Story by Hershel Nobleman
With the recent vicious attack of former Fall River Mayor Flanagan, issues of mental health are back in the news.
For centuries, society has struggled to understand mental illness. In the 1800s, when families could no longer care for loved ones who were mentally ill, many turned to newly created “asylums.” These institutions—often built in quiet countryside settings—were originally meant to be places of healing and peace. Reformers like Dorothea Dix and Dr. Thomas Kirkbride believed that with kindness, structure, and rest, people could recover from mental distress.
At first, it worked. Early hospitals emphasized light, fresh air, and meaningful work. Patients tended gardens, painted, and socialized. Mental health treatment was finally being recognized as a medical issue, not a moral failure.
But by the early 1900s, the system began to crumble. Populations inside these hospitals exploded. Understaffed and underfunded, conditions grew harsh. People were locked away for decades, sometimes for issues that today might be treated with medication or therapy.
In the mid-20th century, reports of neglect and abuse shocked the nation. Famous exposés—like journalist Nellie Bly’s undercover story “Ten Days in a Mad-House”—revealed what really went on behind closed doors.
Then came the 1950s and 60s, a turning point. New medications like Thorazine gave hope that people could live outside institutions. Lawmakers passed policies to close asylums and move patients into community-based care. This process, called deinstitutionalization, was supposed to be a new era of freedom and modern treatment.
Unfortunately, many of those community programs were never built—or were severely underfunded.
As the old hospitals closed, tens of thousands of people were released with nowhere to go. Over the next few decades, homelessness and incarceration rates among the mentally ill skyrocketed. Jails, emergency rooms, and city streets quietly replaced the asylums.
The Pros of Mental Institutions: ✅ Provided long-term care and supervision for people unable to live independently. ✅ Offered stability and structure that many still lack today. ✅ At their best, they treated mental illness as something real and treatable.
The Cons: ❌ Many became overcrowded, abusive, and inhumane. ❌ Patients often lost their rights and their identities. ❌ They created stigma—people feared being “sent away” forever.
Where We Are Today:
Mental health is finally part of public conversation. We talk about anxiety, depression, and trauma more openly than ever before. Yet our system is stretched thin. Waiting lists for therapy are long, psychiatric beds are scarce, and many police departments double as front-line mental health responders.
Some experts now believe we need modern mental health campuses—safe, dignified facilities that provide long-term treatment, not punishment. These wouldn’t be the old asylums of the past, but new centers focused on recovery, education, and reintegration into society.
Should They Come Back?
Maybe not in the old form—but something like them might be necessary. Too many people are suffering in silence, bouncing between the streets, hospitals, and jails. A humane, well-funded system could offer stability, dignity, and a real path to healing.
Because while the walls of the old asylums have fallen, the need they tried to meet has not. The question isn’t whether they should come back—it’s how we can build something better this time.