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ASYLUM CARE The Hungry Forties 1840s: In the hungry-forties of the 19th century many believed that by moving mentally unstable people from a community disturbed by poverty, depravity and social unrest to a closed, humane, but disciplined environment in a lunatic asylum early in the development of their insanity they could be cured and the accumulation of chronic lunatics on poor relief halted. But
the creation of a Lunacy Commission, justified by this
ideal, was not a conscious plan worked out in advance by reforming
politicians and professionals, but the result of people rising
to meet forces that took them by surprise. Forces that
were, once again, symbolised by a bullet.
13.2.1841
The first installment of Charles Dickens' Barnaby Rudge: A Tale
of the Riots of 'Eighty began to be published weekly in the
Clock. Barnaby has charactersitics of idiocy and lunacy.
In chapter forty seven, his mother and Barnaby met a "country gentleman"
in the "commission of the peace" who tries to horse-whip Barnaby.
The widow pleads that "her son was of weak mind".
14.6.1841
Surrey County Asylum opened
Asylum
doctors: 19.6.1841 circular from Samuel Hitch MD of the Gloucestershire
County Asylum to other asylum officers, which led to 44 out of 83
doctors agreeing to belong to an asylum officers association. [ External link to Royal
College of Psychiatrists website]
21.9.1841
In an effort to get Parliament to discuss the "treatment of lunatics",
Thomas Wakley MP, editor of the Lancet,
opposed continuing the Metropolitan Commission for more than a year.
The 1842
Licensed Lunatic Asylums Bill was brought into Parliament on 17.3.1842 by Granville Somerset, as a government measure. He
had the half-hearted support of Lord Ashley, the de facto chair of the Metropolitan
Commission and was opposed by Thomas Wakley MP. The medical opposition inside
and outside Parliament, and Ashley's conversion to the new system
of non-restraint, led to the initial Bill being completely reformed
into a Bill for a National Inquiry into the teatment of lunacy.
Two medical
and two legal commissioners were added to the commission, and the
number of honorary commissioners further reduced. No new commissioners
were appointed during the Inquiry. One of the new medical commissioners
was a
psychiatrist, the other a medical statistician.
1843
3.3.1843
Trial of Daniel McNaughton in the midst of revolutionary
fear.
1844
The 1844 Lunacy Report and the Census of the Insane
Non-restraint The 1844 Report recorded public and private asylums employing the non-restraint system (see 1839) and others that used mechanical restraint, but were not using any at the time of their visit. The non- restraint asylums were: Lincoln, Northampton, Hanwell, Lancaster, Gloucester, Haslar and Suffolk in the public sector, Fairford and Denham Park in the private. The new Haydock Lodge private asylum was also committed to non-restraint. Asylums not committed to non-restraint, but where non was in use when the Commissioners visited were: Cornwall, Dorset, Nottingham, Norfolk, The Retreat at York and Radcliff Infirmary. The Lancet in 1842 contained that on 10.6.1842 no patient in Bethlem Hospital was under restraint.
1845
July
1845 Devon County Asylum opened
1846
November
or December 1846: General rules for County Asylum construction circulated
to Asylum Committees by the Lunacy Commission.
Louisa
Nottidge was confined in Moor Croft House asylum in 1846 but released on
the orders of the Lunacy Commissioners eighteen months later (external link)
1847
John
Conolly's The Construction and Government of Lunatic Asylums
20.5.1847
Death of Mary Lamb who spent the last decade of her life
being cared for in a single house in St John's Wood.
Wednesday
7.4.1847 East and North Riding and York Yorkshire County Asylum
opened
October
1847 Charlotte Bronte's Jane Eyre published. It contains
an entirely unsympathetic image of a mad wife confined in the attic
by a husband defrauded into marrying her in ignorance of her tainted
inheritance:
November
1847 The Lunacy Commission release Mrs Henry Howard from confinement in a single house in Kensington.
1848
Anna Wheeler died about 1848. It was alleged by
Edward Bulwer-Lytton that she died insane. (source)
1851
1852
Critical
report by the Lunacy Commission on Bethlem Hospital. The physician, Edward Thomas Monro, refused to resign, so was
made "consulting physician". When he died, in 1856, it ended the
four generation Monro dynasty at Bethlem
1853
Introducing
the 1853 Lunacy Bills, the Earl of Shaftesbury lamented that he could
not
In
September 1854, Dorthea Lynde Dix came to England, stayed
with Samuel Tuke at York, and then visited Scotland.
