Dr. Benjamin Rush: Compassion for the Mentally Ill

This Founding Father improved the quality of life for patients with mental health issues and initiated what is known today as occupational therapy.

A 1783 portrait of Dr. Benjamin Rush by Charles Willson Peale. Public Domain

Many Founding Fathers were statesmen, soldiers, and lawyers, yet some came from more diverse walks of life. Benjamin Rush, a medical doctor, is best known as a Founding Father, but one of his life’s greatest endeavors was his work on mental health. Rush wanted to change the public perception surrounding mental health.

“Herewith you will receive a copy of my medical Inquiries and Observations upon the diseases of the mind,” Rush wrote to John Adams on Nov. 4, 1812. “I shall wait with solitude to receive your Opinion of them. They are in general accommodated to the ‘common science’ of Gentlemen of all professions as well as medicine. The Subjects of them have hitherto been inveloped in mystery. I have endeavored to bring them down to the level of all the other diseases of the human body, & to show that the mind and body are moved by the same causes and Subject to the same laws.”

Dr. Benjamin Rush wrote the first American book on mental health. Public Domain

At the time, most patients’ struggles were viewed simply as failures on their part instead of medical conditions. Rush’s work with patients struggling with mental health convinced him this was not the case, and he fought for them to be viewed and treated with greater dignity.

When Rush joined the medical staff at Pennsylvania Hospital in 1783, many mental health patients were locked in cold cells. They received very little real care, with the perception being that they weren’t able to be helped. Rush strongly disagreed that this was the case and fought for their betterment, and he had a very personal reason to do so.

The Case of John Rush

Rush and his wife Julia had 13 children, and their eldest, John, suffered from mental illness throughout his life. While serving in the Navy, John participated in a duel during which he fatally shot one of his close friends, Lt. Benjamin Turner. The Navy cleared John of any wrongdoing, as duels were still practiced at the time, but the incident naturally ate at John.

“My Eldest son John since his unfortunate duel, has lost his health and with it his reason,—and is now on his way from New Orleans to his father’s house,” Rush had written to Adams a few years earlier, on July 26, 1809.

When John arrived in Philadelphia, he immediately became one of his father’s patients. Rush increased his efforts to continue to improve conditions and treatments for mental health patients, for his sympathy for these patients only grew with his son among their number. In September of 1810, Rush penned an open letter to the mangers of the Pennsylvania hospital. He requested feather beds and improved accommodations for mental health patients. He also asserted that routines be created for the “exercises and amusements” of the patients—essentially early forms of occupational therapy. After his lengthy list of requests, Rush ended his letter with an unusually personal, yet persuasive, closing statement.

“I shall conclude this letter by an appeal to several members of your board to vouch for my having more than once suggested most of the above means for the recovery and comfort of the deranged persons under your care long before it pleased God to interest me in their adoption by rendering one of my family an object of them,” Rush wrote.

The Pennsylvania Hospital, 1755, engraving by William Strickland. Public Domain

All the work Rush did on mental health drove him to write a book on the subject. “Medical Inquiries and Observations, Upon the Diseases of the Mind” was the first American book on the subject of mental health.

John Adams wrote to his friend: “The Subject you have chosen is one of the most important, interesting and affecting, that human Nature and terrestrial Existence exhibit: and you will merit everlasting Thanks of your Species, for your Attempt to investigate it, whatever your present Success may be.”

Not all of Rush’s methods or theories fall in line with modern medical knowledge and discoveries about mental health. However, he provided a crucial starting point for improving the treatment for future generations of patients.

As Rush wrote in his letter to the managers of the Pennsylvania Hospital, “There is a great pleasure in combatting with success a violent bodily disease, but what is this pleasure compared with that of restoring a fellow creature from the anguish and folly of madness and of reviving in him the knowledge of himself, his family, his friends, and his God!”

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