Mental Health History Timeline
|
lunacy
|
History of the Conceptualizations of Mental
Illness by
Jessie in Japan begins in
"prehistoric times"
History of Mental Illness at the
University of Derby begins some 10,000 years ago with
trepanning - possibly to let evil spirits out, but this was
before written records.
A history of Mental Health, by
an unknown
nursing student (1992), begins in "primitive times".
The Society of Laingian Studies'
Timeline in the treatment of
Madness begins
in 3,100BC when "Menes, the founder of the 1st Dynasty writes
The Secret
Book of the Heart, describing 3 kinds of healers, the
physician, the priest
and the sorcerer".
Ed Brown's annotated cases at Brown Medical
School -
archives
Nebuchadnezzar or Nabonidus (whichever), in the
6th century BC,
Indian medicine
S N Kothare and Sanjay A Pai's chapter on
Evolution of Psychology and Psychiatry
discusses
Ayurveda medicine
which derives from the compendiums of
Sushruta Samhita and
Charaka
[External links to Wikipedia], which date back to about the
6th century BC
Larry Merkel's History of Psychiatry, available from
his
University of
Virginia
seminars as a
pdf
file begins with a discussion of pre-classical
(Egyptian,
Middle-Eastern, Judaic) influences on classical Greek and
Roman theory and
practice.
Drama Therapy and Psychodrama
History begins
with plays of Sophocles in 404BC
Socrates (in
Plato's The Republic)
recommends that
"the offspring of the inferior, or of the better when they
chance to be
deformed, will be put away in some mysterious, unknown place,
as they
should be"
355BC
Aristotle
said those "born deaf become senseless and incapable of
reason."
(Disability Timeline)
Galen, Greek physician
AD 129 Galen born in Pergamum, in what is now Turkey.
He died about
AD 216. His massive writings on medicine included the
theory of the
humours or body fluids (like blood) whose preponderance had a
marked affect
on a person's health and personality. (See
melancholy).
External link:
Hospitals in Islamic History by Dr Hossam
Arafa
"The first known hospital in Islam was built in
Damascus in
706AD". Social Science
History.
See also origin of word hospital.
Bagdhad Hospital after 750.
Al-Fustat Hospital, Cairo, 872.
From the late 11th
century, Hunain ibn Ishaq's Arabic translations
of Galen,
commentaries by Arab physicians, and sometimes the original
Greek, were
translated into Latin. These became the basis of medical
education in the
European universities that started in the late
12th
century
1188
King Henry 2nd bought land next to Newgate (the gate looking
west from the
City of London towards Westminster) for a
prison.
Newgate prison occupied
this site until 1881. The Old Bailey (Central Criminal Court)
now stands
there.
1201 St Nicholas Hospital in Carlisle claims to have
been treating
lepers in 1201 - to have passed to the City as a (general)
hospital in 1477
- Some local historians link this forward to the opening of a
fever
hospital in 1809 and the Cumberland Infirmary in 1828.
Frank Walsh in Union journal
1970
1284
Al-
Mansuri Hospital, Cairo opened. At some time,
1290 (See 1324: 17
Edward 2 cap. 9)
De Praerogativa Regis, the Act
giving the
King (or, possibly, regulating and already established)
custody of the
lands of natural fools and wardship of the
property of
the insane, may have been drawn up between 1255 and
1290. This is part of
feudal law
relating to the idea that all land is by
gift from the highest lord (in England, the King). Until the
English
civil war and interregnum, all
land reverted to the king on the chief tenant's death, to be
reclaimed by
any lawful heir on payment of a fee. The King's Officers,
throughout the
country, who regulated these affairs were called "Escheators"
(See external link). The
Escheators also held
the inquisitions to determine if a land holder was a lunatic
or idiot.
1292
1310 Date given for a German madhouse at Elbing near
Danzig.
Ackernecht, E. H.
1959 (ch.3 p.21-22) mentions 14th century German
mad houses at
Elbing, Hamburg and Nurenberg.
1371 Date given for royal licence to Robert Denton,
chaplain, to
use his own house in the parish of Berking, near the Tower of
London, as a
hospital "for the poor priests
and for the men and women in the sad city who suddenly fall
into a frenzy
and lose their memory, who were to reside there until cured;
with an
oratory to the said hospital to the invocation of the Blessed
Virgin Mary".
See
Tuke, D.H. 1882 pages 53-55 (source Stowe, Survey
of London,
1603 "written in 1598") and
Catholic Encyclopedia - source
Sir William
Dugdale Monasticon Anglicanum, London, 1655-1673
[Tuke also takes from Stowe a story of a madhouse near Charing
Cross which
"a king" took
objection to and had its lunatics removed to Bethlem - thus
starting that
hospitals connection with insanity]
The religious priory of
St Mary of
Bethlem, in London, was
confiscated by King Edward 3rd in 1375, and used for lunatics
from 1377.
(Jones
1972
p.12).
In 1403/1404 it had just
six insane patients and three who were sane.
(Scull
1972
p.19).
This old Bedlam was a
small institution
(on a site south of
what is
now
Liverpool Street
Station),
even in the 17th century when it had about 30 patients. Its
showy
replacement, the
Moorfields
Bedlam,
opened in
1676.
The priory of St Mary of Bethlem was founded in 1247 as a
priory in
Bishopsgate Street, for the order of St. Mary of Bethlehem, by
Simon Fitz
Mary, an Alderman
and Sheriff of London. The
Catholic
Encyclopedia says it was a hospital (place of
refuge) from the
begining 'originally intended for the poor suffering from any
ailment and
for such as might have no other lodging, hence its name,
Bethlehem, in
Hebrew, the "house of bread."'
(on the Mind website) begins in
10,000 BC. She says "in
prehistoric times
there was, as far as historians can tell, no division between
medicine,
magic and religion."
Disability Social History Timeline
begins in
3,500 BC with an account of the
fitting of an
artificial limb the Rig-Veda (sacred poem of India written in
Sanskrit
between 3500 and 1800 B.C. It then jumps to
355 BC
begins with the
feigned madness of David who became king of the Jews
(9th century BC)
is the
earliest in
Joan's mad monarchs series
Michael Warren's
health in Britain chronology
begins in 1066
this had music
therapy for its mental patients.
Dave Sheppard's
Development of Mental Health Law and
Practice
begins in 1285 with a case that linked "the
instigation of
the devil"
and
being "frantic
and
mad"
"A lunatic who had burned a man's house was convicted by
the justices but released on their authority."
16.2.1312 at York: Pardon to Richard Sharpe of Malteby,
for the
death of Agnes his wife, as it appears by the record of John
de Insula and
the others justices of gaol delivery for York, that he was mad
when he
killed her. (Calendar of Patent Rolls
Reign of Edward
the
2nd p.431 5 Edward
II Part 2... Membrane 20 - From John Alan Longbottom)
1377
| Margery Kempe, who was born in Lynn, Norfolk, about 1373 and lived to 1438, dictated a book of her spiritual experiences (1436) which shows how she went "out of her mind" after childbirth, was bound in a storeroom to prevent her from self-harm, suspected of demonic possession, but escaped burning, had visions of angels and visions of men's sexual parts and was seen as both holy and heretic. Through hearing holy sermons and books, she "ever increased in contemplation and holy meditation, but learnt through divine visits to her during and after "cursed thoughts" and "pain" that "every good thought is the speech of God". (See Peterson, D. 1982) [External link to Margery Kempe pages on the Luminarium web] |
1403
Report of a Visitation which had enquired into the
deplorable state of
affairs at Bethlem Hospital (Michael Warren). There is a report of
a Royal
Commission, in 1405, as to the state of lunatics confined
there. (Catholic
Encyclopedia)
1464:
Examples of
people being granted custody of an idiot and his or her
property.
