The history of the treatment of the so-called insane and the concept of the aslyum.

3100 BCE Menes, the founder of the 1st Dynasty writes The Secret Book of the Heart describing 3 kinds of healers, the physician, the priest and the sorcerer. 460-379 BCE Hippocrates believed the brain was involved in sensation and was as well the centre of intelligence, argued that psychological disorders originated from natural reasons as other diseases, rather than reflections of the displeasure of the gods or evidence of demonic possession, and defined such clinical pictures as mania and melancholia.He further pointed out the relationship between the human brain and epilepsias and mentioned dementia Greek medical writers set out treatments for mentally ill people that include quiet, occupation, and the use of drugs such as the purgative hellebore. Earliest records of the study and practice of alchemy among the Greeks of Asia Minor. It was long thought among the Magi that the various metals were connected with their astrological properties, but the goal of the alchemist was the pursuit of a “stone which isn’t a stone”1 reflected in the mystic’s aim to free the soul from the evil confines of matter and return it to God. 

384-322 BCE Aristotle believed the heart was the centre of intelligence and that the brain was a kind of radiator that cooled the blood that was overheated by a seething heart, which explained man’s rational temperament.  Or lack of it.

280 BCE Theophrastus, having “...a long time observed the divers dispositions of men, having now lived ninety-nine years, conversed with all sorts of natures bad and good, and comparing them togither...” writes The Characters, the original DSM, comprised of exactly 28 personality disorders. 120-70 BCE Asclepiades introduced humane treatment of the mentally deranged; some of those treatments were based on interpreting dreams, described and defined the errors in perception and reasoning of the insane and emphasized the point that they should be treated under favorable environmental conditions 

1 to 99 CE The Roman, Celcus, a contemporary of Christ’s, defends the idea that force had to be applied during treatment of insane. To him, the insane had to be punished with fasts famines, fetters and beating, asserting that a sudden sense of fear could cause the insane to recover

23-79 Pliny the Elder, the great Roman naturalist (who asserted that the Earth was a sphere and the heavens unfathomable) composes in 37 volumes a Natural History, devoting many of the volumes to the medicinal properties of plants and herbs, animals and the human body’s own products, as well as the uses of charms in healing the afflictions of mind and body.

100 - 200 CE As physician to the gladiators, Galen, (Claudius Galeno) who was also a writer, likely observed first-hand the consequences of brain and spinal injury. He dissected many animals and believed as Hippocrates did that the brain was the centre of intelligence. His views on the role of the cerebrum and cerebellum prevailed for close to 1,500 years

200 - 499 CE India’s knowledge and use of science and technology more advanced than Europe, the science of Ayurveda informing practices of surgery, development of popular nutritional guides, and codes for medical procedures and patient care and diagnosis that have proven accurate a thousand years later. Augustine writes The City of God in part to respond to claims that Rome fell because it had abandoned paganism. Caelius Aurelianus announces that devils were existing in the appearance of male or female human beings, whose primary task was to deceive the opposite sex, issuing in the centuries to follow of murder of thousands of the insane for the purpose of getting rid of the evil-souls and devils that possess them

622 - Mohammed’s flight from Mecca to Medina, the beginning of Islam 680 - Boniface brings Anglo-Saxon Christianity to the pagans in Germany, cutting down the pagan’s sacred tree to build a church out of it 800 - Baghdad Academy of Science founded 900 - Leechdom, Wortcunning and Star Craft of Early England, a collection of herbal prescriptions, gives remedies for melancholia, hallucinations, mental vacancy, dementia, and folly. 1020 - Avicenna (Ibn Sina) suggests that the three ventricles of the brain perform five distinct cognitives processes: common sense, imagination, cogitation, estimation and memory. His Canon of Medicine, which asserted the fundamentals of neuroanatomy, was in use as a textbook in Europe and the East as late as the 17th century. His treatise De Anima, discusses the relationship of body and soul in man and the causes of melancholy, and advocated only humane treatment of the insane. Avicenna was the first to employ analytical treatment, including use of a free association method, in his treatment of the insane. 1100 First record of an asylum founded in Europe exclusively for sufferers from mental diseases at Mets. 1200 Geel, Belgium becomes an established place of pilgrimmage and settlement for the mentally ill, it survives the centuries and still exists as a therapeutic community, although in modern times under the supervision of medical authorities. Ch’an Buddhism spreads from China to Japan where it is called (at least in translation) Zen Buddhism 1200 Universities of Paris and Oxford founded 1212 The Children’s Crusade. Children marched in tens of thousands from Germany and France to Italy, believing that they could free the Holy Land supernaturally because they were pure in heart. Most of them were drowned, murdered, or sold into slavery

