I Worked in a Snake Pit!
We have shut people away in asylums for a very long time. The names keep changing: mental hospitals, addiction treatment centers, stress management programs. My own brush with the genuine article came during college, when I spent a summer as a psychiatric aide at the state mental hospital near where I lived. The job was to fill in for the regular aides while they took their vacations.
Rules said none of us could work a ward alone, so wherever I was assigned there had to be two aides on duty rather than one. These were locked wards holding the difficult cases. A few patients turned violent without warning. Others had tried to escape before, and some had killed people. Pairing up the aides was justified by how serious the problems were, since any ward demanding that kind of coverage had to house people considered dangerous or unmanageable.
None of the drugs we now take for granted existed back then. There were no modern psychotropic medications to steady anyone. I got no training whatsoever, and because I was a substitute, my assignment could change from one day to the next. My shifts rotated too, days and evenings, though never the overnight.
The hospital grounds felt like a small town. Every week I had to go to the main building and read the roster so I would know in advance which part of the complex to report to, otherwise I risked wandering the grounds and showing up late. A number of the buildings looked old enough to date back to the previous century, maybe as far as the Civil War. Several stood three stories high. Not one of them had air conditioning. My required outfit was a white uniform dress, white stockings, and white nurse's shoes.
The task I remember most clearly was accounting for everyone. We were supposed to have a certain number of patients on the ward, and I had to make the roster names line up with the faces in front of me each day. With so many people to track, I also had to learn in a hurry what set each one off, because missing a warning sign could get me hurt. It did get me hurt that summer, though it could have been worse. I was covering lunchroom duty by myself for a couple of wards beyond my own when a patient with a grounds pass, someone I had never seen, walked up and slapped me hard across the face.
About the only thing that separated me from the people on the ward was the ring of keys to the doors. The wards were packed. Every night, cots went up in the hallways and day rooms to hold the patients who could not fit into the bedrooms. Two aides could not possibly manage that many people, so a lot of the daily work fell to the "trusty" patients. One woman handled the clothing. Patients helped each other bathe, get dressed, and clean up after accidents in the bathroom.