1494
Ship of
Fools.
Michel Foucault suggests that
the publication
of Brant's illustrated narrative poem marks a point in
European culture
where a dialogue between reason and unreason became central.
1495
Syphilis, possibly introduced
from the
new
world, broke
out
amongst troops in Italy and rapidly spread across Europe,
reaching England
and Holland in 1496. It reached India in 1498. In 1500 there
was an
epidemic of syphilis across Europe and in 1505 it reached
China.
The
connection between syphilis and general paralysis of the
insane was not
demonstrated until the 20th century.
| 1500- |
words
|
1518
1520
A small book by
Paracelsus,
written about 1520 and published 1567 was called (English
translation of
title) "Diseases which lead to a Loss of Reason". The
introduction makes it
clear that these are not caused by spirits, but are natural
diseases.
(Ackernecht 1968, pp 22-23)
Until the 1530s, Bethlem stood in open ground
1536
First Act of the Dissolution of the Monasteries. Although the
religious
foundations were closed, any "hospital" (refuge for the
homeless poor)
attached might continue. (The hospital of St Bartholemews in
London, for
example, continued when the priory closed). Continued
existence would be
precarious, however, unless civic authorities sought to
preserve it.
1538
The City of London unsuccessfully petitioned the King to give
them five hospitals plus their endowments. The hospitals
included
Bethlem, St
Bartholomew and
St Thomas. They were needed to house:
27.12.1547 King Henry 8th signed a document giving
Bethlem
Hospital
and St Bartholomew to the City of London. The name "St
Bartholomew" being
changed to "the House of the Poor in West Smithfield".
13.1.1547
King Henry 8th signed a document giving the endowments of
Bethlem Hospital
and St Bartholomew to the City of London.
1557
From 1557, Bethlem was managed by the governors of the
Bridewell House of
Correction (established 1550). The governors were chosen by
the City of
London. Bethlem was controlled by the City of London until it
was
transferred to the National Health Service in
1948
In 1518 King Henry 8th, on the advice of his court
physician, founded
the Royal College of Physicians (London) to control who
practised as a
physician in London and so protect the public from quacks.
"the miserable people lying in the street,
offending every
clean person passing by the way with their filth and nasty
savours" [savour
here means smell]
1546
1547
1583 Philip Barrough (1560-1590) The method of
physic, containing
the causes, signs, and cures of inward diseases in man's body
from the head
to the foot.
1592 An account of a trial for conspiracy to kill the
King, written
by Richard Cosin, contains discussion and definitions of the
terms applying
to the various "degrees" of insanity. See furor, delirium and dementia
| The Elizabethan Poor Law |
|---|
|
1598
1598 Poor Law Act (39 Elizabeth chapter 3) Every parish was to appoint overseers of the poor to find work for the unemployed and set up parish-houses for poor people who could not support themselves. [See Blackstone on overseers] |
1601
1601 Poor Law Act (43 Elizabeth chapter 2) or Old Poor Law Act usually known as the Elizabethan Poor Law or Old Poor Law |
Mind's key dates in the history of mental health and community care
begins in 1601
1611 Authorised (King James) version of the Bible. The bible was a major source for ideas about virtually everything in the 17th century, and later. In her Notes of the history of mental health care (on the Mind website), Katherine Darton outlines some of its influences in her consideration of the Jewish tradition. (Scroll down from 2,000BC).
about 1615
Giles Earle His Booke, a manuscript collection of
lyrics in the
British Museum, contains the first known written version of
the English
Folk lyrics
"Tom o' Bedlam's Song" (see Bedlam
weblinks)
|
First edition of Robert Burton's The Anatomy of
Melancholy.
What it is,
with all the kinds, causes, symptoms, prognostics and several
cures of
it... Philosophically, Medicinally, Historically opened and
cut up. By
Democritus Junior published in Oxford. The
1628 edition
had a ten
picture engraving that was explained by a poem in the
1632 edition. The
verse for the engraving of the maniac is:
But see the Madman rage downright With furious looks, a ghastly sight, Naked in chains bound doth he lie, And roars amain, he knows not why. Observe him; for as in a glass, Thine angry potraiture it was. His picture keep still in thy presence; 'Twixt him and the there's no difference. |
| Origins of la Pitie-Salpetriere and le Bicetre |
|
|---|
|
External link
Histoire de la Pitie-Salpetriere
1612 In place of an old tennis court, Marie de Médicis created a beggars' hospice: l'hospice Notre Dame de la Pitié 6.6.1636 Purchase of land under Louis 13th for the Petit Arsenal or Salpêtriere to make gunpowder. Closed after fifteen years, Louis 14th offered it to the duchesse d'Aiguillon to set up a hospice for beggars with the help of Vincent de Paul. A pdf file at http://www.ifrns.chups.jussieu.fr/ifrns.pdf contains The History of the Neurosciences at La Pitié and La Salpêtrié in French and English. 1633 to 1642 Building the Hôpital Bicêtre in Paris The Bicêtre was originally a military hospital. It was incorporated into the Hôpital Général in 1656 and used successively as an orphanage, a lunatic asylum and a hospital. external link |
October 1636 Commenting on the physics of Galileo, Thomas Hobbes wrote "the motion is only in the medium and light and colour are but the effects of that motion in the brain". Hobbes was to apply the idea of studying motion in matter to the study of light meeting the eye and ideas in the mind. In Leviathan he laid the foundations for assocationist theories of thought.
30.1.1649: English king beheaded
Working with the
Bible, it was possible to
calculate that
something spectacular was likely to happen in the 1650s. For
example, it
could be calculated that the great flood that destroyed all
life not in the
Ark took place 1,656 years after the creation - So 1,656 years after the birth of Christ
could be
equally significant. (Usher's
chronology put the creation in 4004 and the flood
in 2349. 4004-
2349 = 1655). The
execution of a King was woven into
speculation that
Christ could be due to return to establish his kingdom.
October 1650
Rapturous quakers
1651
Winter 1651 George Fox's
vision of blood in the streets of Lichfield
1654
Petition respecting John Pateson at Ormskirk Quarter Sessions,
who had
fallen into a sullen, sad, melancholie and would not go
indoors or eat or
wash himself. [Described
in more detail]. The churchwardens and overseers
were ordered to
make an assessment and provide out of
poor rates for
his care
until
he recovered or died.
compare
America
|
Meric Causaubon's Treatise concerning enthusiasme, as it is an effect of nature, but is mistaken for either divine inspiration or diabolical possession.
1656
Alleged internment of
Rev. Mr George Trosse
(Account not published until 1714)
October 1656 James Nayler
(Quaker)
entered Bristol on a donkey as if he
was Jesus Christ. (see enthusiasm)
He was in prison until 1659. Conflict between Quakers
over performances like this was a stimulous to the creation of
a collective
discipline that,
over a century
later,
made
them the pioneers in the control of insanity.
