From the 1870s to the 1920s according to Richard W. Fox’s 1978 study ‘So Far Disordered In Mind: Insanity in California, 1870-1930,’ California had a higher rate of commitment for insanity than any other state in the nation, a disproportion most reasonably explained, Fox suggests, “by the zeal with which California state officials sought to locate, detained and treat not only those considered “mentally ill,” but also a wide variety of other deviants -- including, as State Hospital physicians put it, “imbeciles, dotards, idiots, drunkards, simpletons, fools” and “the aged, the vagabond, the helpless.”
Not only did California have this notably higher rate of commitment, but the institutions to which it committed citizens differed fundamentally from those in the east where the idea of how to deal with insanity had been from the beginning medicalized, based on regimes -- however more honored in the breach -- of treatment and therapy. The idea of how to deal with insanity in California began and ended with detention.
So broad where the standards for commitment and so general was the inclination to let the state take care of what might in another culture have been construed as a family burden, that even many doctors who ran the system were uneasy. As early as 1862, according to “So Far Disordered in Mind,” a resident physician at the Stockton State Asylum for the Insane complained of receiving patients “who, if affected in their minds at all, it is the weakness of old age, or in temperance, or perhaps most commonly both together.” In 1870, the Federal Census classified one in every 489 Californians as insane. By 1880 the rate had risen to one in 345. After 1903 when the state had reached one in 260 and the asylums had passed capacity, the notion of sterilizing inmates gained currency, the idea being that a certain number could then be released without danger of reproducing. Sterilization, or “asexualization,” of inmates which was legalized in some other states as early as 1907 was made legal in California in 1909. By 1917 the right of the state to sterilize had been extended twice, first to cases in which the patient did not agree to the procedure, then to cases in which the patient had not even been necessarily diagnosed with a hereditary or incurable disorder, but only with “perversion or margin departures from normal mentality.”
By the end of 1920, of the 3,233 sterilizations for insanity or feeblemindedness performed to that date throughout the United States, 2,558, or 79%, had taken place in California.
What was arresting in this pattern of commitment was the extent to which it diverged from the California sense of itself as loose, less socially rigid than the rest of the country, more adaptable, more tolerant of difference. When Fox analyzed the San Francisco commitment records for the years 1906-1929 he found that the majority of those hospitalized, 59%, had been committed not because they were violent, not because they presented a threat to others or to themselves, but simply because they had been reported sometimes by a police officer but often by a neighbor or relative to exhibit “odd or peculiar behavior.” In 1914 for example San Francisco medical examiners granted the wish of a woman to commit her 37-year-old unmarried sister on the grounds that the sister, despite her “quiet and friendly” appearance during detention, had begun “to act silly, lost interest in all things which interest women, could no longer crochet correctly as formerly, takes no interest in anything at present.” In 1915 a 40-year-old clerk was committed because “for three weeks he has been annoying the city registrar, calling everyday and insisting that he is a deputy.” In 1922, a 23-year-old divorcée was committed after a neighbor reported that she was “lazy, slovenly, careless of personal affairs, stays away from home for days, neglecting self and consorting with men.” The same year a 48-year-old pianist was committed on the grounds that “she has been irresponsible for years; has been a source of great annoyance to many institutions such as the YWCA Association, churches, etc.”
The apparently pressing need to commit so many and in many cases such marginally troubled Californians to indefinite custodial detention seems not at the time to have struck their fellow citizens as an excessive lust for social control. Nor did these fellow citizens appear to see their readiness to slough off bothersome relatives and neighbors as a possible defect in their own socialization. Madness, it became convenient to believe quite early on, came with the territory on the order of earthquakes.
The first State Lunatic Asylum in California, at Stockton, was established in 1853 specifically to treat those believed to have been driven mad by the gold fields. According to an 1873 state board of health report this endemic madness had to do with “the speculative and gambling spirit” of the California settlement. It had to do with “heterogeneous elements,” it had to do with “change of climate, habits, and modes of life,” it had to do with being “isolated without sympathy and deprived of all home influences.”
California itself then, according to its own Board of Health, was “well calculated to break some link in reason’s chain and throw into confusion even the best balanced properties of mind.”