1300-c.1400 The Black Death. 1/3 of the population from India to Iceland is wiped out, including about Ĺ of Britain. Casting out devils becomes the common treatment for the mentally ill 1371 Robert Denton, chaplain, obtained a licence from King Edward III (paying 40 shillings for the licence) to found a hospital in a house of his own in the parish of Berking Church, London, “for the men and women in the sad city who suddenly fall into a frenzy and lose their memory, who were to reside there until cured; with an oratory to the said hospital to the invocation of the Blessed Virgin Mary”, establishing the first household, predating the opening of Bedlam by close to 200 years. 1400 In general, medieval Europeans allow the mentally ill their freedom granted they are not dangerous. However, less enlightened treatment of people with mental disorders is also prevalent, with those people often labeled as witches and assumed to be inhabited by demons. Some religious orders, which care for the sick in general, also care for the mentally ill. Muslim Arabs, who establish asylums as early as the 8th century, carry on the quasi-scientific approach of the Greeks.

1403 - St. Mary of Bethlehem, or ‘Bedlam,’ just outside London, first accepted psychiatric patients 1409 Asylum at Valencia founded by a monk named Joffre, out of pity for the lunatics whom he founded hooted by the crowds. The movement thus begun spread throughout Spain, and asylums were founded at Saragossa in 1425, at Seville in 1435, at Valladolid in 1436, and at Toledo before the end of the century. 

1410 - Insane asylum built in Padua, Italy.

1500-1599 - Virtually every form of care of the insane, as well as the monastic establishments in which they were received, disappear with the Reformation. Institutions for the insane start cropping up in Britain and across Europe: Pope Innocent XIII, commissioned two priests to prepare a book concerning how to get rid of the devils and demons from the Christian World, by getting acquianted with them. These priest then prepared a book describing the devil, the ways to know it, and how to kill it, as well as the method of torturing the insane, with full details of various torturing methods and techniques. The insane were prosecuted before the religious courts (Equisition) and burned alive to get rid of the devil located in their souls. Thus, more than hundred thousand mentally ill people were killed during the reign of Francois the First (1515-1547) in France. In the 16th. Century, in Geneva of Switzerland, more than five hundred insane people were burned in the squares of the city before the public, by fastening them to poles, within three months. Even in the 16th, century, Johann Wayer was thinking that seven million of devils were existed in the universe and advising to torture the insane who carried the devils in their body.1 1547 - Insane asylum refounded as St.Mary of Bethlehem in London, England. Became known as Bedlam. Devoted entirely to psychiatric patients. 1570 - Felix Platter, Switzerland, among the first to distinguish between various types of mental disorders. 1621 - Robert Burton, Britain, published Anatomy of Melancholia, a description of depression. 1700 - Private mad houses proliferated in Britain, becoming prosperous and competitive. I guess rich families? 1703 - John Broughton first used the word “psychology” in his book Psychologia: ...the nature of the rational soul. 1758 - William Battie, Britain, source of the slang term batty, published Treatise on Madness, which remains in print today. Advocated therapeutic asylums, not prisons. 1773 - First insane asylum in the US founded at Williamsburg, Virginia 1776 - Inhabitants of Bedlam were a tourist attraction. 

1775- Mesmer, Austrian doctor who believed that “animal magnetism” would cure medical illness, seemed to be successful at treating hysteria in group sessions. Hypnotism is what it was. Although his ideas and methods met with skepticism and ridicule within the medical profession and he was forced to retire, the concepts of suggestion and hypnotism survived. 

