8
Opening Hearts and Hands to Those in Need
With the emergence of formalized medicine in the Revolutionary era, sickness became primarily a problem to be solved rather than a fact of creation prompting spiritual reflection. Many Christians shared the scientific assessment of disease and looked to medical advances to bring relief. Some, like the physician Benjamin Rush, pursued medical careers as part of a Christian call to attend to suffering. With medical discoveries and innovations, diagnoses eased the sense that sin caused disease. Mental distress remained just one form of illness, albeit a particularly tough one, worth remedying. Treatment and care still took place at home and in the local community, but now more often under the care of a formally trained or self-taught physician. In an era of scientific discovery, people were optimistic about the possibility of cure and amenable to professional care. As general hospitals and institutions for the insane sprang up around the country in the early and mid nineteenth century, a period of great hopefulness about treatment and cure for all disease ensued. Christians like the social crusader Dorothea Dix advocated on behalf of the afflicted to ensure the public provision of care for mental illness for all Americans. Cures for physical ailments, however, emerged more readily than remedies for mental maladies. And, by the late nineteenth century, squalid, crowded institutional conditions and a growing number of chronic patients clouded public perceptions and fueled suspicions that those who suffered with mental maladies might bear responsibility for their own illnesses. It was during this period, a time marked by rapid industrialization and economic growth, that stigma most firmly affixed to the nation’s mentally ill. Those confined to the nation’s asylums seemed detached from dreams of American progress and prosperity. Unlike prison inmates, who attracted much attention from Christian reformers, the mentally ill, sequestered and stigmatized, received little notice or care from the nation’s churches. During the country’s progression from a colonial outpost to an emerging world power of the early twentieth century, a period otherwise marked by tremendous ecclesial growth and institution building, the church—and particularly the clergy, the church’s representatives in the public sphere—struggled to compete with outside authorities in the provision of care for mental maladies. As advances in science, the professionalization of medicine, urbanization, population growth, the creation of institutions for the insane, and Enlightenment optimism about the possibility of a cure for mental illness converged, Protestant clergy lost their central position as sole providers of care and lone experts in the definition of mental illness. With such ailments defined as primarily medical issues, the advice of physicians was trusted over the counsel of clergy to bring relief. During the mid-twentieth century, mental illness formed a subject of debate among Christians. Was it a medical or spiritual problem? Who should provide care? Some endorsed treatment from psychologists and psychiatrists; others remained skeptical about care from secular providers. Alongside growing stigma, shifting professionalization further sequestered clergy—and congregational—authority in the private, spiritual sphere, leaving healing for mental maladies as primarily