Friends Hospital bicentennial a reminder that change still needed in mental health care | Philly History

This year marks the 200th anniversary of Friends Hospital opening its doors. The oldest privately operated psychiatric institution in the United States, the 100-acre-spanning hospital has occupied the same spot overlooking Tacony Creek since it accepted its first patients in 1817.

While Friends Hospital has had its share of issues over the years — benefiting from developments in medical science over time just as all medical institutions have — its founding was in many senses revolutionary, and proved to be deeply influential on the evolution of psychiatric care.

Throughout the 18th century, the treatment of individuals suffering from what are today known as mental illnesses was grotesque. The Pennsylvania Hospital — the first hospital in the nation and, consequently, the first that dealt with mental illness — used its patients with psychiatric disorders as an attraction, charging the public a shilling in pre-Revolutionary days to ogle their strange behavior. Up until the 19th century, patients were typically confined to unhygienic holding cells in chains.

Many individuals in the Quaker community heeding their belief that God exists in every individual were appalled by the public denigration and ostracism of those suffering from psychiatric disorders.

In the first half of the 19th century, the United States lagged behind Europe in its treatment of mental illness. A Quaker minister named Thomas Scattergood witnessed Europe's progressive treatment methods firsthand. Struck by periodic bouts of depression, Scattergood visited a mental health facility called the Retreat at York located in England, where he was impressed by the procedures and techniques used by the institution's doctors. He wrote home that he "vented a few tears" because he was so impacted by the kindness that underpinned the Retreat's practices.

Returning to the United States, Scattergood and a group of influential Quakers hatched the idea to found a reform-minded institution in Philadelphia in 1813. Four years later, the Friends Asylum for the Relief of Persons Deprived of the Use of Their Reason (as the hospital was formerly known) accepted its first patients.

Its mission statement described its purpose to "provide for the suitable accommodation of persons who are or may be deprived of the use of their reason" and to "furnish, besides requisite medical aid, such tender, sympathetic attention as may soothe their agitated minds, and under the Divine Blessing, facilitate their recovery."

Over its first 15 years, the Friends Asylum admitted hundreds of people from  ages 16 to 93, men and women alike. Each individual undergoing treatment received a private room with natural lighting. Hospital personnel facilitated conversation with patients, emphasizing compassion and listening. These practices presaged psychoanalysis, which utilizes discussion as a conduit for mental health improvement and greater self-understanding.

This model became popular. Similar institutions emerged in Pennsylvania, such as the State Lunatic Hospital at Harrisburg, which opened in 1851 with a directive from the Pennsylvania General Assembly to adhere to the Friends Asylum's methods.

The hospital's bicentennial is an excellent moment to reflect on its important contributions, as well as the problems that the United States faces now regarding accessibility to treatment for mental illness. Poorer citizens often have trouble obtaining medical services, and many individuals suffering from mental health problems remain trapped in a cycle within the nation's incarceration system.

Using the founders of the Friends Hospital as inspiration, perhaps innovators with similar compassion can proffer bold new ideas for tackling this pressing issue.

Patrick Glennon is a communications officer at the Historical Society of Pennsylvania. pglennon@hsp.org