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Early Champions for Change for Dignity in Mental Health Treatment

Updated on September 6, 2018

"Speak up for those who cannot speak for themselves; ensure justice for those being crushed." ~ Proverbs 31:8

History of institutions and treatment of mental illness

Asylums - what words and images come to mind when you hear this word? Institutions, madhouses, loony bins, nut houses, insane asylums, most likely. It may bring to mind descriptions of conditions in such places as dark, dank, cold, cruel, and inhumane. Patients in asylums were called freaks, maniacs, mad, crazy, loony, lunatics, insane, and nut cases. It's interesting to find the definition of asylum in the dictionary. Here are a few:

1. (esp. formerly) an institution for the maintenance and care of the mentally ill, orphans, or other persons requiring specialized assistance. 1

2. A place offering protection and safety; a shelter 2

3. Any secure retreat. ibid

What a paradox! Today when someone seeks asylum it is to find a place of safety and refuge. But in earlier centuries, asylums were not safe, secure places of refuge. They were places to put away the outcasts of society; they were places of terror, abuse, abandonment, neglect, and cruelty. The horrors of treatment were as horrifically inhumane, all in the name of care. The living conditions were deplorable.

Allison M. Foerschner describes a case study at La Biectre Hospital in Paris, France.

"...starting with patients shackled to the wall in dark, cramped cells. Iron cuffs and collars permitted just enough movement to allow patients to feed themselves but not enough to lie down at night, so they were forced to sleep upright. Little attention was paid to the quality of the food or whether patients were adequately fed. There were no visitors to the cell except to deliver food and the rooms were never cleaned up (Butcher 37). 3

Other treatments in asylums all over the world were just as bad if not worse. Lobotomies, bloodletting, ice bath treatments, morphine and opium, and other powerful drugs, skull drilling, straight jackets and iron restraints, beatings, starvation, many deprivations, and so many more. Patients were demeaned, humiliated, verbally, sexually, physically, and emotionally abused and violated. If ever there seemed to be no hope for those struggling with mental health conditions, it was at that time.

Straight jackets were one humiliating and horrific types of "treatment."
Straight jackets were one humiliating and horrific types of "treatment." | Source

Champions of change

There were a few early champions along the way who initiated changes in the treatment of those suffering from mental illness by instituting and promoting humane treatments. Here are three of the most renown.

Philippe Pinel

Psychiatrist Philippe Pinel was one of the earliest advocates for better treatment of people suffering from mental illness. Pinel believed that mental illness could be cured and/or improved by moral, caring treatment. This humane treatment was often referred to as moral therapy or moral treatment. 4

As chief physician at the famous Paris asylum, Bicêtre, Pinel was outraged at the heinous conditions the patients were subjected to. Among the most disturbing were patients chained in dungeons, treated like animals, and horribly abused. As administrator of the institution, he required all patients be loosed from chains and for all inhumane treatments to cease. Reform began with changes in the living environments in the institutions and hospitals. It began with basic human and physical needs:

  • Exposure to open air
  • Exercise
  • The practice of good hygiene
  • One-on-one friendly, compassionate interactions between Doctor and patient
  • Providing patients with constructive work projects 5

Pinel also instituted a basic form of behavior modification and spent much time classifying various mental disorders.

Pinel ordering removal of chains from patients


Dorothea Dix

Dorothea Dix wore many hats in her lifetime, beginning as an educator in her teens, and onto social advocacy for many inhumane institutions such as jails, and what was then dubbed as insane asylums, in the United States and Europe during the 1800's.

Dorothea's family lived in poverty growing up; her mother suffered from mental illness and her father, an itinerate preacher, was a raging alcoholic. With parents unable to fulfill their parenting responsibilities, Dorothea grew up caring for her two younger brothers. 6 It seems this is what planted the seed of caring and motivated her advocacy for those who could not care for themselves.

Dorothea began her advocacy for prison reform while teaching Sunday School at Ms. Dix took her concerns to the legislature and new reforms were set in place for institutions. The reforms, once being instituted, began to confirm that treating the mentally ill and the incarcerated necessitated those major improvements in treatment. It revealed that full recovery for many was possible. Dorothea Dix helped in founding mental hospitals, schools for the intellectually challenged and those who were blind. Dorothea Dix was a powerful model of an effective advocate for the underdog.

Dorothea Dix
Dorothea Dix

“I come to present the strong claims of suffering humanity. I come to place before the Legislature of Massachusetts the condition of the miserable, the desolate, the outcast. I come as the advocate of helpless, forgotten, insane men and women; of beings sunk to a condition from which the unconcerned world would start with real horror.”

