“From Cure to Custodianship”

The Journal of the History of Medicine and Allied Sciences has just released its January 2010 issue online. Included in this issue is an article by Fulbright scholar Lawrence B. Goodheart. In “From Cure to Custodianship of the Insane Poor in Nineteenth-Century Connecticut” Goodheart provides an account of life at the Hospital for the insane at Middletown, Connecticut (pictured above). Connecticut, Goodheart argues, was the exception among Northeastern states in that it did not open a public institution for the insane until the latter half of the nineteenth century. In documenting the institution’s history Goodheart, examines how initiatives meant to cure individuals and return them to society in a timely manner failed. Rather, custodianship became the norm. The abstract to this article reads:

Connecticut was the exception among the Northeastern and Middle Atlantic states in not founding a public institution for the insane until after the Civil War when it opened the Hospital for the Insane at Middletown in 1868, a facility previously neglected by scholars. The state had relied on the expedient of subsidizing the impoverished at the private Hartford Retreat for the Insane that overtaxed that institution and left hundreds untreated. Despite abundant evidence to the contrary, well meaning officials oversold the idea that the Middletown site would promote cures and be cost effective. A number of unanticipated consequences occurred that mirrored fundamental changes in nineteenth-century psychiatry. The new hospital swelled by 1900 to over 2,000 patients, the largest in New England. Custodianship at the monolithic hospital became the norm. The hegemony of monopoly capitalism legitimated the ruling idea that bigger institutions were better and was midwife to the birth of eugenic responses. Class based psychiatry—the few rich at the Retreat and the many poor at Middletown—was standard as it was in other aspects of the Gilded Age. Public policy toward the insane poor in Connecticut represents an outstanding example of the transition from antebellum romanticism to fin de siècle fatalism.

Also in this issue of JHMAS are two book reviews that may be of interest to historians of psychology. Books reviewed include:

Carla B. Yanni. (2007). The Architecture of Madness: Insane Asylums in the United States. Minneapolis/London: University of Minnesota Press.

Paul A. Lombardo. (2008). Three Generations, No Imbeciles: Eugenics, the Supreme Court, and Buck v. Bell. Baltimore: The Johns Hopkins University Press. (Lombardo’s book was previously reviously discussed on AHP here.)

About Jacy Young

Jacy Young recently completed a Social Sciences and Humanities Research Council (SSHRC) of Canada Postdoctoral Fellow at the University of Surrey in the UK. She earned her doctorate in the History and Theory of Psychology at York University in 2014.