Measurement and the decline of moral therapy

The key theme of this historical paper is to highlight the misallocation of resources that canresult from mis-measurement in social programs. The social phenomenon explored in thispaper is a treatment for mental illness practiced in 19th century Britain called "moral therapy". One of the factors in the rise of moral therapy was that moral therapy asylums could point to mathematical "scientific" cure rates based on discharge and readmission rates to moral therapy asylums. These cure rates were far higher than the cure rates of other, merely custodial institutions of the time.However, failure to properly allow for the difference between acute and chronic mentalillness in the way that cure rates were calculated for these institutions led to a decline infunding for moral therapy asylums.This paper provides a cautionary vignette of how the (mis)use of statistics influenced animportant social policy in 19th century Britain. Quantification also profoundly coloured theview that 19th century legislators and mental health professionals held of the curability of mental illness and hence the appropriate treatment and funding models used.