Why Could you be Sent to an ‘Insane Asylum’ in 19th Century America?

‘Insane asylums’ were the 19th century forerunners of today’s psychiatric hospitals, but people were sent to them for sometimes quite different reasons to today. Here, Casey Hakenson looks at some disturbing cases of why and how people, including women, African Americans, and Native Americans, were sent to ‘insane asylums’ in 19th century America.

Elizabeth Packard, who was sent to the Illinois State Hospital for the Insane in 1860.

Elizabeth Packard, who was sent to the Illinois State Hospital for the Insane in 1860.

Before the 19th century, the only options to institutionalize a person with mental illness were jails and almshouses, where the conditions were often disturbing and dehumanizing. So, in the 19th century, ‘insane asylums’ came along. These institutions were created by reformers to be positive places where ‘lunatics’ could be cured, and ‘idiots’ taught. Yet, almost immediately, people began to be confined to these homes for some of the most benign symptoms. As these ‘homes’ rose in popularity throughout the 1800s, the number of people committed continued to rise as fewer and fewer patients were ever able to leave.


Elizabeth Packard

Let’s begin with one of the most famous instances of imprisonment. Elizabeth Packard was married to a Calvinist minister named Theophilus. Everything seemed to be going well until Elizabeth became interested in popular religious beliefs, such as Swedenborgianism, perfectionism, and spiritualism. These differences resulted in explosive arguments that culminated in her standing up in church while he was preaching and announcing she would be attending services elsewhere. Theophilus began to question his wife’s sanity (or at least claim he did) and had a doctor, J.W. Brown, visit their home disguised as a sewing machine salesman to diagnose Elizabeth. Brown concluded Elizabeth was insane because of her hostility towards her husband and her unorthodox beliefs. Elizabeth Packard spent three years at the Illinois State Hospital for the Insane (from 1860-1863) until her oldest son turned 21 years old and was able to release her. 

The truth of the matter was that in the 19th century, it was often quite easy for a man to institutionalize his wife or daughter. In some U.S. states, the man did not have to present any proof; he only needed the consent of the superintendent of the asylum. Many women were locked up for such erroneous reasons as over-education, PMS, being unmarried, or displaying what was considered over-sexual behavior such as masturbating.

One example of this was Alice Christina Abbot, committed to Taunton State Hospital in Massachusetts in 1867 for allegedly poisoning her stepfather. A bit of background: 17-year-old Alice had recently accused her stepfather of sexual abuse, an allegation that the courts dismissed. The defenses’ primary evidence against her? She didn’t seem upset that her stepfather was dead. (Hmmm. I wonder why…)

African Americans and Native Americans

Yet, of course, women weren’t the only group that were institutionalized for pseudo-scientific reasons. When the U.S. Civil War ended, there was an uptick in the institutionalization of African Americans, who many claimed would delve into insanity caused by their new freedom. African American people, like women and other disenfranchised groups, could be committed for basically any reason. A white employer or community member could claim an African American person was insane, and the accused had little resource to defend themselves in court. In fact, at Central Hospital in Virginia, an all-African American mental asylum, there were no records of anyone willingly institutionalizing themselves. Making matters even worse for the inmates, some doctors claimed that African American people needed to do hard labor to stay mentally sane. For example, at Central, they were put to work on the asylum’s large farm and performing domestic chores. (Sounds like a certain something that had just been outlawed…) And, like many who were confined to these hospitals, a large percentage died from illnesses contracted from overcrowding. 

Native Americans were prone to a similar fate since they were often diagnosed and committed by the white reservation agents who were put in place by the government – men who usually had little to no medical training. Native Americans, too, could be confined for an array of offenses, such as refusing their government’s assimilation tactics, or in one man’s case, a 1913 accusation of ‘horse-stealing mania.’ Native Americans, like other asylum patients, were often treated to conditions akin to torture, sterilized, experimented on, and usually died in these places of ‘healing’. 


A few more examples from a ‘reasons for admission’ list from Weston Hospital in Lewis County, West Virginia were:

-Bad Company

-Bad Habits

-Business Nerves


-Death of Sons in the War

-Deranged Masturbation

-Desertion by Husband


-Domestic Trouble

-Doubt about Mother’s Ancestry

-Feebleness of Intellect 

-Female Disease

-Hard Study

-Imaginary Female Trouble


-Medicine to Prevent Conception

-Menstrual Deranged

-Novel Reading

-Parents were Cousins

-Political or Religious Excitement 

-Suppressed Masturbation


So, what could you get institutionalized for in the not-so-distant past? Anything, really. 


What do you think of the article? Let us know below.


Brice, Anne. “How the U.S. Government Created an ‘Insane Asylum’ to Imprison Native Americans.” Berkeley News, 19 Nov. 2020, https://news.berkeley.edu/2020/11/19/ using-disability-to-imprison-native-americans/. Accessed 1 July 2021. 

Charleston, L.J. “Outrageous Ways to be Admitted to an Insane Asylum in the 19th Century.” News.com.au, 18 Aug. 2019, https://www.news.com.au/lifestyle/real-life/true- stories/outrageous-ways-to-be-admitted-to-an-insane-asylum-in-the-19th-century/news-story/e590c54e3469606d1b2330a52c3d8f6b. Accessed 30 June 2021. 

“Elizabeth Packard: Advocate for the Rights of Married Women.” History of American Womenhttps://www.womenhistoryblog.com/2013/01/elizabeth-packard.html.  Accessed 30 June 2021. 

“How Victorian Women were Oppressed through the Use of Psychiatry.” The Atlantichttps://www.theatlantic.com/sponsored/netflix-2017/how-victorian-women-were- oppressed-through-the-use-of-psychiatry/1607/. Accessed 1 July 2021.

“Packard, Elizabeth (1816-1897).” Encyclopedia.comhttps://www.encyclopedia.com/women/encyclopedias-almanacs-transcripts-and-maps/packard-elizabeth-1816-1897.  Accessed 30 June 2021. 

Peterson, Britt. “A Virginia Mental Institution for Black Patients, Opened After the Civil War, Yields a Trove of Disturbing Records.” The Washington Post, 29 March 2021,  https://www.washingtonpost.com/lifestyle/magazine/black-asylum-files-reveal-racism/2021/03/26/ebfb2eda-6d78-11eb-9ead-673168d5b874_story.html. Accessed 1  July 2021. 

 Tabler, Dave. “125 Reasons You’ll Get Sent to the Lunatic Asylum.” AppalachianHistory.net, 4 December 2008, https://www.appalachianhistory.net/2008/12/125-reasons- youll-get-sent-to-lunatic.html. Accessed 1 July 2021. 

“The Growth of the Asylum.” Historic Englandhttps://historicengland.org.uk/research/inclusive-heritage/disability-history/1832-1914/the-growth-of-the-asylum/. Accessed  1 July 2021. 

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