Insanity: Its Causes and Prevention

by Henry Putnam Stearns

The first is that of the Conn. Hospital for the Insane at Middletown. By reference to the table of occupations of persons admitted last year it appears that more than thirty-four per cent. were of persons, the larger portion of whom had never been educated in any regular method of obtaining a living. Some of them had been accustomed to depend upon the precarious results attending common labor, and some upon domestic labor, while others were without any regular occupation. Probably some of these persons may have had a measure of education in some occupation in early life, but if so, this does not appear in the statistics.

The second is the report of the Hospital for the Insane at Taunton, Mass. Of those who were admitted last year to this institution, it appears that thirty per cent. would be included in the same general classes of the population.

The third is that of the new Hospital for the Insane at Worcester, Mass.; and of the admissions here last year, we find that more than forty-two per cent. were from the above-named classes.

The fourth is that of the Western Pennsylvania Hospital, and of the admissions here, thirty per cent. were of these classes; while an examination of the occupations of those admitted to the Somerset and Bath Asylum, England, shows that nearly forty per cent. were of persons similarly circumstanced.

In these statistics I have included those persons who, in the reports, are classed as domestics, laborers, and persons of no occupation. I have not included wives of laborers, or persons whose occupation was “unknown.” I think it may fairly be assumed that, in the case of laborers, those who dig and shovel and labor on the public works, or in other places, under supervision, and in the case of domestics generally throughout the country, not one in ten has ever had any training or education in any special line of service before they undertook to earn a living in following these avocations; that, in fact, they could not do any thing else.

Possibly reports of other asylums might show statistics varying somewhat from these, but I take it that these are sufficiently accurate for my purpose, which is to show from what class of persons, so far as an education in any of the ordinary employments is concerned, a very large percentage of the admissions to our State hospitals comes. Without doubt a still larger per cent. of the admissions to some of the county asylums in England comes from this class of persons.

But so far we have shown only the per cent. the admissions of this class sustain to that of all admissions to asylums. Their true significance will appear only when we bear in mind the percentage this class of persons sustains to the whole population. The whole number of domestics, common laborers, and persons of no occupation, must be small as compared with the whole number of persons above fifteen years of age, and from whom admissions to asylums come. If, therefore, this amounts to more than one third of all admissions, it must amount to a very much higher per cent. than comes from any other class in the community to these asylums.

It may be proper to add to the above classes of persons the no inconsiderable number who, throughout the States, are engaged as mere operatives in our factories and manufacturing establishments. Many of these are engaged, and have been for years, in tending to some portion of machinery which is nearly automatic in its operations, and which requires little or no special training or education on the part of the operative. There might also be included, for my present purpose, that not inconsiderable class whose education for any business has been only partial, and who, with little previous training, have assumed the full responsibilities of such business.

The fact that more than one third of all admissions to those State hospitals which are located in the older portions of our country are from those who have never been properly educated in any of the regular occupations of life, is certainly significant, and I think will appear more so as we proceed. This, however, is only one element or factor in their condition, and it would be far from correct to conclude that this lack of education is in all, or nearly all, the only cause of their insanity. Doubtless many other causes have united in producing this result, as in other classes of society; but in many cases these other causes would have proved to be insufficient of themselves to effect such a result.

The amount of brain irritation, and consequent stimulation; the worry and anxiety attendant on the lives of the above-named classes of persons is oftentimes very great, and that there may not result actual injury to the brain, there can hardly be any thing of so much importance as an education and training in some regular pursuit. Without this, the individual is left at a large disadvantage in the use of all the ordinary means of success, or even of securing a living by any honorable course of life; while, having had such a training, he always has the consciousness of possessing these resources; and not only this, but the brain remains in an undeveloped and comparatively weak condition without it.