1798- John Haslam (British) describes general paralysis of the insane in Observations of Insanity, a condition that is now known to be caused by syphilis. 1801 - Philippe Pinel in France, takes over the BicÍtre insane asylum and forbids the use of chains and shackles. He removes patients from dungeons, provides them with sunny rooms, and also allows them to exercise on the grounds. Yet in other places, mistreatment persists. Simultaneously, William Tuke in England and Eli Todd in America were working to reform treatment in their respective countries. 1809 - Austrian Franz Joseph Gall suggested that bumps on the skull reflected personality traits such as generosity, secretiveness and destructiveness. Start of phrenology. 1812 - Rush wrote the first American book on psychiatry, Medical Inquiries and Observations upon the Diseases of the Mind. The only psychiatric text in the U.S. for the next 70 years emphasized moral treatment: respect and re-education, not punishment. 1823 - French physiologist Marie-Jean-Pierre Flourens showed that the cerebellum played a part in coordinating movement, and concluded that the cerebrum was involved in perception and sensation. 1825 - Jean Baptiste Bouillaud read a paper before the Royal Academy of Medicine in France that argued that speech was localized in the frontal lobes, just as Josef Gall had suggested earlier based on brain injury studies. 1827 - Textbook on phrenology sold more than 100,000 copies. 1836 - Marc Dax presented case studies in Montpellier that showed that speech disorders were consistently associated with lesions in the left hemisphere. Dax’s son published the manuscript in 1865. 1840s - U.S. reformer Dorothea Dix observes that mentally ill people in Massachusetts, both men and women and all ages, are incarcerated with criminals and left unclothed and in darkness and without heat or bathrooms. Many are chained and beaten. Over the next 40 years, Dix will lobby to establish 32 state hospitals for the mentally ill. On a tour of Europe in 1854≠56, she convinces Pope Pius IX to examine how cruelly the mentally ill are treated. 1843 - James Braid, Scottish surgeon begins use of hypnotic trance as a form of anesthesia. Coined the term hypnosis, derived from the Greek hypnos, meaning sleep.

1847 - While blasting rock, an iron bar embedded itself in the front part of Phineas Gage’s brain. He survived the operation to remove it, though his personality changed radically. He became irreverent, profane, rude and impatient, all contrary to his nature before the accident.

1848 -After much campaigning by American Dorothea Dix, New Jersey built a humane hospital for the insane. Over 30 states followed its lead.

1849 -British psychiatrist John Charles Bucknill used electrical stimulation of the skin and potassium oxide to treat asylum patients with melancholic depression. Electrical stimulation became widespread during the late nineteenth century, but safety concerns reduced its use, but Frances Farmer, famous thirties actress got electro shocked regularly  in the bin, that film came out with JESSICA LANG playing her.

1840 -1859. James Esdaile, resident in Calcutta, uses hypnosis for anesthesia in operations performed on his patients.

1860-Belgian psychiatrist Benedict Morel described the case of a 13-year-old boy, formerly an excellent pupil, who lost interest in school, became withdrawn, seclusive, quiet, and seemed to forget everything he had learned. He spoke often of killing his father. Morel called this mental deterioriation demence precoce, generally associated with old age. German psychiatric Emil Kraepelin adopted the term dementia praecox to refer to conditions in which mental deterioration began early in life.1861 Of 27 million Americans, 8,500 are hospitalized in psychiatric institutions. This is when PATTOn was built. 1879 - Wilhelm Wundt establishes the first psychological laboratory at the University of Leipzig in Germany 1879 - Francis Galton utilizes the method of word association 1879 -Lightner Witmer uses for the first time the term clinical psychology EUREKA! 1880 -Seven categories of mental illness used for U.S. census data: mania, melancholia, monomania, paresis, dementia, (also called dementia praecox, meaning ‘early’ to distinguish it from senility; dipsomania, epilepsy.

