Existing comment:
Custodial Care Regime (1862-1885):
In the late nineteenth century, the hospital grew in size but the percentage of patients successfully treated declined. Lacking confidence in its ability to cure and without a clear sense of direction, the hospital became a long-term home for the chronically ill.
In 1885, fire destroyed the original hospital building. Other asylum structures remained on this site until the late 1960s when the hospital moved to new facilities at the edge of town.
A Road Not Taken:
In the late 1850s, Superintendent Galt attempted a thorough reform of the mental health care system in Virginia. His goal was to return convalescing patients and harmless chronic inmates to the community. He wanted such patients to board with local residents, live on a nearby state-run farm, or work in town during the day but sleep at the hospital at night.
In 1877, a new superintendent, Dr. Harvey Black, reintroduced Galt's proposal. In neither instance was the plan endorsed by either the Board of Directors or the state legislature. The proposal was one hundred years ahead of its time.
Institutional Drift:
After the Civil War, the hospital staff steadily lost confidence in its ability to cure victims of mental illness. In 1876, the asylum "restored" only 31 of 377 patients. A year later, the superintendent reported fewer than 7% of the hospital's residents had a favorable chance of being cured.
Increasingly, insanity was considered a hereditary problem or a physical disease which defied solution. The reappearance of mechanical restraints further signified the staff's frustration, exasperation, and bewilderment.
The asylum was gradually become a facility to for the chronically ill.
Custodial Care:
In 1882, the asylum dedicated itself to a program of custodial care. Instead of giving priority to acute cases with a good probability of being cared, as Superintendent Black wanted, the Board of Directors and the state legislature insisted that the hospital admit patients on a first-come, first-served basis, regardless of their chances of recovery.
Dr. Black was replaced b a new superintendent, Richard Wise, who declared, "I feel that it is our duty to fill every bed and corner that we posses with these unfortunates." Wise made good on his promise. Within four years, between 1879 and 1883, the patient population increased from 323 to 447.
A Maintenance Program:
During the era of custodial care, several recreational programs were inaugurated, including magic lantern (slide) shows, fighting excursions, picnics, tea parties, theatrical performances, and diverse games. The staff also stressed the importance of physical labor as a means of occupying hospital residents. Patients were encouraged to clean the institution, work in the recently opened blacksmith shop, and do chores on the newly acquired farm.
Basic institutional maintenance was an ongoing problem. The hospital had to be repeatedly painted, refurnished, repaired, and modernized. In 1875, the superintendent reported, "A person who has not had practical experience in management of an insane asylum can form no idea of the amount of repair necessary to keep an institution of this kind in good order."
The End of an Era:
On Sunday night, June 7, 1885, fire -- probably electrical in nature -- consumed the original hospital building. Several other asylum structures were destroyed that night. One patient died. Two were missing and presumed dead.
Modern buildings replaced those destroyed, and the hospital remained on this site until the late 1960s when it moved to new facilities on Ironbound Road. Shortly afterward, the old complex was razed.
During the hospital's existence on this site, staff members failed to discovered "the cure" to mental illness, but some of their efforts laid the groundwork for future programs, policies, and innovations.
Today, commitments to compassion and science are at the foundation of mental health care. Also Galt's vision of decentralized, community-based treatment programs reemerged in the second half of the twentieth century and is now a prominent (but still controversial) feature of mental health care in the United States. |