Institutionalization of the Mentally Ill Homeless

This used to be a routine process in our country but then it was essentially dissolved, as this article from City Journal notes, and the horror on the streets of most cities—and in our Parkway—is what we now have.

An excerpt.

If it’s true that “men moralise among ruins,” as Benjamin Disraeli wrote, the ruins of America’s nineteenth-century mental institutions should invite some serious reflection. Built between 1850 and 1900, these crumbling edifices speak to our onetime dedication to caring for the mentally ill. Almost all were designed on the Kirkbride Plan, named for Pennsylvania physician Thomas Story Kirkbride, author of an influential treatise on the role of architecture and landscape in treating mental disorders. Even in their dilapidated state, it’s possible to see how the buildings, which followed a method of care called the “moral treatment,” gave the mentally ill a calming refuge from the gutters, jails, and almshouses that had been the default custodians of society’s “lunatics.”

Unfortunately, in the middle of the twentieth century, as asylums became grossly overcrowded and invasive treatments aroused public concern, the moral treatment came to seem immoral. The eventual result was the process known as deinstitutionalization, which steadily ejected patients from the asylums. Instead of liberating the mentally ill, however, deinstitutionalization left them—like the asylums that once sheltered them—in ruins. Many of today’s mentally ill have returned to pre-Kirkbride conditions and live on society’s margins, either sleeping on the streets or drifting among prisons, jails, welfare hotels, and outpatient facilities. As their diseases go untreated, they do significant harm to themselves and their families. Some go further, terrorizing communities with disorder and violence. Our failure to care for them recalls the inhumane era that preceded the rise of the state institutions. The time has come for new facilities and a new moral treatment.

When Kirkbride published On the Construction, Organization, and General Arrangements of Hospitals for the Insane in 1854, he expressed concerns that remain relevant today. “The plan of putting up cheap buildings in connection with county or city almshouses for the care of the insane poor, and under the same management, cannot be too severely condemned,” he wrote. “Such structures are sure to degenerate into receptacles of which all humane persons will, sooner or later, be heartily ashamed.” Proper care, Kirkbride continued, occurs “only in institutions specially provided for this class of disease.” He concluded that “the simple claims of a common humanity . . . should induce every State to make a liberal provision for all its insane, and it will be found that it is no less its interest to do so, as a mere matter of economy.”

Kirkbride’s arguments were compelling, and state legislatures across the country began building asylums to his specifications, spending millions to care for the mentally ill during the late nineteenth century. Set in serene landscapes and composed of substantial brick edifices, the asylums resembled palatial estates. The Hudson River State Hospital for the Insane in Poughkeepsie, New York, was designed in 1867 by Frederick Clarke Withers in High Victorian Gothic; its grounds were the work of Frederick Law Olmsted and Calvert Vaux, the same duo responsible for Central Park in Manhattan. Buffalo State Asylum for the Insane, begun in 1870, was designed by H. H. Richardson in a style that marked the advent of his Romanesque Revival period, with grounds again planned by Olmsted and Vaux. The enormous New Jersey State Lunatic Asylum at Morristown owed its founding to the persistence of Dorothea Dix, a nurse who famously lobbied state legislatures for funding for the mentally ill. Designed by Samuel Sloan in Second Empire Victorian in the early 1870s, the building was said to have the largest continuous foundation in the United States until the construction of the Pentagon about 70 years later.

Retrieved August 21, 2015 from

About David H Lukenbill

I am a native of Sacramento, as are my wife and daughter. I am a consultant to nonprofit organizations, and have a Bachelor of Science degree in Organizational Behavior and a Master of Public Administration degree, both from the University of San Francisco. We live along the American River with two cats and all the wild critters we can feed. I am the founding president of the American River Parkway Preservation Society and currently serve as the CFO and Senior Policy Director. I also volunteer as the President of The Lampstand Foundation, a nonprofit organization I founded in 2003.
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