Lunatic, Idiot and Epileptic Asylum

Date: 1842
Location: Milledgeville, Baldwin County, Georgia
Surnames/tags: mental_illness asylum institutions

Contents 1 History 2 What actually happened 3 Positive Outcomes 4 Sources

History

• In 1837, in response to a perceived need to provide care for citizens who were indigent and/or unable to care for themselves, Georgia lawmakers authorized a "Lunatic, Idiot, and Epileptic Asylum". ^[1] Five years later, in 1842 the hospital opened in Milledgeville, the state capital at that time. There is information available through Wikipedia that presents the basic history of the hospital. However, this did not address some of the abuses that took place in that institution.
• At the beginning, the hospital was called the Georgia Lunatic Asylum. It began on a forty acre campus, located south of Milledgeville near Midway. Subsequently, it expanded to 1,750 acres. The first superintendent was Dr. David Cooper, who was also one of the hospital trustees. In 1898, the institution's name was changed to the Georgia State Sanitarium, then to the Milledgeville State Hospital in 1929 and finally to Central State Hospital in 1967.^[2]
• The hospital was under the supervision of the State Welfare Department.

What actually happened

• Originally, patient care was based on the "institution as family" model where the patients were organized into family like groups and were treated humanely. But as the hospital was successful, the patient population increased and evolved from acutely disturbed to chronically ill and organically disabled so was primarily custodial.
• In 1872 the hospital had a ratio of 112 patients per physician, a number that would not improve for almost a century. Central State underwent a dramatic increase in patient population during the second half of the century, when local communities began sending unwanted or problematic residents to the asylum, regardless of their diagnoses. ^[3] In 1897 the hospital changed its name to the Georgia State Sanitarium.
• The patient population grew steadily throughout the twentieth century. The increase in numbers resulted in a concurrent decrease in the quality of care. The overwhelming number of patients also led to a pattern of conscious neglect, whereby hospital staff met the basic daily needs of their charges but were unable to provide appropriate treatment for their illnesses. Such interventions as insulin shock and electro-convulsive therapy occurred in massive numbers until the coming of chemical intervention, which in lieu of staff increases helped reduce the patient load of nearly 12,000 during the early 1960s. In 1967 the facility was renamed to its current title of Central State Hospital. ^[4]
• Compulsory Sterilization laws were adopted in over 30 states between 1934 and 1945. These laws were directed to individuals with a disability: mentally disabled or ill or belonged to social disadvantaged groups. About 3,284 people were sterilized in Georgia by the end of 1963. 77% of those were deemed mentally ill. The most prominent "feeder institutions" in Georgia were Milledgeville State Hospital and the Georgia Training School for Mental Defectives. ^[5]
• Experimentation with unlicensed drugs without consent. This was not a widespread practice but was found to be happening in CSH. Initially the Fulton County Medical Society defended the practice. They did not feel it necessary to obtain consent because families were not familiar with the patient's needs. Fortunately the Governor, prevailed and strict rules were put in place to protect the rights of the patients. ^[6]
• Dangerous lack of staff providing care and oversight to patients - 15 doctors to care for 5,200 patients (1929) with a per capita expenditure for patients 64 cents per day. ^[7]
• Some of the staff, including physicians, were not appropriate in the position of caring for and overseeing these vulnerable patients. It was reported that at least 25% of the medical staff were involved with alcohol or drugs while on duty. Some doctors were hired as staff after being dismissed as a mental patient. When this was exposed in 1959, 14 of the 48 doctors did not have a Georgia medical license.^[8]

Positive Outcomes

• In 1959, the Atlanta Constitution reporters did an in depth investigation that served as a catalyst for self examination and changes at the facility after it was printed in March, 1959. Some of the significant changes are listed below.

  The Governor created a Division of Mental Institutions in the State Department of Public Health.

  It was required that the person in charge of the hospital be a qualified psychiatrist.

  Qualified psychiatrists were hired to care for the patients.

  Standards were established for administering experimental drugs to any patient.

• The Central State Hospital is currently providing psychiatric evaluation; treatment and recovery services for referrals from the state's criminal justice and corrections systems (Forensic Services) and community residential homes for individuals with behavioral health disorders.^[9].

Sources

1. ↑ Monroe, Doug. Asylum: Inside Central State Hospital, once the world's largest mental institution. Atlanta Magazine. 18 Feb 2015.
2. ↑ Graham, Paul K. Admission Register of Central State Hospital, Milledgeville, Georgia, 1842-1861,
3. ↑ Graham, Paul K. Admission Register of Central State Hospital, Milledgeville, Georgia, 1842-1861. Decatur, Ga.: The Genealogy Company, 2011.
4. ↑ Graham
5. ↑ https://www.uvm.edu/~lkaelber/eugenics/GA/GA.html
6. ↑ Britton, Gene. "Doctors Offer to Quit, Get Vandiver's Pledge". The Atlanta Constitution, 07 Mar 1959, Sat. Page 5
7. ↑ Clarke, Edward Young Jr. The Atlanta Constitution (Atlanta, Georgia). State Sanitarium, Georgia’s Noblest Charity. 30 Nov 1902, Sun. Page 9.
8. ↑ "Alcohol, Drug History is Found in 25 Pct. of State Hospital Doctors". The Atlanta Constitution (Atlanta Georgia), 06 Mar 1959, Fri. Page 1
9. ↑ https://dbhdd.georgia.gov/central-state-hospital-milledgeville