Overview of Mental Health in New York and the Nation

Colonial Period– Mid 1840s

Family care and custodial care provided by local poorhouses and almshouses predominated.  Caregivers were influenced by by Calvinist views that mental illness resulted from sin.

  • 1806 The State provided for the poor and indigent insane by enacting legislation for $12,000 for 50 years to go to the New York Hospital, the single corporate hospital designated to care of the institutional insane. Demand rapidly exceeded capacity.
  • 1809 The State allowed any town or municipality to contract directly with the governors of the New York Hospital for care of insane persons within its jurisdiction.
  • 1816 The State provided an additional fifty-year annuity of $10,000 annually to New York Hospital for additional construction. This facility built with these funds became the Bloomingdale Asylum.
  • 1821 Bloomingdale Asylum opened. It used moral treatment and was devoted exclusively to the care of the insane. At this time, most mentally ill people were still housed in poorhouses.
  • 1827 An "Act Concerning Lunatics" forbade confinement of insane persons   in prisons or houses of correction.

1840s-1890s:  Era of the Asylum

The number of penitentiaries and orphanages rose. The belief that mental illness was treatable grew in popularity. Causes and cures were seen as rooted in environmental and psychological factors. Moral treatment was the most popular form of therapy.  Moral treatment was influenced by  social norms, religious beliefs, medical expertise, scientific theory and demographic characteristics, and key components included:

However, asylums were prey to excessive overcrowding and, as the century progressed, biological theories of mental illness became increasingly popular.

Early Twentieth Century:  Progressive Reform

Progressive Era reformers believed that mental illness was the product of environmental factors and that it was both preventable and progressively serious.  These beliefs gave rise to the Mental Hygiene Movement, which as characterized by the psychopathic hospital, child psychiatry and outpatient clinics.  All of these innovations were intended to prevent the emergence of mental illness or to provide early treatment designed to avert serious mental disorder.

1945 – 1960: Policy Revolution

1960s-90s: Community Mental Health

The community mental health movement was buoyed by successes of drug treatments. Noting the failure of hospitals to integrate patients into the community, proponents of community mental health called for the dismantling of the state hospital system..