Insane and feeble-minded in institutions 1910.

  • United States. Bureau of the Census.
Date:
1914
Catalogue details

Licence: Public Domain Mark

Credit: Insane and feeble-minded in institutions 1910. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    considered as coming into this class, and accordingly was not taken up until 1904. The postponement of the inquiry, however, in- volved this disadvantage, that it interfered with direct comparisons between the number of insane and the general population as classified by race, nativity, age, etc. Some of the most interesting questions arising in connection with the subject of insanity can be determined only by means of such comparisons. For instance, the question naturally arises as to the age or period of life at which the tendency to insanity is most marked. This calls for the computation of the ratio of insane to general population by age periods. But it was felt that a census of the insane taken for the year 1904 could not be safely compared in detail with a census of the popu- lation taken four years earlier. Accordingly, the re- port for 1904 did not show any ratios except the ratio of the total number of insane enumerated in 1904 to the total estimated population for the same year. Possibly the position taken regarding this matter was unduly conservative, but, however that may be, it is undoubtedly true that the best results to be obtained from a census of the insane will not be realized unless it is contemporaneous or nearly so with a general census of population. For this reason the law pro- viding for the Thirteenth Census in 1910 authorized an enumeration of the special classes in institutions cover- ing the same year. In any interpretation or analysis of the statistics relative to the insane it should be borne in mind that the term insanity applies to a group of mental diseases which differ widely in their causation, course, and outcome. Accordingly, statements or conclusions which are correct for the group as a whole may not hold good of the more or less distinct classes which make up this group. For instance, the statistics pre- sented in this report indicate an increased tendency or liability to insanity in the period of old age. Yet probably this is indicative of the influence upon the data of one type of insanity only, namely, that known as senile dementia, which makes its appearance only in old age. The limitations under which the data for a census of the insane must be obtained make it impracticable to go very far towards distinguishing the different forms of insanity, although in the present report a step has been taken in that direction by differentiating cases of alcoholic psychosis and of general paralysis. From a sociological and legal point of view, however, the insane represent a fairly homogeneous class of de- fectives; and it is from this point of view that the statistics regarding the number of insane, their sex, ages, nativity, distribution, etc., have their main value and significance. Comparative summary: 1850 to 1910.—The follow- ing table shows the number of insane persons enu- merated at each census from 1850 to 1910, those in institutions for the insane and outside such institu- tions being shown separately for the censuses of 1880 and 1890. Prior to 1880 no separate return was made of the insane in institutions; and since 1890, as already explained, no enumeration has been made of the insane outside of institutions. Table 1 INSANE ENUMERATED IN INSTITUTION? FOB THE INSANE. INSANE ENUMERATED OUTSIDE SUCH INSTITUTIONS. TOTAL INSANE ENUMERATED. Number. Per 100,000 popu- lation. Num- ber. Per 100,000 popu- lation. Number. Per 100,000 popu- lation. 1910 187,791 150,151 74,028 40,942 (s5 m 204.2 183.6 118.2 81.6 (') <l) 32,457 51,017 (!) m h (') (') 51.8 101.7 187,791 150,151 106,485 91,959 3 37,432 3 24,042 '15,610 204.2 1904 183.6 1890 170.0 1880 183.3 1870 3 97.1 3 76.5 1850. 3 67.3 ■ No enumeration of insane outside of institutions. - Included in the enumeration but not returned separately. » Enumeration believed to have been seriously deficient. It is not to be supposed that the veiy marked in- crease in the number of insane reported in 1880 as compared with the preceding census measures an in- crease in the actual amount of insanity. It can only be accounted for by an improvement in the efficiency of the canvass consequent upon the fact that in 1880 special attention was given to the enumeration of the defective, dependent, and delinquent classes. This branch of the census work was placed under the gen- eral charge of an expert special agent, and a special supplementary schedule was adopted for the enu- meration of the insane. The extra compensation which the enumerator received for filling out this schedule doubtless operated as an incentive to vigi- lance in finding and reporting cases of insanity. At the same time, as stated in the census report, it was impressed upon him that he should exert himself to find these defective persons and make a full report of each case. He was instructed to counsel with physicians upon this point, to make inquiries of neighbors, and to report all defectives, whether the information respecting them should be derived from the family to which they belonged or from other sources, if in his judgment it was worthy of confidence. By this method it was sought to obtain approximately as complete an enumeration of defectives outside of institutions as of the inmates of such institutions. * * * Moreover, the work of the enumerators was supplemented by correspond- ence with physicians, in all parts of the United States, to the number of nearly 100,000, all of whom were furnished with blank forms of return, and were in- vited and urged to report to the Census Office all idiots and lunatics within the sphere of their personal knowledge. Four-fifths of them responded to this