From the end of the Civil War to the onset of the Great War, the United States experienced an unprecedented increase in commitment rates for mental asylums. Historians and sociologists often explain this increase by noting that public sentiment called for widespread involuntary institutionalization to avoid the supposed threat of insanity to social well-being. However, that explanation neglects expanding rent seeking within psychiatry and the broader medical field over the same period. In this paper, we argue that stronger political influence from mental healthcare providers contributed significantly to the rise in institutionalization. We test our claim empirically with reference to the catalog of medical regulations from 1870 to 1910, as well as primary sources documenting rates of insanity at the state level. Our findings provide an alternative explanation for the historical rise in US institutionalizations.

从南北战争结束到第一次世界大战爆发，美国的精神病院承诺率空前提高。历史学家和社会学家经常通过指出公众舆论要求广泛的非自愿制度化来避免所谓的精神错乱对社会福祉的威胁，来解释这种增加。但是，该解释忽略了同期在精神病学和更广泛的医学领域内寻求租金的扩大。在本文中，我们认为精神卫生保健提供者的强大政治影响力极大地促进了制度化的发展。我们参考1870年至1910年的医疗法规目录以及记录州一级精神错乱率的主要资料，对我们的主张进行经验检验。