— Dorthea Dix

Clifford W. Beers

Here is a man who was the epitome of courage, resilience, and determination. In my mind, he is more than a great champion for change in the treatment of mental illness, but a hero. What makes Beers' story so remarkable is that with grit he openly wrote about his confinement in an asylum after a suicide attempt, in his autobiography, A Mind That Found Itself. With the extreme, archaic stigma present in his day, this was at great risk of his reputation and credibility. With no-holds-barred, he revealed the cruel and deplorable conditions of his confinement. Like his fellow crusaders, Pinel and Dix, Beers became a catalyst for change in the treatment of people with mental illness.

Later on, Beers founded Mental Health America, a national organization that advocated for change in the treatment of people with mental illness, to educate people on the faulty stigma's of mental illness, and to work towards mental illness prevention. Today, Mental Health America continues to advocate and facilitate ongoing change in the area of mental health.

Clifford Beers: A Mind That Found Itself
Clifford Beers: A Mind That Found Itself

" A Mind that Found Itself" is Clifford Beer's story of his confinement in a mental institution. It has been an inspiration to many mental health professionals and those seeking to better understand or treat mental illness.


A pen rather than a lance has been my weapon of offense and defense; for with its point I have felt sure that I should one day prick the civic conscience into a compassionate activity and thus bring into a neglected field earnest men and women who should act as champions for those afflicted thousands least able to fight for themselves.”

— Clifford W. Beers - A Mind That Found Itself (1907)

Thank you Pinel, Dix, and Beers

We who have struggled with mental health challenges appreciate these three selfless and compassionate human beings, and those who have since taken the baton and pushed for dignity and compassion through their advocacy for those with mental illness.

The Mental Health Bell - A powerful story of a symbol of hope

In the 1950s Mental Health America created a symbol representing hope and change in mental health treatment. It is called the Mental Health Bell. Mental Health America contacted all the asylums and institutions who used iron chains and restraints and requested that they send them the discarded items. They then took those chains and restraints and melted them down and created a bell, the Mental Health Bell, which symbolizes hope and freedom for the mentally ill by changing mental health treatment.

On the Bell is this inscription:

Cast from shackles which bound them, this bell shall ring out hope for the mentally ill and victory over mental illness."

To hear the Mental Health Bell ring brings a chill to my spine and tears to my eyes in gratitude for the brave and mighty efforts of Clifford Beers and Mental Health America, for the advances and changes in mental health treatment, and for the brotherhood of all of us who have suffered from mental illness.


1 Random House Kernerman Webster’s College Dictionary. (2010). Retrieved July 1 2015 from

2 American Heritage® Dictionary of the English Language, Fifth Edition. (2011). Retrieved July 1 2015 from

3 Foerschner, A. M. (2010). "The History of Mental Illness: From 'Skull Drills' to 'Happy Pills'." Student Pulse, 2(09). Retrieved July 01, 2015, from

4 Markov, Sergey. (2014). "Philippe Pinel - The Father of Modern Psychiatry." Biographies of Geniuses. Retrieved July 01, 2015, from

5 The J Rank Psychology Encyclopedia, Famous Psychologists & Scientists. Retrieved July 01, 2015, from

6 (2009). "Dorothea Lynde Dix." Retrieved July 02. 2015, from

7 Dorothea Dix. (2015). The website. Retrieved July 02, 2015, from

© 2012 Lori Colbo


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    • AudreyHowitt profile image

      Audrey Howitt 

      5 years ago from California

      This is just a wonderful article!

    • Relationshipc profile image


      5 years ago from Alberta, Canada

      Thank god for the few people who are able to see what is right and wrong and stand up for their beliefs. Positive change would never happen without it.

    • Jodah profile image

      John Hansen 

      5 years ago from Queensland Australia

      What a wonderful hub drawing attention to the inhumane treatment of the mentally ill and the wonderful heroes who helped to change this. voted up.

    • DealForALiving profile image

      Sam Deal 

      5 years ago from Earth

      Thank you so much for sharing this with fellow Hubbers. The last paragraph of your article is beautiful.

    • mary615 profile image

      Mary Hyatt 

      5 years ago from Florida

      Thank God I have had no personal experience with mental illness, but my heart goes out to those who have; especially the children who are so misunderstood and mistreated. I still remember that movie, "The Snake Pit"!

      Voted UP, etc. and shared.

    • lambservant profile imageAUTHOR

      Lori Colbo 

      6 years ago from Pacific Northwest

      It hurts to hear you share the cruel and judgmental comments from peple, especially people you know. The tragedy of we humans is that we have a tendency to judge others in situations they have never experienced. And truly, it all boils down to fear. We are afraid of what we don't understand. To deal with that fear, we judge and lash out at those who are suffering. God bless you for your unconditional love and care for your son. Mama's are the best advocates.

