The rise of moral treatment has numerous origins. In England it can be closely linked to the Quaker movement who saw the brutal conditions of asylums – where the use of irritant chemicals, beating, starvation and physical restraints were common – as morally reprehensible.
Full Answer
How was moral treatment used in the asylum?
Begun under the guidance of the third Superintendent Dr. William Metcalf, and continued by Dr. Charles Kirk Clarke, moral treatment was used as a framework to improve the lives of patients under the asylum’s care. Members of the Rockwood Bicycle Club, 1885. Made up of both staff and patients.
What were some of the successes of the moral treatment movement?
One of the greatest successes of the moral treatment movement was the reform of the 19 th century asylum system.
What is the origin of moral treatment?
The rise of moral treatment has numerous origins. In England it can be closely linked to the Quaker movement who saw the brutal conditions of asylums – where the use of irritant chemicals, beating, starvation and physical restraints were common – as morally reprehensible.
What is moral treatment for the mentally ill?
Moral treatment was widely believed to be kinder than other types of treatment available to the mentally ill because it limited the use of physical restraint and did not condone corporal punsishment.
Who proposed the moral treatment for mental disorder?
In the United States, the first proponent of moral treatment was Benjamin Rush. A Philadelphia physician, Rush had been one of the signers of the American Declaration of Independence. For Rush, the hustle and bustle of modern life contributed to mental diseases.
Why was moral treatment significant?
Its most important contribution, certainly, was fighting the dehumanisation of the mentally ill – by recognising the rationality of sufferers and the power of compassion in helping them, moral treatment changed the face of mental health care forever.
What was moral treatment in asylums?
Moral treatment, a therapeutic approach that emphasized character and spiritual development, and called for kindness on the part of all who came in contact with the patient, flourished in American mental hospitals during the first half of the 19th century.
What was the purpose of asylums?
Asylums were not built for institutionalizing mental patients. The original meaning of the word asylum is a "retreat" or "sanctuary," and these institutions were originally built to act as sanctuaries for the protection of mental patients.
When was moral treatment introduced?
The moral treatment system Towards the end of the 1700s, William Tuke (1732-1822), founded a private mental institution outside York called The Retreat. It was here that the development of moral treatment and 'non-restraint' policy in public asylums began.
What treatment was provided by early asylums?
Psychotherapy emerges. For the most part, private asylums offered the treatments that were popular at that time. In the late 19th and early 20th centuries, most physicians held a somatic view of mental illness and assumed that a defect in the nervous system lay behind mental health problems.
What is the concept of moral treatment?
An approach to treating mental illness in the 19th century influenced by humanistic philosophy and a belief that a rational, caring approach would enable patients to normalize their thoughts and actions.
Was moral treatment successful?
Moral treatment was short-lived, enjoying popularity for less than fifty years. Despite this fleeting success, it is evident that the movement from constraint and repression to kind treatment and perceiving the mad as rational beings was a fundamental transition in the history of psychiatry.
How mental health was viewed and treated in the past?
TREATMENT IN THE PAST. For much of history, the mentally ill have been treated very poorly. It was believed that mental illness was caused by demonic possession, witchcraft, or an angry god (Szasz, 1960). For example, in medieval times, abnormal behaviors were viewed as a sign that a person was possessed by demons.
How did insane asylums start?
1752. The Quakers in Philadelphia were the first in America to make an organized effort to care for the mentally ill. The newly-opened Pennsylvania Hospital in Philadelphia provided rooms in the basement complete with shackles attached to the walls to house a small number of mentally ill patients.
When were asylums first created?
The first hospital in the U.S. opened its doors in 1753 in Philadelphia. While it treated a variety of patients, six of its first patients suffered from mental illness. In fact, Pennsylvania Hospital would have a pivotal impact on psychiatry.
Who said moral treatment is a way to help mentally ill Quakers?
Historian Anne Digby countered that Quakers have always placed great importance on self-control, and she argued that moral treatment's coercive tactics would have seemed like a natural and familiar way to help mentally ill Quakers regain that self-control ( 68 ).
What is moral treatment?
