In 1996, America abolished its long-standing welfare system in favor of a new and largely untried public assistance program. Welfare as we knew it arose in turn from a previous generation's rejection of an even earlier system of aid. That generation introduced welfare in order to eliminate orphanages. This book examines the connection between the decline of the orphanage and the rise of welfare. Matthew Crenson argues that the prehistory of the welfare system was played out not on the stage of national politics or class conflict but in the micropolitics of institutional management. New arrangements for child welfare policy emerged gradually as superintendents, visiting agents, and charity officials responded to the difficulties that they encountered in running orphanages or creating systems that served as alternatives to institutional care. Crenson also follows the decades-long debate about the relative merits of family care or institutional care for dependent children. Leaving poor children at home with their mothers emerged as the most generally acceptable alternative to the orphanage, along with an ambitious new conception of social reform. Instead of sheltering vulnerable children in institutions designed to transform them into virtuous citizens, the reformers of the Progressive era tried to integrate poor children into the larger society, while protecting them from its perils.

Mental Institutions in America: Social Policy to 1875 examines how American society responded to complex problems arising out of mental illness in the nineteenth century. All societies have had to confront sickness, disease, and dependency, and have developed their own ways of dealing with these phenomena. The mental hospital became the characteristic institution charged with the responsibility of providing care and treatment for individuals seemingly incapable of caring for themselves during protracted periods of incapacitation. The services rendered by the hospital were of benefit not merely to the afflicted individual but to the community. Such an institution embodied a series of moral imperatives by providing humane and scientific treatment of disabled individuals, many of whose families were unable to care for them at home or to pay the high costs of private institutional care. Yet the mental hospital has always been more than simply an institution that offered care and treatment for the sick and disabled. Its structure and functions have usually been linked with a variety of external economic, political, social, and intellectual forces, if only because the way in which a society handled problems of disease and dependency was partly governed by its social structure and values. The definition of disease, the criteria for institutionalization, the financial and administrative structures governing hospitals, the nature of the decision-making process, differential care and treatment of various socio-economic groups were issues that transcended strictly medical and scientific considerations. Mental Institutions in America attempts to interpret the mental hospital as a social as well as a medical institution and to illuminate the evolution of policy toward dependent groups such as the mentally ill. This classic text brilliantly studies the past in depth and on its own terms.

Ever since the English settled in America, extreme poverty and the inability of individuals to support themselves and their families have been persistent problems. In the early nineteenth century, many communities established almshouses, or "poorhouses," in a valiant but ultimately failed attempt to assist the destitute, including the sick, elderly, unemployed, mentally ill and orphaned, as well as unwed mothers, petty criminals and alcoholics. This work details the rise and decline of poorhouses in Massachusetts, painting a portrait of life inside these institutions and revealing a history of constant political and social turmoil over issues that dominate the conversation about welfare recipients even today. The first study to address the role of architecture in shaping as well as reflecting the treatment of paupers, it also provides photographs and histories of dozens of former poorhouses across the state, many of which still stand.

Expelling the Poor argues that immigration policies in nineteenth-century New York and Massachusetts, driven by cultural prejudice against the Irish and more fundamentally by economic concerns about their poverty, laid the foundations for American immigration control.