America Once Locked Away Its 'Difficult' People and Threw Away the Key — Now They're Your Coworkers Posting About Therapy on LinkedIn
Last week, a VP at a Fortune 500 company posted on LinkedIn about her struggle with anxiety and how therapy helped her become a better leader. The post got 15,000 likes and hundreds of supportive comments from other executives sharing their own mental health journeys.
Seventy years ago, that same woman would have been quietly committed to a state hospital and likely never seen again.
The Great Hiding
For most of American history, mental illness wasn't treated — it was hidden. Families dealt with "difficult" relatives the way they dealt with other shameful secrets: by making them disappear.
The solution was institutionalization on a scale that's hard to comprehend today. By 1955, over 560,000 Americans were locked away in state mental hospitals, many for life. That's more than the current population of Wyoming, all confined because they exhibited behaviors that society deemed unacceptable.
These weren't hospitals in any meaningful sense. They were human warehouses designed to remove "undesirable" people from public view. Patients were often committed for reasons that seem absurd today: women for being "too emotional" or "sexually promiscuous," men for drinking too much or struggling with what we now recognize as PTSD from war.
Once committed, patients rarely left. The average stay at these institutions was measured not in months, but in decades. Many people entered as young adults and died there as elderly patients, having spent their entire adult lives locked away from the world.
The Commitment Process
Getting someone committed was shockingly easy. In many states, it required little more than the signature of a relative and a brief examination by a doctor — often a general practitioner with no psychiatric training.
Families would tell neighbors that their relative had "gone to visit family" or was "traveling for their health." The truth was too shameful to acknowledge: they had a family member who was mentally ill, and they had chosen to make that person disappear rather than deal with the social stigma.
The commitment papers often read like criminal charges: "suffers from melancholia," "exhibits nervous exhaustion," or simply "is of unsound mind." These vague descriptions could apply to almost anyone going through a difficult period, yet they were sufficient to justify lifetime imprisonment.
Women were particularly vulnerable to commitment. Postpartum depression, grief over losing a child, or even asserting too much independence could result in a diagnosis of "hysteria" and immediate institutionalization. Husbands could commit wives with minimal paperwork and no requirement to prove actual mental illness.
Life Inside the Institutions
The conditions inside these facilities were horrific by any standard. Patients lived in overcrowded dormitories, often with 50 or more people sharing a single room. Privacy didn't exist. Personal belongings were confiscated. Contact with the outside world was heavily restricted or forbidden entirely.
"Treatment" consisted mainly of keeping patients sedated and compliant. Lobotomies — surgical procedures that destroyed parts of the brain — were performed on thousands of patients, often without their consent. The procedure left many in vegetative states, but it was considered successful because it made patients easier to manage.
Electroshock therapy was administered routinely, not as a medical treatment but as punishment for "difficult" behavior. Patients who complained, tried to escape, or simply asked too many questions would be subjected to electric shocks that left them confused and docile.
The staff-to-patient ratios were so low that actual care was impossible. Attendants were often untrained and poorly paid, leading to widespread neglect and abuse. Patients might go days without bathing, receive inadequate food, or be left in their own waste.
The Families Left Behind
For families, committing a relative meant erasing them from family history. Children grew up not knowing they had an aunt or uncle locked away in a state hospital. Family photographs were edited to remove the committed person. Their names were no longer mentioned at family gatherings.
This wasn't just shame — it was practical necessity. Having a mentally ill family member carried such stigma that it could affect employment opportunities, marriage prospects, and social standing for the entire family. The solution was to pretend the person had never existed.
Parents who committed children often told their other children that their sibling had died. It was easier to grieve a dead child than to explain why they had chosen to lock away a living one.
The Beginning of Change
The transformation began in the 1960s with a combination of factors: investigative journalism exposed the horrific conditions in state hospitals, new psychiatric medications made outpatient treatment possible, and changing social attitudes began to view mental illness as a medical condition rather than a moral failing.
The Community Mental Health Act of 1963 began the process of deinstitutionalization — closing the massive state hospitals and moving patients back into communities. The idea was to provide treatment in less restrictive settings while allowing people to maintain connections to their families and communities.
By 1980, the patient population in state mental hospitals had dropped to fewer than 140,000. By 2000, it was under 60,000. The era of warehousing mentally ill Americans was ending.
The Therapy Revolution
What happened next was unprecedented in human history: mental health treatment became not just acceptable, but fashionable.
Psychotherapy, once reserved for the severely mentally ill, became a middle-class lifestyle choice. "Seeing a therapist" transformed from a shameful secret to a sign of self-awareness and personal growth.
Celebrities began talking openly about their struggles with depression, anxiety, and addiction. What once would have ended careers became humanizing stories that increased public sympathy and understanding.
The introduction of Prozac in 1987 marked another turning point. Here was a medication that could treat depression without the severe side effects of earlier drugs. Taking antidepressants became as routine as taking blood pressure medication.
The Social Media Confessional
Today's mental health discourse would be unrecognizable to previous generations. Social media platforms are filled with people sharing their therapy insights, medication experiences, and mental health journeys.
Anxiety and depression, conditions that once led to lifetime institutionalization, are now discussed as casually as physical ailments. People post about their therapy appointments the way they post about going to the gym.
LinkedIn, the professional networking platform, regularly features posts from business leaders discussing how mental health treatment improved their leadership skills or work performance. The same executives who once would have hidden any hint of psychological struggle now use it as evidence of their self-awareness and commitment to personal growth.
The Numbers Tell the Story
The transformation is staggering when measured statistically. In 1955, 0.4% of the U.S. population was institutionalized for mental illness. Today, that number is essentially zero — fewer than 35,000 Americans are in state psychiatric hospitals, down from over half a million.
Meanwhile, outpatient mental health treatment has exploded. Over 50 million Americans received mental health services in 2021, most while maintaining their jobs, relationships, and active roles in their communities.
The therapy industry has grown from a tiny profession serving institutionalized patients to a massive field employing hundreds of thousands of practitioners. Teletherapy, accelerated by the COVID-19 pandemic, has made mental health treatment accessible to people in rural areas who previously had no options.
From Shame to Strength
Perhaps the most remarkable change is cultural. Mental illness has transformed from society's deepest shame to a source of personal strength and authenticity.
People now list their mental health conditions in social media bios alongside their job titles and hobbies. "Anxiety survivor" and "depression warrior" have become identity markers rather than sources of shame.
Workplaces that once fired employees for any hint of mental illness now offer mental health days, employee assistance programs, and on-site counseling services. Companies compete to offer the best mental health benefits as a way to attract talented employees.
The Invisible Revolution
This transformation happened so gradually that most people don't realize how radical it's been. The America that locked away over half a million people for being "difficult" is the same country where mental health awareness is now considered a corporate responsibility.
The conditions that once meant permanent exile from society are now managed by millions of Americans who lead successful, public lives. The shame that once destroyed entire families has been replaced by openness that builds communities.
Your coworker posting about their therapy breakthrough on LinkedIn isn't just sharing personal information — they're participating in one of the most dramatic social transformations in American history. They're living proof that the people we once threw away weren't broken after all; they just needed a different kind of help.
The locked doors have been opened, the keys thrown away, and the people inside have rejoined society as our colleagues, friends, and leaders. And somehow, most of us never stopped to realize just how extraordinary that transformation really is.
