Before it became politically incorrect to do so, census workers used to record whether people were deaf, dumb, blind, insane, or idiotic. These are perfectly reasonable statistics for measurement – it helps the states determine funding allocation for insane asylums.
Now, obviously an insane idiot cannot accurately diagnose himself for the census marshals. Thus the questionnaires provided instructions to the workers :
The fact of idiocy will be better determined by the common consent of the neighborhood, than by attempting to apply any scientific measure to the weakness of the mind or will.
The problem was that society had a poor understanding of what it meant to be insane, or an idiot. Unwed mothers were frequently sent to mental hospitals under the rationale that moral failings were a sign of feeble-mindedness1. Or, more likely, their family members were embarrassed of them. As a result, state institutions turned into holding bins for burdensome relatives and socially redundant women. By 1904, the US had 150,000 patients institutionalized — about 0.2% of the population.
During the Progressive Era, people got it into their heads that the most compassionate thing we could do for our growing population of idiots and lunatics was to sterilize them. Indiana became the first state to enact sterilization legislation in 1907, with Washington and California following shortly thereafter.
The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes… Three generations of imbeciles are enough.
–Justice Oliver Wendell Holmes, Jr.
In the 1927 case of Buck v Bell, the Supreme Court ruled that eugenics-based sterilization was indeed constitutional, and opened the door for compulsory sterilizations at mental institutions nationwide. Progressive California led the way, performing over a third of the sterilization operations in the country.
Those with institutionalized family members were not necessarily pleased. While it might make sense to have a relative committed to keep them from inheriting the farm, most people don’t want to go so far as to see their family members neutered (see also: The Selfish Gene).
People began hiding their idiots and lunatics from the census workers. Later versions of census instructions warn:
It not infrequently happens that fathers and mothers, especially the latter, are disposed to conceal, or even to deny, the existence of such infirmities on the part of children. In such cases, if the fact is personally known to the enumerator, or shall be ascertained by inquiry from neighbors, it should be entered on the schedules equally as if obtained from the head of the family.
After World War II, eugenics pretty much fell out of favor in society, as did the idea of labeling anyone as mentally defective. The US Census Bureau stopped asking questions about the blind, deaf, insane and idiotic, and by 1955 the accepted treatment for mental affliction was to take two Thorazine and go live on the street.
Today we have fewer than 50,000 patients in psychiatric hospitals, despite the population increasing over fourfold since 1904. The 12,000 homeless people in San Francisco are just temporarily embarrassed millionaires, I guess.
1. Don’t blame us, we were only copying the UK! In 1913, Parliament passed the Mental Deficiency Act, which labeled women with illegitimate children as “moral imbeciles.” Here’s Winston Churchill eloquently arguing in favor of eugenics.
1. Measuring America: The Decennial Censuses From 1790 to 2000. US Census Bureau
2. Bureau of the Census Catalog, 1790-1972