANE and otherwise assumed to be “DEMONICALLY POSSESSED” as MEDICAL PATIENTS. This was effectively the first true MEDICAL MENTAL HOSPITAL IN EUROPE and the known world.
    Pilgrim also had it’s own RAILROAD SPUR and STATION, like Auschwitz, ironically, and two trains per week came from NYC bringing new patients from the JAILS and CITY HOSPITALS, and bringing EMPLOYEES, and the occassional VISITOR.
    This was occuring between 1933 and Pilgrim is still in existence today. Although the use of the Long Island Railroad’s private railroad spur and trains ended in the 1960′s.
    The patient population was still huge and diverse, but somewhat reduced by the advent of NEUROLEPTIC TRANQUILIZERS and other treatments, which were poor compared to todays, but permitted some patients to be removed from the facilities and back to the streets…
    John Kennedy and his administration put into effect the FEDERALLY MANDATED “COMMUNITY MENTAL HEALTH ACT” which required the States and localities to establish OUTPATIENT TREATMENT FACILITIES for the huge numbers of former patients/inmates they had dumped on the streets without outpatient supports, housing, medical or psychiatric clinical services of any kind in many cases. Those with referrals to clinics, or shelters were not managed and often slipped through the cracks and disappeared into the criminal system or simply died prematurely of the effects of poverty, starvation, and very often the MEDICATIONS we used to reduce the burden on the system and taxpayers wallets without fully understanding the horrendous damage they could and were doing to patients in the excessive and inappropriate dosages which were administered and then not managed post discharge.
    TO BE CONTINUED…

