From isolated asylums to the medical mainstream : psychiatry’s journey towards normalization within somatic medicine, 1900-1970

Abstract

Early in the twentieth century, therapeutic pessimism gripped psychiatry as chronic patients overcrowded mental asylums. Psychiatry grew isolated from the rest of medicine and many feared the specialty was medically irrelevant. Psychiatrist Adolf Meyer devised reforms that would integrate psychiatry into medical schools and general hospitals. This was meant to remove the stigma attached to mental illness and asylums. Moreover, psychiatrists would form productive relationships with somatic physicians which they lacked in asylum practice. This transition, however, was challenged by physicians who argued that the mentally ill had no place in their institutions. Through Meyer’s reforms, psychiatry’s role in medicine and society was altered, and a process of psychiatric normalization ensued across North America. A close examination of this transformation in Nova Scotia provides a case study that demonstrates how Meyer’s ideas spread via medical journals, and through students such as Dr. Robert O. Jones, who implemented Meyer’s reform strategy.