The 5th Monarchy Men believed that 1656 could be the year
when Christ
would return to earth. The year after, and again in
1661, the 5th Monarchy Men
undertook an armed
uprising to bring about his kingdom.
|
|
Opening of Hôpital Général, Paris: hospital, poorhouse and factory |
|---|
| The hospital (as it was spelt in the 17th century) was the putting together of a number of buildings for the relief of the poor. These included La Salpétrière (for women) and Le Bicêtre, which later became the Paris asylums for the insane. | |
|
meaning of
hospital
Foucault: The Great Confinement |
external link (scroll down for
English
translation
external link |
1657
5th Monarchy rising headed by Thomas Venner.
1660: Restoration of English
Monarchy In 1661, the
Royal prerogative over idiots and lunatics
moved from the Court of King's Wards to the Lord
Chancellor.
Charles 2nd's Lord Chancellor was Edward Hyde, Earl of
Clarendon.
The papers of the
Clerk of the Custodies of Lunatics and Idiots
went back to the days of Lord Clarendon. (J. Lowry Whittle,
Registrar
of Lunatcs in
1882 - who inherited the papers)
From
November 1660
(arrested) to 1672, John Bunyan, a
Baptist
preacher,
was imprisoned
almost continuously in Bedford Gaol for preaching outside the
established
church. In prison he wrote Pilgrims Progress and his
religious
autobiography
Grace Abounding to the Chief of Sinners.
Grace Abounding
described religious
experiences
that sound like diseases mad doctors were soon to
identify.
1.1.1661 to 4.1.1661 Venner's Rising. 5th Monarchy rising suppressed and
Veneer and the
other leaders executed on 19.1.1661. A hundred 5th Monarchy
Men and some
4000
Quakers were imprisoned. "The first
official declaration of absolute
pacifism
was made by the Quakers in 1661, after a number had been
arrested after
Venner's unsuccesful rising". (Hill 1972, p.241)
May 1665: First case (St Giles, Cripplegate) of the
London Plague.
By the end of July, more than 1,000 Londoners were dying each week. During
August it reached many provincial towns. In London, it got worse in
September, but then lessened as the weather became cooler. London returned
to some degree of normality during the winter. Many provincial towns were
badly stricken in 1666. (external link)
[Solomon Eccles may, or may not, have run naked as a sign during
the plague]
Sunday 2.9.1666 for five days: Great Fire of London.
After the Great Fire, Robert Hooke was appointed city
surveyor and
designed the new
Bethlem
(Bethlehem Hospital) in Moorfields. This opened in
1676. It was replaced by the
St George's Fields
Bethlem in
1815. The Moorfield's Bethlem had 130 patients in 1704.
|
| At the door of the new Bedlam the visitor was confronted with sculptures commissioned from the Dutch artist Caius Gabriel Cibber (1630-1700). One (above) of mania or raving madness, the other of melancholy. Those who pass a theatre or a strip-joint today are tempted in by photographs of the performance. This drama had a hundred year run and its actors were involuntary exhibits. |
The new Bethlem was a place for display, set in gardens and modelled on the Tuileries, the palace of the French King. This is the Bethlem where the lunatics were displayed to visitors for a fee (until 1770). Londoner's on holiday could visit the zoo animals at the Tower of London and then stroll up to Moorfields to see the humans. Thomas Tryon complained in 1695 about the public being admitted on holy-days:
"It is a very undecent, inhuman thing to make... a show... by exposing them, and naked too perhaps of either sexes, to the idle curiosity of every vain boy, petulant wench, or drunken companion, going along from one apartment to the other, and crying out; this woman is in for love, that man for jealousy. He has over-studied himself, and the like."
|
|
France saw the last plague epidemic in 1668, until it reappeared in 1720. Foucault precedes his discussion of the Panopticon with a description of measures to be taken at the end of the seventeenth century "when the plague appeared in a town". These specific orders were for Vincennes. |
|
1669 In Salem, a Quakeress known for
signing with her nakedness,
is found to have a distempered mind |
|
1670
In England the earliest records of private madhouses on a
regular basis
are from 1670 onwards. [See Clerkenwell, below -
Hoxton House (1695) -
Irish's (1700)].
From the beginning, madhouses were
automatically
subject to the
common
law
of England. One could apply to the
courts for
redress against wrongful imprisonment in a madhouse as
anywhere else. When
inspection of madhouses was introduced
(in 1774), it
was mainly
to
assist
the courts.
1679
1690
In his
An Essay Concerning
Understanding,
John Locke said there is a
degree of
madness in
almost everyone. This is because emotions force us
to persist in
falsely or
unreasonably associating some ideas. Madness is the inability
to let reason
sort out ideas by relating them correctly to our experiences.
Locke's ideas set a pattern for 18th century English views of
reason and
unreason. Madness was seen as a persistent inability to
associate ideas
correctly.
1692
6.3.1682 John Moore, Bishop of Norwich, preaches before the
Queen a sermon
afterwards published as
Of Religious Melancholy
1695
Hoxton House became a private madhouse
1696
Bristol Poor Act established a Board of Guardians who
used a
building near St Peter's Church, Bristol as a workhouse for
100 boys.
The addition of "infants, the aged, infirm, and lunatics" (by
1700?)
changed its character and it became
St
Peter's Hospital. In the 18th century this had
lunatic wards. In
the 19th century (1832?) it became a lunatic asylum.
English asylums in the eighteenth century were small and they
were not run
by the state. The best known and the largest was Bedlam or Bethlem in the
city of
London. This had 130 patients in 1704. There was a growing
number of
private
madhouses -
Probably
about 40 in 1800. After 1774
private madhouses had to have a licence and it is from the
surviving
licence records that we can estimate how many there were.
Charitable
asylums were opened in the eighteenth century in eight English
towns:
Norwich (1713),
London (1751),
Manchester
(1766),
Newcastle
(1767),
York (1777),
Liverpool
(1792),
Leicester (1794)
and
Hereford (1797).
The ninth
opened in Exeter
in 1801.
Eighteenth Century
Psychiatry
Ackernecht (1968, p.) argues
that psychiatry
"reached the status of an independent science" in the
eighteenth century.
But not due to "developments in medicine but to the philosophy
of
enlightenment which pervaded the whole century".
Reasons were:
Belief in
"possession by evil spirits" came to be regarded as
"superstition".
Reason was the highest good for
the
philosophers, so they sympathised especially with
those who lost
their reason. He argues that:
1700
David Irish
in his madhouse
near Guildford, Surrey, claimed to cure by
good food and
comfort, and would care for those who were not curable for
life, if paid
Quarterly:
"Since the concept of
the immortal soul was of no importance in this philosophical
system, mental
disorders could be viewed as disorders of the mortal brain or
thinking
apparatus and as such could now at last be studied on a
scientific basis.
At the same time it became possible to give up a purely
somatic viewpoint
and to introduce
psychology deliberately into psychiatry.
Cartesian philosophy, no doubt, played a part in
this
development."
