Primary Sources in the Classroom: Project Ideas for Investigating Mental Health Care in the United States through Digitized Asylum Reports

The Cummings Center for the History of Psychology (CCHP) houses a fairly large collection of American asylum reports, from both public and private institutions, which range from the early 1800s through the 1960s. The Cushing Memorial Library Collection of Asylum Reports includes nearly 500 reports and the exciting news for you is they are now all available online in full-text for you and your students to use. Use the search bar to search for single words within the collection or use the advanced search to look for complete phrases or to omit certain words. You can organize and view the collection by date or title. The reports are available as PDFs, many of them word searchable, so download away.

You may be thinking, “Sure, this all sounds neat, but how can I use these reports in my classroom?”  Great question. Instructors have used the reports on site in a variety of ways and nearly all of those projects are adaptable to off-site users.

Example 1: An investigation into the language used to describe the mentally ill. Students, alone or working in groups, download three reports from three different decades and investigate the language used to describe mental illnesses. This can be a starting point for students to research how descriptive language has changed or evolved and how the diagnosis of mental illness has changed as well. For example, many reports will include information on patients with tuberculosis and epilepsy, two examples of conditions that are no longer considered mental illnesses.

Example 2: An investigation of how the treatment of mental illness has changed in your state or region. Students, working alone or in groups, identify an asylum in your state or region for which we house reports. They can research whether that treatment facility is still open and its history in the region. They can use details from the reports to learn more about the history of mental illness and treatment in your state or region.

Example 3: An investigation into the history of the treatment of the mentally ill. Treatment for mental illness is always evolving and these reports provide an opportunity to examine treatment methods over time. Students, alone or in groups, can determine the most popular treatment methods used and further investigate how methods have changed or been discarded. If you’d rather your students not continue the work outside of class, you could facilitate a class discussion on the topic instead. The discussion could begin with students listing the most popular methods in their reports and continue with a discussion providing more details such as the validity of certain methods or perhaps how a method has evolved and is still used today. A sub-project here would be to have students select reports from both before the introduction of antipsychotic medications and after in order to analyze how drugs changed the course of mental health treatment.

Example 4: An investigation into the costs of asylums and state hospitals. The asylum reports, especially those of public institutions, provide very detailed information regarding operational costs. Students can review reports and find actual dollar amount for things like flour and bed sheets as well as staff and treatment costs. You and your students can use this data to have a discussion about the cost of mental health care in America. You can look at the data within the context of deinstitutionalization and the Community Mental Health Act of 1963 as well as the streamlining of certain treatment methods in order to reduce costs.

Example 5: An investigation of the differences in public and private care for the treatment of the mentally ill. Students, working alone or in groups, locate a report from a public institution and a private institution from the same time period. While reviewing the two reports they can look at costs, differences in treatment methods, patient population information and patient data like length of stay and the rate of “cured patients.” Following the students’ gathering of information, you could facilitate a larger discussion surrounding current issues regarding the costs of mental health treatment and how socio-economic status may affect treatment options.

Example 6: Keep it simple. Have each student review an asylum report of their choosing and ask them the following questions: (1) What is the most surprising thing you read? (2) What did you find most interesting? (3) What is one question you had after reading the report? Follow this up by leading a class discussion.

Primary sources often get the bad rap of being inaccessible and hidden away in archives. Sure, we can’t digitize everything in archives, but every now and then we have the ability to make materials available online and provide greater access to primary source documents. This is one of those times. The Cushing Memorial Library Collection of Asylum Reports available at the Cummings Center for the History of Psychology is a rich collection of primary source documents you and your students can use in a variety of ways. If you’re interested but need a little guidance please do not hesitate to reach out to us via email, as we are always willing to help. 

About the Author

Lizette R.  Barton, MLIS, is a reference archivist at the Cummings Center for the History of Psychology.