1882 -Francis Galton in England established an anthropometric lab for the statistical analysis of differences among people 1890 - James McKeen Cattell, America, formed his own lab to study reaction time differences among people, collaborated with Francis Galton in using this method to study intelligence. He coined the term mental tests, and began the testing movement. 1890 - In an attempt to alter the behavior of six severely agitated patients, Dr. Gottlieb Burckhardt, superintendent of a Swiss psychiatric hospital, drilled holes in their heads and extracted sections of the frontal lobes. Two patients died. The surgery was considered morally reprehensible at the time. 1890 - William James’ Principles of Psychology published 1892 - Founding of the American Psychological Association. Clinical psychology section formed in 1919. 1895 - Sigmund Freud and Josef Breur, Austria, published Studies on Hysteria, a study of the unconscious mind. 1900 - Sigmund Freud published The Interpretation of Dreams. Marked the popularity of the psychoanalytic movement, which made popular such terms as the unconscious, the Oedipus complex, ego, id. Psychoanalysis placed much importance on sexuality and sexual development. 1905 - Carl Jung started using word-association methods to uncover unconscious processes. 1905 -Joseph Pratt, internist, and psychologist Elwood Worcester started to use supportive discussion with hospitalized psychiatric patients. Origins of group therapy. 1906 -Sir Charles Sherrington coined the term “synapse” to refer to the gap between to two excitable cells.1908 -Alfred Binet and Theodore Simon in France, on the behest of the government, developed the Binet-Simon Scale, the first measure of intelligence. Henry Goddard took the tests to America.1908 -      Clifford Beers publishes his autobiography, A Mind That Found Itself, detailing his degrading, dehumanizing experience in a Connecticut mental institution and calling for the reform of mental health care in America. Within a year, he will spearhead the founding of the National Committee for Mental Hygiene, an education and advocacy group that will evolve into the National Mental Health Association

1909 - William Healey established a child guidance clinic in Chicago for juvenile delinquents. It employed a team of psychiatrists, social workers and psychologists 1911 -Swiss psychiatrist Eugen Bleuler introduced the term “schizophrenia” (literally split mind) to describe a condition characterized by disorganization of thought processes, incoherence of thought and emotion, and a turning inward, splitting off from reality.The split also refers to the split between the intellect and emotion, but not between personalities, as is commonly, and incorrectly, believed. 1913 -Emil Kraepelin divided mental illness into those that could be cured and those that could not, thereby beginning classification schemes that still persist today. 1917 - World War I brings with it a need to screen and classify military recruits. One of the tests was Robert Woodworth’s Psychoneurotic Inventory, likely the first test to assess abnormal behavior.

1917 - Wagner-Jauregg discovered that general paresis, or neurosyphilis, can be treated by intentionally infecting the patient with malaria.Later received the Nobel Prize for his work

1920 -John Watson describes the way in which he trained Albert to fear white rats. Mary Clover Jones in 1924 demonstrated how such fears could be removed through conditioning, ushering in the beginning of behavior therapy. 1921 -Swiss psychiatrist Hermann Rorschach’s Psychodiagnostik described how to use inkblots to diagnose psychiatric conditions. It didn’t become popular until 1937, when two manuals and scoring procedures were published. 1932 - Sakel introduced insulin coma therapy as a treatment for schizophrenia. Also used to treat morphine withdrawal. 1934 -Electroconvulsive therapy (ECT) introduced by von Meduna, a Hungarian physician, using intramuscular injections of camphor. It did not reliably produce seizures, which he believed could ease schizophrenia. Kinda of like mainlining Vicks Vaporub. 1935 -Ivan Pavlov, famous for his dog who salivated in response to a signalbell, and Portuguese neurosurgeon Egas Moniz were among those attending a neurological conference in London. Yale University’s John Fulton conducted a day-long symposium in which he demonstrated that two chimpanzees, after undergoing frontal lobe removal, were unperturbable.No neurotic behavior could be induced. The question naturally arose about whether similar surgery in humans wouldn’t eradicate anxious behavior. 1935 -      Christiana Morgan and Henry Murray publish the ThematicApperception Test (TAT), which asks a person to use ambiguous pictures to make up stories, describing the actions, thoughts and feelings of the people in the stories. The TAT is a form of projective test, designed to access unconscious beliefs, thoughts and feelings of the patient

