In the early 20th century, offices of public health around the country made efforts to develop programs and outfit facilities with the necessary medical accommodations for those suffering from mental illness. A new emphasis on "mental hygiene" and an increasing reliance on science and biology as the underlying cause of mental illness prompted state and city officials to document and report on mental health cases, data, treatment, and facility solutions. The Essex County Hospital for the Insane was described as having a "well appointed pathological laboratory, the patients are scientifically and humanely cared for and everything connected with the institution and the management of the patients seems worthy of commendation." (New Jersey Legistlative Documents, vol. 5, 1908). Organized in 1872, The Essex County Hospital for the Insane located on South Orange Avenue, administered to both accute and chronic cases of mental illness (Urquhart, 1913). Overbrook, a more expansive facility would later be errected in Cedar Grove, NJ.
In an attempt to quantify and describe symptoms that were often times varied and imperceptible, doctors and other medical personnel sometimes relied on moralistic, vague, and biased characterizations.