"allowing them good fires, meat, and drink, with good
attendance, and all
necessaries far beyond what is allowed at Bedlam, or
any other place
that he has yet heard of and cheaper, for he allows the
melancholy,
mad, and such whose consciences are oppressed with a
sense of sin,
good meat every day for dinner, and also wholesome diet for
breakfast and
supper, and good table-beer enough at any time."
Irish, D.
1700
pp 53-4, quoted
Hunter and Macalpine 1963 p.279)
| Norwich Bethel opened. The first known charitable madhouse in England (apart from the special case of Bethlem). It is also has the longest history in one place. Norwich was then England's second largest city. The Bethlem was established by an individual private bequest. It had 28 patients in 1753. The Norwich Incorporation of the Poor had been established by Act of Parliament in 1712. |
1714
The
1714 Vagrancy Act is
thought to
have
been the first English statute to provide specifically for the
detention of
lunatics, but Blackstone
argues that it was based
on common law. [See also my introduction to Mental Health and Civil
Liberties and
Valerie Argent's discussion of the law on confinement]
| Lunatic Wards to Guys Hospital opened |
1724
Trial of Arnold for the murder of Lord Onslow established the
wild beast
test
1725
Richard Blackmore's
Treatise of the Spleen and
Vapours
1728
James
Monro
was resident physician at
Bethlem
Hospital
from 1728 to
1752
Wednesday 31.5.1738:
Alexander Cruden escaped from
Wright's
madhouse,
Bethnal Green,
and successfully applied to the Lord Mayor to prevent his
recapture. He
published an account in 1739
(The London-Citizen Exceedingly
Injured)
"as plainly showing the absolute necessity of regulating
Private Madhouses
in a more effectual manner than at present"
May 1738 Conversion of Charles and John Wesley. See
Evangelical
Revival - Methodist
Hymns -
Enthusiasm
13.12.174?
Susannah Wesley wrote to her son John (founder of
the
Methodists) about a man with "more need of a spiritual, than
bodily
physician" who was sent to
a Chelsea madhouse by "that wretched
fellow Monroe",
the physician to Bedlam. The letter is reproduced in
Hunter and Macalpine 1963 p.423
with the
date
13.12.1746, but G.E. Harrison in "Son to Susanna" (p.119) says
she was
buried in Bunhill Fields on 1.8.1742.
1744
Construction of
naval hospitals at Gosport (Haslar), Plymouth and
Chatham
authorised. [Plymouth was built 1758-1762, Chatham, not until 1827-1828]
The
Haslar hospital was built between 1745 and
1761.
"The hospital catered for a full range of illnesses and
included wards for medical, surgical,
fever,
flux,
smallpox, consumptive,
scorbutic and recovery as well as lunatics. In the late 19th and early 20th
centuries, Haslar was one of the most important naval hospitals in the
country. It became the
main lunatic asylum for the navy as well as providing for
infectious diseases between 1898-1902"
(PAPHE external link) - The navy placed
lunatic patients in
Hoxton House, at least
until 1818, but also had insane patients
at Haslar
8.8.1746 George 2nd granted a Royal Charter to St
Patrick's
Hospital,
Dublin, Ireland, founded from the legacy of
Jonathan
Swift. Swift
had been
found of unsound mind by a Commission of Lunacy in 1742.
"St Patrick's was built by architect George Semple following Dean Swift's detailed and painstaking instructions. It is now the oldest, purpose built psychiatric hospital continuously functioning on its original site in these islands and one of the oldest in the world." (external link) |
1749
David
Hartley's
Observations on Man, his Frame, his Duty, and his
expectations linked the
association of
ideas
theory of human mind to the nervous system. Sensations set up
vibrations
in our nerves which move rather like sound waves through air.
Thought is
the association of these vibrations (ideas) when they meet.
Hartley's
theory, although rarely accepted without critical
modification, was
influential in philosophy, in the scientific study of mind,
and in
medicine. Some connection of thought to the body was necessary
(at this
time) for it to be
considered a medical issue, and considering the nerves as
conductors along
which thought waves run provided a possible connection of mind
and body.
At the turn of the
nineteenth/twentieth
century,
theories such as those of
Sigmund
Freud
provided a means for medicine to include psychological
"functional"
disorders as well as "organic" ones.
1750
The Gentleman's Magazine reported that a Dr Newton
"keeper and
physician to
a private
madhouse, near
Islington turnpike" had died. About this time,
William Battie
acquired premises in Islington Road for private patients and
in 1754 took
over Newton's madhouse in Wood's Close.
(Hunter, R.A. and Macalpine, I.
1963 pp 200-201 and 402-403). (See below and
1776)
| Saint Luke's Hospital for Lunatics opened in Upper Moorfields, opposite [??] (see sketch map) Bethlem Hospital on the north side of what is today Finsbury Square. William Battie was its physician to 1764. He also acquired premises for private patients. Saint Luke's had 57 patients in 1753. It moved to Old Street in 1786 |
1752
John Monro was
physician at
Bethlem
Hospital from 1752. He also opened a private asylum
at
Brooke
House
Hackney in 1759 and took over the house at Clerkenwell
in
1776
Sometime in the mid 1750s: a magistrate secured the release of
Mrs Gold's
daughter
from Hoxton House (madhouse), where she had been confined by
her husband.
1754
In December 1754, The Royal College of Physicians
declined a
suggestion
that they should be an authority for regulating madhouses in
London.
1755
"Pourquoi l'homme seul est-il sujet
à
devenir imbécile?"
Rousseau
asked in his
discourse on the origin of inequality.
Cole translates
imbécile
as
dotard:
"Why is man alone liable to grow into a
dotard? Is it not that he returns to his primitive state; and
that, while
the brute, which has acquired nothing and has therefore
nothing to lose,
still retains the force of instinct, man, who loses, by age or
accident,
all that his perfectibility had enabled him to gain,
falls by this
means lower than the brutes themselves?"
[See
degeneration theory]
| Madhouses for the Rich: When the very rich were lunatic or idiot, their relatives could afford to confine them as single lunatics - as the British Royal Family did in 1788, 1801, 1811 and 1916. One motive for this was secrecy. Madhouses for two or more inmates were more vulnerable to the risk of exposure, because more people were involved, and because the registration of inmates was required from 1774, but they might provide more humane custody at a lower price. Physicians and others who arranged single confinement, would also refer people to private madhouses, in which they would have some financial stake. Some of these catered especially for the rich. Irish's in Guildford, already advertised good conditions in 1700 . (We can trace a continuous line from Irish to Stilwell's in Hayes in the mid-19th century). Whitmore became a madhouse in 1757. Thomas Warburton's association with Willis, building up its aristocratic clientele, probably dates from the 1790s, before the second episode of the King's madness. Rev Willis became Dr Willis in 1759 - which gives some indication of the start of his business. John Monro opened Brooke House in 1759. Ticehurst may have opened in 1763, Cleve Hill (later Brislington) in 1794. Sidney House (later Manor House) admitted its first patient on 1.8.1829. An article by Harriet Martineau in 1834 argued that rich lunatics would be better cared for in asylums than singly. The case for the "domestic" (single) treatment of some patients was argued by Dr Edward James Seymour (1831/1832). Those who managed asylums for the rich usually also provided single houses as an option. |
1761
1762
5.9.1762 to 4.10.1762:
Mrs
Hawley
confined in
a Chelsea madhouse. Her release was secured by a
writ of habeas
corpus.
begins
by discussing attitudes before and
after
the industrial revolution
| The 1774 Madhouse Act was based on the recommendation of the 1763 Select Committee of the House of Commons on Madhouses that |
|
"the present state of the private madhouses in this kingdom, requires the interposition of the legislature."
