HIST 4370: Mind Matters: Mental Illness in U.S. History from Asylums to Jails

In the first comprehensive one-volume history of the treatment of the mentally ill, the foremost historian in the field compellingly recounts our various attempts to solve this ever-present dilemma from colonial times to the present. Gerald Grob charts the growth of mental hospitals in response to the escalating numbers of the severely and persistently mentally ill and the deterioration of these hospitals under the pressure of too many patients and too few resources. Mounting criticism of psychiatric techniques such as shock therapies, drugs, and lobotomies and of mental institutions as inhumane places led to a new emphasis on community care and treatment. While some patients benefited from the new community policies, they were ineffective for many mentally ill substance abusers. Grob's definitive history points the way to new solutions. It is at once an indispensable reference and a call for a humane and balanced policy in the future.

Circuit Riders for Mental Health explores for the first time the transformation of popular understandings of mental health, the reform of scandal-ridden hospitals and institutions, the emergence of community mental health services, and the extension of mental health services to minority populations around the state of Texas. Author William S. Bush focuses especially on the years between 1940 and 1980 to demonstrate the dramatic, though sometimes halting and conflicted, progress made in Texas to provide mental health services to its people over the second half of the twentieth century. At the story's center is the Hogg Foundation for Mental Health, a private-public philanthropic organization housed at the University of Texas. For the first three decades of its existence, the Hogg Foundation was the state's leading source of public information, policy reform, and professional education in mental health. Its staff and allies throughout the state described themselves as "circuit riders" as they traveled around Texas to introduce urban and rural audiences to the concept of mental health, provide consultation for all manner of social services, and sometimes intervene in thorny issues surrounding race, ethnicity, gender, class, region, and social and cultural change.

The nineteenth-century "cult of curability" engendered the optimistic belief that mental illness could be cured under ideal conditions--removal from the stresses of everyday life to asylum, a pleasant, well-regulated environment where healthy meals, daily exercise, and social contact were the norm. This utopian view led to the reform and establishment of lunatic asylums throughout the United States. The Texas State Lunatic Asylum (later called the Austin State Hospital) followed national trends, and its history documents national mental health practices in microcosm. Drawing on diverse sources--patient records from the nineteenth century, papers and reports of the institution's various superintendents, transcripts of interviews of former employees, newspaper accounts, personal memoirs, and interviews--Sarah C. Sitton has recreated what life in "our little town" was like from the institution's opening in 1861 to its de-institutionalization in the 1980s and 1990s. For more than a century, the asylum community resembled a self-sufficient village complete with its own blacksmith shop, icehouse, movie theater, brass band, baseball team, and undertakers. Beautifully landscaped grounds and gravel lanes attracted locals for Sunday carriage drives. Patients tended livestock, tilled gardens, helped prepare meals, and cleaned wards. Their routines might include weekly dances and religious services, as well as cold tubs, paraldehyde, and electroshock. Employees, from the superintendent on down, lived on the grounds, and their children grew up "with inmates for playmates." While the superintendent exercised almost feudal power, deciding if staff could date or marry, a multigenerational "clan" of several interlinked families controlled its day-to-day operations for decades. With the current emphasis on community-based care for the mentally ill and the negative consequences of de-institutionalization increasingly apparent, the debate on how best to care for the state's--and the nation's--mentally ill continues. This examination offers historical and practical insights which will be of interest to practitioners and policy makers in the field of mental health as well as to individuals interested in the history of the state of Texas.