Building a moral-medical psychiatry

Abstract

Abstract This chapter from Vice and Psychiatric Diagnosis picks up the thread from the parallel history of morality and madness from Chapter 4 and examines more closely the response of American colonists to madness and wrongful conduct, continuing through the development of US asylum doctors and Psychiatry proper, continuing on up to the turn of the twenty-first century. The eighteenth and nineteenth centuries witnessed the development of the concept of social deviance, addressing needy others which were, in various ways, unable or unwilling to conform to the standard social expectations of the time. These groups included ‘madpersons’, thieves, vagabonds, drifters, orphans, unwed mothers, and increasingly, as medical care developed, intellectually disabled people and demented elderly people. The needs posed by social deviance, amplified by industrialization and urbanization, led to social welfare programs in general, and asylums, psychopathic clinics, jails, prisons, jails, schools for delinquents, and constituting the diverse social welfare institutions familiar to us today. These institutions ultimately became funded primarily by governments, dependent upon the will of the polity for their successes and failures. The ambivalence of the public about social welfare institutions is described and applied to the contemporary issues of the vice/mental disorder relationship.