    • CraftytotheCore profile image


      6 years ago

      Hi Lamb! In reading your story here, I had to keep going back to it to absorb it all because it sounds very similar to mine.

      I understand completely what you mean about the summer camp issue. Same thing happened to me too.

      He was supposed to go to a strictly special needs camp. But he ended in a main streamed camp.

      What I found was that he started picking up good character skills of those children that helped him during the day. At school last year, he was in a behavioral unit so he was with other kids with issues. He picked up a lot of unwanted behavior there. So I know exactly what you mean. The Autistic children seem to mimick what's in their environment.

      Today my son had come home from school and for the first time picked up one of my "good" habits. He tipped over a cup on the table and said, "oh well, at least it was empty!". That's exactly what I do when he spills something. (I don't make a big deal and usually say something like oh at least there wasn't much in it or something like that.) So, they really do mimick good and bad behavior!

      The other thing too is that I know what you mean about people saying things when they should not talk about something they don't know anything about.

      For example, my son has speech issues. He was diagnosed with phonological disorder. Yet you wouldn't believe how many people have said to me that I must have caused that by speaking for him all the time.

      ? I don't even know how they come up with half the stuff they say to people who live daily with challenges of raising a special needs child!

      I've heard my share of cruel statements. And all I say to myself is shame on them. They have no idea what they are even saying!

      My son is in 2nd now. I know what you mean about the temper tantrums too.

      I had people coming around me all the time saying I spoiled him and that's why he behaves that way. One person told me it's because I never tell him no. I couldn't make these people understand a word of what I was saying, that he wasn't like other children.

      The worst comment to me, although there have been a lot, was one time at a family picnic, my son wanted to go to this play house that all the cousins were hanging around in. Immediately one little girl told my son he couldn't play with them. He started crying. I walked over and said that everyone should share and not exclude anyone. But the little girl started mouthing off to me. The parents did nothing. Instead, I took my son and started walking away. He scratched me and was crying beyond hysteria.

      Someone walked up to me and literally said, "that's offensive that you son acts that way".

      Needless to say, I don't do family get-togethers with my children for that reason. I've had very little support from anyone in my family.

    • lambservant profile imageAUTHOR

      Lori Colbo 

      6 years ago from Pacific Northwest

      That's an awful experience you had to go to. Autism is often times hard to pin down and depending where they are on the spectrum, no two cases are alike.

      In second grade my son was put in a class for behavior problem/special needs of unknown type because they did not know how to handle his outbursts, inattentiveness, and inability to cope with certain stimuli (noise mostly). We had school psychologists, psychiatrists, and therapists work with him but none of them were able to identify his problem. He's 21 now and I think back then they knew very little about Aspb. I knew there was something very wrong at 18 months. With his temper tantrums I sensed there was something different from what my other 3 boys had done. There was a sense of terror and a complete inability to cope with whatever it was that was bothering him. Sometimes the tantrums were for typical stuff - can't have something, or I told him no for something, but other times I had no idea why he was going to pieces. Whenever tantrums came though, regardless of the reason, there was something scary there, I knew something inside him was wrong. I was given lots of parenting advice, yada yada. When he got into school is when people started telling me something was wrong. They just didn't know what.

      He was very, very hypersensitive to loud noise, or certain kinds of noise and he would run and hide, even as a 9 year old boy. He was terrified of fireworks, and when I told him he could go in the house, people said I was coddling him and teaching him to be more afraid. We quit celebrating the 4th of July with those people. Amusement park excursions were a nightmare.

      He had no social skills when it came to other children. He would take up with one activity and kind of became an obsession, and if the other kids didn't want to play that activity, he kept playing himself and they would get exasperated and leave. He didn't like playing outside, he wanted to be home most of the time and do one activity. The favorite activity would change every once in a while. First it was Pokémon, then it was game boy, then it was some other cards of the day, then video games, but this was all through the course of his entire childhood, middles school and high school. In high school he was picked on a lot, but he did begin to make a lot of friends, but kids that were kind of unaccepted or of unfavorable element. They were not often safe, healthy kids. But throughout his life he has had a sweet spirit, quite loveable to those close to him. From the beginning, adults were who he related to.

      A lot of the textbook symptoms don't seem very apparent anymore, but then I am not around him much. He still has a plethora of friends, and has had many girlfriends. His life was hard also due to divorce and custody issues.

