Mental institutions under pressure

‘Mental institutions under pressure’: research topics

The research focuses on the following three levels:

1. medical-epidemiological research into patterns of illness, malnutrition, mortality – primarily based on anonymised patient data;
2. research into institutional practices and social aspects: care practices, experiences, caregiver-patient relationships, how individuals and institutions responded to the war conditions, etc;
3. research into the ideological-administrative aspects, focusing on the prevailing opinions in and about psychiatry and care for the disabled, the longer-term policy, and the role of the boards. In this part, the influence of contemporary scientific views on the policies within (and with regard to) the institutions will also be examined. 

Although the research focuses on the entire sector, four (clusters of) institutions are examined in detail: Dennenoord in Zuidlaren, Rhijngeest, Endegeest and Voorgeest in Oegstgeest, the Willem van den Berghstichting in Noordwijk, and St Anna and St Servatius in Venray. These four institutions, which represent the separate ‘pillars’ in Dutch society, were spread across the Netherlands and have left behind comprehensive and fairly complete archives. This allows us to create a quantitative reconstruction of the population, reconstruct the policies of the individual institutions, and make a multi-voiced discursive analysis of patients, staff, and administrators.  

Meanwhile, the first article about Dennenoord has been published. This publication focuses on the consequences of the lack of space and on the evacuation of the patients.

The research project was officially launched on 14 March 2019 and will run until early 2023. The research is conducted by NIOD researchers Prof. Ralf Futselaar and Dr. Eveline Buchheim. 

Psychiatric patients in Nazi Germany

In Nazi Germany, psychiatric patients were considered undesirable. Between 1933 and 1945, nearly 300,000 patients were murdered, with the knowledge and, in most cases, active cooperation of their therapists. The recognition of these crimes took a long time. This is partly due to the relative invisibility of this group of people; institutionalised people with intellectual disabilities or mental illnesses are rarely very visible. Only in 2009 did the German Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology) issue a statement acknowledging its own responsibility for the massacre; the caregivers to whom these vulnerable people had been entrusted had taken the lead in their neglect and ruination.

The German case raises questions about the fate of the psychiatric and mentally challenged patients in the Nazi-occupied Netherlands. Did Germany export the ideology of the Volkskörper from which ‘life-unworthy’ elements had to be purged? There are no indications that this was the case. Although eugenic ideas were fairly common in Dutch psychiatry in the 1930s, there is no evidence of an active extermination policy.

However, this does not mean that the patients had nothing to fear. Recent research shows, for example, that social status could play a role in the distribution of food during the Hunger Winter of 1944 (De Zwarte 2019). The status of the ‘insane’ and ‘idiots’, as they were called in those days, was not particularly high. Moreover, they were highly dependent on their caretakers. Were they actually disadvantaged and neglected, though? How did the institutions and homes where they stayed cope with the war conditions? How serious were the shortages of food, textiles, and fuel, and what were the consequences? How did the war affect the work force and were there enough nurses to provide adequate care?