1935 - Moniz performed the first leukotomy on a female patient by destroying the fibers connecting the frontal lobes to the rest of the brain. Her agitation and paranoia diminished, but successive patients only seemed dull and apathetic. Of course some survivors became psychiatrists at big clinics. Still, when Moniz published his work, it was swiftly put into practice. 1938 - Lauretta Bender publishes her Bender-Gestalt Scale Test, used as a measure of personality and of brain dysfunction. 1938 -     After visiting a slaughterhouse and seeing animals knocked out by electric shock, Cerletti and Bini introduced electrically produced seizures. Inadequate anesthesia sometimes resulted in bone fractures, and patients complained of memory loss, and the process is considered more effective in treating depression than schizophrenia. 1939 -45 - World War II. U.S. Army developed a better classification system to include disorders suffered by servicemen such as psychophysiological, personality and acute disorders. 1943 - Minnesota Multiphasic Personality Inventory published by Hathaway. 1948 - Using an ice pick and a hammer, neurosurgeon Walter Freeman performed a lobotomy on 34-year-old Frances Farmer, actress and political activist, after all other treatments failed to subdue her communist leanings and aggression. IS THIS TRUE? I think it was just elec shock! She became mediocre and slow after the surgery, but then she drank. She ended her days as a hotel clerk. She died of cancer in 1970. 1948 - Norbert Weiner coined the term cybernetics. Later, L.Ron Hubbard would found scientology on top of this. Hubbard believed past lives left ‘engrams’ on the soul, which could be recalled and which would restimulate anxieties. Then, he believed shocks in childhood left scars, but that they could be removed with AUDITING, which was much what FREUD was doing. Listening off the events

1949 -Australian psychiatrist J. F. J. Cade introduces the use of lithium to treat psychosis. Lithium will gain wide use in the mid-1960s to treat those with manic depression, now known as bipolar disorder. 

1950 - researchers begin to identify psychosomatic diseases such as peptic ulcers, hypertension, brochial asthma. Illnesses divided into those causes by organic factors and those brought on by psychological factors. 1951 Carl Rogers published Client-Centred Therapy. 1951 –Fritz Perls introduces Gestalt therapy, which focuses on becoming aware of the present. The past is important only in how it effects the present. Perls ran current time processes with Q & A and psychodrama that would reawaken past emotional patterns. He’d have patient ‘talk’ to Mom, though Mom wasn’t in the room. 

1951-Soviet Union stops lobotomies after seeing that patients became fixed and unchangeable. 1952 -     First edition of the DSM-I, the Diagnostic and Statistical Manual of Mental Disorders. First official manual of mental disorders for clinicians.1952 -The first of the anti-psychotics, the major class of drug used to treat psychosis, is discovered in France and is named chlorpromazine (Thorazine).1952 -    Hans Eysenck, a behavioral psychologist who coined the term behavior therapy, published a scathing critique of the various forms of psychotherapy. Sets off a flurry of research activity to prove him wrong. 1952 -French researchers Pierre Deniker, Henri Leborit and Jean Delay discovered the antipsychotic chlorpromazine, marking the beginning of psychopharmacology. 

1953-Victor Frankl a concentration. Camp survivor said belief in ones having something they were meant to do helped them endure the nazis, he introduced logotherapy, which focuses on man’s search for meaning. 

1953 -BF Skinner shows how to apply operant principles of behaviour. 1954 -    Psychopharmacology hits the U.S. Thorazine was the biggest selling tranquilizer and manufacturers can’t keep up with demand.

