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Sketchy History at Washington's Psychiatric Hospitals

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Patients and Prisoners

Thanks for sharing! Want a Free Book? Stay in Touch! Follow us on social media to add even more wonder to your day. Mackenzie on January 1, On that date, there were at total of 36 patients at the hospital -- 26 of whom were termed "lunatics" and 10 of whom were referred to as "ordinary patients. This may have been a function of the fact that by the hospital buildings were in such a state of disrepair see below that the hospital was no longer able to accommodate the number of patients for which it had been designed. For example, a report made to the House of Delegates by "The Committee on the Part of the House of Delegates Appointed to Visit and Inspect the Maryland Hospital" indicates that the west wing of the building was in such bad repair that it was not being used.

Note: Dr. John Mackenzie continued to serve as one of the hospital's treating physicians after , and so, presumably, he did not stop admitting his private patients to the facility. However, it may have been that by conditions at the hospital were such that it was unable to attract many private patients.

In addition, records indicate that the hospital was badly in debt, in part because of low reimbursement rates and bad debt by the various Maryland counties, many of which had often simply failed to pay for indigent patients from their jurisdictions, despite a legislative requirement that they do so. The indebtedness of the hospital may also have limited the size of the indigent patient population that could be accepted. An estimated 30 mentally ill Maryland citizens were hospitalized in other states in , a circumstance that was attributed to the limited capacity and poor condition of the Maryland Hospital.

In the institution was officially renamed "The Maryland Hospital," a name that, evidently, had been in use since In the two years between and , the patient population grew to 54 individuals -- 42 psychiatric patients, and 12 general patients.

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Early reports indicate that by that time the abandoned roadbed of the "The Old Joppa Road" also known as the Old Road to Philadelphia -- directly to the north of the original hospital building -- had already been purchased by the Hospital. The annexation of the Old Joppa Road, plus the additional land purchased in , extended the hospital property's northern boundary to Monument St. A report from the s cites as one of the reasons for the hospital's debt the fact that the hospital was assessed for part of the cost of originally paving Monument St. As noted above, contemporary reports indicate that when the State resumed full operating control of the hospital in it found that the building that housed it had been permitted to fall into serious disrepair.

From the outside the building was still quite impressive in its appearance and, in fact, it received some national attention as a monumental building and was considered a Baltimore landmark for many years. However, upon closer inspection both the basic structure and the interior were found to have been in "ruinous" condition by the middle 's. For example, a passage from a report made in , pursuant to an inspection that had been ordered by the Maryland House of Delegates, reads: " The report went on to say that, it was noted that at that time there were 22 patients that required "close" i.

These repairs evidently included the purchase of about three additional acres of land; the subdivision of two large, open wards on upper floors of the east wing into private rooms; the replacement of the tin roof of the "center" portion of the building; improvements in the wall that surrounded the hospital to prevent escapes and to enhance privacy ; and the demolition and complete rebuilding of the section of the west wing that had at one time been the original hospital building; i.

The annual report of notes that, in , that section of the hospital, i. Drawings and other reports indicate that the replacement structure almost identically resembled the original structure , at least on the outside. The report specifically mentions the fact that the new structure was erected in the same location as the original building. Similarly, maps from , and show identical locations and approximately identical "footprints" for the primary hospital building in each of these years, and drawings of the hospital from , , and appear to be almost identical.

Contemporary references to the demolition of the "original hospital" in the late s are confusing in that the demolition of the "original hospital" referred only to the demolition and replacement of just that portion of the west wing that had been the original hospital building in The balance of the west wing, as well as the "Center Building," and the east wing were repaired, remodeled and improved in later years -- but these remaining portions of the building survived until they were demolished, along with the rest of the structure in the s see below.

Some early records indicate that certain patients were permitted "to go partially at large. However, other reports indicate that many, or even most, patients were kept in "strict confinement" -- either in individual "cells" or behind the hospital's high walls.

A number of local newspapers, including the [Baltimore] Sun, were known to have contributed subscriptions to the hospital's patients. The primary treatment modality used during the period was called "Moral Management" see below. In a manner perhaps consistent with modern industry practices, the annual reports from the early s seemed to have painted a somewhat misleadingly rosy picture of life at the institution.

Changing the Way Washington Cared For the Mentally Ill

Nevertheless, these reports do indicate that the providers placed great emphasis on the importance of cleanliness, good hygiene, patient activities, nourishing foods, personal dignity, and freedom of movement. Between and , the patient population expanded rapidly. For about a period of time after the State resumed full control in , physician services at the hospital were provided by a number of Baltimore physicians, including John Mackinzie -- each of whom were to have served gratuitously for one year.

