One might think that such sensitive information about our ancestors would be kept under heavy restrictions. But to my surprise, I found that three microfilms of patient registers for Massachusetts insane hospitals, asylums, and schools for persons with disabilities, from the Massachusetts State Archives, are available to everyone on the internet.
These records have been available to researchers on microfilm at the State Archives for many years. However, the access to these records online is not immediately apparent. Almost all digital images and indexed records on familysearch.org are catalogued under “Historical Record Collections.” You won’t find these records here. Instead, they are accessible through the Microfilm Catalog.
When you click on an entry in the Family History Library (FHL) microfilm catalog, scroll down the page to see a roll list. On the right, there may or may not be a camera icon next to the icon of a film reel. The presence of a camera icon means that this film is available digitally. Clicking on the camera icon will bring you the image browser, an interface you may or may not be familiar with through previous research.
Each film does not have it’s own index, although some volumes are self-indexed. In fact, these microfilms do not contain any sort of finding aid or mention that multiple institutions from different parts of the state are on the same microfilm. I took it upon myself to create my own finding aid and breakdown the contents of these microfilm publications. At first, I only located one film through the FHL catalog. However, since FHL is synced with WorldCat.org, I searched WorldCat for entries under the same subject and located two additional microfilm publications that are on FamilySearch. [links to films are hyperlinked in Film No. below]
Item No.1 Danvers Insane Hospital (Danvers, MA), 1878-1890
Item No.2 Danvers Insane Hospital, 1878-1904
Item No.3 Danvers Insane Hospital, 1904-1907
Item No.4 Foxborough Insane Hospital (Foxborough, MA), 1893-1918
Item No.5 Medfield Insane Asylum (Medfield, MA), 1896-1906
Item No.6 Northampton State Hospital (Northampton, MA), 1858-1876
Item No.7 Northampton State Hospital, 1858-1906
Item No. 1 Northampton State Hospital (Northampton, MA), 1892-1906
Item No. 2 Northampton State Hospital (Northampton, MA), 1906-1907
Item No. 3 State Colony for the Insane (Gardner, MA), 1902-1905
Item No.4 Taunton Insane Hospital (Taunton, MA), 1854-1876
Item No.5 Taunton Insane Hospital, 1854-1906
Item No. 6 Taunton Insane Hospital, 1906-1907
Item No. 7 Westborough Insane Hospital (Westborough, MA), 1886-1902
Item No.1 Worcester Insane Hospital (Worcester, MA), 1899-1902
Item No.2 Worcester Insane Hospital, 1902-1907
Item No.3 Hospital Cottages for Children (Baldwinville, MA), 1882-1918
Item No.4 Perkins Institution and Massachusetts Asylum For The Blind (Watertown, MA), 1864-1875
Item No. 5 Massachusetts School For The Feeble Minded (Waltham, MA), 1864-1909
Item No. 6 Tewksbury Asylum for Chronic Insane (Tewksbury, MA), 1866-1907
Item No. 7 Hospital for Epileptics at Monson (Palmer, MA), 1898-1918
These records contain some very useful genealogical information. Most patient registers provide the following information:
No. of Times Committed
Patient No. (And old patient no. if previously admitted)
Civil Condition (Married, Widowed, or Single)
State or County of Birth (sometimes the exact town is given)
City or Town of Residence
How Committed – This column indicates which court ordered that they be committed to an institution.
Date of Commitment
How Supported – This indicates whether the state, town, or private party paid for their care and the date on which they agreed to provide it.
Date of Discharge
How Removed – This indicates what officials removed the person or how they obtained freedom from the facility. This column may say “Bd. of Ins.,” which stands for Massachusetts’ Board of Insanity and Charity, or “Trustees,” which are Trustees of the State Hospital or Asylum. Occasionally other reasons are provided like “Died,” “Escaped”, or even “Eloped.”
Remarks – This column provides information on whether individual’s mental health improved or not. The clerk usually gave the abbreviations “M. Imp.” for Much Improved or “N. Imp.” for Not Improved. This column would also provide the cause of death if the individual was deceased. If the person had been removed to the custody of another institution, it would indicate the name of the place to which they were removed.
Image Source: FamilySearch.org 
The Massachusetts State Archives has the following statement about Institutional Records on their Genealogy Research page:
“It is very important to note that per Massachusetts state laws, access to the records of state institutions may be restricted to preserve the privacy of individuals at the institution. Medical (Massachusetts General Law4§7(26)c, MGL111§70E, MGL123§36), mental health (MGL123§36), personal (MGL4§7(26)c, o, p, MGL6A§1), evaluative (MGL66A§1), and criminal (MGL4§7(26)c, MGL6§167) information is restricted according to state laws. Criminal offender information is open upon the death of the individual, but medical and mental health records remain restricted. Researchers MUST contact the Archives before planning a visit to use these records in order to determine what restrictions will apply.
The Massachusetts Archives holds the records of a variety of state institutions, including prisons, almshouses, mental health facilities, public hospitals and sanatoriums, and reform schools. These records were created by a number of state agencies, including corrections, youth services, public health, public welfare, and mental health. The records vary from institution to institution, but can include records such as case files and histories, records of admissions and discharges, and other records that provide information on the lives and families of people at these institutions. Please contact the Archives to determine whether records are held for a specific institution and time frame.
Criminal offender record information (CORI) is open upon the death of the individual, but medical and mental health information remains restricted. Researchers MUST contact the Archives before planning a visit to use the records in order to determine applicable restrictions and how you might access the information.”
Patient files for those admitted to State Institutions are at the State Archives or the Department of Mental Health. Linda Hall-Little’s blog post “52 Ancestors Weeks #29 – Update of the ‘Insane’” explains her own experience using Massachusetts mental health records for genealogical research and is an excellent example of how researchers can find more clues.
A personal estimate would indicate that about 85,000 names are within these records. A further study of these patient registers could provide very detailed insight into not only one’s family history, but also the early history of social welfare policies in Massachusetts. These records could serve as a great indexing project for a society, but I’d still leave it up to the genealogical community to best decide what happens to these records. There may be sensitive information in here that might not sit well with some descendants.
*According to genealogist Charlene Sokal, not all films have been digitized or are in custody of FamilySearch. Some records are missing/unavailable all together. If a particular institution does not appear in my finding aid, check WorldCat for other patient registers that may be available in the FHL Microfilm Catalog for interlibrary loan. Massachusetts Genealogical Council is negotiating with FamilySearch to index the films that have been digitized.
 For more information about Massachusetts’ history regarding public responsibility for persons with disabilities “State Hospitals of Massachusetts – Historical Overview.” 1856.org (http://www.1856.org/historicalOverview.html accessed 29 May 2016).
 “Film # 007833946,” database with images, FamilySearch (https://familysearch.org/ark:/61903/3:1:3Q9M-CS3J-D4NL: accessed 29 May 2016,) Record of Persons Supported at Worcester Insane Hospital, Register No.22, 1902-1907, page 1.
 William Francis Galvin, “Researching Your Family’s History at the Massachusetts Archives.” Secretary of the Commonwealth of Massachusetts (https://www.sec.state.ma.us/arc/arcgen/genidx.htm: accessed 28 May 2016.)
Copyright (c) 2016 Jake Fletcher.
Jake Fletcher, “Record Spotlight – Massachusetts Department of Health, Institutional Registers, 1863-1918 on FamilySearch.org,” 28 May 2016. http://travelyourgenealogy.com/2016/05/28/record-spotlight-massachusetts-department-of-health-institutional-registers-1863-1918-on-familysearch-org: