Negotiating power: Constructing authority at St. Elizabeths hospital

Date

2018-08

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Abstract

The history of St. Elizabeths is as complex as the individuals who resided there. No one entity, whether it was the government, staff, or patient population ever exercised complete control of the environment. Rather, life at the hospital was a constant re-negotiation of power. By combining a broad range of primary sources from 100 years of operation (1855-1955) including menus, treatment records, patient registers, manuals, and correspondence, this thesis sought to recreate the gendered, racial, and class-based social dynamics of St. Elizabeths. The use of prescriptive and descriptive source bases allows for the exploration of law and science, alongside cultural sentiment and expectations of the emerging mental health field. While institutional care varied around the country, the physical proximity of St. Elizabeths to Washington, D.C. placed it in the national spotlight. The availability of funding helped to usher in new technology while simultaneously contributing to overcrowding. Despite the authority of the medical staff of federal government, the position of patients was never as a static recipient of care. The reactions of patients to treatment as they navigated their position in the hospital and wider social expectations display personality along with elements of compliance and resistance. Despite the cultural identification of women, children, African Americans, and foreigners as most likely to need hospitalization, the statistics from the case register prove that none of these categories were the ones primarily receiving service. While letters indicate that the treatment of women was of special concern to the public, they did not receive the majority of care. Rather, other social and cultural factors such as nationality, economic and marital status, and religious affiliation contributed to higher asylum commitment in this hospital.

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Keywords

Asylum, Mental health, Nineteenth century, St. Elizabeths, Institutionalization

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