Steven, the scale problem may be the most clarifying thread here. The early asylum was not a smaller version of the state hospital. At a human size, routine and personal knowledge could still function as care, because the place could know a patient closely enough for structure to be therapeutic.
Past a certain census, the same tools quietly changed jobs. What had been supervision turned into administration, and the routine that once steadied a patient became a form of containment. A place built to return people to ordinary life slid into a machine for holding the ones the world would not take back. That makes the history harder than either benevolence or social control, and more useful: a humane idea can fail by being asked to work at a scale where the conditions that made it humane no longer hold.
Dr. Pliszka: Excellent article with much depth. Thanks as always!
Ashok
Steven, the scale problem may be the most clarifying thread here. The early asylum was not a smaller version of the state hospital. At a human size, routine and personal knowledge could still function as care, because the place could know a patient closely enough for structure to be therapeutic.
Past a certain census, the same tools quietly changed jobs. What had been supervision turned into administration, and the routine that once steadied a patient became a form of containment. A place built to return people to ordinary life slid into a machine for holding the ones the world would not take back. That makes the history harder than either benevolence or social control, and more useful: a humane idea can fail by being asked to work at a scale where the conditions that made it humane no longer hold.
You make a good point- in Part II I will elaborate on why this overcrowding happening- the results I think will surprise everyone!