UC Berkeley

The Death of the Asylum: How Federal Policy, Popular Culture, and Drugs Killed the American Mental Hospital (1940-1946) is a historical study of three interwoven elements that led to the end of asylums or psychiatric institutions in mid-20th century America. The dissertation is an interdisciplinary project that brings together methodologies from the history of architecture, psychiatry, and law to tell the story of the extinction of an American institution and building type. The work argues that 1946 was a pivotal year for the beginning of “deinstitutionalization,” defined as the phasing out of institutional treatment of mental illness in asylums established in the late 19th-century and towards an outpatient medical model. This shift fundamentally altered the profession and practice of psychiatry.The first chapter explores the legacy of journalistic exposés and literature starting in the late-19th century by writers who were hospitalized for feigned or real mental illness. These writers, such as Nellie Bly and Mary Jane Ward, used their experience in the asylum to write books and articles that chronicled their often-shocking journeys and critiqued the treatment they received. The chapter begins with a historical overview of the original ideals and humanitarian intentions of the 19th-century asylum. A new architectural typology in the late 1800s, this building type was rooted in the healing power of nature and the built environment. This historical and architectural exposition provides a stark contrast to what became of asylums by the mid-20th century, which the conscientious objectors of Chapter 2 sought to change. The chapter then primarily analyzes Ward’s popular novel The Snake Pit (1946) and its Hollywood film adaptation (1948), and Ward’s courageous but costly involvement in mental health reform. The second chapter begins in 1940 with the Selective Training and Service Act to tell the story of the four conscientious objectors who created the Mental Hygiene Program of the Civilian Public Service during World War II. I argue that these leaders—Leonard Edelstein, Hal Barton, Phil Steer, and Will Hetzel—changed the trajectory of mental health treatment in the United States through their activism. After being assigned to work in understaffed asylums as part of their alternative service because of their pacifist beliefs that protested the war, these conscientious objectors led a movement to document widespread abuses among hundreds of mental hospitals, analyze existing mental health commitment laws, and educate and retrain future employees of mental hospitals.The final chapter follows the career of journalist and wartime correspondent Albert Q. Maisel, who worked with the conscientious objectors in Chapter 2 who had formed the National Mental Health Foundation at the conclusion of World War II. In partnership with the conscientious objectors, Maisel procured eye-witness testimonies and haunting photographs to write a scathing and damning exposé article titled “Bedlam 1946,” which was published in Life Magazine on May 6, 1946. The chapter concludes with the National Mental Health Act (NMHA), which was signed into law by President Harry Truman on July 3, 1946. The Act funded the creation of the National Institute of Mental Illness (NIMH), catalyzed the development of psychopharmacological treatment, and was the final nail in the coffin for the American asylum. Through archival research, this dissertation demonstrates how, in 1946, the dream of the curative mental asylum was over.