By visits and intimations that she would report to London,
she caused alarm. To make sure she got her case in first,
she caught the night train to London and reported to the Home
Secretary the next morning. Shortly afterwards a Royal Commission
was appointed to enquire into the asylums and lunacy law of
Scotland (1855). This was followed by the 1857 Lunacy and Asylums Bill, Scotland. (Hunter, R.A. and Macalpine, I. 1963 pages
911-912)
1855
1857
Asylum
doctors clashed over how to deal with wet beds. The
ideas of Samuel Gaskell laid the foundations of psychiatric
nursing, but this interference with the autonomy of asylum superintendents
was a threat to the British Constitution.
1858
17.7.1858 Rosina Bulwer-Lytton, estranged
wife of novelist and cabinet minister Edward Bulwer-Lytton, and daughter
of Anna Wheeler, released from Inverness Lodge asylum, Brentford, where she had
been confined at the request of her husband. The release followed
a newspaper scandal. (source)
During
1858 two patients in private asylums were found to be sane by commissions of lunacy. One was Mrs Turner at Acomb House near York, the other Mr Ruck at Moor Croft House, Middlesex.
1859
April
and August 1859 and July 1860: Three reports from a Select Committee
of the House of Commons "on
the operation of the Acts and Regulations for the care and treatment
of lunatics and their property"
John
Stuart Mill's On Liberty criticised the operation of writs de lunatico inquirendo:
26.11.1859
to 25.8.1860 Wilkie Collins The Woman in White, about a villainous confinement
in an asylum, serialised in Charles Dicken's All the Year Round.
The book was dedicated to Bryan Waller Procter [Lunacy Commisioner]
Therapeutic Pessimism: The pessimistic period in asylum history developed during the second half of the nineteenth century. Medical theory was strongly influenced by social darwinist beliefs that insanity is the end product of an incurable degenerative disease carried in the victim's inherited biology, and the experience of asylums, and reanalysis of their statistics, undermined the earlier beliefs in their therapeutic value. In the late 19th and 20th centuries, the pessimistic period in asylum history ran gently into a backwater period. Most progress in mental health policy took place outside the asylums, in specialist hospitals like the Maudsley, or in outpatient departments, and the asylums became the quiet back wards where chronic patients live.
1863
Broadmoor Criminal Lunatic Asylum opened, in Crowthorne,
Berkshire. The criminal lunatics from Bethlem were moved to Broadmoor in 1864 and Bethlem
became a hospital for the 'superior class'. Pauper patients were
presumably moved to the City of London Lunatic Asylum which opened at Dartford,
Kent on 16.4.1866.
March
1863-December 1863 Charles Reade's Hard Cash also about a villainous confinement in an asylum,
appeared as installments in Charles Dickens's magazine All the
Year Round.
1864
John
Clare died in Northampton Asylum in 1864. During the many years
he spent there, he wrote some of the most beautiful poetry ever
spoken in English. Bird's Nests is one of his last poems.
1867
Metropolitan
Asylums Board set up to oversee relief to London's sick and infirm
poor, so that the workhouses could be freed to discipline the able-bodied.
The Board proposed two new asylums for chronic lunatics and idiots
at Leavesden and Caterham.
1872
22.11.1872
Louisa Lowe's case before Queen's Bench in which she charged the
Lunacy Commission with concurring in her improper detention at Brislington House and The Lawn, Hanwell.
1873
21.5.1873
On a visit to Fisherton House in Wiltshire, Robert Wilfred Skeffington Lutwidge, uncle of Lewis
Carol, and a Lunacy Commissioner, was murdered by William M'Kave,
a patient.