A large part of their report was an examination of the issues raised by the (eventually successful) attempts of a Mr La Fortune to secure the release of a Mrs Hawley (confined in a Chelsea madhouse 5.9.1762 to 4.10.1762) by writ of habeas corpus. They were specifically concerned with the extent to which madhouses were used to confine people who were not lunatics.
1764
William Battie retired as visiting physician to St Lukes,
becoming, in the
same year,
President of the Royal College of Physicians (for
just one
year).
1765
1765 to 1769
William
Blackstone's
Commentaries on the
Laws of
England
published by the Oxford University Press.
| Manchester Lunatic Asylum opened |
| Newcastle Lunatic Asylum opened as a Subscription Hospital for patients from Newcastle, Northumberland and Durham. It became a licensed house in which Newcastle Corporation maintained a financial interest. |
September 1767: English Prime Minister described as "a lunatic brandishing a crutch" by Junius, the anonymous author of letters to the Public Advertiser. William Pitt (the elder), Lord Chatham, was physically incapacitated by gout and, from about March 1767, was in a state of mental withdrawal described by Daniel Hack Tuke (p.106) as a "dismal and complete eclipse" for "upwards of a year" of his "mental powers". There was no morbid illusion of the fancy, but there was utter prostration of the intellect". [As the first Junius letter was published January 1769, and the last in January 1772, I assume the reference is to a letter that made public Chatham's state in September 1767.]
|
|
The
1774 Madhouses Act
established a
commission of the Royal College of Physicians |
|
Each September, from 1774 to 1827, Royal
College of Physicians appointed five of its Fellows
commissioners for the year. They met in October to grant
licences. They
could not refuse or revoke a licence.
(see law)
At least once in the year they visited each madhouse,
making a minute
of its condition. Any keeper refusing admission forfeited his
licence.
(see law)
A Secretary to the Commissioners was to be sent a notice
of the
admission of
every lunatic who was not a pauper to any licensed house in
England and
Wales. He kept registers of these in which he also entered
commissioners'
visiting minutes and those sent to him by the clerks of the
county visitors
(County Clerks).
(see law)
The RCP President, in the name of the Treasurer was to
prosecute
anyone
(in the London
area)
who kept an unlicensed house, admitted any
patients without a medical certificate or failed to notify the
Secretary of
the admission of a non-pauper.
(see law)
The commission could not release a patient improperly
confined. This
was the traditional role of the High Courts at Westminster,
for whose
benefit the registers were principally kept. The Westminster
courts could
also order special visits and reports, and examine those
engaged in the
execution of the Act.
(see law)
Private individuals could apply to the commission to
find out if someone was registered as a patient and, if so,
where he or she
was detained.
(see law)
The commission was financed entirely from fees charged for
licenses, from which the Treasurer paid every commissioner one
guinea for
each house visited (irrespective of the time taken) and the
Secretary an
annual salary.
(see law)
Outside London, houses were to be licensed and visited by the
Justices of
the Peace.
(see law)
Medical cartificates were required for the detention of a
person as a
lunatic.
(See law)
| 1776 The Olney Hymns published. Written by John Newton and William Cowper. Cowper was deeply melancholic and had periods of insanity. In his best known hymn, he pleads for "a closer walk with God, a calm and heavenly frame". But he has lost it: "What peaceful hours I once enjoyed! How sweet their memory still! But they have left an aching void, The world can never fill". Cowper's life and poetry were influential in suggesting associations between mental distress and creativity. For me his most beautiful poem is one he wrote in the autumn of 1793 To Mary (Mrs Unwin) who cared for him for many years and who, being herself reduced to dependency, Cowper cared for in turn. (See Ashley's 1845 assessment and Rossetti's 1870s assessment) ... and visit the Cowper and Newton Museum |
William Battie died in 1776, and the Clerkenwell madhouse was taken over by John Monro. His son, Thomas, relinquished it in 1803, when it became a boarding school. (Hunter, R.A. and Macalpine, I. 1963 pp 200-201). The site was used in the 1890s to build the Northampton Institute (external link) (Now part of City University).
| York Asylum opened |
lunatic sent to madhouse for matricide
1780
"In the sultry, early June days of June 1780, the Lord George
Gordon No-
Popery Riots rolled through town". On Tuesday 6.6.1780,
William Blake was
caught up in the riot, and witnessed the sack of Newgate
prison. On
12.6.1780 William Cowper wrote to John Newton congratulating
him "upon the
wisdom that witheld you from entering yourself a member of"
[George
Gordon's] "the Protestant Association". When Charles Dickens made a novel of the riots,
his leading
character combined lunacy and weak-mindedness.
1782
The Royal College of Physicians was
advised by the
Attorney
General that its funds were at risk if it
prosecuted
someone for running a madhouse without a licence.
1784
William Walker, a pauper who murdered his
wife
1786
Margaret Nicholson
attacked the
king with a knife
Saint
Luke's Hospital
moved from
Moorfields
to Old Street. Thomas and Mrs Dunston were Master and Matron.
The visiting
physician was Samuel Foart Simmons. St Luke's had 298 patients
in 1815. On
an 1832 London map it stretches along Old Street from Bath
Street to
City Road. Simmons resigned as physician in 1811 and was
succeeded by
Alexander Robert Sutherland,
also licensee of
two
private houses:
Blacklands House, Chelsea. and
Fisher House, Islington.
John Warburton, another private
asylum owner,
was also physician from 1829 and Sutherland was succeed by his
son
AlexanderJohn Sutherland from
1841 to 1860.
Henry
Monro, also a private asylum owner,
was a physician from 1855 to 1882. In
1881 the address was
St Lukes
Hospital For Lunatics, Old St, City Road, London, and the
Resident
Medical Superintendent was George Mickley
1787
William Perfect M.D., proprietor of
West Malling asylum, published
Select Cases in
the Different Species of Insanity, Lunacy or Madness, with the
modes of
practice as adopted in the treatment of each.
Mathew Clay, insane burglar, discharged to
the care of
his father
1788
Wedneday 5.11.1788 Newspaper article revealed that
George 3rd, who
was ill, had been
"delirius". That
evening, the King's
personal physician,
Sir
George Baker, found him "under an entire alienation
of mind".
Other physicians called in to advise included: William
Heberden,
Richard Warren
,
Henry Revell
Reynolds and
Lucas
Pepys.
Most of the doctors had experience in the Royal College of
Physicians'
Commission for
Visiting Madhouses, but they were not specialists
in mental
disorder. At the end of November, Dr Anthony Addington, a
society doctor
who had treated William Pitt the elder's disorder and had once
run a
private madhouse, was called in to advise.
The King was removed from Windsor to Kew, for a more
therapeutic
confinement and to be closer to London doctors, and was there
(Friday
5.12.1788) introduced to Rev. Dr Francis Willis, the owner
of
a
private
madhouse
in Lincolnshire, who took control of the King's
treatment.
