A postcard image of a large asylum building

Teaching with Primary Sources: Early Mental Health Care and Asylums

On-site Workshops | Off-site Activities | Additional Resources

Asylums and state hospitals represent the origins of the formalized mental health care system in the U.S. To understand our system today, we need to understand how it developed. Teaching mental health history through primary sources can help students connect more deeply with a topic that is overflowing with misinformation, misunderstanding, and stigma.

If you are interested in exploring a specific topic not covered on this page, please contact us at ahap@uakron.edu and we will be happy to assist you.

Annual Reports from Asylums and State Hospitals

Every institution submitted a report annually to their Board and state government. These reports contain day-to-day details about the operations of an institution in a given year. Typical reports list patient demographics and statistics, operational highlights, struggles the institution is facing, and financial reports. Some reports will also feature case studies, floor plans, or even photographs. They are a rich primary source for information on the history of disease classification, treatment philosophy and adoption, and institutional experiences.

The Archives of the History of American Psychology holds the largest multi-region collection of asylum and state hospital reports in the U.S. It contains over 570 reports representing 33 states between the years 1834 to 1967. The bulk of the collection is digitized and searchable through our website.

On-site Workshops

Duration: Approximately 60 minutes
Recommended Group Size: 10-30 visitors

This hands-on archival workshop delves into the history of mental health institutionalization in the U.S. Attendees are guided by one of our staff experts through an exercise using original asylum and state hospital reports published in the nineteenth and early twentieth centuries. Topics explored include diagnoses, treatments, and changes to the institutional model over time.

We also offer a variation of this workshop that focuses specifically on issues of race and gender.

To book this workshop, please contact us at ahap@uakron.edu. In your email, please include your estimated group size, date and time availability for your visit, accessibility needs, and your institutional affiliation (if applicable). All program scheduling is dependent on staff availability; bookings are not finalized until you receive confirmation from a member of our team.


Off-site Activities and Assignments

Can’t make it to Akron? Thanks to our online repository, you can run your own activity from the comfort of your classroom.

We offer an Educator's Guide and Student Worksheet to guide your off-site activity. The Educator's Guide includes links to recommended annual reports from across the U.S. to get your class started, plus comprehensive notes to guide your classroom discussion.

You can access additional reports in our online repository. The Student Worksheet can be completed using any of the digitized reports in our collection. We recommend:

  • Assigning reports from different states to emphasize similarities and differences across the U.S.
  • Assigning reports from the 1800s to half of your class and reports from the 1900s to the other half. This will help with conversations about change (and consistency) over time.

Research Guides

Want to give your students a more in-depth assignment? Have them search the annual report collection for specific topics of interest. We have created a series of Research Guides to help get you started:

  • Race and Segregation: The institutional mental health care system was segregated until after the Civil Rights Movement. Some states – primarily in the South – admitted Black patients to separate buildings or constructed entirely separate institutions. There was only one mental health institution for Indigenous Peoples, the Asylum for Insane Indians (Hiawatha Asylum) in Canton, SD. Conditions were drastically poorer in these segregated facilities as compared to the buildings designated for white patients. Explore our Race & Segregation Research Guide, which includes a list of suggested annual reports to get you started.
  • Restraints: The use of restraints was common but regularly debated in the history of U.S. mental health institutions. Although antithetical to the philosophy of moral treatment, mechanical restraints and chemical restraints were adopted to varying degrees in all states. This history also overlaps with the development of sleep aids, such as in the development of the Utica crib and the use of chemical restraints. Explore our Restraints Research Guide, which includes a list of suggested annual reports to get you started.

Additional Digitized Resources

The Archives of the History of American Psychology and the Institute for Human Science and Culture hold several postcard collections that feature asylums and state hospitals. The images are excellent sources, especially for discussions of architecture and ground design.

It should be noted that there was rarely any association with the institution itself: the photos were taken, edited, labelled, and printed by postcard publishers. The majority feature the exterior of the building(s) and surrounding grounds; interior images and people are rare. It is also rare to find a message on a postcard that references the image directly; when they do, these tend to either be stigmatizing or refer to a personal association (patient, family member, staff).

Two of these collections are digitized and searchable online:

The Robert H. Wozniak Asylum Postcard Collection includes 1,235 postcards of asylums and state hospitals across the U.S., with a handful of international sites as well.

The David P. Campbell Postcard Collection features one binder of 335 postcards dedicated to different types of public institutions, including those for mental health care.

The Archives of the History of American Psychology contains many other collections relating to the history of institutional mental health care. Many of these collections have not been digitized. To explore our full collection, visit our online repository. Research requests can be made to ahap@uakron.edu.