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However, this proved to be an unsatisfactory arrangement, primarily because the volunteer physicians found that their private practices were growing, and, at the same time, the demands of the Maryland Hospital were too great. Furthermore, as noted above, its buildings seem to have been in such poor condition that the hospital was probably unable to attract many private, paying, patients.

In any case, the arrangement for gratuitous physician coverage lasted only about one year. In Dr. William Stokes, a graduate of the University of Maryland College of Medicine, was appointed as the hospital's first full-time State-employed physician. A second physician was hired shortly thereafter. During this same period, nursing services were provided primarily by an order of Catholic nuns; the Sisters of Charity of St. Vincent de Paul. The above referenced report of indicates that, for its 54 patients, the hospital's staff consisted of two Physicians Dr. Stokes, as the "President Physician," and another physician, the "Executive Officer" , twelve nuns, three additional male staff members, and three additional female staff members.

The Sisters of Charity and the other female staff members were each paid five dollars a month. The male staff members were paid ten dollars a month. Roughly synonymous with what today might be a diagnosis of Schizophrenia or Manic Episode. Obsession with a single, often paranoid idea. The term "idiocy," not unlike terms such as moron, imbecile and lunatic, did not have the pejorative meaning in that it does today.

In the hospital was again renamed, this time to "The Maryland Hospital for the Insane," one year before the General Assembly passed legislation that specified that the Maryland Hospital was only to accept psychiatric patients. Two years later, in , the connection between the hospital and the Sisters of Charity was severed, following what evidently was a power struggle between the Sisters of Charity and the hospital's resident physicians.

According to a number of sources, the disagreement was over the fact that the Sisters refused to recognize that the decisions of the hospital's physicians were "supreme" in all clinical and administrative matters. Following the departure of the Sisters of Charity, the Hospital engaged a matron and a number of nurses to replace them. The Sisters of Charity went on to establish another psychiatric facility, known as the "Mount Hope Retreat," which later became the Seton Institute. An interesting footnote is the fact that the Sisters of Charity were later accused of using the Mount Hope Retreat to "unlawfully imprison" and torture patients.

This accusation was made in the literary work, The Cornets: or the Hypocrisy of the Sisters of Charity Unveiled , a book that supposedly described the author's personal experiences while confined as a patient to the Mount Hope Retreat. Such claims must be considered within the context of the growing anti-Catholic sentiment of the era, and must also be balanced against historic evidence of the many selfless acts of the order. Despite the new construction and other improvements, by the facility had become badly overcrowded.

webdisk.cmnv.org/939.php On April third of that year, the General Assembly passed an act that required the Maryland Hospital to be "devoted exclusively to the treatment of lunatics. This same act required that "one-half of [the Maryland Hospital] However, the expansions and other changes did not allow the facility to keep up with demand, and overcrowded conditions continued. In , the hospital's name changed again, at least informally, this time to The Maryland Hospital for the Insane at Baltimore.

According to hospital records, during an 11 month period in some 43 patients were admitted to the Maryland Hospital; 39 patients were discharged from the hospital; and six patients died. On November 30, there were patients 80 males and 73 females at the Maryland Hospital; of these, 88 were private paying patients, and 65 were public patients.

An annual report of notes that of those patients who were discharged in that year, the large majority were private patients. By way of explanation, the report points out that the illnesses of the "public" patients tended to be significantly more chronic than those of the "private" patients.

Although certainly not suggested in the report, an alternative explanation for the much higher "cure rate" for the private patients could have been , of course, that they may very well have received better care and treatment than the public patients -- and, just like today, the private patients were probably more likely to have had housing available to them in the community.

Records from the period indicate that a number of children were admitted to the Maryland Hospital, although most patients were adults. Enoch Pratt was among the distinguished local citizens who were affiliated with the Maryland Hospital in its early days. Records indicate that the well-known philanthropist and founder of Sheppard Pratt Hospital served as a member of the Maryland Hospital's Board of Visitors from - It has also been noted that Mr.

Pratt donated, in addition to his time, several gifts to the Maryland Hospital over the years. For example, he reportedly donated billiards tables in the years and Among his other gifts was a piano. Various improvements were made to the Maryland Hospital during the s and s. For example, the Hospital had installed gas lighting fixtures by The Hospital's annual report of notes that running water in the bathrooms and water closets flush toilets were added to the West Wing of the building, and the hospital was connected to the Baltimore City public water system.

The old heating system that had included 13 separate hot air furnaces and five coal stoves, was replaced in or around with a single hot water heating system -- an improvement which was cited as resulting in significant improvement in both comfort and safety. Entrance in Dorothea Dix, the outspoken advocate and crusader for the mentally ill, pointed to the inadequacy of the bed capacity of the Maryland Hospital for the Insane in her impassioned address before the Maryland General Assembly.