An Assessment of the Medical and Social Functions of Mental Health Institutions in the Ottoman Empire
Year: 2026
Type: article
Abstract: This study aims to examine the historical development of the conceptual framework and institutional structure related to mental health in the Ottoman Empire. The care and treatment of the mentally ill in Ottoman society was carried out through public health institutions, primarily darüşşifas and bimarhanes. Continuing the Anatolian Seljuk tradition of healthcare architecture, these structures, which were established in different cities under the waqf system, were initially multifunctional healthcare centers serving different disease groups, however over time they focused more distinctly on the treatment of mental disorders. By the 19th century, bimarhanes faced serious problems in terms of both physical infrastructure and treatment practices, with widespread use of chaining, prolonged isolation, and neglect. This negative situation brought reform efforts to the forefront in Ottoman health history, and a significant transformation process began, particularly with the work of Italian physician Dr. Luigi Mongeri. The administrative and practical reforms implemented during Mongeri’s tenure as chief physician at the Süleymaniye Hospital aimed to limit mistreatment of patients and establish a more humane approach to care. This reform process also brought about a spatial reorganization with the relocation of the hospital to the Toptaşı Hospital in 1873. The 1876 Bimarhanes Regulation established the first systematic legal framework in the field of mental health in the Ottoman Empire, defining the management structure of bimarhanes, patient admission procedures, treatment processes, and patient rights. Although this regulation represented significant progress at the theoretical level, the lack of qualified personnel and institutional infrastructure in rural areas led to practical difficulties, and the central hospitals in Istanbul experienced capacity problems due to the number of cases referred to them. This situation limited the ability of the reforms to establish a permanent and comprehensive mental health system throughout the empire. The historical development of mental health institutions in the Ottoman Empire shows that a holistic approach was adopted in the treatment of mental illness, incorporating methods such as medication, diet, and physical interventions, as well as music, the sound of water, and environmental adjustments, reflecting the transition between traditional medical understanding and modern psychological approaches. In the 19th century, following the abolition of practices such as chaining and isolation under the influence of modern psychiatry, more humane treatment methods based on supervision, regular care, and medical observation came to the fore. From this perspective, the foundation-based institutional structure, the ideal of humane treatment, and legal regulation initiatives demonstrate that the Ottoman Empire developed a unique and noteworthy model in the field of mental health, and this legacy provides an important historical foundation for the institutionalization process of modern psychiatry.
Author: Söylemez, Yusuf Ziya
Institution: Inonu University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7204183934