  4. Kschltr
    Posted July 13, 2006 at 10:01 pm | Permalink

    As it is now mid July and this thread is archived with the June contributions, I don’t imagine anyone is reading this, but I have a little time on my hands this afternoon, So…
    The trend to deinstitutionalize patients is generally a money driven decision and NOT based in our desire to advocate for the rights of our fellow man. When it becomes too damned expensive to warehouse people and/or “conventional” treatment modalities become too costly, we get creative. Or, the anal retentive, social control types allow folks like me to get creative.
    We create viable, less restrictive, safer, and far less costly alternatives to the existing systems, but then when some authoritarian types have a brain fart and commit socially irresponsible acts of negligence and allow people to slip through the cracks, resulting in folks getting hurt, there is generally a public outcry and patients are then involuntarilly committed to place like Mid-Hudson Forensic, Kirby Forensic, or shipped off to the now popular and multiplying, Prison Psych Wards.
    Here in New York State there were few Prisons with large psychiatric population, although it is debateable that most crime is a result of society’s mental illness and our inhumanity towards our own fellow citizens. Most folks who commit acts of violence are generally folks who have had violence committed against them, live under horrendous conditions, are discriminated against and/or disenfranchised by the dominant culture of their community and as such react emotionally or out of a perceived survival necessity to provide for themselves and their families or for their protection.
    It is interesting to note that folks who commit “White Collar” Crimes just because the feel entitled, and don’t really have any pressing need to steal, embezzel, commit fraud, leverage stock deals etc… get a slap on the wrist from our lying, thieving politicians and judges because GREED is just normal and emotionally charged, outrageous acts of compassion or out of a need to survive and/or protect ourselves and our families are not “Normal” reactions to being screwed over and abused, neglected, starved, labeled, discriminated against, or attacked by our ANTI-SOCIAL Dominant SOCIETY.
    Folks who are let out of the institutions as part of our more humane and far LESS COSTLY programs, are left without services, neglected, allowed to slip through the cracks when the cutbacks ineveitably follow the establishment of “CREATIVE, LESS COSTLY and LIBERAL” alternatives. Those less able to attend to their needs are then further isolated and alienated, refused employement and services and then end up back in the institution or a PRISON PSYCH WARD.
    This works well for the “STATE” and the ANTI-SOCIAL Citizens of my STATE. It seems that whenever a “crime” is committed by a mental patient, there is a public outcry and the homeless mentally ill are swept off of the streets to places like “Jersey” or Connecticutt as there ain’t no room at the inn in NYC, when the Street Crimes Units get into full swing. If they aren’t shooting African Immigrant Street Vendors 19 times at point blank range (They actually fired 41 rounds) just because he’s trying to accomodate them and is reaching for his wallet, they are rousting homeless mentally ill folks and running them into dangerous, overcrowded shelters, where they become victims of those street folks who prey upon them.
    That’s why most homeless folks would rather make their own accomodations and/or freeze to death on some cold nights in NY. Sleeping on subway grate to stay warm is often considered safer than the traditional alternative.
    A few years ago a psychiatric patient known to the City of New York’s Health and Hospital Corporation was experiencing relationship problems and his housing situation was unstable. He began experiencing anger and symptoms which he recognized as predictive and precipitive of a possible psychotic break. The patient attempted on four (4) occasions during a two week period to get himself voluntarilly admitted to two (2) different New York City Health and Hospital Corporation Psychiatric Units via their respective emergency departments. He was refused admission as the staff, I am told, didn’t believe he needed to be admitted, and just thought he was a “skel who was lazy, and looking for free room and board…”
    The patient did experience a break and a young woman was pushed in front of a subway train during one of the patient’s psychotic breaks. The City was negligent. He attempted to get admitted, they refused him admission. He was sent to Mid Hudson and later to Prison as they convinced him he had committed that particular act of violence deliberately to get revenge for the CITY refusing his request to be admitted…
    So, after being found Not Guilty By Reason Of Mental Illness, which generally is a LIFE SENTERNCE in New York, he was forced to further criminalize himself and plead guilty in hope of maybe someday being released from PRISON. They generally don’t release folks who are involved in homocides and found NOT GUILTY BY REASON OF MENTAL ILLNESS.
    Our savage society wants to punish folks for their inhumanity and negligence out of a sense of revenge. They attributed this individual’s crime to revenge for their refusal to meet his demands. Actually, they refused to do their jobs, respect his medical needs, or respect the health and wellbeing of the entire community. The City was negligent, abusive and in a money driven, anti-mental patient rage, sought revenge for the injury and death of this individual which was directly attributable to their negligence. Yes, the inmate did commit the act, but the system was negligent and should have considered his request to be hospitalized, whether he expressed the need or documented the causes in a convincing way to the staff at the ER or not until the situation could be sorted out.
    Most folks don’t REQUEST to be admitted unless their is an obvious need of some sort. The need MAY NOT BE FOR HOSPITAL BASED CARE, and maybe financially or otherwise driven by circumstances faced by the patient, but until that is actually determined, it is incumbent upon the system to provide for both the safety of the individual seeking admissions as well as the potential safety of the public in the event they are WRONG!
    Of course, then the patient needs to be redirected to the appropriate services to get their needs met in a safe, and in this case “COST EFFECTIVE” manner. These shifts in public opinion and policy are driven by both moral outrage, and money. Most decisions based upon a need to incarcerate, abuse, disenfranchise, imprison folks, or as in the past, LOBOTOMIZE, conduct FORCED STERILIZATIONS, CHEMICALLY RESTRAIN, PHYSICALLY RESTRAIN etc… often to the point of death, are embarked upon by ignorant people who fear their own darker thoughts, and are not intelligent or compassionate enough to attempt alternatives.
    Most of us don’t want anyone to be abused or imprisoned, but we don’t want them in our neighborhoods with our children either, do we?
    That’s why the Padavan Bill exists in New York State. We can’t open group homes for the mentally ill because the community has 2 years to lobby and engage in legal activity to prevent such homes from being placed in residential neighborhoods. They cite lowering of PROPERTY VALUES, and are afforded the opportunity to recommend alternative site selections in order to keep the mentally ill out of thier communities.
    Of course, when it’s their kids who are mentally ill it is a different story isn’t it? So, alternatives are sought to get around the lengthy and costly legal battles which ensue over purchasing or leasing one damned suburban residence and modifying it to accomodate a handful of former patients. It’s pathetic. Of course, Mentally Retarded and Developmentally Disabled Folks are far less dangerous, at least that is the public’s perception. And so those projects are not hampered by legislative process in quite the same way.
    We are all dangerous. I am a psychiatric RN, I’ve been a RN since leaving military service in 1983. Before becoming a RN I was part of the most effective killing force on the planet. I’m pretty damned dangerous. I studied war and researched the Operational Parameters of High Tech Warfare as an OPS/ADMIN/COMM specialist for the Pentagon, COMOPTEVFOR, NATO, etc… at one of the Navy’s premier Weapons Research Facilities. I worked with Marines who guard Weapons of Mass Destruction as well. I also have a history of PTSD. Some folks would like to call it something else, but that is what it is. I have never been arrested, but have been discriminated against for years.
    I am also the former DIRECTOR OF CONSUMER/RECIPIENT AFFAIRS for New York State’s Office of Mental Health’s Long Island Region (pop: 3 Million). I will not take their shit.
    Hell, I may even kill ‘em if they violate my constitutional rights again. Afterall, I served defending other people’s rights and that constitution in a capacity as a government trained “Killer”. I hope they don’t piss me off again. I bet you do too!