The Hunting of the Snark - an Agony in Eight Fits,
by Lewis Carroll, published
The third Middlesex County Asylum was opened at Banstead, in Surrey, in 1877, thus continuing the trend (evident in the location of Metropolitan Asylums Board asylums) of sending people to asylums far from their home. Under community care policies, in the late 1950s and early 1960s, special measures had to be taken to enable relatives in inner London boroughs to visit patients in distant hospitals. 12.2.1877 House of Commons appointed a committee under Thomas Dillwyn "to inquire into the operations of Lunacy Law so far as regards security afforded by it against violations of personal liberty" The Lancet fact-finding commission on "The Care and Cure of the Insane"
Emil
Kraepelin (1856-1926) published Kompendium der Psychiatrie
(later editions: Psychiatrie: Ein Lehrbuch für Studierende und
Ärzte - Psychiatry: A Textbook for Students and Doctors) which
established an orthodox classification of psychiatric diseases based
on clusters of symptoms (syndromes) with underlying physical causes. Kraepelin
regarded each mental disorder as distinct from all others, having
its own aetiology, symptoms, course and outcome. His major groups
were dementia praecox and manic-depressive psychosis
Mrs Georgina Weldon sued Dr Forbes Winslow over an attempt to examine her and have her confined in an asylum at her husband's request. This case was a prelude to the 1890 Lunacy Act, which required alleged lunatics to be examined before a magistrate. The confinement of Elizabeth Packard in the United States relates to similar changes there. The second Gloucester County Asylum opened at Coney Hill. First edition of Handbook for the instruction of attendants on the insane. Prepared by a sub-committee of the Medico-Psychological Association. 64 pages. Baillière & Co.: London.
The 1886 Idiots Act allowed rates to be raised for building an "idiot asylum" or "mental deficiency colony". 13.1.1887 The case of Louisa Lowe against Charles Henry Fox for confining her, reached the House of Lords. She lost the case and had to pay costs. Lord Halsbury, in giving judgement, said "we have nothing to do with the truth or falsehood of the statements" in the certificates of the doctors or the order for the person's detention.
"all that which the keeper of the asylum has to regard is whether the statements which are made in the order are such as to justify him in exercising the powers given to him under the statute, of detaining in confinement the person committed to his charge." The 1889 Lunatics Law Amendment Act provided for the truth of allegations to be tested legally before the confinment.
Following the 1888 Local Government Act (which created London County Council), the old Surrey County Asylum in south London became a Middlesex County Asylum and the London County Council took over from Middlesex a project to build an asylum at Claybury, in Essex. Claybury Asylum opened in 1893. Colonies for epileptics were opened in different parts of England and Scotland from 1888. Eleven were still operating as epileptic colonies in 1962: the Maghull Homes, near Liverpool (founded 1888); Meath Home, Godalming (1892); Chalfont Colony (1894); Lingfield Training Colony (1897); St. Elizabeth's, Hertfordshire (1903); David Lewis Colony, Cheshire (1904); Langho Colony near Blackburn (1905), Bridge of Weir Colony, Renfrewshire, Scotland (1906); St David's Hospital, Edmonton (1916); St Faith's Hospital Brentwood (by 1930), and Cookeridge Hall, Leeds. Science Time Line 1885 1890s: By the end of the 19th century the failure of asylum therapy had convinced people that insanity is incurable. The insane were sent to even larger asylums for custody, to be protected from exploitation whilst society was protected from them.
