Tuesday, March 1, 2016

The Asylum Chronicles: A brief look at the Insane Department of the Erie County Poorhouse during the Mid Nineteenth Century

Erie County Poorhouse Insane Asylum by Robert J. Higgins

Research for the next installment of the Orphans and Inmates series has lead away from the cholera hospital and directly into the insane asylum.  The Erie County Poorhouse, like all early institutions of its kind, always served those persons considered to be insane. Much like cholera in the early to mid nineteenth century, insanity reached epidemic proportions in New York as the century progressed and the evolution of institutionalization and treatment in the state is as complicated as it is fascinating.  This particular essay will serve as a window into the asylum in the middle decades of the century.

One must tread with care when looking back in time and not judge the actions and opinions of others by the standards of today.  I can think of no better advice for the scholar of nineteenth century institutions.  Certainly there were times when the treatments were barbaric for those determined to have diseases of the brain, or diseases of the mind.  There were many discussions in the medical literature while physicians were trying to understand the difference between the brain and the mind and whether a diagnosis of insanity could be treated in the manner of other physical ailments. However, this dialogue was a giant leap forward from the idea that insanity was the result of a curse or demonic possession.

A movement toward improved treatment of the insane began in New York in the middle decades of the nineteenth century with the heroic efforts of Dorothea Dix, who witnessed first hand the deplorable conditions under which many insane inmates lived.  Since their doors opened in the late 1820's, the  poorhouses of New York state were the primary refuge for the indigent chronic insane. These institutions quickly became overwhelmed with a diverse population of people in need, and the care of the insane was just one of many issues administrators found they were ill equipped to manage.  

Prior to the Willard Asylum Act of 1865, patients sent to the State Lunatic Asylum in Utica were transferred to the poorhouse in their home county if they could not be cured within two years. The Willard Asylum Act was passed requiring the removal of all patients with a diagnosis of insanity from poorhouses across the state.  Those thought to be curable would be sent to the State Lunatic Asylum in Utica and those considered incurable to the new Willard Asylum for the Insane in Ovid.  However, The Erie County Poorhouse was one of several poorhouses in New York that were exempt from this law because they had suitable facilities and continued to house insane patients there until 1896.  

At the first location in Black Rock (1829-1851) there was a separate building for the insane, but no details have been uncovered regarding when it was built or how it operated within the larger institution.  The specific treatment of this sub-population in the beginning of the poorhouse's history is difficult to determine because the records for this period are not very detailed.  The poorhouse system was designed to be a self sustaining farm where the inmates contributed to the production of food and the upkeep of the facility.  However, a good portion of the population was unable to work and often the majority of the chores were carried out by the insane patients.  These individuals worked the gardens, the kitchens, and the laundry.  They quarried stone, dug ditches, made clothing and whatever else needed to be done.

The Erie County Poorhouse moved to the Buffalo Plains location in 1851 and also included a separate building for the insane.  The inventories submitted by the keeper of the asylum suggest that restraint was often used, as straight jackets, handcuffs, restraining chairs and padlocks were consistently counted among the other items in the asylum.  No treatments were detailed in the hospital records, however, regular work for those who were able, fresh air and exercise were indicated in the municipal reports.  

The Keeper's Report for the Erie County Poorhouse, submitted annually to the Erie County Board of Supervisors, suggests that in 1872 the asylum was becoming overcrowded.  The Keeper of the poorhouse, the attending physician and the Superintendent of the Poor expressed concerns over the dangers of having two to three patients confined in a cell meant for a single occupant. Additionally there was a temporary shed that had been built some years before to accommodate the ever increasing number of inmates which was still in use and in a bad state of repair.  One of the chief concerns about the continued use of this structure was that it was ill equipped to keep the inmates warm during the winter months.

Funds were requested to enlarge the asylum and repair its roof. Enlargements or modifications to the insane house were completed in 1874, 1877 and 1879, and addressed issues such as poor lighting and ventilation, weeping walls, cramped cell size, lack of facilities for bathing and inadequate water supply.  The modifications included a dormitory style sleeping area in addition to individual cells, which would reduce expenses in addition to providing superior ventilation and light.

In the report of 1876 the Chairman of the Board of Supervisors reiterated many of the same concerns mentioned by asylum administrators, and added to them the fact that there was no separate hospital for the inmates of the asylum. Inmates who experienced illness or injury were transferred to the general hospital department, often causing disruption among the staff and other patients.  In 1878, the Commissioner of the State Board of Charities, Eighth Judicial District, also expressed concerns about a separate hospital.  He reported that although a hospital ward was added as part of the administration building, it had been converted to dormitories when the asylum again became over crowded,  requiring patients, again, to be transferred to the general hospital department of the poorhouse.

                                    Floor Plan of the Insane Department of the Erie County Poorhouse* 

The Erie County Board of Supervisors were very critical of the running of the poorhouse in the early years of the 1870's and in 1874 investigated the administrators and staff members who held positions in 1871, 72 and 73.  A resident physician testified that liquor was purchased for use in the hospital and the insane asylum. The purpose for offering liquor to the inmates is not clear: "...it is given to those insane men who will be benefited by it and who labor on the farm; it is given to them three times a day; such as is used at the insane-house is obtained by the keeper; I have nothing to do with giving it out..."

Also evident from this testimony was that inmates of the poorhouse were employed as domestic laborers in the insane department and paid a small wage.

Report from the Committee on the Poor Department.  From the Proceedings of the Board of Supervisors of Erie County, 1874.
My sense of this period from the municipal reports is that living conditions in the insane department of the Erie County Poorhouse were often less than ideal.  However, asylum administrators, county officials and the State Board of Charities were actively trying to remedy them.  Confounding factors included money (always), the ever increasing number of inmates, and a poor understanding of the nature of mental illness.  The latter most certainly impacted the growing inmate population and will be the next installment of the Asylum Chronicles so stay tuned! 

*from the Report on the Chronic Insane In Certain Counties Exempt by the State Board of Charities from the Operation of the Willard Asylum Act, 1882.