Is There a Need for Asylums? (02:41)

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One-third to one-half of America’s homeless suffer from mental illness. In the past, asylums like St. Elizabeth's Hospital in Washington D.C. cared for the basic needs of thousands of mentally ill patients.

Dorothea Dix: Improving Conditions for the Mentally Ill (04:18)

Appalled by the treatment of the insane in the mid-1800s, Dorothea Dix worked to persuade legislature to establish 32 new asylums in various states, including the monumental government hospital for the insane in Washington, D.C.

Disappointing Results of Moral Therapy (04:24)

Despite Dix's hope that moral therapy would restore sanity, at this time asylum founders could only guess at the causes of mental illness. Like most patients of the era, the first patient admitted to St. Elizabeth's mental hospital never recovered.

Asylum Populations Grow (04:03)

In the years following the Civil War, St. Elizabeth's population grew, filling with immigrants. The hospital came to depend on patient laborers. After three years in an asylum, Elizabeth Packard writes about the mistreatment and abuse she witnessed.

Mistreatment and Abuse Reported in Asylums (03:30)

As documented cases of asylum abuse rise, the reputations of insane asylums deteriorate. Without a basic understanding of the organic illnesses which cause insanity very few patients ever recovered from mental illness.

Neurology and the Case of Charles Guiteau (04:47)

New studies in neurology suggest that insanity is a disease of the nervous system and that only through the study of the nerves and brain can mental disorders be understood. Autopsy of the brain of an insane assassin supports this theory.

Sigmund Freud Introduces Psychotherapy (03:16)

In the early 1900s, emphasizing how early childhood experiences shape the self, Sigmund Freud challenges the belief that insanity is strictly a biological disease. Psychoanalysis begins to play a role in treatment and patient analysis.

Searching for a Cure: Patient Experiments (04:05)

While St. Elizabeth's Hospital doubles in size, and Director White struggles to manage its growing population, various patient experimentations begin in the hopes of discovering an effective form of treatment.

Community Treatment Facilities (02:39)

In the wake of World War II, doctors focus on treating shell-shocked soldiers. With stress as the leading cause of mental illness, psychiatrists begin using psychotherapy to treat patients in community treatment facilities.

Break-Through in Psychiatric Medications (04:28)

Just as asylums fill above and beyond capacity in the 1950s, psychiatric medications prove successful in treating various mental illnesses and many patients are released under the common misconception that they are cured.

Deinstitutionalization Movement (06:32)

While activists begin staging protests in the 1960s, the rise in legal battles to free mental patients persuades President Kennedy to launch the policy of deinstitutionalization. With the reform movement asylum populations begin to decline.

The Homeless Mentally Ill (04:16)

Mentally ill patients lacking the capacity to adjust to life in society may end up homeless. With the decline of facilities such as St. Elizabeth's Hospital the burden of long-term care now falls on families and area shelters.

A Positive Asylum Experience (03:12)

A small number of people still find St. Elizabeth's Hospital a source of effective care in dealing with mental illness. One homeless woman describes how her two-year stay at St. Elizabeth's helped her learn the skills she needed to return to society.

The Future of Asylums (03:21)

Experts continue to debate the need for and effectiveness of structured mental health facilities, such as asylums, in some cases. Without federal funding the future use of St. Elizabeth's Hospital remains uncertain.