The Construction of Hospitals for the Insane
PART I.
Chapters 1 - 10More to come...
CHAPTER XVII
ENCLOSURES.
IT is desirable that the pleasure-grounds and gardens should be securely enclosed, to protect the patients from the gaze and impertinent curiousity of visitors, and from the excitement occasioned by their presence on the grounds. This, therefore, becomes a matter for consideration in the selection of a site.
This enclosure should be of a permanent character, about ten feet high, and so located that it will not be conspicuous, even if it is at all visible, from the building. The site, as well as the position of the building on it, should have some reference to this arrangement. If sufficient inequalities of surface exist, the wall or fence, as it may be, should be placed in the low ground, so as not to obstruct the view; but if the country is too level to admit of this, the same end may be attained by placing the wall in the centre of a line of excavation of sufficient depth to prevent its having an unpleasant appearance, and yet to render it entirely effective. Although the first cost of a wall will be about double that of a fence of the proper kind, still its durability and greater efficiency in every respect, will make it cheaper in the end. The amount of land thus enclosed should never be less than thirty acres, while forty or fifty acres are a more desirable amount, so that the pleasure-grounds of the male and female patients, which, as before observed, should be entirely distinct, may be sufficiently extensive. Even a whole farm thus enclosed has great advantages, and such an expenditure is fully justifiable. This has been done at the Government Hospital near Washington, where more than three hundred acres are thus surrounded by a permanent wall, with the greatest comfort and advantage to the institution, and all concerned feel that few expenditures give more satisfaction than those for properly enclosing the grounds of a hospital.
Important as I regard the permanent enclosure of extensive pleasure-grounds and gardens, in the manner suggested, as protecting the patients from improper observation, keeping out intruders, enlarging the liberty of the insane generally, securing various improvements from injury, and permitting labor to be used as a remedy for more patients than could otherwise be done, still it is proper to add, that high walls around small enclosures, and in full view of the buildings, are even less desirable than a simple neat railing, which would neither keep determined visitors out, nor active patients in. The first of these objects—keeping the public out,—it must not be forgotten, is the prominent one thought of, in recommending a wall to be placed around the pleasure-grounds of a hospital. The presence and watchfulness of intelligent attendants must still be the grand reliance to prevent the escape of patients, and any arrangement that does away wth the necessity of constant vigilance, is to be regarded as undesirable about a hospital for the insane.