Introduction to Moral Treatment. Moral treatment was the main way that the Asylum treated patients. As an 1825 history of the Asylum explained, “Although the use of drugs and medicaments is allowed, in almost every case, to be indispensible, less weight is attached to it in the Friends’ Asylum, than to moral treatment” ( Waln 15 ).
Why are Quakers supposed to focus on moral treatment?
Quakers are supposed to focus on the importance of inward changes of heart and making one’s behavior match one's inner life. For Godlee, moral treatment’s focus on the comfort of other people, as opposed to the cure of the patients, made moral treatment seem deeply un-Quaker.
Why is moral treatment considered cruel?
Moral treatment was widely believed to be kinder than other types of treatment available to the mentally ill because it limited the use of physical restraint and did not condone corporal punsishment.
What does it mean to treat patients like rational beings?
Treating the patients like rational beings meant using restraint only as a last resort, to ensure the safety of the patient and those around him or her, not as a punishment. Under moral treatment, the superintendent and keepers treated the patients as individuals, and helped them to try to regain control of themselves.
Was moral treatment at the Asylum non-violent?
Although moral treatment at the Asylum was non-violent and focused on getting the patients to try to take control of their lives again, some of moral treatment’s manifestations could be cruel. For some examples of the cruel side of moral treatment, see the stories of Nathan Y. and Abraham S. in the Case Studies.
How did moral treatment affect asylum?
The moral treatment movement had a huge influence on asylum construction and practice . Many countries were introducing legislation requiring local authorities to provide asylums for the local population, and they were increasingly designed and run along moral treatment lines.
What are the four moral syntheses in the asylum?
A patient in the asylum had to go through four moral syntheses: silence, recognition in the mirror, perpetual judgment, and the apotheosis of the medical personage. The mad were ignored and verbally isolated. They were made to see madness in others and then in themselves until they felt guilt and remorse.
Why did the asylum movement fall into decline?
It fell into decline as a distinct method by the 20th century, however, due to overcrowding and misuse of asylums and the predominance of biomedical methods.
What does "moral" mean in French?
At that time "moral", in French and internationally, had a mixed meaning of either psychological/emotional (mental) or moral (ethical). Pinel distanced himself from the more religious work that was developed by the Tukes, and in fact considered that excessive religiosity could be harmful.
How many hospitals did Dix help establish?
Dix fought for new laws and greater government funding to improve the treatment of people with mental disorders from 1841 until 1881, and personally helped establish 32 state hospitals that were to offer moral treatment. Many asylums were built according to the so-called Kirkbride Plan .
What does Foucault say about moral asylum?
Thus Foucault argues that the "moral" asylum is "not a free realm of observation, diagnosis, and therapeutics; it is a juridical space where one is accused, judged, and condemned.".
What were Rush's treatment methods?
However, Rush's treatment methods included bloodletting (bleeding), purging, hot and cold baths, mercury, and strapping patients to spinning boards and "tranquilizer" chairs. A Boston schoolteacher, Dorothea Dix (1802–1887), also helped make humane care a public and a political concern in the US.
What was the moral treatment system in the 1800s?
In the early 1800s, attitude towards care of the mentally ill shifted away from security and containment and towards a system that ‘aimed to treat people with mental illness like rational beings’. The so-called moral treatment system would forever change the face of psychiatry but was it really the forward-thinking, ...
What was the most important contribution to the dehumanization of the mentally ill?
Its most important contribution, certainly, was fighting the dehumanisation of the mentally ill – by recognising the rationality of sufferers and the power of compassion in helping them, moral treatment changed the face of mental health care forever.
Why was Hanwell Mental Asylum opened?
Because of the approach’s belief that environmental factors were vital in restoring a patients’ mental health, a new wave of mental institutions focused on rehabilitation and recovery were opening their doors, one of the first being Hanwell Mental Asylum in West London.
Who was the father of moral treatment?
Chief among those who spearheaded introduction of the moral treatment movement in the United States were Benjamin Rush , Dorothea Lynde Dix, Thomas Scattergood, and Thomas Story Kirkbride. Benjamin Rush was a physician and also Surgeon General of the Continental Armies. 47 He is also recognized today as the father of American psychiatry.
When was the moral treatment movement?
