Mad Yankees: The Hartford Retreat for the Insane and Nineteenth-Century Psychiatry

Mad Yankees: The Hartford Retreat for the Insane and Nineteenth-Century Psychiatry

Mad Yankees: The Hartford Retreat for the Insane and Nineteenth-Century Psychiatry

Mad Yankees: The Hartford Retreat for the Insane and Nineteenth-Century Psychiatry

Synopsis

Throughout the Western world, the emergence of insane asylums during the nineteenth century marked a significant change in the public perception as well as the medical treatment of mental illness. Mad Yankees tells the story of one of the earliest such institutions in the United States, the Hartford Retreat for the Insane. Opened in 1824, it was the first hospital of any kind in Connecticut and the only private mental asylum in the nation founded by a state medical society. Although conceived as an elite institution, for many years the Hartford Retreat cared for the indigent insane and paying clients alike.

A number of remarkable physicians associated with the Retreat shaped early psychiatry in Connecticut and placed the state in the vanguard of treatment for the mentally ill. Dr. Eli Todd's ethic of a "law of kindness" toward the afflicted and claims of extraordinary cure rates gained the hospital an international reputation. A coterie of doctors associated with Todd -- including Mason Cogswell, Samuel B. Woodward, Amariah Brigham, and John Butler -- became prominent advocates of "moral" treatment that led to caring for the insane with respect and dignity.

Yet as Lawrence B. Goodheart explains, care of the mentally ill in nineteenth-century Connecticut was not without its ironies. The faith of the Retreat's founding generation in the restorative ability of the asylum gradually waned, as the burden of providing extended custodial care to the chronically ill produced outcomes that were not originally anticipated. During the Gilded Age, the contrast between the state-funded Connecticut Hospital for the Insane, which opened in 1868 in Middletown, and the elegant Hartford Retreat madeclear the class and associated moral differences between public and private care. Less was heard about "the law of kindness" and moral treatment of patients and more about moral unfitness and the benefits of eugenics. As the

Excerpt

From the vantage point of the twenty-first century, it is remarkable to consider how far our understanding of mental illness has come since the founding of the Hartford Retreat for the Insane (now the Institute of Living) in 1822. At the same time it is illuminating to discover the roots of current thinking in the groundbreaking work of the psychiatric physicians who led the retreat in its early years. While both our understanding of mental illness and our ability to treat it have significantly advanced since then, this enlightening historical monograph proves that many of the founding principles that governed the practices of this remarkable institution in its earliest years remain relevant today.

Dr. Eli Todd, the founding superintendent of the retreat, led a revolution in the care of the mentally ill, promoting the novel concept of mental illness as a disease. Todd and other early superintendents, especially Amariah Brigham, were empiricists, making early attempts to classify mental illness and searching for evidence that their treatment approaches worked. Brigham, much like today's psychiatrists, balanced an interest in environmental aspects of mental illness with an interest in its biological roots, pioneering concepts of social psychology while introducing modern European neuroanatomy to America.

Moral treatment, of course, was the Hartford Retreat's guiding animus in its earliest decades, and the central tenets of this approach remain relevant today. With the advent of this treatment philosophy, the symptoms and behaviors of mental disorders came to be understood as secondary to disease. Once thought of as disease, mental illness necessitated treatment rather than mere containment. Treatment was to be humane and focused on the individual's personal (psychological) needs, as well as his or her social setting, and medical (biological) considerations. In the 1970s Dr. George . . .

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