  5. Kschltr
    Posted July 13, 2006 at 10:01 pm | Permalink

    As it is now mid July and this thread is archived with the June contributions, I don’t imagine anyone is reading this, but I have a little time on my hands this afternoon, So…
    The trend to deinstitutionalize patients is generally a money driven decision and NOT based in our desire to advocate for the rights of our fellow man. When it becomes too damned expensive to warehouse people and/or “conventional” treatment modalities become too costly, we get creative. Or, the anal retentive, social control types allow folks like me to get creative.
    We create viable, less restrictive, safer, and far less costly alternatives to the existing systems, but then when some authoritarian types have a brain fart and commit socially irresponsible acts of negligence and allow people to slip through the cracks, resulting in folks getting hurt, there is generally a public outcry and patients are then involuntarilly committed to place like Mid-Hudson Forensic, Kirby Forensic, or shipped off to the now popular and multiplying, Prison Psych Wards.
    Here in New York State there were few Prisons with large psychiatric population, although it is debateable that most crime is a result of society’s mental illness and our inhumanity towards our own fellow citizens. Most folks who commit acts of violence are generally folks who have had violence committed against them, live under horrendous conditions, are discriminated against and/or disenfranchised by the dominant culture of their community and as such react emotionally or out of a perceived survival necessity to provide for themselves and their families or for their protection.
    It is interesting to note that folks who commit “White Collar” Crimes just because the feel entitled, and don’t really have any pressing need to steal, embezzel, commit fraud, leverage stock deals etc… get a slap on the wrist from our lying, thieving politicians and judges because GREED is just normal and emotionally charged, outrageous acts of compassion or out of a need to survive and/or protect ourselves and our families are not “Normal” reactions to being screwed over and abused, neglected, starved, labeled, discriminated against, or attacked by our ANTI-SOCIAL Dominant SOCIETY.
    Folks who are let out of the institutions as part of our more humane and far LESS COSTLY programs, are left without services, neglected, allowed to slip through the cracks when the cutbacks ineveitably follow the establishment of “CREATIVE, LESS COSTLY and LIBERAL” alternatives. Those less able to attend to their needs are then further isolated and alienated, refused employement and services and then end up back in the institution or a PRISON PSYCH WARD.
    This works well for the “STATE” and the ANTI-SOCIAL Citizens of my STATE. It seems that whenever a “crime” is committed by a mental patient, there is a public outcry and the homeless mentally ill are swept off of the streets to places like “Jersey” or Connecticutt as there ain’t no room at the inn in NYC, when the Street Crimes Units get into full swing. If they aren’t shooting African Immigrant Street Vendors 19 times at point blank range (They actually fired 41 rounds) just because he’s trying to accomodate them and is reaching for his wallet, they are rousting homeless mentally ill folks and running them into dangerous, overcrowded shelters, where they become victims of those street folks who prey upon them.
    That’s why most homeless folks would rather make their own accomodations and/or freeze to death on some cold nights in NY. Sleeping on subway grate to stay warm is often considered safer than the traditional alternative.
    A few years ago a psychiatric patient known to the City of New York’s Health and Hospital Corporation was experiencing relationship problems and his housing situation was unstable. He began experiencing anger and symptoms which he recognized as predictive and precipitive of a possible psychotic break. The patient attempted on four (4) occasions during a two week period to get himself voluntarilly admitted to two (2) different New York City Health and Hospital Corporation Psychiatric Units via their respective emergency departments. He was refused admission as the staff, I am told, didn’t believe he needed to be admitted, and just thought he was a “skel who was lazy, and looking for free room and board…”
    The patient did experience a break and a young woman was pushed in front of a subway train during one of the patient’s psychotic breaks. The City was negligent. He attempted to get admitted, they refused him admission. He was sent to Mid Hudson and later to Prison as they convinced him he had committed that particular act of violence deliberately to get revenge for the CITY refusing his request to be admitted…
    So, after being found Not Guilty By Reason Of Mental Illness, which generally is a LIFE SENTERNCE in New York, he was forced to further criminalize himself and plead guilty in hope of maybe someday being released from PRISON. They generally don’t release folks who are involved in homocides and found NOT GUILTY BY REASON OF MENTAL ILLNESS.
    Our savage society wants to punish folks for their inhumanity and negligence out of a sense of revenge. They attributed this individual’s crime to revenge for their refusal to meet his demands. Actually, they refused to do their jobs, respect his medical needs, or respect the health and wellbeing of the entire community. The City was negligent, abusive and in a money driven, anti-mental patient rage, sought revenge for the injury and death of this individual which was directly attributable to their negligence. Yes, the inmate did commit the act, but the system was negligent and should have considered his request to be hospitalized, whether he expressed the need or documented the causes in a convincing way to the staff at the ER or not until the situation could be sorted out.
    Most folks don’t REQUEST to be admitted unless their is an obvious need of some sort. The need MAY NOT BE FOR HOSPITAL BASED CARE, and maybe financially or otherwise driven by circumstances faced by the patient, but until that is actually determined, it is incumbent upon the system to provide for both the safety of the individual seeking admissions as well as the potential safety of the public in the event they are WRONG!
    Of course, then the patient needs to be redirected to the appropriate services to get their needs met in a safe, and in this case “COST EFFECTIVE” manner. These shifts in public opinion and policy are driven by both moral outrage, and money. Most decisions based upon a need to incarcerate, abuse, disenfranchise, imprison folks, or as in the past, LOBOTOMIZE, conduct FORCED STERILIZATIONS, CHEMICALLY RESTRAIN, PHYSICALLY RESTRAIN etc… often to the point of death, are embarked upon by ignorant people who fear their own darker thoughts, and are not intelligent or compassionate enough to attempt alternatives.
    Most of us don’t want anyone to be abused or imprisoned, but we don’t want them in our neighborhoods with our children either, do we?
    That’s why the Padavan Bill exists in New York State. We can’t open group homes for the mentally ill because the community has 2 years to lobby and engage in legal activity to prevent such homes from being placed in residential neighborhoods. They cite lowering of PROPERTY VALUES, and are afforded the opportunity to recommend alternative site selections in order to keep the mentally ill out of thier communities.
    Of course, when it’s their kids who are mentally ill it is a different story isn’t it? So, alternatives are sought to get around the lengthy and costly legal battles which ensue over purchasing or leasing one damned suburban residence and modifying it to accomodate a handful of former patients. It’s pathetic. Of course, Mentally Retarded and Developmentally Disabled Folks are far less dangerous, at least that is the public’s perception. And so those projects are not hampered by legislative process in quite the same way.
    We are all dangerous. I am a psychiatric RN, I’ve been a RN since leaving military service in 1983. Before becoming a RN I was part of the most effective killing force on the planet. I’m pretty damned dangerous. I studied war and researched the Operational Parameters of High Tech Warfare as an OPS/ADMIN/COMM specialist for the Pentagon, COMOPTEVFOR, NATO, etc… at one of the Navy’s premier Weapons Research Facilities. I worked with Marines who guard Weapons of Mass Destruction as well. I also have a history of PTSD. Some folks would like to call it something else, but that is what it is. I have never been arrested, but have been discriminated against for years.
    I am also the former DIRECTOR OF CONSUMER/RECIPIENT AFFAIRS for New York State’s Office of Mental Health’s Long Island Region (pop: 3 Million). I will not take their shit.
    Hell, I may even kill ‘em if they violate my constitutional rights again. Afterall, I served defending other people’s rights and that constitution in a capacity as a government trained “Killer”. I hope they don’t piss me off again. I bet you do too!

  6. Posted May 10, 2011 at 3:16 pm | Permalink

    It’s all about communicating with each other.

  7. Kierkegaard
    Posted December 14, 2012 at 4:01 am | Permalink

    I’m probably one of the only people in the US who’s actually read Pengilly’s book. It inadvertently underscores several points little known to the modern reader:

    1. In the 1880s, at a time when child prostitutes starved in the streets of London, the Province of New Brunswick provided free care– including food– to the indigent mentally ill. Mrs. Pengilly was penniless; when released, she lived with neither of her sons, one of whom was an alderman, but went to Boston where she lived on charity at the YWCA.

    2. Yes, cuffs and restraints were used. They are used today on patients doing violence to themselves or others. The bulk of Mrs. Pengilly’s complaints centered on force-feeding, a barbarous practice, but one she was evidently in need of, since it was her self-starvation and messianic religious ravings that landed her in the “Provincial Lunatic” in the first place.

    3. Despite her ceaseless complaints, she appeared to suffer no violence at the hands of her warders. Once released, she importuned every public official who would agree to see her in both New Brunswick and Massachusetts and was treated by them with a courtesy that frankly makes one nostalgic for the era. Her solution to the “unChristian” practices at the asylum was to appoint herself as head of its Board of Directors, which they very politely declined to do.

    4. Institutionalized patients today are often drugged to a zombie-like state. No drugs were administered in this book to anyone except for those physically ill. Which age was the more barbaric?

  8. Ron Moule
    Posted April 19, 2014 at 10:14 am | Permalink

    I am interested in creating film/play-scripts based upon this and related works


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