Meerenberg Mental Asylum

The care of the mentally ill in history has never been particularly easy or gentle until quite recently. Before the 19th century, they were lumped in with criminals and generally forgotten about, occasionally even paraded around like circus attractions. Perhaps more often than that, they were simply 'disposed' of, the authorities of the time finding themselves unable to deal with these strange illnesses. The 19th century saw a more scientific approach to the problem arise, as the fields of psychiatry and psychology were formed, and authorities throughout Europe found themselves employing more 'civilized' means of managing these people, even going so far as to attempt rehabilitation.

In the Netherlands, the 'Law of the Insane', formulated by the government in 1841, immediately led to the founding of the country's first true Insane Asylum, called 'Meerenburg'. Many techniques were adopted from their English neighbours by the Asylums first director; Marinus Everts. Amongst them were such improvements as the lack of restraints for the patients, which in previous decades and centuries came in the form of shackles and cuffs, amongst other methods. Meerenburg was the first Asylum on the European mainland to introduce such a policy of no restraints.

Old, nigh-medieval, methods of 'curing' patients were not immediately disposed of however. Bloodletting retained a prominent role in the therapy process for some time, the intentional creation of Lesions and Abcesses on the heads of patients in order to ease the disappearance of 'evil juices' was also not uncommon. One particular interesting old method that remained in use for some time was known as the 'Boot of Junot'. This was a brass boot in which the leg of a patient was placed, following which, the air was sucked out to the point of creating a vacuum. This process was extremely painful. However, it was believed that this process was ultimately beneficial, as it resulted in the blood being drawn from the upper regions of the body and head down to the feet, thereby dragging down all the imperfections in the brains with it.

Money was an important issue for both the patients and the asylum. Insurance companies hadn't sprouted into existence yet afterall. Thus poorer patients (or rather their family members) had to turn to churches and other charitable organizations. A total of 5 different 'classes' of 'luxury' were known to the Meerenburg Asylum. The richest patients paid a total of 1350 guilders per year, which in those days was worth several yearly salaries for less wealthy individuals. Even the poorest class of patients still had to pay some 320 guilders a year however, which would often lead to severe financial problems for their families. It was not unheard of for the richer patients to have their own furniture and artwork transported to their new home, some even had their own servants with them in the asylum.

Patientlabor was considered an important facet of treatment. By keeping the patients busy, thus it was argued, their mental afflications would no longer become at the forefront, as the patient was distracted by focusing on their work. Some doctors took this philosophy to curious extremes;

'Thus it is in an Asylum, to my insight, of utmost importance to organize everything to be most complicated as is possible. That is to say, that there is labor involved in every matter to a greater or lesser degree. For instance, it should be economical to place the bathroom near the pump in order that one might supply the water more easily; in an Asylum however, to my insight, this is completely wrong; the bath should be as far away from the pump as possible.' - Schroeder van der Kolk, Director Willem Artz-House, 1841

Treatment of the patients certainly improved to some degree, though not quite to the satisfaction of the officials and doctors in charge of the facility. While the doctors were drawn from the upper echelons of society, the lower level employees such as the nurses and caretakers, were drawn from the poorer classes of society. The therapists viewed the caretakers as unruly, rule, lewd, unmotivated, and far too often drunk. As a result of these conflicts, more than half of the personnel departed the Asylum on a yearly basis, resulting in a constant flow of new employees being brought in and old ones leaving. Furthermore, after 1860, the organizational flow of the Asylum was beginning to break down; A violent increase of the number of cases, particularly chronic ones, resulting in lack of space, increasing tension on the wards, and an ever worse personnel situation.

By the end of the century, the situation was slowly improving. New scientific views on the problem of mental illness were forming. The field of Psychology, which until now was the sole 'scientific' method of the time to be applied to these cases, was now being complimented by the emerging field of Psychiatry. Rather than a psychological cause, psychiatrists argued, some, if not most, of these problems were the result of physical ailments, and could be improved upon or even cured by the proper administration of medication or surgery. German psychiatrists formed a great influence on their Dutch colleagues. And much like their German colleagues, these Dutch psychiatrists believed that psychiatric patients should be treated as no different than those in a regular hospital. This vision was embraced by Doctor Jacob Van Deventer, who became the director of Meerenburg in 1892. He viewed the Asylum as no different than any regular hospital, and strove to reform the Asylum accordingly.

Ofcourse, by a more contemporary understanding, this was hardly something that he achieved, and the often experimental techniques employed by psychiatrists and psychologists alike, in the name of science, would hardly be considered ethically permissable in today's society. Various forms of treatment were employed, ranging from the commonly known extremes such as Electro-shock therapy or Lobotomy, to more obscure ones such as wrapping the patient in wet linnen, letting them soak in water for weeks or even months at a time, or sensory deprevation.

During the end of the 1880's, Doctor Van Deventer argued that untrained and uneducated caretakers should be replaced by trained hospital nurses, an argument which was supported by the national organization for psychiatry during the 90's.

In 1921, Meerenberg would be renamed the Santpoort Provinciaal Psychiatrisch Ziekenhuis, a label which it would retain until 1975, when the old name was re-instated. Many of the more unsavory practices of 'patient care' would continue until at least after world 2. During world war 2, the Nazi occupiers let the place wither, closing the institution without re-locating the patients. Many of the patients would starve to death, as nearby villagers could only infrequently provide food and water for the patients, who now had no caretakers except for a few Nazi guardsmen who ensured none of them except. It's known that during this time, a number of Jews were also hiding in Meerenberg, who saw an opportunity to avoid detection by sequestering themselves in the Asylum.

After world war 2, care at the Asylum greatly improved as modern and humane methods increasingly became available, nonetheless forced electroshock therapy did continue until at least the 70's on a number of unruly patients. In 1973, the institution was closed for 6 months after an incident with such an application of electroshock therapy led to the death of a patient, which sparked a national debate on the method and ultimately led to a ban on the therapy which was only lifted in the mid 90's when more controlled and humane methods of electroshock therapy became available. In 1982, the hospital was closed after the director of the time was involved in a scandal, although the nature of this scandal was never revealed to the public. In addition, a lack of public funds left the hospital without the funds to continue operating. The local government let the hospital decay without demolishing the buildings or cleaning out the place. In fact, many of the old tools used as far back as the turn of the 20th century can still be found in the deeper areas of the hospital, those areas which have not been looted by homeless people who took up residence after 1982.

In 2005, the hospital was re-opened by a private psychiatric healthcare firm, which has since opened the doors to a considerable number of psychiatric cases which the psychiatric healthcare system deems 'untreatable'.