While mental institutions in the 1930s provided care and support to many patients, overcrowding due to rapid growth led to a decline in patient care. As patient populations increased from 200 to nearly 1800 in most institutions, facilities became understaffed. This resulted in more undertrained nurses and higher rates of patient deaths due to lack of attention. Additionally, barbaric medical procedures like lobotomies were introduced and caused many patients to die from the dangerous surgeries.