History of Mental Health in the US

History of Mental Health Topic Proposal

Misdiagnosis is an inextricable part of neurodivergent people’s lives and the history of mental health writ large. Sufferers can spend years, if not entire lifetimes receiving incorrect treatment for their condition(s), significantly altering their experience. However, this fact is often eclipsed in historiographical accounts by discussions around mental asylums’ poor health standards and unsafe medical practices. Considering misdiagnosis rates remain high today, it is worth learning how common and by what means this phenomenon historically occurred. This project will specifically follow incorrect diagnoses of bipolar disorder––both false positives and false negatives––due to the disease’s uniquely harmful effects and the narrow treatment path its sufferers require. Individuals with bipolar disorder often later admit to having seen their initial BD diagnosis as incorrect due to their manic symptoms, further complicating this topic. The negative effects of misdiagnosis should be assessed among other historical failures to better assess the psychiatric community’s contributions to overall patient suffering and identify points of future improvement.

This project will use autobiographies from those suffering from mental illnesses and with experience in psychiatric facilities to frame its main arguments. Key works include The Pits and the Pendulum: A Life with Bipolar Disorder by Jessica Kingsley and A Quiet Mind by Sean Blackwell. Medical works following specific diseases’ changes in classification criteria will explain diagnostic failures during this period––roughly the 1970’s onward. To this point, Mason, Brittany, Brown, and Croarkin’s Historical Underpinnings of Bipolar Disorder Diagnostic Criteria and Jablensky’s The Failure of Nosologists will be instrumental, seeing as manic-depression and schizophrenia were often the go-to misdiagnoses for bipolar disorder. Collating these sources, we begin to see how and why bipolar disorder misdiagnosis occurs, and the human impact it incurs. In doing this, we learn how to prevent these mistakes in the future to forestall future suffering.

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Elizabeth Packard was a vital figure in the reformation and social awareness of mental health in the 19^th century. After being involuntarily committed to the Illinois Insane Asylum by her reverend husband for merely having differing religious beliefs, she remained institutionalized for three years. While institutionalized, she continuously plead to be released and was adamant that she was not in fact insane. It was not until her son came of age three years later that she was released and able to begin her efforts of preventing other women from enduring her own experiences. Elizabeth Packard’s experience of being institutionalized and subjected to her husband’s control inspired her to begin a long career of increasing patient’s rights as well as women’s autonomy in society.

For this research project, I propose focusing on how Elizabeth Packard’s experience of being wrongfully institutionalized impacted the creation of legislation and long standing social reforms for both women and patients in asylums. Her own personal works such as Modern Persecution, or Insane Asylums Unveiled: As Demonstrated by the Report of the Investigating Committee of the Legislature of Illinois, The Prisoner’s Hidden Life, or Insane Asylums Unveiled: As Demonstrated by the Report of the Investigating Committee of the Legislature of Illinois, and Marital Power Exemplified in Mrs. Packard’s Trial and Self-Defense from the Charge of Insanity, will prove essential to understanding her own desires and accomplishments during and after her stay in the asylum. The use of secondary sources such as Linda Carlisle’s Elizabeth Packard: A Noble Fight and Benjamin Reiss’s Theaters of Madness: Insane Asylums and Nineteenth-Century American Culture, will provide general context, historical analysis, and background on this subject. This project will provide further insight on women’s rights in society and asylums as well as represent the early reform efforts of asylum and mental health care.

Secondary Sources:

Carlisle, Linda V. Elizabeth Packard: A Noble Fight. University of Illinois Press, 2010.

This book provides a strong background to Packard’s life and how her experiences caused her to pursue advocating for the mentally ill. It describes her own experience in the asylum and her relationship with her husband and how those events led to her passing of legislation and the lasting effects of that legislation on the psychiatric community.

Carlson, A. Cheree. The Crimes of Womanhood: Defining Femininity in a Court of Law. Baltimore: University of Illinois Press, 2008.

Carlson’s work puts the work of these women in the context of femininity in the court and how their accomplishments were monumental to legislation for women. Carlson has a chapter dedicated to Elizabeth Packard that will place her work in the context of proving women’s sanity in the court and how that impacted both Elizabeth and future women in asylums.

Chesler, Phyllis. Women and Madness. New York: Palgrave Macmillan, 2005.

Chesler’s works to compare Packard’s experience to that of other women which shows the importance of Packard’s experience in the asylum. This work also provides context and an understanding of other women’s treatment in the asylum allowing for a better understanding of Packard’s personal accounts.

Grob, Gerald. The Mad Among Us: A History of the Care of America’s Mentally Ill. New York: The Free Press, 1994.

Grob touches on Elizabeth Packard’s story to further the understanding of treatment of mentally ill patients throughout history. He uses her story to explain how her experiences and then political activism led to the creation of the National Association for the Protection of the Insane and Prevention of Insanity.

Hartog, Hendrik. Mrs. Packard on Dependency. Yale J.L. & Human, 1989.

Hartog focuses on how the men involved in Elizabeth Packard’s commitment to the Illinois Insane Asylum represents the dependence that women had on men during the late 19^th century. This source is beneficial to this research because it also utilizes Packard’s accounts to show how Packard increasingly attempted to become legally less dependent on her husband and men in general.

Himelhoch, Myra Samuels, and Arthur H Shaffer. “Elizabeth Packard: Nineteenth-Century Crusader for the Rights of Mental Patients.” Journal of American studies 13, no. 3, 1979: 343–375.

Himelock and Schaffer argue that while Packard was a strong figure in the reform of mental institutions, she was often attacked by both the press and physicians for the reforms she was trying to pass. This is an important secondary source because it shows the relationship that Packard’s efforts had with the public.