The 1890 Lunacy Act was a major consolidating Act that remained the core of English and welsh Lunacy Legislation until it was repealed by the 1959 Mental Health Act The major change associated with the Act (actually made in 1889) was that it said private patients, apart from chancery lunatics (whose cases were dealt with by the Court of Chancery) should not be detained without a judicial order from a Justice of the Peace specialising in such "reception orders". Pauper patients already required an order from the magistrates to be detained - although that provision was probably originally an authorisation of public funds rather than a safeguard of liberties as the reception order was intended to be. (Click here to read the summary of the law about admission to an asylum from 1828). The law respecting the admission of private patients under the Act is outlined in a booklet for the private asylum at Haydock Lodge. Special Schools Leicester Education Authority the first in England to provide special instruction for backward and weak-minded children. 1895
Lanark County Asylum, Hartwood, Lanarkshire, Scotland, opened. (external link)
Lebanon
Hospital for the Insane, Asfuriyeh, founded. Planned (1896) as "the
first home for the insane in Bible Lands" its catchment area was
Lebanon, Syria and the Middle East. [external link]
1905 The spirochaete responsible for syphillis identified. The Wasserman reaction provided a test for it in 1906. This was first used at Colney Hatch Asylum in 1912. Of forty patients diagnosed as suffering from General Paralysis of the Insane, 38 gave a positive reaction. Using the test it was calculated that one tenth of the male patients suffered from General Paralysis of the Insane. In the last half of the 19th century, when other conditions were included because of similar symptoms, the percentage had been calculated as one in five. (Hunter and Macalpine 1974 p.211) Mental Deficiency: The mid-19th century asylums were developed to treat insanity. However, although congenital idiots and imbeciles were not considered treatable, many were sent to lunatic asylums for custody or control. As the century developed, they tended to be sent to the new, cheap, asylums. Those who were considered physically and morally harmless often stayed with their families, were placed with a substitute family or were kept in workhouses. Fear of racial degeneracy dominated policy in the early 20th century. It was feared that a "submerged tenth" of the population would outbreed the rest. The Royal Commission on the Care and Control of the Feeble Minded (1904-1908) reported that mental defectives were often prolific breeders and allowing them so much freedom led to delinquency, illegitimacy and alcoholism. They rejected sterilisation as a solution, and called for separation and control.
Hidden
12.7.1905 Birth of John, youngest son of George (later King George 5th) and Mary. John died, aged thirteen on 18.1.1919. Prince John suffered from epilepsy and from learning difficulties that suggested he was mentally deficient. His existence was kept secret and, from 1916, he was cared for at Wood Farm, Wolferton, near Sandringham, Norfolk by a nurse Mrs 'Lalla' Bill and a male orderly. In February 1996 (?) a photograph of John wearing a sailor suit, holding hands with Queen Mary and his sister Mary, was discovered in a photograph album and later published in British newspapers. An internet biography of him was published by Britannia later in 1996 and a romanticised drama of his life The Lost Prince, written by Stephen Poliakoff, for BBC1 Television was broadcast in January 2003.
"one person in every 118 of our population is mentally defective, being either mad, idiotic, or feeble-minded" (Francis Galton The Problem of the Feeble-Minded An abstract of the report of the Royal Commission, with commentaries. Quoted Jones, K. 1960, p.65)
1910 Rampton Hospital, Nottinghamshire, opened as England's first State Institution for mentally defective people considered dangerous. Broadmoor now specialised in the insane, Rampton in the mentally deficient. 14.2.1910 to 23.10.1911 Winston Churchill Home Secretary. Churchill was a strong supporter of sterilisation. His proposals for the forcible sterilisation of 100,000 moral degenerates were considered too extreme and so sensitive that they were kept secret until 1992. "The unnatural and increasingly rapid growth of the feeble- minded classes, coupled with a steady restriction among all the thrifty, energetic and superior stocks constitute a race danger which it is impossible to exaggerate. I feel that the sources from which the stream of madness is fed should be cut off and sealed up before another year has passed" (Winston Churchill to Prime Minister Asquith, 1910, quoted by Clive Ponting, in The Guardian Outlook 20.6.1992)
10.7.1910 George Gibson, an attendant at Winwick Asylum, and other disgruntled Lancashire asylum workers, formed the National Asylum Workers Union, which soon spread through the United Kingdom, including Ireland, with a branch secretary in most asylums. The union affiliated to the Labour Party in 1914 and was active in Labour Party affairs. It became the Mental Hospital and Institutional Workers' Union in 1930. In 1946 it merged with the Hospital and Welfare Services Union to form COHSE, the Confederation of Health Service Employees. Since 1993 it has been UNISON 8.7.1911 The first national conference of the National Asylum Workers Union was held at Pitmans Hotel, Birmingham Delegetes came from Winwick Asylum, Banstead, Bexley, Bodmin, Caterham, Cardiff, Chester, Claybury, Exminster, Hellingly, Lancaster, Leavesden, Macclesfield, Maidstone, Menston, Norwich, Prestwich, Rainhill, Storthes Hall, Wakefield and York. Apologies were received from Abergavenny, Talgarth, Colney Hatch, Darenth, Hanwell, Aylesbury, Haywards Heath, and Narboro. (Michael Walker, Unison)
Science Time Line 1920 1919
1920s 1930s
Ministry of Health Act 1919 established a Minister of Health to secure the health of the people including the treatment of physical and mental defects. By an Order in Council of 1920 the Minister took over the Home Secretary's powers under the lunacy and mental deficiency laws. These included appointing the non- legal members of the The Board of Control. June 1922: A jury awarded enormous damages to an escaped mental patient in his case against a lunacy commissioner.
