The star-independent. [volume] (Harrisburg, Pa.) 1904-1917, 1914-12-16
IS S|NSAN|TY IN 1.-THE
IU.S. Increasing?
Question Discussed by
/: DR.. Joseph A. Hill in
! Government Report
/: on Insane
GREAT INCREASE
I: IN INSTITUTIONS
Cannot Be Regarded, However, as Con-
elusive Proof That the Same Con-
ditions Exist Outside of the Hos
( pitfalls for the Insane

creasef This question is discussed by
DIR. Joseph A. Hill in the government
report on the Insane in Institutions.
soon to be issued by William J. Harris,
Director of the Census, in the Depart
ment of Commerce. That there has
been an enormous increase in the num-
Der of insane under institutional care
IS made evident by the statistics pre-
sented in this report, but, for reasons
there set forth, this in itself can not
be regarded as conclusive proof of an
increase of insanity in the general pop
ulation outside of institutions.
. The number of insane reported in in
stltutions increased from 15O,151 in
1904 to 1S7,791 in 1910-an increase
of 20 per cent. in six years. The total
population of the United States in the
came interval increased only IL per
GENT Therefore, the insane in insti-
tutions increased twice as fast as the
population. In 1904, out of every
100000 persons in the total population,
lS4 were reported in institutions for
the insane; by 1910 the number had
h;creased to 204. In other words, in
1904 one person out of every 543 was
Confined to an institution for the in
sane, IN 1910 one person out of every
$50. There was q similarly marked in
crease i'll the number of annual admis-
Sons to these Institutions, 60,769 per-
Sons having been admitted in 1910, as
compared with ,622 in 1904, an in
grease, of % per cent. The number of
admissions per 100000 population in
creased from 81 in 1904 to &c in 1910.
Cause of Increase
These increases are at least partly
attributable to the extension of the pro-
visions made for the care of insane
persons and to the growth of the prac-
tiee of placing them in institutions.
There is an increasing disposition and
Willingness on the part of the public
to accept institutional treatment. The
old-time horror of the lunatic asylum,
fully justified, perhaps, by the inhuman
practices formerly prevailing in such in
stitutions, has largely disappeared, and
it is coming to be recognized that the
modern institution for the insane is
simply hospital for the treatment of
mental diseases, fulfilling essentially
the same purpose in the community as
any other hospital for the sick. In the
interval between 1904 and 1910 the
number of institutions for the insane
Increased from 32S to 366, the average
VI lHlldlto pei luSllJultOh
creasing from 45S TO 512.
Insane Asylums overcrowded
Notwithstanding these developments,
the provisions for the Institutional care
eff the insane are still very inadequate
in most parts of the United States.
There are general complaints of over
crowded institutions and of the neces
sity of turning patients away. I'm
Il nop1;+io,,s ba ctr IF
ii new hospital for the insane or the ex
tension of an existing one may be fol
lowed by an increase in the number of
insane in institutions without being in
dicative of any increase in the preva-
lence of insanity in the community
from which the patients are received.
At the same time there has been a
great improvement in the agencies for
discovering cases of insanity and
bringing them under institutional care.
The advance in methods of medical di-
agnosis leads to the detection of mental
disease in cases brought to general hos
pitals for the sick. The institution for
the insane is becoming more generally
accessible not only by the increase in
the number of such institutions, but also
by the improvements in the means of
transportation and communication. The
automobile is mentioned as factor of
some importance in this connection,
making it possible to bring to the hos
pital patients in poor physical condi-
tion. These are some of the influences
which, as stated in this report, may
have contributed to the apparent in
crease of insanity or to the increase in
the number of recognized and recorded
cases without being indicative of any
actual increase. The author of this
report believes that there has been, at
the same time, an actual increase of in
sanity, but that it is not as great as
the statistics of the number of insane
in institutions would indicate.
An increase of insanity is probably
in some degree natural consequence
of the rapid growth of cities in the
United States. Between 1880 and 1910
the proportion of the population of the
United States living in urban commu-
mites increased about 100 per cent.
while the rural population increased
only about 40 per cent. As result
46 per cent. of the total population of
the United States was urban in 1910,
as compared with 20 per cent. in 1880.
The percentage living in cities of over
100000 inhabitants, nearly doubled in
the same interval, being 12.4 per cent
in 1880 and 22 per cent. in 1910.
More in City Than Country
There has been popular impression
that the lonely isolation of country
life is an important cause of insanity.
The statistics, however, indicate that
more insanity is caused by the stress
and strain, the keener competition, the
congested housing conditions, and the
vice and dissipation of city life. in |
proportion to population the number
of inmates of hospitals for the insane
received from urban communities is |
twice as great as the number received |
from rural districts. OF the 60,769
persons admitted to insane hospitals in
1910, 1864 came from cities, villages.
or other Incorporated places of slore
than $500 inhabitants, while 20.442 |
came from the smaller towns or country
districts, leaving 1878 for whom the
place of residence was not reported. Of |
more significance, however, are the
statistics showing the number of ad- |
MISSIONS in proportion to the total |
DODul ation of each clase of copn,n,;