This restrain was used at Osawatomie State Hospital, probably in a women's ward.
"Though it looks like an implement of torture designed in the Dark Ages, there are times when it looks like God's protecting arm around you."--Lara Jefferson, These Are My Sisters, 1947
Before the days of psychoanalysis and Prozac, mental health was largely a mystery. Doctors did not know how to treat the symptoms of disorders such as schizophrenia, depression, and anxiety. As a result, they attempted a variety of treatments that by modern standards seem cruel. The straitjacket was one of these. At the height of its use, it actually was considered humane.
Before the Civil War, the mentally ill had been placed in poor houses, workhouses, or prisons when their families could no longer care for them. Patients often lived with criminals and were treated likewise, locked in a cell or even chained to the walls. By the 1860s, Americans wanted to provide better assistance to the less fortunate, including the mentally ill. The number of facilities devoted to the care of people with mental disorders increased significantly. Meant to be a place of refuge, these facilities were referred to as insane asylums. Between 1825 and 1865, the number of asylums in the United States increased from nine to 62.
The establishment of asylums did not mean that treatment greatly improved. Doctors still did not understand what caused their patients' behavior. They listed such things as religious excitement, sunstroke, and reading novels as possible causes of mental illness. Additionally, they believed that patients had lost all control over their morals, and strict discipline was necessary to help the patient regain self-control. The asylum provided the restraint a patient could not supply himself. Confining the patient in a straitjacket was one way to do this.
Many doctors considered straitjackets to be a humane form of treatment, far gentler than the chains patients encountered in prisons. The restraint supposedly applied no pressure to the body or limbs and did not cause skin abrasions. Moreover, straitjackets allowed some freedom of movement. Unlike patients anchored to a chair or bed by straps or cuffs, those in a straitjacket could walk. Some doctors even recommended restrained individuals stroll outdoors, thereby reaping the benefits of both control and fresh air.
While considered humane by some, straitjackets were frequently misused. Over time, asylums filled with patients and lacked adequate staff to provide proper care. The attendants generally were not trained to work with the mentally ill. Some feared the patients and resorted to restraints to maintain order and calm. Patients might remain in restraints for days.
Kansas Mental Health Facilities
Such was the case at the Osawatomie State Hospital, established by the State of Kansas in 1866. The facility had beds for 12 patients when it opened. By the end of the next year it housed 22 with applications for 50 more. In 1945, the ratio of patients to physicians was 854 to one. As a result of such conditions, restraints were used longer at Osawatomie than in Kansas' other mental health facilities. The documented use of straitjackets continued until at least 1956.
Around 1950, Charles H. Graham, a reporter with the Kansas City Star, wrote a series of articles on the conditions at Kansas' state hospitals. At Osawatomie he found that force was commonly used to restrain male patients, while females wore straitjackets and wrist cuffs. One attendant reported that of the 70 patients on the ward, half might be in straitjackets at any given time. Graham saw no apparent abuse in the women's ward, but described the scene as bedlam:
"These women were doing the best they could in a building that is utterly unfit for the care of mental patients, or any other kind. . . . There is no place to which any patient can retire to escape momentarily the Bedlamic scene, and as a result, some of them 'blow up.' That brings on the restraints."
Graham found it interesting that Osawatomie continued to use restraints while Larned State Hospital, a facility for the criminally insane in western Kansas, had abandoned them by 1948.
Osawatomie was eventually able to phase out the use of restraints through increasing staff and improving facilities. Advances in psychology, including the development of tranquilizing drugs, made the devices unnecessary. Attendants were still leery of removing the restraints, though. According to one, "They were convinced that the patients would kill us. We couldn't get a mental image of any other way than repression."
Once used at the Osawatomie State Hospital, the straitjacket pictured here is in the collections of the Kansas Museum of History. Its small size and general shape indicate it probably was used in the women's ward.