Michael Rembis, a visiting scholar in UB's Department of History and the Center for Disability Studies, specializes in the history of disability and eugenics in the United States. His new course, entitled Madness in America, examines the broad range of approaches to mental illness and the many wrongs committed in the name of curing people of their "insanity."
Twenty-two undergraduate and graduate students are enrolled in the course this semester. One goal of the course, Rembis says, is for students to realize that the history of mental health was not one continual march toward "progress," but was affected by the social, cultural and scientific trends of the time.
"The number of Americans being medicated for 'mental illness' has increased dramatically in recent decades and it has been estimated that half of all Americans will experience some form of mental illness during their lifetime."
"I hope that my students will realize that the history of madness in North America is a critical but vastly understudied area of our collective past," says Rembis.
The new course on the history of madness will be part of a new interdisciplinary master's degree program in Disability Studies, which will admit its first cohort of graduate students in the fall 2011 semester. The new MA program is offered through the UB Center for Disability Studies and is administered by Rembis and by the center's director and UB Distinguished Professor of History, David A. Gerber.
One of the first laws enacted in the early American colonies pertaining to the care of "distracted" persons was passed in 1676 in Massachusetts, explains Rembis. It required town authorities to care for such people so that they would not "damnify" their neighbors. Similar laws, such as Connecticut's 1699 "Act for Relieving Idiots and Distracted Persons," were soon passed in other colonies.
The Pennsylvania Hospital, the nation's first that accepted the mentally ill as patients, opened in 1751. The citizens of Philadelphia would visit the hospital to view the insane, who were housed in cells in the basement. Going to view the insane became such a popular pastime that in 1762 the hospital began charging an admission of four pence.
"Before the emergence of moral treatment in the early 19th century, 'lunatics' in madhouses in Europe and the United States had been kept in dank, gloomy, foul-smelling cells, with little light and no heat. They were watched over by keepers, who used whips, chains, hand-cuffs, ankle-irons and Madd-shirts," says Rembis.
And treatments such as these have certainly captured the attention of Rembis' students.
Danielle Blahowicz, a junior at UB majoring in history and Spanish, enjoys having previously dark corridors of American history illuminated by the course.
"I've learned so much about the conditions, abuses and treatments of the asylums," says Blahowicz.
"Also, we have often touched on many other issues of institutionalization: whether it is the overcrowding, the lack of funds to support the hospitals, the lack of staff or the lack of scientific knowledge to know how to cure or treat mental illness. Essentially, there was no real cure for mental illness."
The lack of a cure for maladies of the mind didn't prevent people from coming up with cruel and unusual methods to alleviate the afflicted of their insanity.
Early medical practitioners believed that insanity was caused by abnormal blood flow. Madhouse inmates were subjected to excessive bloodletting, spinning chairs, gyrators and various forms of water treatment in an attempt to cure them of their lunacy.
"The class has taught me, above all, to think critically," says Sarah Handley-Cousins, a doctoral history major enrolled in Rembis' course. "The class touches on such diverse themes - race, gender, class, medicine, psychology - that we are coming away from each class with a more nuanced, inclusive and critical understanding of mental illness.
"Whether it is the historical treatment of those who lived with mental illness, the rise in psychoanalytic theory or forced sterilization, Dr. Rembis has taught us to analyze the way our American culture treats those who are labeled 'mentally ill.'"
And the history of America's treatment of the mentally ill was often barbaric by modern standards.
"In 1916, Henry Cotton, superintendent of the Trenton State Hospital in New Jersey, began removing his patients' teeth as a cure for insanity. Cotton also removed patients' tonsils, colon, gall bladder, appendix, fallopian tubes, uterus, cervix, ovaries and seminal vesicles, all in an effort to cure them. A 1924 study revealed that 43 percent of Cotton's patients had died, and that he had killed more than 100 people with his intestinal surgeries alone," says Rembis.
A 1942 study conducted by the doctors at New York's Bellevue Hospital submitted 98 children between the ages of 4 and 11 to two daily electroshock treatments.
While more contemporary psychiatric practices were certainly less violent, the side effects were still unpleasant.
The 1954 introduction of Thorazine into psychiatric medicine forever changed how mental illness would be treated, giving rise to large pharmaceutical corporations playing a major role in psychiatric treatment. Despite painful and debilitating side effects, such as irreversible motor dysfunction, Thorazine and other neuroleptic drugs are still administered today.
During the 1970s, neuroleptic drugs - often referred to by patients as "chemical straight-jackets" or "zombie juice" - were given to juvenile delinquents, the elderly in nursing homes and about half of the nation's "mentally retarded."
It was also during the '70s that Valium became the most prescribed drug in America. The popularity of Valium and other mild tranquilizers skyrocketed during the '50s and '60s, as people looked to alter or enhance their mood.
Sales decreased when studies revealed that these medications had an extremely high rate of addiction. The pharmaceutical corporations rebounded by releasing new lines of "anti-depressant" medications, such as Prozac, during the 1980s. Similar drugs are still popular in today's psychiatric medicine.
"The idea that mental illness is a 'brain disease' or the result of a 'chemical imbalance' that can be cured or controlled with drugs remains powerful in the United States," says Rembis.
While the history of treating mental illnesses in America is sordidly fascinating, Rembis hopes students walk away with more than just a grim description of past "medical practices."
And his students seem eager to learn more about America's checkered past when caring for the mentally ill.
"I have been personally inspired to pursue this topic, and the related topic of medical history, in my own personal reading and research," says Handley-Cousins.
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