1955 - More than 55,000 men, women and children in the U.S. undergo lobotomy. CUTTING OUT FRONTAL LOBES! It was forced on them of course. JFK’s sister had operation forced on her by DAD cuz she was in puberty and ‘fresh’ and retarded. She became a vegetable.Pop didn’t tell MOM, he just did it. Mom saw diff and flipped out. So God rewarded the family a bullet took out the front of JFK’s brain. Identical operation! 1955 -Wechsler Adult Intelligence Scale published.1955 -Peter Milner and James Olds, recorded brain waves from rats while seeing reinforcement or self-stimuation. Mid-1950s - The numbers of hospitalized mentally ill people in Europe and America peaks. In England and Wales, there were 7,000 patients in 1850, 120,000 in 1930, and nearly 150,000 in 1954. In the United States, the number peaks at 560,000 in 1955. 1956 -Bateson, Jackson, Haley, and Weakland publish Toward a Theory of Schizophrenia in which they posit a communication based theory of human behavior and introduce the concept of the double bind 1957       The term neuropsychology was by now a recognized subfield of the neurosciences. 1958 Joseph Wolpe describes systematic desensitization. 1959 -Although Sigmund Freud, the founder of psychoanalysis, insisted that medical training was not necessary to perform psychoanalysis, the medical profession took over the field and locked psychologists out. Diverse forms of treatment of mental illness 1959 R.D. Laing publishes The Divided Self. He was in and out of nut houses but became a shrink. Was the huge big star and literary darling duringthe sixties and seventies. My pal who got murdered took me to hear him talk at Sta Monica Civic Aud.1961 –ANOTHER famous man, KIROSAWA, wrote/directed dozens of Jap films, in and out of nut houses. All his life. Eric Berne introduced transactional analysis in Transational Analysis in Psychotherapy. 

1961 Sociologist Erving Goffman’s book, Asylums, claims that most people in mental hospitals exhibit their psychotic symptoms and behavior as a direct result of being hospitalized.1961 -         Psychiatrist Thomas Szasz’s book, The Myth of Mental Illness, amplifies earlier assertions such as those by Erving Goffman that mental ‘disease’ is a metaphor, argues that psychiatric disorders including schizophrenia do not exist. 1962 -   Judge Bazelon, United States Court of Appeals for the District of Columbia circuit, wrote for the majority that psychologists who are appropriately qualified can testify in court as experts in mental disorder. Forensic psychology begins. 1962 -   Ken Kesey publishes One Flew Over the Cuckoo’s Nest, based on his experiences working in the psychiatric ward of a Veterans’ Administration hospital; Kesey’s novel wins the Pulitzer Prize. CHANGES how everybody thot about nuts. 1962 -Albert Ellis introduces rational-emotive therapy, which uncovers irrational beliefs that lead to emotional distress and reformulates those beliefs through a technique called “disputing.”

1964-  Stanley Milgram publishes Obedience to Authority Emergence of humanistic psychology as “third force” in psychology 1967 Rollo May publishes Psychology and the Human Dilemma 1968 -Abraham Maslow publishes Toward a Psychology of Being 1969 -Gregory Bateson publishes Schizophrenia and Family1969 -   Albert Bandura publishes Principles of Modification of the Behavior 1969 Joseph Wolpe publishes The Practice of Behavior Therapy 1969 - Elizabeth Kubler-Ross publishes On the Death and Dying 1971 B. F. Skinner publishes Beyond Freedom and Dignity1971 -Swiss psychiatrist Medard Boss founds the Zurich Institute for Daseinsanalytic Psychotherapy and Psychosomatics 1978 - Italy passes legislation closing the doors of all psychiatric institutions to new admissions. Diagnoses of schizophrenia virtually disappear: in the following four years, one case is diagnosed in the region of Verona, pop. 90,000. See, if people don’t believe in it, don’t encourage it, it’s not a problem. I had a friend who was schizy and had two screenwriting oscars. His mother had it,was locked up for twenty yrs.

1979-1992 Dr Peter Breggin writes a half dozen books on Medicine’s response to madness. Debunks electro shock, psychotropic meds. Click on that to see the titles. Get them at ABE BOOKS used, a buck each.

1980 - APA published the DSM-III. One of the changes is a more exact criteria for diagnosing schizophrenia. Triggered research that evaluated the reliability, validity and usefulness of criteria used in DSM-III for mental disorders. Psychopathology research expanded substantially. 1988 -Independent coalition of patient advocacy and and survivor groups is formed in America, named MindFreedom Support Coalition International 1989 - Joseph Campbell publishes The Power of Myth 1989 -R.D. Laing d. (b. 1927) a doctor who maintained the insane were blessed and SUPER SANE!

