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May 4, 1984

Mental Illness and American Society, 1875-1940

JAMA. 1984;251(17):2274. doi:10.1001/jama.1984.03340410076043

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In recent years many social scientists and historians have written about mental hospitals and society's ways of coping with the mentally ill. Almost all the authors seemed to have had some ax to grind—to attack capitalist society, or psychiatry, or psychoanalysis. One of the least hostile historians is Gerald Grob, professor of history at Rutgers University, who in 1973 published the book entitled Mental Institutions in America: Social Policy to 1875. Now he presents its sequel, to 1940. This is a scholarly work, clearly written, obviously carefully researched, and well documented—93 pages of notes and 321 pages of text.

Grob shows that the care of the mentally ill was originally the responsibility of their community—city or county—but gradually the responsibility was transferred to the states. This led to the ever-increasing size of state hospitals which, for several reasons, steadily accumulated more and more elderly and chronic cases who needed custodial