Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (2002, Robert Whitaker)
The Quakers opened their small home in 1706. It was a simple place, with gardens and walks where the ill could get their fill of fresh air. They fed patients four times daily and regularly provided snacks that included biscuits along âwith a glass of wine or porter.â They held tea parties, at which the patients were encouraged to dress up. During the day, patients were kept busy with a variety of tasksâsewing, gardening, and other domestic activitiesâand given opportunities to read, write, and play games like chess. Poetry was seen as particularly therapeutic. [...]
In this gentle environment, few needed to be confined. There was rarely a day when as many as two patients had to be secluded at the same timeâseclusion in a dark, quiet room being the common practice for controlling rowdy patients. In its first fifteen years of operation, not a single attendant at the York Retreat was seriously injured by a violent patient. Nor was this cooperative behavior the result of a patient group that was only mildly illâthe majority had been âinsaneâ for more than a year, and many had been previously locked up in other English asylums, where they were viewed as incurable.
The Quakers, humble in nature, did not believe that their care would unfailingly help people recover. Many would never get well, but they could still appreciate living in a gentler world and could even find happiness in such an environment. As for the path to true recovery, the Quakers professed âto do little more than assist nature.â They wouldnât even try to talk their patients out of their mad thoughts. Rather, they would simply try to turn their minds to other topics, often engaging them in conversation about subjects their patients were well versed in.
Their simple, common-sense methods produced good results. During the York Retreatâs first fifteen years, 70 percent of the patients who had been ill for less than twelve months recovered, which was defined by Tuke as never relapsing into illness. Even 25 percent of the patients who had been chronically ill before coming to the retreat, viewed as incurable, recovered under this treatment and had not relapsed by 1813, the year Tuke published Description of the Retreat.
on prioritising quality of life and deemphasising 'cure'
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