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The proposal by Thomas Scattergood and two Quarterly Meetings in the Philadelphia area to create an asylum that would treat Pennsylvania Quakers was considered by the Yearly Meeting of Philadelphia, until in 1813 the Yearly Meeting officially moved forward with the founding of Friends Asylum, with Quakers who were willing to give money to support the project forming the Contributors to the Asylum. The Managers’ Committee and Building Committee were appointed by the contributors to plan and construct the asylum, until it was able to open for patients in 1817.
After opening in 1817, Friends Asylum needed staff to fill all the roles required to care for and treat its patients. It also needed a governing structure, to ensure that all the tasks and requirements for an asylum to run smoothly were attended to. Many of the methods used were based on practices from the earlier York Retreat, and moral treatment was usually viewed as the way to cure patients of their mental illness, with medical care only being used as thought necessary.
In 1850, the superintendent of the asylum took over the duties of the head physician. With moral treatment now considered a medical practice, it was considered important for the superintendent to understand and manage all aspects of patient treatment rather than splitting authority between the superintendent and the medical department.
In 1888, Friends Asylum was officially incorporated in Pennsylvania, in order to be more in line with state laws around private organizations. When they officially incorporated, the Contributors to the Asylum were replaced by the Corporation of Friends Asylum for the Insane. The creation of the position of president was a move away from the more egalitarian structure of Quaker meetings, and this period of incorporation can be seen as part of a broader trend of the Asylum becoming more concerned with competing as a business.
In 1897, with new medical advancements and increasing challenges to the moral treatment model, the Corporation decided to create the post of Steward, which would manage all the responsibilities of running the asylum outside of treating the patients. The Corporation believed that placing staffing and operations in a separate position would relieve the superintendent’s workload and allow him to focus on patients.