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PTSD Compensation and Military Service
a great extent, with the disposition of a particular case dependent upon such factors as whether a disabled person was considered to be violent or nonviolent, was mentally or intellectually disabled, was able to maintain gainful employment or had access to familial material support, and was accepted as a charge of the local community1 (Braddock and Parish, 2001). From a public welfare perspective, a great deal of overlap exists between the early support systems for the mentally and physically disabled and for the indigent and the criminal. The residents of early asylums, workhouses, almshouses, and houses of correction were a heterogeneous mixture of the criminal, the poor, the orphaned, the elderly, and the sensorily, physically, and mentally impaired (Braddock and Parish, 2001).
The earliest legislation that specifically included a provision for the care and maintenance of persons with mental disabilities was authorized in 1751 in the Pennsylvania colony as part of the law establishing the first general hospital in America (Braddock and Parish, 2001). The petition associated with that legislation cited the growing number of “Lunaticks or Persons distempered in Mind and deprived of their rational Faculties” as justification for the new provision. A 1776 judicial decision in Pennsylvania established what seems to have been the first municipally mandated institutional provision for the mentally ill in the colonies. The Pennsylvania court ordered that “a small Levy be Laid to pay for the buildings of ye house and the maintaining of ye said madman according to the laws of ye government” (Braddock and Parish, 2001).
Throughout the early 1800s counties often dealt with the mentally ill with a practice known as bidding out or auctioning out. When a disabled person was auctioned out, the county paid a stipend to the lowest bidder for the provision of one year of care (Breckenridge, as cited in Braddock and Parish, 2001). Auctioning out would not necessarily have been an improvement over the “beatings of the head [that] were employed to treat people with many mental diseases, including depression, paralysis, and intellectual disability” during the 1700s, as many auctioning-system-related abuses occurred with little or no official monitoring of the care of these wards (Braddock and Parish, 2001). Over time the practice of auctioning out fell out of favor, as local municipalities found its continued implementation to be cost prohibitive.
Fishback, in his essay on public assistance during the American colonial period (Fishback et al., 2006), notes that the Philadelphia Almshouse,
Under England’s Poor Law of 1601—also known as the Elizabethan Poor Law—the local community was required to provide certain maintenance through compulsory taxation when a family was unable to provide for a mentally ill member. This provision, and its associated economic burden, often led to a person with mental disability being forcibly driven from local communities (Braddock and Parish, 2001).