PILLARS OF MADNESS: A History of American Psychiatry

PILLARS OF MADNESS is an eight-part documentary film series produced in association with Oh Penny Pictures. This series offers a comprehensive exploration of the history of American psychiatry, charting its evolution from early practices to contemporary challenges. By weaving together expert commentary, historical footage, and personal narratives, this series aims to illuminate the complexities of mental health care in the United States.

An insightful documentary series, this is one that seeks to educate and foster open dialogue about mental health. By addressing the historical context alongside contemporary challenges, the series encourages viewers to reconsider their perspectives on psychiatry and support mental health initiatives.

“OUT IN THE WORLD YOU CAN’T UNDERSTAND US.” Ralph Remington, Patient - Lunatic Asylum at Utica.

FILMS AT A GLANCE

• Part I - PILLARS OF OLD MAIN: The Model Institution
  This episode goes in-depth to explore the history and legends of “Old Main,” the hospital that set a national standard for treatment models starting in the mid-nineteenth century. The Utica State Hospital played a foundational role in the development of public health infrastructure, both in America and the developed world.

• Part II - THE MAN BEHIND THE CURTAIN: The Patient & the Public Image
  The official history of “Old Main” is filled with successes and admiration, praised by politicians and news outlets for the public benefit it provided. However, a deeper examination reveals a darker side of that history. This film explores the official public perception of the asylum in relation to the patient experience, offering a candid look that may not be for the faint of heart.

• Part III - FOUNDATIONS OF MODERN PSYCHIATRY: Chapter 1 (Moral Treatment from Pinel to Dix & Brigham)
  Beginning with an idea, this film presents the congruent lineage of philosophy and scientific rigor and their respective impacts on the development of psychiatric medicine. It tells the story of the individuals credited with establishing mental health treatment and the philosophies that underpin their contributions.

• Part IV - FOUNDATIONS OF MODERN PSYCHIATRY: Chapter 2 (WWI to the Present)
  Continuing the "Foundations" theme, this part explores the influence of culture, technology, and philosophy on mental health treatment. Following World War I, society began to transition into the modern era, observed through the development of an approach to public health resembling the model we have today. This film examines advancements made in the twentieth and twenty-first centuries and how the current system relates to its foundational principles.

• Part V - THE ACTS: Politics of Mental Health in America
  Healthcare in America has always been intertwined with politics. Our ethics and values have shaped this ongoing debate. This film traces the history of politics and government policy related to public health—featuring political debates, government initiatives, civil commitment laws, and shifting cultural attitudes toward social welfare. It examines their impacts on society then and now.

• Part VI - THE SAILOR & THE SEA: An Examination of Mind & Body
  This installment delves into the historical theories concerning the mind-body connection, often based on untested hypotheses to explain mental illness. The film investigates the science, theories, and pseudo-science that have shaped diagnostic methods for mental health. With advancements such as imaging technology and breakthroughs in neuroscience, there have been significant strides in understanding and treating mental illnesses.

• Part VII - THE ROCK & THE MACHINE: The Architecture of Mental Health
  Exploring the history and evolution of mental health institutions, this film presents the aesthetics, construction, and functionality expressed in the architecture of these facilities, including the iconic “Old Main.”

• Part VIII - COMPOUND: Salvation Through Chemistry
  Drugs have played a significant role in medicine, and this film explains the development and administration of psychiatric medications. It covers early drug theories, the evolving science of drug development, and unconventional drug approaches, presenting a timeline of landmark experiments along with their successes and failures.