      An interesting thing happened when he went to summer camp one summer (the only time). The school convinced us that going to this summer camp where there were other kids with special needs would be a good idea. I regret deeply sending him because most of the kids were seriously developmentally disabled, had trouble communicating and he felt he had nothing in common. His issues were nothing like theirs, he was very high functioning, and very intelligent. Please don't hear me say that he was better, or that there was anything bad about the other kids. It's just that he was mismatched. He functioned at a different level in with different issues and he could not relate or cope at the age of 8. One of his room mates was an autistic boy who screamed most of the time. The boy grabbed his flower that he had picked on a hike and tore it up. He obsessed on this incident. He didn't understand it and why he was there. I think for him to be away from home was too difficult as well. He just wasn't ready.

      Very painful memories. He's better, but has different kinds of struggles now. I pray for him all the time that he can find his nitch in this world and realize his potential.

      Thanks for sharing your experience. You and your boy will be in my prayers. How old is he now?

    • CraftytotheCore profile image


      6 years ago

      Lamb, you are definitely someone I want to stay in touch with. :)

      My son was also diagnosed with Asperger's and what a shame it took so long.

      I've been through an awful time.

      When I left my comment prior, I had to run out. So I'm back now. I'll tell you more. I hope you don't mind.

      My son had a very delayed speech issue. I took him to the pediatrician and he told me there was nothing wrong. He'll grow out of it. Because the public school here has a lottery for children in pre-k and k, he wasn't accepted, but there was a Christian private school close by. I enrolled him there. After about six months going there, the teacher confronted me in the hallway and said that she thought he had a speech issue and was going to take a seminar about it so she could learn how to deal with it in her classroom. Using my son as the example, I was called in to a meeting and that's when these others tried to say I had caused this on my son somehow. Luckily the professionals in the room saw right through that and told them that this child has a speech issue and needs therapy and it was not caused by me! So, to make a long story short, the public school in the same district as the private school, they set up 6 speech therapy sessions. I had to bring him to that school, but it's not my home district. My son was not familiar with it. The speech therapist dragged my son down a hallway kicking and screaming for me until he vomited. That's when I said enough! I found out that the private school got a $2,500 kick back for my son needing special services.

      Now, going forward, I took him out of that school and homeschooled. He had two speech evaluations. His speech was less than 5% (however that works). I said then, how does someone have NO speech? Does that mean he has a handicap or is special needs? I was told by 3 different professionals at that time that no, he just had a speech problem.

      Finally, a few years went by....he ended up in two hospitals last year. Medical bills exceeded $200,000. Insurance didn't pay for everything.

      So, he is much better now. He is functioning and this year the school was able to mainstream him with a full-day aide.

      I have a lot more to tell, but it would literally take a whole book to explain it all.

      You can delete this if you want. I'm going to follow you to keep in touch!

    • lambservant profile imageAUTHOR

      Lori Colbo 

      6 years ago from Pacific Northwest

      Crafty I am terribly sorry for your difficulties with getting help for your son. I spent years doing the same for my son, but with no diagnosis. In late middle school or earl high school he was finally diagnosed with Aspbergers.

      It is so hard on the children and frustrating for parents. Lord willing, someday soon this will not happen. Blessings friend.

    • CraftytotheCore profile image


      6 years ago

      Finding services for children in my area is tough to come by. My son spent time in two hospitals last year and then 9 more weeks in out-patient. He has Autism. What I've come to understand is this.

      1) Yes, times have changed. Thank God my son was treated kindly with respect the times we have sought help.

      2) It's a sad shame though there we still have those that are intolerant to the handicap or those that suffer with mental illness.

      3) I find in my area, the majority of the "help" is only interested in the grant money they get for supposedly offering services. My experience with these groups of which I speak are they exploit children for their own self-serving purposes. I have not found true "help" yet. (Again, just from my own journey here with a son with special needs.)

      But, in speaking about this, I came across a man from another country. In America we are better off than most. That man told me situations about people in his country leaving handicap people in rooms locked away from society, only allowing them a little food to keep them from starving.

      Nice Hub! I think anything we can do to promote awareness is better than being silent.

    • lambservant profile imageAUTHOR

      Lori Colbo 

      7 years ago from Pacific Northwest

      Arb, it really depends on where one lives. Where I live there a plenty of services. It is not a flawless system, but it is much better than many. Thanks for your comments.

      LG, always good to hear from you. God bless.

    • lifegate profile image

      William Kovacic 

      7 years ago from Pleasant Gap, PA


      A very good hub on a very important topic her on HubPages. Voted up, useful, interesting, and, oh yes, awesome!

    • arb profile image


      7 years ago from oregon

      Great write. I am saddened once again however, by the lack of programs available today for these wounded warriors.


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