The Use and Implications of Photographs for Mental Health Care Reform

•   Introduction
• Almshouse Care
• Early Reform Attempts
• Commission Campaign
• Aftermath
• Exhibits October 6, 1908 Report
• Traveling Exhibition images
• Montevue Asylum Images
• Curator's Comments

The Maryland State Lunacy Commission State Care Campaign 1908-1910

"The first steps toward the correction of any abuse or evil is publicity." Preface to 24th Annual Report of the Lunacy Commission, 1909

For over thirty years, from 1874 to 1908, similar descriptions to the one presented above regularly appeared in official reports to Maryland's political leaders, yet the care of the state's indigent mentally impaired citizens, or as they were then termed the "pauper insane," saw little or no improvement. Hidden away to languish in county almshouses, asylums, and even jails, the pauper insane garnered little public or private notice in an era of supposed religious devotion and charitable generosity.

The camera helped to change all that. Photographs played an important role in bringing bad conditions to light and in persuading politicians and the general public that the state should take responsibility for the care of its indigent insane.

This exhibition, drawn from the holdings of the Maryland State Archives, focuses on the use of photographs in the campaign for mental health care reform in Maryland during the early twentieth century, an effort spearheaded by the Maryland State Lunacy Commission.

The history of mental health care in nineteenth century Maryland displays an uneven rate of progress and enlightenment. Though the state rarely stood in the forefront of embracing new ideas in treatment, it generally led its Southern sisters in enacting more modern policies toward the care of the insane. Fiscally conservative Maryland, one of the first states in the nation to found a public mental institution, saw support wax and wane throughout the nineteenth century. Patient overcrowding and chronic understaffing characterized state facilities. The two state-run hospitals, Spring Grove (1797) and Springfield (1896), could accommodate only several hundred individuals.

The majority of mentally impaired Marylanders remained either in the homes of relatives, or if poor, in the county almshouses and jails. By 1893, approximately one thousand such individuals resided in Maryland county facilities. Almshouses served also as the warehouses for the incapacitated, chronically ill, and elderly populations. Residents included those afflicted with Alzheimer's disease, epilepsy, and mental retardation, or "feeble-mindedness" as it was then known.