10.12.1788: The House of Commons published a Committee
report
containing
the evidence of Royal Physicians on the state of the King's
mind.
1789
23.4.1789 Services of thanksgiving throughout the
country to
celebrate the recovery of King George 3rd from
insanity.
"Britons Rejoice.
Your King's Restored"
|
March 1790: Decree that within six weeks "all persons detained in fortresses, religious houses, houses of correction, police houses, or other prisons, whatsoever...so long as they are not convicted, or under arrest, or not charged with major crimes, or confined by reason of madness, will be set at liberty". The mad were to be examined and either set at liberty or "cared for in hospitals indicated for that purpose". In Paris: arrangements were made for insane men to be sent to the Bicêtre and insane women to the Salpétrière (200 insane women moved there in 1792). After an initial period of confusion, the two institutions became reserved for the insane.
|
|
|
|
Philippe Pinel was appointed physician superintendent of the Bicêtre in 1793. He decided to unchain the lunatics. He was put in charge of the Salpêtriere in 1795 |
1790
John Frith tried for
treason
(penalty hanging, drawing and
quartering) for throwing a stone at the King's coach. He was
found
unfit to plead.
|
1791
Jeremy Bentham published Panopticon; or, the Inspection-House: Containing the Idea of a New Principle of Construction Applicable to Any Sort of Establishment, in which Persons of Any Description Are to Be Kept Under Inspection. |
|
| Although Bentham's star plan was not much used, the principle of the "all seeing eye" of the superintendent was. It was the basic principle, for example, of John Conolly's The Construction and Government of Lunatic Asylums in 1847 - See also asylum forms - Bevans 1815 | |
13.3.1791 Ellen Riggott was christened at Chesterfield in Derbyshire. Her father was Charles Riggott, her mother is not recorded. She may have entered the Ashover Poorhouse at birth. In 1828 she was recorded as a "female idiot, not dangerous, disordered from infancy". Ashover closed in 1838. In 1851 Ellen was one of two women admitted "thinly clad and very dirty" to the new Derbyshire County Asylum from Haydock Lodge. The asylum case book records a picture of her. She died 7.6.1853.
| Liverpool Lunatic Asylum opened |
Liverpool Royal Lunatic Hospital, which was associated with the Royal Infirmary and Manchester Royal Lunatic Hospital, associated with its Royal Infirmary, York Lunatic Hospital, Bootham; St Peter's Hospital, Bristol; Fonthill-Gifford, Hindon, Wilts; Droitwich Asylum, Belle Grove House, Newcastle-on-Tyne, Bethel Hospital Norwich
In London or the surrounding counties: Bethlem Hospital, St Luke's, The Lunatic Ward of Guy's Hospital. Plus private houses: Brooke House, Clapton (Dr Monro's); Hoxton Asylum. To these we should add Bethnal Green, Whitmore House, Holly House (just opened). Possibly Fisher House. There would have been other private houses, many very small (two or three lunatics). The list of London houses licensed in 1815 was 25.
Surrounding counties: Lea Pale House, Stoke, near Guildford; Ticehurst, Sussex.
Claims for poor relief increased
as a result of the war (see
Speenhamland and
St
Marylebone). The authorities sought to reduce
social unrest by
responding generously to the claims of the dependent poor and
harshly to
any form of insurrection.
| Leicester Lunatic Asylum opened |
Susanah Millicent steals a petticoat
1795
Miss Broadric, who murdered her
lover
1796
June 1796
The
Retreat, a hospital for insane
Quakers
and those they
recommended, opened by the Religious Society of Friends in
York. The
Society of Friends had developed a powerful collective
discipline of its
members. At the Retreat, this was adapted to the control of
insanity,
replacing many physical restraints with moral restraints. In
the 1830s, the
Tuke family, who founded the Retreat, went on to reform the
internal
discipline of the Society of Friends.
[
External link to Retreat
website]
words
|
September 1796
Mary Lamb murdered her mother in a fit of insanity. She was confined in Fisher House, Islington for a period and lived in the care of her brother for the rest of her life, sometimes being cared for in a licensed house or a single house. |
| Hereford Lunatic Asylum opened as an offshoot of Hereford General Infirmary (founded 1776). Founded as a public subscription hospital, it became a licensed house in 1802. It was the centre of Parliamentary enquiry in 1839 and closed in 1853. Hereford General Infirmary became Hereford General Hospital. |
1798
|
Nineteenth Century Asylums
The nineteenth century opened dramatically with a pistol shot, and the gun fingers of Hadfield and McNaughton were to trigger the opening of many asylums. The state entered the field in a big way. By the end of the century there were 74,000 patients in public asylums. The early period of state asylums was custodial, out of it developed a period of therapeutic optimism that reached its height in the 1840s, and declined into therapeutic pessimism in the second half of the nineteenth century. 1800 15.5.1800 The ball of a pistol fired at George 3rd by James Hadfield just missed by a foot. Hadfield was detained as a criminal lunatic. 28.7.1800 The 1800 Criminal Lunatics Act aimed at the safe custody of criminal lunatics, especially any who threatened the king. The consequent long term detention of lunatics in county gaols triggered the 1808 County Asylums Act. [[Fear of lunatics, heightened by the publicity about Hadfield and the Act, may be reflected in the life of Mary Lamb] |
| St Thomas's Hospital, Exeter, Devon opened. This was the last of the series of asylums constructed in the eighteenth century by voluntary subscription, as the 1808 County Asylums Act provided the opportunity to combine money raised by rates with subscriptions. |
February to June 1801 The second crisis over King George 3rd's sanity. The Willis family held the king captive with the assistance of keepers from Thomas Warburton's aristocratic Hoxton madhouse business.
June 1804 James Norris could not be afforded an extra cell at
Bethlem because naval and army lunatics were "pouring
into" Bethlem as a result of the war.
(
John Haslam). In 1808 the Navy's lack of
provision for clothes at Hoxton House meant (some of?) its lunatics wore
only a piece of blanket. Lunatic wards for sailors opened at Haslar in
1818
and for soldiers at Chatham in 1819
Work began on Fort Pitt, between Chatham and Rochester, in
1805 and
on Fort Clarence in 1808
(external link -
archive). Which, in
retrospect,
seems rather
late - Coastal defence of Britain seemed unnecessary after
1812.
After the war,
Clarence became a military prison and lunatic asylum.
1806
January 1806 The short lived Ministry of All Talents (1806-1807)
shifted the
political landscape enough to allow in lunacy legislation in
1808. After
that, however, changes were blocked by the Lords until
1828.
1807
Before renewing the licence for
Great Foster
House,
Egham, Surrey County magistrates required a pledge
from Richard
Browne, surgeon
that he would remove chains used to chain disturbed patients
to the floor
in the bedrooms and other rooms when keepers were absent. They
suggested
more attendants and "less violent means". (see
law)
External link on the threat of
invasion -
archive.
|
23.6.1808
The
1808 County Asylums Act
was
the first
Act
permitting counties to levy a rate to build asylums. It was
promoted by
Charles Watkins Williams Wynn.
Its main
purpose was to remove lunatics from gaols and workhouses to
buildings where
they would be easier to manage. I found nothing in the
preparation of the
Bill referring to asylums as places for cure.
