Recovery From Schizophrenia: Psychiatry And Political Economy

114 THE POLITICAL ECONOMY OF SCHIZOPHRENIAINDUSTRIALIZING AMERICALabor was in short supply in industrializing and expanding America during thefirst half of the nineteenth century. 67 “English observers in the mid-nineteenthcentury,” writes historian Daniel Boorstin, “admired the ease with whichAmerican labourers moved about the country, from one job to another. Theywere amazed at the general freedom from fear of unemployment….” 68 Realwages, in consequence, were higher in the United States than Europe. 69 Themembers of the Yates Committee to the New York legislature in 1824, reported:In this country the labour of three days will readily supply the wants ofseven, while in Europe the labour of the whole week will barely sufficefor the maintenance and support of the family of an industrious labourer orpeasant. 70Pauperism was exceedingly rare by European standards, and what there wasexisted largely in the maritime cities, where newly arrived immigrantscongregated. Less than one per cent of the population of Philadelphia werepaupers in the 1820s and less than two per cent of the population of New YorkState. 71 Unemployment remained low during much of the antebellum period,becoming more significant from the 1850s onward. 72 Population increase and thelate Victorian depressions of 1873, 1884 and 1893, however, brought highunemployment and poverty. 73 Peacetime labor shortage of early nineteenthcenturydimensions has not been seen since in the United States until the shortlivedboom of 1999–2000.Was American psychiatry more rehabilitative in its emphasis in the earlynineteenth century, in response to the heavy demand for labor? It is certainly truethat moral treatment was vigorously adopted by the first corporate asylums thatwere established (by public subscription) in those years. The founders of theseNew England hospitals were much influenced by the examples and writing ofTuke and Pinel and applied their methods from the moment the doors wereopened—at the Friends’ Asylum, Frankford, Pennsylvania (1817), BloomingdaleAsylum, New York (1821), McLean Hospital, Boston, Massachusetts (1818), andthe Retreat at Hartford, Connecticut (1824). The independent PennsylvaniaHospital in Philadelphia, which established a separate branch for the insane in1841, was also a model of progressive care. These hospitals, many of themestablished by Quakers, were, like the York Retreat, primarily intended for thetreatment of private patients. Some, however, like the Hartford Retreat and theBloomingdale Asylum, took substantial numbers of paupers in return for publicfunding. As in the best British private establishments, staffing was comfortably high—one attendant to two patients was common. Restraints were very rarely used,and a full, if somewhat over-regimented, schedule of social and work activitieswas established for all inmates. Such was the success and public good favor of