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The first patient is admitted to the Public Hospital for Persons of Insane and Disordered Minds in Williamsburg, Virginia. This is the first public building in North America that was solely devoted to treatment of mentally ill
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Dorothea Dix is born on April 12, 1802, in Hamden, Maine.
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In 1841, Dix paid a visit to an East Cambridge, MA, jail,where she intended to teach Sunday school. She inquired as to where the mentally ill were kept, and she was escorted into a horrifying underground chamber, where mentally ill women were housed infrigid, filthy conditions.
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Dix spent the next 18 months visiting various Massachusetts poorhouses and prisons, and documenting the circumstances in which she found the mentally ill. Over and over again, Dix was horrified to find these poor unfortunates caged, chained, bound, inadequately fed, abused, and tortured by the very people who should have been their protectors, but who had instead become their captors.
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She began to lobby various community leaders, imploring them to join her in her mission to improve conditions for the mentally ill. Three famous activists joined her cause: Horace Mann, the famous educator; Charles Sumner, the abolitionist; and Samuel Gridley Howe, head of the Perkins Institute for the blind. With the help of these men, Dix was able to secure legislation and funding to appropriately house and care for the mentally ill at Worcester State Hospital.
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Dix lobbies lawmakers and courts for better treatment until her death in 1887. Her efforts lead to the establishment of 110 psychiatric hospitals by 1880.
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On assignment for New York World, Nellie Bly fakes lunacy in order to get into the Women's Lunatic Asylum on New York’s Blackwell's Island. Her report, "Ten Days in a Mad-house,” detailing the terrible living conditions at the asylum, leads to a grand jury investigation and needed reforms at the institution.
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Indiana is the first of more than 30 states to enact a compulsory sterilization law, allowing the state to "prevent procreation of confirmed criminals, idiots, imbeciles and rapists." By 1940, 18,552 mentally ill people are surgically sterilized.
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Dr. Walter Freeman and his colleague James Watt perform the first prefrontal lobotomy. By the late 1950s, an estimated 50,000 lobotomies are performed in the United States.
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Italian neurologist Ugo Cerletti introduces electroshock therapy as a treatment for people with schizophrenia and other chronic mental illnesses.
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President Harry Truman signs the National Mental Health Act, calling for the establishment of the National Institute of Mental Health to conduct research into neuropsychiatric problems.
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Marketed as Thorazine by Smith-Kline and French, chlorpromazine is the first antipsychotic drug approved by the Food and Drug Administration. It quickly becomes a staple in asylums.
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The number of mentally ill people in public psychiatric hospitals peaks at 560,000.
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President John F. Kennedy signs the Community Mental Health Act to provide federal funding for the construction of community-based preventive care and treatment facilities. However, because of the Vietnam War and the economic crisis, this program was never properly funded.
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With the passage of Medicaid, states are incentivized to move patients out of state mental hospitals and into nursing homes and general hospitals because the program excludes coverage for people in "institutions for mental diseases."
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The California Legislature passes the Lanterman-Petris-Short Act, which makes involuntary hospitalization of mentally ill people vastly more difficult. It did not go into full affect until July 1, 1972. One year after the law goes into effect, the number of mentally ill people in the criminal-justice system doubles.
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There are 650 community health facilities serving 1.9 million mentally ill patients a year.
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President Jimmy Carter signs the Mental Health Systems Act, which aims to restructure the community mental-health-center program and improve services for people with chronic mental illness.
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Under President Reagan, the Omnibus Budget Reconciliation Act repeals Carter's community health legislation and establishes block grants for the states, ending the federal government's role in providing services to the mentally ill. Federal mental-health spending decreases by 30 percent.
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An Ohio-based study finds that up to 30 percent of homeless people are thought to suffer from serious mental illness.
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Federal funding drops to 11 percent of community mental-health agency budgets.
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Clozapine, the first "atypical" antipsychotic drug to be developed, is approved by the United States Food and Drug Administration as a treatment for schizophrenia.
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Studies suggest approximately 16 percent of prison and jail inmates are seriously mentally ill, which is roughly 320,000 people. This year, there are about 100,000 psychiatric beds in public and private hospitals. That means there are more three times as many seriously mentally ill people in jails and prisons than in hospitals.
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In the aftermath of the Great Recession, states are forced to cut $4.35 billion in public mental-health spending over the next three years, the largest reduction in funding since deinstitutionalization.
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There are 43,000 psychiatric beds in the United States, or about 14 beds per 100,000 people—the same ratio as in 1850.
