20th vs. 21st Century Understandings of Mental Health: Exploring the California State Archives
In this post, we hear from a Dunn Lab Undergraduate Student, Kristina Jacobsson. Kristina is a rising Junior at Harvard Collegeconcentrating in History of Science with a sub-field in Psychology. Before joining the lab, she interned with The Global Bioethics Organization, where she studied and helped to educate the public on bioethics. Kristina is passionate about issues in children’s health, and particularly how these issues can impact people into adulthood. Kristina shares highlights from her recent trip to the California State Archives where she analyzed historical records on the institutionalization, treatment and rehabilitation of people with mental illness in the 20thcentury. With this post, Kristina hopes to shed light on the importance of understanding the science and society of our past to improve the way we diagnose and treat mental illness today and in the future.
As an undergraduate studying the History of Science at Harvard College, I have learned the value of researching the science of the past. I have become proficient in analyzing records ranging from objects, to archives, interviews, and films. I’ve learned that these records have a unique task of illuminating how science and knowledge was approached in the past. Moreover, these scientific practices reflect the values and perspectives of the society at the time. In this way, the history of science can help us learn about the science and society of the past, but also it can help us better understand how that science is implemented in society today.
A few weeks ago, I travelled to the California State Archives to study the history of mental illness in California. The archives, established in 1850, are home to thousands of records that detail the history of California and its people. Although many archives have digitized their records for online access, this was not the case for the California State Archives. Due to the vast amount of records, hardly any of them have been digitized and many are restricted for public access. This meant I had to go in person, so away I went!
At the archives, I investigated the institutionalization, treatment, and rehabilitation of “defectives” in California. Believe it or not, that is the label applied during the 20th century to people who were mentally ill, poor, or from racial minority groups . Many of these people were inhumanely institutionalized in state mental hospitals. Reasons for institutionalization lie in the American eugenics movement, which was a popular 20th century belief system that applied Darwin’s theory of natural selection and Mendelian genetics to human acquired traits. Lead by wealthy white men, this movement tried to stop marriage and procreation between “unfit” individuals. Although scientists began to discredit eugenics in the mid 20th century, it had already become ingrained in society as cutting-edge science used to justify discrimination and racism. Therefore, many people who experienced mental illness were relegated to institutions, and many minority groups were labelled as having mental illnesses so that they would also be involuntarily placed in these institutions.
To learn more about this history, I analyzed state hospital records from the Department of Mental Hygiene. The Department of Mental Hygiene was established in 1945 and lasted into the late 20th century with the goal to provide people with psychiatric disabilities with treatment and rehabilitation and to educate communities about “mental hygiene.”
In these records, I was surprised to discover three themes, which made clear similarities in how mental illness was understood and researched in the 1900s as compared to today.
1. Mental illness was widespread and costly.
Despite the great differences between who was labelled as having mental illness, and how mental illnesses were diagnosed, the records indicate that mental illnesses were extremely prevalent across the population. State hospitals, for example, often cited a great amount of overcrowding.
2. There was a desire to treat and rehabilitate people with mental illness.
A pamphlet from a hospital superintendent who described the hospital’s mission to the relatives and friends of the patients, opened with the sentence, “those of us who are responsible for the care and treatment of hospitalized patients see them as individuals like ourselves who can, through better understanding and treatment, be brought back in most instances to useful living.” Although the language of returning to “useful living” is problematic and does not fit with today’s understanding of mental illness, the message holds true. Today, so many families and friends yearn to support their loved ones who experience mental illness and hope that they receive the care and treatment that they deserve to live their lives to the fullest.
3. There was an emphasis on community engagement and education around mental health.
To my surprise, there was a great emphasis on the role of the community in preventing and supporting individuals with mental illness. One report, for example, described the desire to expand mental health services beyond state hospitals to new, local clinics. These clinics would provide people with psychiatric disabilities considered low-risk who would otherwise go to a hospital, with short-term treatment. They would also provide educational services to educate communities on mental illness prevention and care.
Overall, the study of mental health has increased dramatically in recent decades. Large strides have been made to better understand the etiology, diagnosis, and treatment of mental illnesses. However, the history of mental illness is not limited to these recent discoveries and we still have a long way to go to reduce the burden of mental illness. I am grateful for the opportunity to step back into the past and learn more about the history of mental health and how this science reflected the society of the time. I hope to take this more nuanced understanding forward into my modern-day research on mental health.