A brief history of the mental health system in North Carolina

Discovering Hannah's death certificate felt like opening the door to part of my family's past that had been hidden for decades.  But after contacting Broughton Hospital, I had to come to terms with the realization that I may not find out much about her life and death.  I decided the best route would be to find out how much information was out there about Morganton State Hospital during Hannah's stay.

The main source I took my information from is called People, Patients and Politics: the history of the North Carolina mental hospitals, 1848-1960 by Clark R. Cahow.  Unless otherwise stated, I owe all the information to his research and discoveries.

Dorothea Dix, activist for the mentally ill and created the first American mental asylums.

Dorothea Dix, activist for the mentally ill and created the first American mental asylums.

The state of North Carolina had no institutional care before 1856.  Mild to moderately mentally ill people who were not considered violent mainly roamed throughout their towns asking for money and suffered abuse as the town oddity.  Some wealthy families sent their mentally ill relatives to institutions in neighboring states.  Those considered dangerous to society had basically two choices:  the local jail or hidden away.  When Dorothea Dix crusaded for a mental hospital in North Carolina in 1848, she made the following statement:

In Lincoln County, near a public road, stands a decent dwelling; near by is a log cabin, strongly built and about ten feet square, and about seven or eight feet high; no windows to admit light; the square logs are compactly laid; no chimney indicates that a fire can be kindled within, and the small low door is securely locked and barred.  Two apertures at right angles, ten inches long by four wide, are the sole avenues by which light and air are admitted within this dreary cabin, so closely secured, and so cautiously guarded.  You need not ask to what uses it is appropriated, the shrill cries of an incarcerated maniac will arrest you on the way...examine the interior of this prison, you will see a ferocious, filthy, unshorn, half-clad creature, wallowing in foul, noisome straw.  The horrors of this place can hardly be imagined:  the state of the maniac is revolting in the extreme...For assuring public and private safely, his family have the only alternative of confining him on their own farm rather than seeing him thrown into the dungeon of the County jail.

At this time, insanity and mental illness was considered divine judgment on people who brought on the condition themselves due to wickedness and/or inferiority.  Family members of mentally ill people felt shame and embarrassment. In the later 1880s, public attitude somewhat changed to where it believed institutions could actually help and cure the mentally ill, but not completely:  "All too often the mentally ill person continued to be regarded not as a sick person to be treated but as an undesirable charge to be tolerated.  Once the public became convinced that hospitalization was an end in itself, the local community found it easy to forget the patients committed.  Patients sent to a large, centralized, and somewhat isolated institution were now out of sight and soon out of mind." 

After Morganton State Hospital opened in 1883, the institution soon suffered the misfortunes of the other asylums in the state:  overcrowding and budget cuts.  In the "Report of the State Hospital at Morganton, N.C. for the Two Years Ending November 30, 1920," the superintendent of Morganton State Hospital, John McCampbell, MD, remarks to the Board of Directors that "At no time during this period have we had a full corps of officers and employees, and more than once we have been reduced to the point of grave danger for a lack of proper help."  I believe Cahow sums it up best when he states, "The first hundred years of institutionalized care of the insane in North Carolina is best characterized as a period of public indifference and meager State appropriations which resulted in inadequate facilities, low salaries, insufficient and poorly trained staff, undermanned and overworked professional personal, and a political structuring of the hospital system that fostered patronage and direct interference." 

The more research I do, the more I seem to find, sometimes conflicting.  But what I found next was shocking and disturbing.