Mental Illness in Maryland: Public Perception, Discourse, and Treatment, from the Colonial Period to 1964

Abstract

This dissertation is an overview of the public perception of, discourse concerning, and treatment of Maryland's mentally ill citizens from the Colonial Period to 1964. The present day view of the mentally ill in the early colony is, at best, fragmentary. The numbers of such Marylanders were small and little information exists to frame a picture of what constituted their daily life or the level of care until about 1785. The decision to confine individuals at home or at an institution entered public discourse. Certain families entrusted their relatives to hospitals. Mentally ill people constituted a highly visible presence during the first half of the nineteenth century. A vacillating public interest and tepid financial support for their cause, however, prevented access to higher quality care for the majority. County almshouses and jails continued to house the "pauper insane" in a regressive manner. During the second half of the nineteenth century, the rights and well-being of mentally ill citizens came to public notice. The possibility of a sane individual being unjustly confined within a mental hospital fired the public imagination. Court cases and patient exposés persuaded legislators that some laws and formalized state oversight of institutions were required. The first three decades of the twentieth century marked an epoch of progress. A reform campaign resulted in the transfer of all patients from the county almshouses into modern, newly-constructed state mental hospitals. The insular settings, however, ultimately made them less visible. The Great Depression and Second World War era induced shortages that adversely affected state hospital patients. Many such patients languished in sub-standard conditions. A troubling 1949 photographic exposé ultimately pressured state officials to bring system-wide improvements. The 1950s ushered in a new era for Maryland's mentally ill citizens. The advent of psychotropic drugs allowed patients to leave the hospitals. Programs to assist in the transition back into the community were developed by the State and public advocates. Members of a once faceless, inarticulate group came to be perceived as individuals who could contribute to and enrich the life of our communities.