Rising Psychosis Rates

Rising Psychosis Rates

I've mentioned before a book by E. Fuller Torrey and Judy Miller. The Invisible Plague: The Rise of Mental Illness from 1750 to the Present. (New Brunswick, N.J.: Rutgers University Press, 2001) that argues (I think quite persuasively) that psychosis rates have been rising in the Western world since the 17th century. There are no specifically mental hospitals in America until 1773--unlike Britain, which had them for centuries by then. The "furiously mad" might be locked up in the poorhouse if they were considered a danger to others, and there are a very few cases where persons were confined by family members at the request of the colony. One such example was a young man who was found not guilty by reason of insanity for killing his mother. Institutions specifically for the mentally ill were extremely scarce.

I was looking through Lloyd Vernon Briggs, History of the Psychopathic Hospital, Boston, Massachusetts (Boston: Wright & Potter Printing Co., 1922), and it mentions that in 1764, Thomas Hancock left the city of Boston 600 pounds (a big chunk of money for the time) to create a public mental hospital for the inhabitants of the province. The town government declined to accept this gift, because there weren't enough insane people in Massachusetts to justify building such a facility. The population at the time would have been about 200,000 people. Today, about 1% of the total population has schizophrenia, and a somewhat smaller percentage has bipolar disorder severe enough to require hospitalization. If 1% of the population of Massachusetts back then had schizophrenia, that would be about 2000 people.

Now, it is certainly the case that only some of those would have been ill enough to justify hospitalization. Small town America was extraordinarily tolerant of mental illness, perhaps because they knew these people well enough to know who might be dangerous, and who was not. The costs meant that a person who was merely acting strangely would probably not be hospitalized. Still, if even 5% of those 2000 people were acting in a way that might cause concern about violence (to others or to themselves), that would be 100 people throughout the province. And yet the Boston government didn't believe that there was a need.

This isn't proof that Torrey and Miller's claim is correct. Perhaps Boston's selectmen had some other reason for refusing the gift, or not wanting a mental hospital in their midst. But it does certainly lend credence to the idea that the reason that there are no institutions, and surprisingly few examples of mental illness in Colonial America, has something to do with very low rates of mental illness compared to today.