The Moral Treatment Movement (1800–1850) The moral treatment movement was introduced in the United States by mental health workers who either had studied or had visited Europe where they became acquainted with moral treatment principles. However, unlike Pinel's version of the moral treatment movement, which made no reference to religious morality, ...
What were the first principles of occupational therapy?
The above analysis indicates that the first principles of occupational therapy, as developed by Dunton, were derived from the moral treatment movement, the arts and crafts movement, pragmatism, and medicine.
What was the purpose of Dix's crusade?
She was enraged with this lack of concern for these patients and thus began her crusade for the improvement of mental health institutions, a crusade that led her eventually to England and a meeting with Queen Victoria and Pope Pius IX. 35. Dix's crusade led to expansion of mental health institutions and other reforms.
Why do physicians have more power than patients?
38,39 Most often, physicians have more power than patients and family members because they have more biomedical knowledge, institutional support, and language skills.
What did Kirkbride believe?
He expressed his belief that “patients responded to greater freedom with better behavior.” 44. Later, Kirkbride became the founding member of the Association of Medical Superintendents ...
What did Dix's crusade lead to?
Dix's crusade led to expansion of mental health institutions and other reforms. She also promoted the use of moral treatment principles as taught by Benjamin Rush, Philippe Pinel, and William Tuke, for whom she had much respect.
What was Goffman's asylum based on?
Goffman’s Asylums was based on fieldwork he conducted at St Elizabeth’s hospital in Washington, DC. Goffman argued that, once admitted, patients had to learn how to behave in a mental hospital, a process he described as “institutionalization.”.
What is the most controversial topic in the history of psychiatry?
The history of asylums has probably been the most controversial topic in the history of psychiatry, arguably in the history of medicine. We all know about London’s Bedlam, and have a sense of other infamous mental hospitals, ranging from Bellevue Hospital in New York to Danvers State Hospital, the birthplace of lobotomy.
When did psychiatry start?
Although there were a number of previous attempts to account for the history of psychiatry, efforts to do so really got started in the early 1960s, when a disparate assortment of philosophers, psychiatrists, sociologists, and others began turning to it.
Was asylum humane?
While some asylums were, frankly, terrible, others were quite humane, and although prognosis was often grim, some patients were successfully treated. Not only were many people voluntarily committed, but families, rather than state authorities, often brought their troubled relatives for help. The devil was in the detail.
What is moral treatment?
Moral treatment was an approach to treating mental disorders in a humane and compassionate way, which involved teaching patients to be disciplined as well. Moral treatment was upheld within the asylum by giving patients work to do and leisurely activities to enjoy – both of which also depend on some physical features. For example, Kirkbride proposed in his plan that some sort of farm building should be built. Inmates would be able to work in this building, either by growing crops for the hospital or tending to the farm animals. Occupying the patients with work was unique to 19 th century asylums – critics accused earlier asylums “of being dens of idleness” (Roy Porter, Madness: A Brief History ).
How far away should an asylum be from a town?
Kirkbride notes in his asylum plan that any asylum “should be in the country, not within less than two miles of a town”. This is to ensure that all the necessary supplies and services can be easily obtained, which will further ensure the maintenance of the asylum, and therefore the maintenance of the patients. Kirkbride goes on to add that the country should be “healthful” and “pleasant”, with the surrounding scenery being “attractive”.
Who was responsible for moral treatment?
The person most responsible for the early spread of moral treatment Template:Citation needed in the United States was Benjamin Rush (1745–1813), an eminent physician at Pennsylvania Hospital. He limited his practice to mental illness and developed innovative, humane approaches to treatment. He required that the hospital hire intelligent and sensitive attendants to work closely with patients, reading and talking to them and taking them on regular walks. He also suggested that it would be therapeutic for doctors to give small gifts to their patients every so often. However, Rush's treatment methods included bloodletting (bleeding), purging, hot and cold baths, mercury, and strapping patients to spinning boards and "tranquilizer" chairs. [1]
What is moral treatment?