Branthwaite Report on the diet of patients and Bond Report on nursing service in mental hospitals published by the Board of Control. 1924 to 1926 Royal Commission on Lunacy and Mental Disorder 21.4.1925: Board of Control Conference on what to do about the nursing service in mental hospitals Board of Control Conference to consider ways for increasing mental hospital accommodation in England and Wales
Wood Report on Mental Deficiency published by the Board of Control Meagher's Report on treating General paralysis of the Insane by inducing malaria, published by the Board of Control 1930 1.4.1930 Under the 1929 Local Government Act, councils took over functions from the poor law guardians. This brought to an end (by incorporation into local councils) the separate structure of government established under the 1834 Poor Law and subsequent Acts In 1930 the average number of patients in the 98 "County, County Borough and City Asylums" was 1,221 ( Jones, K. 1972, p.357).
The new Bethlem Royal at Beckenham in Kent was completed in 1930. The old Bethlem at St George's Fields became the Imperial War Museum. Moss Side Hospital, Maghull, Liverpool, was opened in the 1930s as England's second State Institution for mentally defective people considered dangerous. (See Rampton). It had been serving as a hospital for soldiers. Hedley Report on colonies for mental defectives published by the Board of Control On
5.5.1933 the first residents of Borocourt Certified Institution
for Mental Defectives moved into a converted Victorian mansion
Germany The case for eugenics (breading healthy people) and euthanasia (humane killing) reached an extreme under the National Socialist (Nazi) regime in Germany. The Nazi party came to power in 1933, committed to the construction of a racially pure "Aryan" Germany. In addition to the attempted elimination of Jewish people, attempts were made to eliminate mentally and physically degenerate Aryans. In September 1935 the Law for the Protection of German Blood and German Honour forbade marriage or sex between Jews and "citizens of German or cognate blood". England Laurence George Brock, chair of the Board of Control, published his committee's report on the voluntary sterilsation of mental defectives, with memoranda on what was happening elsewhere in the world. Wilson Report on hypoglycaemic shock treatment in schizophrenia published by the Board of Control, followed in 1938 by a report that also dealt with cardiazol shock treatment External
Link: Renato Sabbatini's article on The History of Shock Therapy in Psychiatry explains
the relationships
Germany
In Spring 1939, a Reich Committee for Scientific Research
of Hereditary and Severe Constitutional Diseases was established
that oversaw the killing of an estimated 5,000 'deformed' children
in a 'euthanasia' programme that finished in November 1944. In July
1939 planning of the 'T4' programme of 'mercy killings' of the
insane began. Experimental gas chambers were tried out at Brandenburg
euthanasia centre in late 1939. An estimated 80,000 to 100,000 people
were killed before the T4 programme was 'stalled' in August 1941
after public protest. Experiments in humane extermination continued
in occupied Poland. In September 1941, 250 mental patients and 600
Russian prisoners of war were gassed at Auschwitz. During the war,
about six million Jews from all over Europe were exterminated in
the Polish camps. Science Time Line 1939
COMMUNITY CARE Historical Background to Community Care National Health Service Breakdown of taboo of silence. 1950s 1958 1960s 1972 Royal Commission on the Mental Health Laws 1954 to 1957 The Hurt Mind 1959 Mental Health Act Enoch Powell's Water Tower Speech 1962 Hospital Plan Hospital scandals Better Services White Papers, 1971 and 1975 1981 Care in the Community Green Paper |
