Is there anything to learn from the history of asylums? My students said yes.
Art therapy, nature-based-therapy, and physical-activity-based therapy were all featured in historic asylums.psychiatric asylum with my colleague, Dr Hannah Proctor.
"Bedlam and Beyond: The Controversial History of the Asylum" is a seminar-based class where students explore why asylums emerged, what happened in them, and why they began to shut down during the second half of the 20th century. During the course of the year, we also discuss a whole range of controversies, including why people ended up in asylums, how they were treated, and whether asylums were a force for good or ill in society.
For the most part, people view asylums with suspicion. They are often depicted in film and television as places where unusual or evil things occur, providing the setting for many horror films. But, as we learn in the class, that was not the entire story. Asylums were a product of theand were founded in the hope of improving the lot of the mentally ill, many of whom were homeless, imprisoned, or kept at home in varying conditions.
Most asylums were state-funded, marking one of the first examples of public healthcare. And numerous forms of, were offered to patients as forms of moral therapy. All of these approaches to improving mental health are acknowledged today as being beneficial. We wanted to encourage the students to think about the lessons that emerge from asylum history, rather than condemning them to the history wastebasket, so we assigned them a group project called"Build a Better Asylum.
" Taking what they had learned about the history of the asylum, as well as the current challenges facing the mental health system, they were tasked with creating an asylum fit for the 21st century. They definitely did not let us down. The asylums students envisioned balanced the good things about asylums with the bad. Asylums were often run in a very top-down fashion, with the medical superintendent being in charge of all major decisions.
Patients did not tend to get much of a say in terms of treatment, how their days were structured, what they were free to do, or where they could go, let alone what kind of medical treatment they would receive. The vast majority of asylum staff also had very little say inOur students decided, therefore, that their"better" asylums should be run much more democratically.
Patients should have much more of a say in all aspects of their lives and how the asylum is run. They should be involved in a significant amount of decision-making, especially with respect to things like, clothing, interior design, and even the design of the asylum and its grounds.
In addition, patients should, as much as possible, consent to treatment. Similarly, occupational therapy was widespread in many asylums. As Kylie Smith has shown in the case of, often such activities were nothing more than free labor, only a few steps removed from slave labor in fact. But in other asylums, patients had more of a say in what they were able to do.
Our students argued that patients should be offered work opportunities, but should be free to select the sort of work they wanted to do based on their skills and interests. Since a good, meaningful job can contribute to good mental health , such opportunities could pave the way for employment outside the asylum for patients.
For example, a great deal of the work in asylums was agricultural work, intended to provide food to patients and staff. While some such work was exploitative, the students' research at the archives of the Stirling District Asylum and, specifically, on the asylum magazine,, indicated that some patients really enjoyed such work, especially rearing animals. They argued that animals could play a key role in improving the well-being of patients and aiding their health in other ways.
Some of the groups also recommended many of the therapies employed in historic asylums, including art therapies, physical activity, and nature-based therapies — including swimming, which relates to the use ofin asylums. Although drugs would play a role, they should be more of a last resort and not take the place of talking therapies and other non-invasive approaches.
Many students argued that asylums should be smaller in scale, housing a few dozen patients, rather than hundreds or thousands, as was the case in the past. They also thought that the doors of the asylums should be open as much as possible, bringing both the community in and allowing patients out. One group recommended having a community café as a way of facilitating engagement with the outside world.
Others pointed to historic sports days, picnics, and Highland Games held by institutions of the past as a way of integrating asylums and the broader community. In addition to having spaces for sport and physical activity, which many historic asylums had, the students'"better" asylums would also boast another feature of their predecessors: beautiful grounds. Nature, they argued, could play a crucial role in the lives of patients and their recovery.
Similar arguments were made in the past, and this is why asylums, such as, were situated in such beautiful settings. Indoor plants were also used in many asylums in order to brighten up patients during the dull, dark months of winter.
Finally, the students thought that the role of the asylum should not be over when the patient was able to leave. Asylum staff should also be involved in helping patients reintegrate into the community. In turn, patients would be encouraged to drop in for support when necessary. Above all, asylums of the future would have to live up to the true definition of the word: a place of sanctuary.
Whether there is a place for the asylum in the 21st century remains to be seen. Either way, our students would argue that many features of historic asylums deserve reconsideration as we think about new ways of dealing with mental illness that are truly fit for the 21st century.
I would like to thank Rosie Al-Mulla-Taylor at the Stirling University Archives, Jennifer Challinor at the Crichton Trust, and Anne Rinaldi at the Ewart Library for the support they provided to our students. The Best Ways to Begin AgainSelf Tests are all about you. Are you outgoing or introverted? Are you a narcissist?
Does perfectionism hold you back? Find out the answers to these questions and more with Psychology Today.
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