5.10.1808: Order of Bedfordshire Justices that a notice be placed in the Northamptonshire Mercury and County Press of their intention to provide a lunatic asylum for the County. (Quarter Session Rolls, Bedfordshire and Luton Archives) Nottingham (already planned) opened 1811, Bedford in 1812, Norfolk in 1814, Lancaster in 1816, Stafford and Wakefield in 1818, Lincoln and Cornwall in 1820, Gloucester in 1823. See also 1827. |
1810
1811
June 1811 The Royal College of Physicians considered
that the
1774 Madhouse
Act
needed
revising, but appears to
have been deterred by the expense of private
legislation. The
cause was picked up by George Rose in
1813
See Clapham (London)
example
1828
|
The General Lunatic Asylum for the Town and
County of
Nottingham, at Sneinton, opened
"It was the first institution that came under the Asylum Act of 1808 and Sneinton was notable in being the first public mental hospital in the country to be created from monies raised by rates. The original Sneinton asylum opened for 60 patients... and it is still possible to see part of the original wall near Sneinton Market" Dave Ogden |
5.12.1811 George, Prince of Wales, became Regent, after the final descent of George 3rd into insanity. For the rest of his life (he died 29.1.1820) George 3rd remained in confinement at Windsor under the control of Dr Robert Darling Willis. The King's own physicians (including Henry Halford) were unable to see him without the permission of Dr Willis. The Prince Regent became the patron of the planned Cornwall County Lunatic Asylum.
|
"I heard the unanimous blessings... bestowed by Englishmen upon a murderer... the act was unjustifiable... but, the people did not rejoice because a murder had been committed... but because his act...had ridded them of one whom they looked upon as the leader amongst those whom they thought totally bent on the destruction of their liberties"
Much more substantial funds went to the support of the Perceval family. Spencer Perceval junior, the eldest son of the assassinated Prime Minister, became an MP and an honorary lunacy commissioner. His religious enthusiasm led to a description of him as having "gone mad" in the House of Commons in March 1832. John Thomas Perceval, a younger son, was confined as a lunatic in 1831 and helped to found the Alleged Lunatics Friend Society in 1845.
| June? 1812 Bedfordshire County Asylum opened. The intention to provide was announced in 1808. The first county asylum for paupers only. Its first superintendent (to 1818) was a house painter with experience of caring for a lunatic. The House Surgeon at the Bedford Infirmary attended to the occasional medical needs of asylum patients. From June 1823 this was a Mr Harris. James Harris was licensed to open a nearby private asylum in 1827. He resided there, and (from 1828) acted as non-resident medical superintendent to the County Asylum. |
| Asylums were opened at Edinburgh (1813) and Glasgow (1814). The Edinburgh Asylum included funding from the government and from an international subscription. The Glasgow Asylum was constructed in the shape of a star - Following Bentham's Panopticon Plan |
2.3.1813 Mr Roberts, solicitor to the Royal College of Physicians, visited Mrs Foulkes at a house in Ivy Lane, Hoxton, owned by Mr Dunston, Master of St Luke's to ask why she was detaining four lunatics there (some in strait-waistcoats) without a licence. The college successfully prosecuted her.
May 1813 Description of the Retreat, an institution near York, for insane persons of the Society of Friends, by Samuel Tuke
"To encourage the influence of religious principles over the mind of the insane is considered of great consequence, as a means of cure."
7.7.1813 House of Commons granted Rose leave to bring in a Bill to repeal the 1774 Madhouses Act and make other provisions in its place. [Bills to reform the Madhouses Act were promoted, unsuccessfully by George Rose in 1813, 1814, 1816 and 1817. In 1815, he moved for and chaired the 1815-1816 Select Committee of the House of Commons on Madhouses. The impulse for Rose's Bill may have come from the Royal College of Physician's, which had decided in 1811 that it could not promote its own Bill for revision.]
December 1813 William and Samuel Tuke (of the Retreat) and Godfrey Higgins, a magistrate, bought their way onto the York Asylum Board of Governors to break through the asylum's secrecy.
December 1813 to April 1814 Correspondence between William Hone, James Bevans and Edward Wakefield about a possible London Asylum. [external link to Kyle Grimes 1999]
| Wednesday 18.5.1814 Norfolk County Asylum opened near Norwich. Unlike Nottinghamshire and Bedfordshire, Norfolk had a hundred year history of asylum provision, and the new asylum was supplementary to existing provision. |
![William [or James] Norris
7.6.1814](Norris.jpg)
|
7.6.1814 Patient, William [or James] Norris, sketched in his
harness in
Bethlem
Hospital. The etching was based on the drawing
which had been
done
at the request of
Edward
Wakefield. William Hone got George Cruikshank to
etch the drawing in 1815, which he then published from his new
Fleet Street
bookshop.
[external link to Kyle Grimes
1999]
"a stout ring was rivetted round his neck, from which a short chain passed to a ring made to slide upwards or downwards on an upright massive iron bar... Round his body a strong iron bar about two inches wide was rivetted... which being fashioned to and enclosing each of his arms, pinioned them close to his sides.... bars... passing over his shoulders, were rivetted to the waist bar both before and behind..." (Edward Wakefield to Select Committee in 1815) |
26.12.1814 A fire at York Asylum killed four patients and prevented effective investigation of the asylum.
1815
The
Moorfields
Bethlem
was replaced by one at St George's Fields, South London, in
1815.
Following a
Select Committee Report in 1807,
the
Government made an agreement with Bethlem's Governors that the
new asylum
should
have two wings for 60 criminal lunatics. By
1852
Bethlem
contained over 100
of the country's 436 criminal lunatics. They were moved to
Broadmoor in
1863.
The
present Imperial War
Museum
is the administrative block of the Moorfields Bethlem. The
dome was added
in 1846.
James Bevans, "Architect of Grays Inn Square", put before the
1815 Select
Committee on madhouses a
"Panopticon Plan" for a proposed
London
Asylum, which was never built. This asylum had a chapel for
the patients,
whereas four other plans that
Susan Piddock looked at, the new
Bethlem,
Wakefield,
Hanwell and
Devon did not.
Under
William and Mrs Ellis, however,
religion
and
work, were
features
of Wakefield
and Hanwell
from the start.
6.7.1815 Suicide of
Samuel Whitbread, leading Whig politician, social
reformer and
theatre goer. See 1818 and
1822
11.7.1815: First
Report
from the Select Committee of the House of Commons on
Madhouses
Act regulating
private
asylums in Scotland
1816
26.4.1816 to 11.6.1816: Further
Reports from the Select Committee of the House of Commons on
Madhouses
July 1816
John
Haslam
dimissed from
Bethlem
Hospital. Thomas
Monro, the visiting physician, was also dismissed,
but succeded
by his son,
Edward
Thomas
Monro (see 1852) in a joint appointment with
Sir George
Leman Tuthill.
| Sunday 28.7.1816: Lancashire County Asylum (1st), Lancaster Moor opened. Administrative records start in 1810 |
Jonathan Martin, the mad
Methodist, attempted
to shoot a Church of England Bishop. See
1829
1818
30.7.1818
Pembroke House officially opened for East
India Company Lunatics. Possibility that they to had been confined at
Hoxton House previously.
