Therapeutic work and mental illness in America, c. 1830–1970
in Work, psychiatry and society, c. 1750–2015
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This chapter shows the key role played by patient labour in the birth, development, and decline of the hospital treatment of the mentally ill in the United States. Patient labour was present at the birth of the asylum, as a key feature of both theory and practice. In the late nineteenth century, its change to non-therapeutic drudgery corresponded with the ascendance of custodial pessimism and the warehousing of the chronically ill poor. Its revival at the start of the twentieth century was engineered by an optimistic alliance of psychotherapists, clergy and physicians, reflecting the national mood of expansionism and financial promise. Soon, however, both Freudians and harried hospital bureaucrats put an end to the idea that work would help individuals overcome their symptoms and re-direct their inner resources. In public asylums it was succeeded by non-therapeutic labour that hospitals relied upon for economic survival. When the asylums were dismantled in the 1970s and 1980s, legal attacks on unpaid patient work played a key role.

Editor: Waltraud Ernst

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