Moral treatment was an approach to mental disorder based on humane psychosocial care or moral discipline that emerged in the 18th century and came to the fore for much of the 19th century, deriving partly from psychiatry or psychology and partly from religious or moral concerns. The movement is particularly associated with reform and development of the asylum system in Western Europe at that time. It fell into decline as a distinct method by the 20th century, however, due to overcrowding and misuse of asylums and the predominance of biomedical methods. The movement is widely seen as influencing certain areas of psychiatric practice up to the present day. There has been criticism that the approach blamed or oppressed patients according to the standards of a particular social class or religion.
What was the moral treatment of the Enlightenment?
Moral treatment developed in the context of the Enlightenment and its focus on social welfare and individual rights. At the start of the 18th century, the "insane" were typically viewed as wild animals who had lost their reason. They were not held morally responsible but were subject to scorn and ridicule by the public, sometimes kept in madhouses in appalling conditions, often in chains and neglected for years or subject to numerous tortuous "treatments" including whipping, beating, bloodletting, shocking, starvation, irritant chemicals, and isolation. There were some attempts to argue for more psychological understandings and curative environments. For example, in England John Locke popularized the idea that there is a degree of madness in most people because emotions can cause people to incorrectly associate ideas and perceptions, and William Battie suggested a more psychological understanding, but conditions generally remained poor. The treatment of King George III also led to increased optimism about the possibility of therapeutic interventions.
What was the purpose of the York Retreat?
Rejecting medical theories and techniques, the efforts of the York Retreat centered around minimizing restraints and cultivating rationality and moral strength. The entire Tuke family became known as some of the founders of moral treatment. They created a family-style ethos and patients performed chores to give them a sense of contribution. There was a daily routine of both work and leisure time. If patients behaved well, they were rewarded; if they behaved poorly, there was some minimal use of restraints or instilling of fear. The patients were told that treatment depended on their conduct. In this sense, the patient's moral autonomy was recognized. William Tuke's grandson, Samuel Tuke, published an influential work in the early 19th century on the methods of the retreat; Pinel's Treatise On Insanity had by then been published, and Samuel Tuke translated his term as "moral treatment".
What is moral treatment?
Moral treatment was a product of the Enlightenment of the late eighteenth century. Before then people with psychiatric conditions, referred to as the insane, were usually treated in inhumane and brutal ways. In France, England, and the United States, people who cared for the insane began to advocate for more kindly treatment. In France Philippe Pinel instituted what he called traitement moral at the Bicêtre hospital in Paris. According to Pinel, insane people did not need to be chained, beaten, or otherwise physically abused. Instead, he called for kindness and patience, along with recreation, walks, and pleasant conversation. Around the same time that Pinel called for his reforms, William Tuke, an English Quaker, founded the York Retreat for the care of the insane. Rejecting traditional medical intervention, Tuke emphasized the rural quiet retreat where insane people could engage in reading, light manual labor, and conversation. Never having more than thirty residents, the York Retreat remained small and hence able to focus on the individual needs of its residents.
Who was the first person to advocate moral treatment?
In the United States, the first proponent of moral treatment was Benjamin Rush. A Philadelphia physician, Rush had been one of the signers of the American Declaration of Independence. For Rush, the hustle and bustle of modern life contributed to mental diseases.
Why did the dream of moral treatment die?
The dream of moral treatment died because of a combination of overcrowded hospitals along with the advent of eugenics and Freud around the turn of the twentieth century.
What did Dix insisted on?
Dix insisted that hospitals for the insane be spacious, well ventilated, and have beautiful grounds. In such settings, Dix envisioned troubled people regaining their sanity. In the 1840s and 1850s there was much optimism for the cure of insanity through kind treatment without restraints.
Who advocated for more kindly treatment?
In France, England, and the United States, people who cared for the insane began to advocate for more kindly treatment. In France Philippe Pinel instituted what he called traitement moral at the Bicêtre hospital in Paris.
What was the perspective of the second half of the nineteenth century?
During the second half of the nineteenth century, the optimism surrounding moral treatment began to wane.
Moral Treatment: A New Therapeutic Model
Organized sports and bicycling were also popular. These activities were believed to assist recovery, as they broke up the monotony of asylum life.
Bibliography
Baehre, Karl Rainer. The Ill-Regulated Mind: A Study in the Making of Psychiatry in Ontario, 1830-1921. ProQuest Dissertations and Thesis (1985).