1992 - James Hillman & Michael Ventura publish We’ve Had a Hundred Years of Psychotherapy and the World’s Getting Worse 1992 -       A survey of American jails reports that 7.2 percent of inmates are overtly and seriously mentally ill, meaning that 100,000 seriously mentally ill people have been incarcerated. Over a quarter of them are held without charges, often awaiting a bed in a psychiatric hospital. 1993 -A review of neuroimaging studies indicated that three brain regions are involved in schizophrenia: the frontal, the temporolimbic and the basal ganglia, that they could see it, so that it’s organic, involved with circulation in the brain while Gur and Pearlson noted that the same abnormalities show up with other conditions such as mood disorders, though not to such an extreme degree. Implying a sliding scale for organic disturbance. 1994 -American Psychiatric Association publish the DSM-IV-TR, Diagnostic and Statistical Manual of the Mental Disorders, Fourth Edition, Text Revision.

1995 -Richard Webster publishes the definitive analysis: Why Freud Was Wrong: Sin, Science and Psychoanalysis 2001 - Robert Whitaker publishes Mad In America, a thoroughly-researched indictment of treatment of the mentally ill in America. DRUGS IN ASYLUMS -A psychiatric hospital (also called at various places and times, mental hospital, mental ward, asylum, insane asylum, lunatic asylum, or colloquially nut house, funny farm, and other synonyms listed below) is a hospital specialising in the treatment of persons with mental illness. Psychiatric wards differ only in that they are a unit of a larger hospital. Psychiatric hospitals have a number of differences from other hospitals. First, they often have elaborate procedures to prevent patient suicide (for example, appliances with power cords are not allowed, and access to stairways and high, open windows is restricted). Second, they attempt to reduce the amount of sensory stimulation that patients receive. Contrary to popular belief, psychiatric hospitals are generally quiet, even boring places. Third, psychiatric hospitals often try to provide as normal an environment as possible. For example, unlike most other hospitals many or most patients in psychiatric hospitals wear everyday clothes rather than patient examination garments. In the United States, psychiatric hospitals in the past were often set up as separate institutions with funding and administrations separate from those of general health care. Since the development of psychotropic drug therapies in the 1950s, there has been an increasing move towards integration of psychiatric treatment within the general health sector. Psychiatric wards in general hospitals and various outpatient commitment programs are replacing the old asylums worldwide. In the United Kingdom during the late 18th, 19th and early 20th centuries, county authorities were expected to provide their own asylums, for the care or incarceration of the insane. Private institutions had existed before this, and provided the only care available. Throughout this period, private institutions continued to exist and be founded for so called idiots and imbeciles, who were usually those who today would be said to have mental retardation or learning disabilities. The county asylum structure was nationalised in 1948, when the institutions were absorbed into to the National Health service. As in the U.S. and worldwide, most psychiatric hospitals have been replaced by Care in the Community and psychiatric wards in general hospitals. It was only until relatively recently that incarceration was mandatory for all with considerable mental health problems. Today, secure and medium-secure units care for those who require more support or supervision. Today, in both countries, if a patient had been admitted to the hospital on a voluntary basis, the patient is often allowed to check him or herself out of the hospital against medical advice. In most jurisdictions, to leave requires at least a day’s notice. This is so in the event a doctor decides the patient would still present a danger to self or others, there is time to commence involuntary commitment procedures. Efforts have often been made to improve mental health care. Nevertheless, many problems remain in those countries where free health care is not available or where funding is limited. This especially affects those with little money to pay for expensive facilities. Limited funding of hospitals can lead to a lack of adequate staff and resources which can lead to the use of restraints and medication for punishment rather than treatment. Procedural deficiencies such as a lack of documentation for involuntary treatment and other serious deficiencies remain all too common in some countries

. a fascinating  HISTORY OF DRUG USE. 

*       *       *