In the early part of the 20th century, the American Eugenics Movement argued that all people who were mentally ill, mentally retarded or physically disabled were polluting the gene pool of the country. Such individuals were seen as a threat to society and the probable cause of most of the criminal activity and social problems of the country. In many states, support for the Eugenics movement resulted in legislation requiring mandatory sterilization, incarceration, and in many cases, the castration of persons with disabilities. In each state, hundreds of thousands of people with mental illness or intellectual disabilities were placed in institutions, the largest of which housed as many as 20,000 people.
In the 1940s, new genetic research demonstrated unequivocally that the founding precepts of the Eugenics movement were invalid. However, by that time hundreds of thousands of people with intellectual disabilities or mental illness had been admitted to state institutions.
In Pennsylvania, there were about 40 state hospitals and state mental retardation centers. It was common for physicians and other professionals to tell families of children with disabilities that it was “best that you put him away and forget about him.” It was also common for children and adolescents who might be difficult to handle or even young girls who were pregnant to be institutionalized. Within the state institutional system, there was no basis for rehabilitation or treatment. No one ever got better because the intent was to protect society, not to ensure the well being of individuals living in the institution.
In the 1960s
In the late 1960s, state institutions across the nation housed almost 156,000 people with intellectual disabilities and 550,000 people experiencing mental illness. It was common for over 100 people to share a single bedroom. Often, people were naked and lay prostrate on the floors to cool off because the rooms had inadequate ventilation. Facilities were filthy, with excrement and urine on the floors and walls, and the odor was horrific. I particularly remember the noise at Pennhurst. The moaning, screaming and crying was deafening. Within the state institutions, people might be placed in nude seclusion for days.
Of course, there was no due process, and a person could be admitted with no legal recourse. As in Ken Kesey’s One Flew Over the Cuckoo’s Nest, the more a person resisted control, the more severe the intervention became. Electro-shock treatment was frequently used as punishment, and straight jackets and mechanical restraints were commonly used to restrain people. The environments were brutal, but at the time, there were almost no other alternatives for people who had a serious mental illness or intellectual disability. Only a few organizations existed, such as the Easter Seals, which operated exclusively on charitable contributions.