With the increasing credibility of these institutions, the populations skyrocketed. It was common for homeless people, tramps and hobos to become ‘patients’ of the asylums seasonally for shelter and food, and then “elope,” or slip away when the good weather returned. Families would often submit their elderly relatives to asylums because they lacked the resources or time to deal with them appropriately. The problem with overcrowding developed because the institutions had no established criteria for accepting or rejecting patients into their care. Rapid growth in populations caused patient care to suffer. In the Athens Asylum the patient population jumped from 200 to nearly 1800, with an insignificant alteration in staffing. The community found that these institutions were an easy means to remove unwanted people from society. There was no effort to provide any other programs or support, because the state was paying for the asylum.
The severe overcrowding led to a sharp decline in patient care and once again, the revival of old procedures and medical treatments. Restraints returned. Instead of sleeping in single rooms as the Kirkbride Plan had designed, patients were sleeping in wooden cribs stacked three patients high. Ice water baths were once again used, along with shock machines and electro- convulsive therapy. And in the early 1930s the notorious lobotomy was introduced into American medical culture.
The original lobotomy was a medical procedure where the neural passages from the front of the brain are surgically separated from those in the back of the brain. The common result of this procedure was the patient forgetting their depressing or discouraging feelings or tendencies. This was a very delicate, time-consuming procedure that required great skill and training from the practicing surgeons. Because the lobotomy appeared to effectively alter the mental health of patients, great effort was invested into developing a more practical procedure with similar desired results.
To the satisfaction of his peers and the mental health community, Walter J. Freeman developed the trans- orbital lobotomy. This new medical procedure could be performed quickly and required limited after- care for the patient. The procedure was performed as follows:
-To induce sedation, inflict two quick shocks to the head.
-Roll back one of the patients’ eyelids.
-Insert a device, 2/3 the size of a pencil, through the upper eyelid into the patients’ head.
-Guided by the markings indicating depth, tap the device with a hammer into the patients’ head/ frontal lobe.
-After the appropriate depth is achieved, manipulate the device back and forth in a swiping motion within the patient’s head.
Because this new form of lobotomy could be performed so quickly and easily, the trans- orbital craze swept the nation’s asylums. Freeman himself performed over 3,000 lobotomies and was labeled the traveling lobotomist. Trans- orbital lobotomies were performed on hundreds of Athens Asylum patients in the early 1950s. In a local newspaper, on November 20, 1953, the headline read “Lobotomies are Performed on 31 Athens State Hospital Patients,” and the article boasted that nearly 25 of those who received surgery would be able to go home with their relatives Sunday. Freeman and the trans-orbital lobotomy stirred up harsh criticism from those who learned of his flamboyant methodology. Due to the number of complications and deaths that resulted from the procedure, it was referred to as “psychic mercy killing” and “euthanasia of the mind.” This was by far mental health care’s darkest hour.