Think of me

The Public Hospital for Persons of Insane and Disordered minds, Colonial Williamsburg, VA, was the first mental hospital in America. The Hospital admitted its first patient in 1773. It had 24 cells, which were not all filled until the 1800s. James Galt, formerly the keeper of the Public Gaol, was appointed head administrator.

This was the era of Restraints. The hospital had two missions. One, to cure the 'curable', and two, to confine the dangerous. The tools used to meet this purpose included a few medications, such as paregoric, ipecac and laudanum, certain old standards such as bloodletting, and free use of metal restraints.


The hospital closed down in 1781 due to wretched conditions, and reopened five years later with more innovations, including a fenced exercise yard. In 1793, the hospital acquired its first electrostatic machine, to 'shock patients out of their illness.'

The hospital acquired new physicians including John Minson Galt, and continued to expand into the next century. In the 1840s, the Moral Management approach came about. Attempts were made to humanize the treatment methods and the living conditions.

The hospital was renamed Eastern Lunatic Asylum, a place of refuge for people unable to survive in the outside world.

This was also the era of Phrenology, or the study of the form of human brain to determine character.

 In 1841, the hospital acquired a new electrostatic machine.

In the Moral Management era, a non-restraint approach was pursued as far as possible, and patients were often 'rewarded' for good behavior. Treatment became more specialized, and the doctors were devoted to their patients full time.

John Minson Galt II, with twelve other superintendents of lunatic asylums across the US, formed the Association of Medical Superintendents of American Institutions for the Insane, a forerunner of the APA. They also published the country's first psychiatric journal, The American Journal of Insanity.

The 1850s saw several changes under the supervision of John Minson Galt II. He publicly declared that the mentally ill were 'our brethren', started accepting slaves in the hospital, and proposed an overhaul of the system, suggesting placement of the mentally ill in the community as boarders. He was a man ahead of his time, and his plans were not well received.

The treatment of the mentally ill still centered around sedatives, and increasing use of Morphia frequently led to chronic constipation.

In 1862, the Union army took over and the hospital was sacked. It was repaired and re-expanded in 1868. African American patients were segregated to a facility in Richmond. This was the era of Custodial Care. Patients were encouraged to get physically active and worked to maintain the hospital. The hospital housed about 300 patients.

Gradually, the hospital became more a facility for the chronically ill, with fewer and fewer people being 'restored to community' each year. The era of restraints came back.

 In 1885, a fire destroyed most of the hospital. The hospital was rebuilt, renamed the Eastern State Hospital and moved to a new location in 1937. It housed almost 2000 patients at this time. The old building was razed down in 1960.

A ceramic cup belonging to one of the patients was recovered by archaeologists during the site's excavation in 1972.
It said, simply, ' Think of me.'

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About purplesque

Psychiatrist, cook, bookworm, photographer. Not necessarily in that order.
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7 Responses to Think of me

  1. scorpion1116 says:

    How wonderful for you to have to opportunity to take a look back to the some of the origins of your profession! I find this all very interesting, and thank you for sharing. I do not have a medical degree of any kind, but I spent my teenage years as a CNA, and many of my adult years as a Licensed Nursing Home Administrator. In one of my "poorer" facilities, a 60-bed facility in the worst part of town, we were often used as a placement facility for the state mental institution for those residents whose age and infirmity became more of a concern than their mental illness. At one point I had 18 schizophrenics, and 2 of the 10 surviving people in the country who had undergone frontal lobotomy as a treatment for mental illness.
    I started my career as an Admissions Coordinator, so it became part of my job to read charts, evaluate Rx and Dx, and assess the hospital patients for appropriate long-tern care placement. I continued to do this part after I became an Admin. Many times I had to visit Central State Mental Hospital to evaluate a geriatric resident. It was a very old facility that had been "Band-Aided" somewhat to employ a few more humane practices and newer security technology, but you KNEW where you were when you stepped through the threshold, and the 100-year-old misery of the maltreated still seeped through the walls and hallways.
    I was always happy when a geriatric resident was able to transfer to my facility. We had a loving staff who believed in patient dignity, and an Administrator who recognized that this would be their last stop in this place called Earth, and was determined to provide them with better days, better meals, a comfortable bed, and some sunshine of their faces.

  2. Purplesque says:

    Thank you for sharing that. I've always wondered what the long-term care facilities are like, and am waiting for an opportunity to go see them in person. There's nothing better than working at a place where you feel gratified at the end of the day, no matter how rough it has been. I'm still new to the field, and its hard to deal with the sicker patients with bad prognoses. The strength it must take to take care of the sickest of the still amazes me.

  3. Aubrey says:

    A fine, carefully done historical piece, brought home to the heart and mind by those two final, devastating sentences.

  4. Purplesque says:

    Thank you. That cup was at the very end of the exhibit that we saw..that's when I knew I wanted to share it here.

  5. Lakshmi says:

    I think psychiatrists are the strongest of all human beings. To deal with physical illness takes commitment. To deal with diseases of the mind requires extreme grit. Kudos.

  6. Purplesque says:

    Thank you, though I'm afraid its a little early for kudos. I'm still at the fledgling stage, and while I love what I do, the fear of not having enough grit is always there. It gets better each day. p.s. Your new year resolution seems to be going strong!

  7. gregsmithmd says:

    Excellent. Love this history. Thanks for the great post and pictures.

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