A Milestone in Moral Treatment
The Foundation takes its name from Thomas Scattergood, a 19th-century Philadelphia Quaker minister who protested the harsh conditions faced by the mentally ill. Scattergood advocated for moral treatment, a model of treating the mentally ill with dignity, respect, kindness, and love. This model partly inspired the Philadelphia Quaker community to found the Friends Asylum for the Relief of Persons Deprived of the Use of Their Reason, the nation’s first privately run psychiatric hospital, in 1813. Based on the Quaker belief that all humans have “that of God” within them, the hospital was a special place where those who suffered from mental illness were treated with respect and dignity.
In 1998, the Hospital (www.friendshospital.com) and its entire campus were named a National Historic Site, in recognition of its leadership in the evolution of behavioral healthcare in America.
Thomas Scattergood (1748-1814) was a tanner by profession and a minister by compulsion. By numerous accounts, he suffered from depression, and as we often see in people who endure that affliction, he was highly productive in his work. Early in his life, he traveled the countryside helping to lead Meetings of the Religious Society of Friends, despite the fact that his depression rarely lifted. This was a considerable task, considering that Friends were a group that disdained leadership, especially in spiritual matters. He became a minister in 1781.
Thirteen years later, he traveled to York, England, and he visited two young institutions: the Quaker school and The Retreat. The Retreat was a revolutionary hospital founded on the principles of moral treatment for the mentally ill. Upon his return to the United States six years later, Scattergood began in earnest to recreate both types of institutions in Pennsylvania.
Mainstream society of the early 1800s viewed the insane as a “necessary evil and an integral part of the social hierarchy." A cure for insanity was deemed not only an impossible task, but unnecessary. Most individuals simply wanted that the mentally ill would be merely taken away from society. Those with mental illnesses were seen as spiritually damned and were commonly treated with social isolation, chains, physical restraints, and punishment. Quakers, however, considered it necessary to find a cure for the mentally ill: "if it is sincerely believed that in every man there is a 'divine principle' and nothing, be it slavery, poverty, or insanity, should prevent that man from obeying that principle, then insanity becomes merely another obstacle to be removed from the road to inward enlightenment and, like slavery and poverty, curable.”
Thus, in 1811, Scattergood’s proposal to create Friends Asylum for the Relief of Persons Deprived of the Use of their Reason was a moral obligation for the Quaker community. The community saw it as a way to not only care for but cure the mentally ill. By 1813 various committees had recommended Scattergood’s proposal and Philadelphia Yearly Meeting, the largest organized group of Friends in the region, appointed a committee to raise funds and organize the construction of the asylum. Scattergood was a member of this committee.
The product of their endeavors was Friends Asylum, later called Friends Hospital. Committee member Samuel Tuke, grandson of the founder of The Retreat in York, England, published a book about The Retreat to help raise awareness of the new project as well as funds. In that book, Tuke said at other institutions of the 18th century, “the general treatment of insane persons was, too frequently, calculated to depress and degrade, rather than to awaken the slumbering reason or to correct its wild hallucinations.”
Friends Asylum would be different. Patients (so different from the inmates of other institutions) were to be given moral treatment. Moral treatment entails the recognition of the mentally ill as fellow men and brethren to be cared for with dignity, respect, kindness, and love within comfortable, pleasant surroundins. Indeed, for nearly 200 years Friends Hospital has shaped by example the path of psychiatric care in America.
The men and women of Friends Hospital, at first concerned Friends and later trained psychiatrists, psychiatric nurses, psychologists and therapists, helped create the very treatments that have helped to heal the mentally ill. From the earliest days, Friends Hospital utilized occupation as a curative for patients: men often worked on the working farm that helped sustain the hospital community, while women worked in kitchen gardens, weaving, or otherwise contributing to the community. Thus, the concept of occupational therapy was born. Horticultural therapy, which has proven valuable for the mentally ill, the developmentally disabled, and the physically disabled, also originated at Friends Hospital, which had patient greenhouses in the mid 1800s. In an age before psychiatric medication, Friends physicians embraced other cutting-edge treatments, such as hydrotherapy, in order to ease patients’ suffering. A nursing school trained psychiatric nurses until the 1930s, and physicians regularly wrote of their experiences and trained other psychiatrists. Today, the Hospital hosts the Drexel University College of Medicine Department of Psychiatry. The Hospital was named a National Historic Landmark in 1999.
Thomas Scattergood did not live to see the results of his proposal; he died in 1814 of Typhoid fever. “But this man of the sad features and dour turn of mind had successfully served as the catalyst for one of the most important events in the history of American Psychiatry.