What was Moral treatment?

"Moral treatment was an approach to mental disorder based on humane psychosocial care or moral discipline that emerged in the 18th century and came to the fore for much of the 19th century, deriving partly from psychiatry or psychology and partly from religious or moral concerns. The movement is particularly associated with reform and development of the asylum system in Western Europe at that time. It fell into decline as a distinct method by the 20th century, however, due to overcrowding and misuse of asylums and the predominance of biomedical methods. The movement is widely seen as influencing certain areas of psychiatric practice up to the present day. The approach has been praised for freeing sufferers from shackles and barbaric physical treatments, instead considering such things as emotions and social interactions, but has also been criticised for blaming or oppressing individuals according to the standards of a particular social class or religion."
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"In 1813, Samuel Tuke, grandson of William, published a book titled Description of the Retreat, an institution near York for insane persons of the Society of Friends. In his book, he gave an account of “Moral Treatment". Physical coercion and restraint were deplored and were replaced with



relationships with attendants who were carefully selected to offer inmates guidance and treat them humanely. Patients were to be treated with respect, as adults, not as children, and were to be urged in the direction of self-restraint and self-control [2]. The violent were separated from the nonviolent. Environmental factors were seen as playing an important role in the etiology of the mental problems. Attention to the social milieu largely replaced physical methods of treatment.

The mad were not seen as animals, but as suffering humans who had gone astray and who could be led back to the right path through kindness, compassion, and rational conversation. Moral treatment was a profoundly social form of treatment. The experience of madness was to be corrected by placing people in humane and caring social environments that emphasized social interaction and the cultivation of latent faculties and healing processes. Moral Treatment had far-ranging effects on the face of institutionalization in Europe and in America. The book that Samuel Tuke wrote about the York Retreat spurred the investigation and reform of madhouses throughout the Continent [3].
Moral Treatment spread rapidly to the United States. Benjamin Rush, considered the founder of American psychiatry, believed that disease, political institutions, and economic organization were so interrelated that any general social change produced accompanying changes in health. For him, proper political stimuli and a stable and ordered society were required for health. “Mental health implied a society which would provide the proper stimuli and necessary conditions for well-being” [4].
As a result of the influence of the Tukes, Pinel, and others, the asylum movement grew rapidly, and soon every population center in America had a beautifully constructed asylum created to provide the mentally ill with the most modern forms of social treatment in a safe and humane environment. By 1844, American proponents of Moral Treatment "Moral treatment" had amassed an impressive body of evidence to support their belief that mental illnesses were treatable and that asylum treatment could restore patients to health. By 1837, Eli Todd at the Hartford Retreat had cured 91.3 percent of his recent cases, and Woodward at Worcester had discharged more than 82 percent as recovered. They proposed that the mentally ill had as much chance for recovery as a person who was ill with any other acute disease of equal severity [5]."
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