Mann, Emily. Mrs. Packard. New York: Theatre Communications Group, 2009.

This is a production that is based on Elizabeth Packard’s life events. This is beneficial because it represents how impactful Packard’s story and efforts were.

Moore, Kate. The Woman they Could not Silence: One Woman, Her Incredible Fight for Freedom, and the Men who Tried to Make Her Disappear. New York: Sourcebooks, 2021.

This secondary source is a new approach on Elizabeth Packard’s story and provides the most recent historiography on her life experience. It provides a general background and information that is important to understanding Packard’s entire story.

“Packard v. Packard: 1864.” Great American Trials. Encyclopedia.com. 

This the court case between Reverend Theophilus Packard and Elizabeth Parsons Ware Packard. This is an important source because it shows Elizabeth as the defendant and able to defend herself in the court of law as a woman. The outcome of the case concluded Elizabeth to be sane, and important step to her ability to be able to pursue further advocacy for women in mental health.

Pouba, Katherine and Ashely Tianen. Lunacy I the 19^th Century: Women’s Admission to Asylums in the United States of America. Oshkosh: University of Wisconsin Oshkosh, 2006.

This source provides a general understanding of women’s experiences in asylums in the 19^th century and how it relates to Elizabeth Packard. This will provide a general context and understanding that will then provide a basis to place Packard’s story in.

Reiss, Benjamin. Theaters of Madness: Insane Asylums and Nineteenth-Century American Culture. Chicago: University of Chicago Press, 2008.

Reiss touches on both Packard’s experience in the asylum and how her experience resulted in the creation of legislation. This work will be most beneficial in the understanding of the laws and legislation passed and how psychiatry was viewed by women in the 19^th century.

Sapinsley, Barbara. The Private War of Mrs. Packard. New York: Kodansha International, 1995.

Sapinsley touches on Elizabeth’s relationship with her husband and how it influenced her eventual institutionalization. It also provides a great basis for information on her homelife in general.

Primary Sources:

Eghigian, Greg. From Madness to Mental Health: Psychiatric Disorder and Its Treatment in Western Civilization. Piscataway: Rutgers University Press, 2009.

Eghigian’s work comprises of primary sources and firsthand accounts of mental health patients throughout history. He includes in this a firsthand account of Elizabeth Packard called “Mrs. Cheneworth’s Suicide – Medical Abuse” that showcases how the treatment of women in the Illinois asylum was exploitive and detrimental to their health and safety.

Geller, Jeffery, and Maxine Harris. Women of the Asylum: Voices from Behind the Walls, 1840-1945. New York: Anchor Books, 1995.

Geller and Harris’s work provides both overall context for the condition of asylums during Packard’s commitment while also including Packard’s personal accounts. This work is important because Packard described her stay in the asylum and the conditions that she lived with for those three years. It also touches on her life after her stay and her attempts to defy her husband’s desire to re-commit her.

“One Woman’s Life Work: Mrs. Packard’s Long Labors for Relief of the Insane.” Chicago Daily Tribune (1872-1922), Aug 01, 1897.

This is a news article and eulogy regarding Elizabeth Packard’s efforts in helping the insane and women. It includes how she raised funds for hospitals, increased women’s rights, and how she went about to accomplish her goals. This is an important document because it shows what the public thought of her efforts in the late 19^th century.

“Modern Persecution.” Disability History Museum. 1873.

This primary source is a collection of drawings and images that regard to Elizabeth Packard’s experience before, during, and after her stay in the Illinois asylum. This is a beneficial source because it provides visual aid to the treatment of Elizabeth as well as portrays treatment in asylum overall.

Packard, Elizabeth. Marital Power Exemplified in Mrs. Packard’s Trial and Self-Defense from the Charge of Insanity. Chicago: Clarke & Co Publishers, 1870.

This is Elizabeth Packard’s personal account of the lawsuit she had against her husband for wrongly committing her to the Illinois Insane Asylum and then proceeding to imprison her in their home after her discharge from the asylum. This is important to this research because it gives Packard’s direct opinion on her own trial while also providing a primary source on the entire ordeal.

Packard, Elizabeth. Modern Persecution, or Insane Asylums Unveiled: As Demonstrated by the Report of the Investigating Committee of the Legislature of Illinois. New York: Pelletreau & Raynor, 1873.

This is Elizabeth Packard’s own publication on her entire experience from the bible class that gave her husband the desire to declare her insane to her life in the asylum, and her legal attempts to increase the protection of those in asylums. This source is extremely vital to this research for its invaluable firsthand accounts and abundance of writing from Packard herself.

Packard, Elizabeth. The Prisoner’s Hidden Life, or Insane Asylums Unveiled: As Demonstrated by the Report of the Investigating Committee of the Legislature of Illinois. Chicago: Packard, 1868.

Elizabeth Packard worked alongside the Illinois Legislature to create this primary source that combines her personal experience with that of the broader treatment of patients in insane asylums during the late 19^th century. This source will provide further context on her experience and how she was able to get the state to listen to her story and pass legislation.  

Packard, E. P. W. “Depravity of A Clergyman.: The Wife of a Preacher Imprisoned Three Years on Pretense Of Insanity” Chicago Tribune (1860-1872), Jan 28, 1864.

This is a news paper article that Elizabeth Packard wrote when she was released from the asylum. This is an important document because it is one of the first accounts from her and it openly states how her husband mistreated her and wrongly committed her. The content of the article is what is interesting since she was a woman openly berating her husband.