A Hospital For Washington's Insane

Changing the Way Washington Cared For the Mentally Ill

Eastern Washington Hospital For The Insane promised humane treatment for the mentally ill.

Eastern Washington Hospital for The Insane opened in 1891. The first 122 patients were transfers from Western Washington Hospital for The Insane.

The hospital represented a break in the way that the mentally ill were cared for in Washington. The French theory and practice of "moral treatment" reached America. Moral treatment ended the use of chains and asked staff to treat mentally ill as patients rather than criminals. Moral treatment outlined orderly, regimented activities, such as access to a library, as part of the patients individualized treatment plan. It ended bloodletting, purgatives, emetics, and torturous hot and cold showers that had been all too typical of past treatments.

Eastern Washington State Hospital cherry-picked the best parts of moral treatment theory and left the rest behind. The fundamental course of treatment was isolation from family and friends, and those non-disabled patients worked on the hospital grounds. The use of restraints was limited and had to be authorized by the doctor.

Moral treatment became the standard of care in Washington just as it was falling out of favor in the rest of the nation. Moral treatment failed to cure most patients, and the pressures to do so lead to dishonest bookkeeping. Patients were discharged prematurely and hospitals used the word "recovered" loosely, which lead to a revolving door of patients being readmitted and released. Moral treatment, with its high cost and lack of promised results, lost favor with state legislators and began losing funding.

Not until the beginning of World War II was a clear change in treatment seen at Eastern State Hospital. Group and one-on-one counseling became part of patient treatment. Another advancement came in 1954 with the use of pharmaceuticals. In 1963 the federal government passed the Community Mental Health Center Act. The hope was that individuals could receive short-term out-patient care from new, smaller facilities rather than face long-term institutionalization.

Today only those suffering the most severe cases are sent to Eastern State Hospital.

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