English Heritage:
Royal Naval Hospital, Haslar,
Gosport, built
1745-1762 as the first hospital for Royal Naval sailors
August 1818 The
Royal Naval Asylum. Haslar, opened at Gosport,
near
Portsmouth in 1818. The naval officers in Hoxton House were removed to Haslar.
Relatives
appreciated this as the treatment at Haslar was good, but were
distressed
when deductions from pensions were made as a contribution to
costs
(Hansard
16.7.1844). [The
Naval Hospital opened at Yarmouth, in Norfolk in 1811 was
very short lived as a hospital. However, it was used as an army lunatic
asylum from 1844 to 1854 and became a Naval Lunatic Asylum in 1863/1869
[
Kathryn Morrison (7.1995)
says "the
former naval
hospital at Great Yarmouth became the naval lunatic asylum in
1869, and
special mental units were added to Haslar in 1908 - 1910, and
to Plymouth
in 1905"]
| 1.10.1818: Staffordshire County Asylum opened. Administrative records start in 1812. |
2.11.1818 Suicide of Samuel Romilly, lawyer and radical MP who had been at the front of the campaign to reduce the number of capital offenses
| 23.11.1818: West Riding Yorkshire County Asylum, Wakefield opened. The Committee's minutes date from 1814 |
1819
Bethlem was used by the army and navy for some of their
lunatics. In 1819, the army converted
Fort Clarence,
Chatham (Rochester, Kent) to a military prison and
lunatic asylum (separate parts). The asylum, like
Pitt and
Netley which succeeded it,
was situated in a naval port where soldiers could be received from abroad.
From there they might be moved to other asylums. Clarence, Pitt and Netley
were the receiving asylums (or lunatic wards). Separate military asylums
were created for long-term care and custody at
Yarmouth (1846-1856) and
Bow and
Coton Hill. Military pensioners were also kept in non-military
asylums throughout the country.
1820
29.1.1820 Death of George
3rd, who had been confined at Windsor since December 1811
|
20.4.1820
Lincoln
Lunatic
Asylum opened. Originated in a bequest made in
1803
August 1820 Cornwall County Asylum opened. Notice of intention to build had been published in October 1810 |
| 1820-1821 Dundee Royal Lunatic Asylum opened. external link |
| Under the 1821 Irish Lunatic Asylums for the Poor Act, eight or nine District Asylums opened in Ireland (by 1835) at (eight of them) Armagh, Connaught, Carlow, Clonmel, Limerick, Londonderry, Maryborough, and Waterford |
1822
Monday 12.8.1822 Suicide of Robert Stuart, Viscount
Castlereagh, the
Foreign Secretary. An evening paper in London reported he had
died of an
attack of gout in the stomach. The Times, the following
morning,
reported that he had "been suffering under a nervous fever,
accompanied by
a depression of spirits". He "refused to have his bed made on
Sunday night,
expressing an apprehension of taking cold". "Yesterday
morning... During
the absence of his servant, it appears his Lordship had got
possession of a
razor or some sharp instrument, which he applied to his
throat..."
William Wilberforce thought that if Castlereagh,
Romilly and
Whitbread had been observers of the Sabbath they
might not have
collapsed under the strain. (Howse 1953 p.17)
1823
Commencement of lectures on mental diseases by Alexander
Morison
(1779-1866). An outline of these was published in 1825.
They are
described by
Hunter
and Macalpine as "the first formal lectures on
psychiatry".
Morison was physician visitor to
Surrey madhouses from (about)
1808/9/10, and
(non-resident)
physician to
Hanwell from 1832,
Bethlem from 1835 to 1853
and
Surrey County Asylum from
1841. From
about 1824,
Nic Harvey (1996) says Morison
developed an
extensive private practice recommending and organising a full
range of
domestic and
asylum care
for private insane patients.
|
24.7.1823
Gloucester County Asylum
|
| Now known as Horton Road |
1824
George Combe's Elements of Phrenology published.
Phrenology was the
identification of an individual's faculties by feeling the
shape of the
skull. Franz Joseph
Gall
(1758-1828) was one of the first to
carry out
anatomical dissections of the human brain. He argued that mind
was based on
the brain, that different characteristics of mind would give
different
shapes to the surface of the brain (variations in the size of
lobes) and
that the shape of the brain imposed itself on the skull.
Johann Kasper
Spurzheim (1776-1832) combined this theory with the idea that
the
individual's environment should be adapted to his or her
faculties. This
could be done in institutions such as schools and asylums.
Amongst those
who followed the science of phrenology were the educational
pioneer,
Robert
Owen,
the medical journalist,
Thomas
Wakley
and the medical superintendents of many lunatic asylums,
including
William
Ellis,
John
Conolly
and
Samuel
Gaskell.
Phrenology
provided the scientific basis on which
moral
management
could be considered a medical issue. The Edinburgh
Phrenological Society
was established by George and Andrew Combe in 1820.
Philadelphia
Phrenological Society (the first in the USA) started in
1822. The
London Phrenological Society was established by John Elliotson
(and others)
in 1823, In December of the same year, the
Phrenological
Journal (of Edinburgh) started (the first). In
1825,
William
Ellis established the Wakefield Phrenological
Society.
1825
First Act
regulating private
asylums in Ireland
1826
The autumn of 1826 saw the onset of John Stuart Mill's
"dull state of nerves"
which was cured by poetry.
|
29.6.1827:
Report from the Select Committee on Pauper Lunatics in the
County of
Middlesex and on Lunatic Asylums presented by
Robert
Gordon
The madhouse and county asylums Acts that
followed this
report are an inter-related product of the concern about the
management of
Middlesex Pauper Lunatics. They are legislation by and for
London
(Middlesex) magistrates and the magistrates who built Hanwell
were also an
integral part of the Metropolitan Commission that regulated
the private
houses - including the large pauper houses.
|
| 1828 | "Insanity is the scourge brought down on sinful men by the wrath of the Almighty" (George Man Burrows, opening words of Commentaries on the Causes, Forms, Symptoms, and Treatment, Moral and Medical, of Insanity 1828. Quoted Kraepelin 1918, pages 38- 39 (See 1811) |
| The 1828 County Asylums Act |
|
|
The 1828
Madhouses
Act
established:
The Home Secretary's Metropolitan Commission: |
|
Five physicians, including the Secretary and Treasurer of the Physician Commission; six Middlesex JPs and ten other honorary commissioners, were appointed by the Home Secretary in August 1828 to form a commission specifically to control London's madhouses. The medical commissioners were paid one pound an hour, the others were not paid.
A lawyer was appointed the Commission's Treasurer-Clerk (London Clerk) to establish an office and keep (national) registers.
New commissioners were appointed as and when necessary. With a few exceptions, the honorary ones needed replacing relatively often, but all but one of medical commissioners served until 1845 (and some beyond).
The commission was funded, in excess of licence receipts, by the national Treasury. It only licensed houses if it saw fit, and the Home Secretary could revoke a licence on its recommendation.
Quarterly licensing meetings were held, to which applicants had to submit, in advance, written details of proposed houses.
Commissioners (usually two medical and one honorary) visited each house at least four times a year and their reports were taken into account before the (annual) renewal of the licence.
The Westminster courts could no longer order visits and reports and did not have statutory access to registers. Instead the commission had power to release a patients on its own authority.
The Chart of the Metropolitan Commissioners begins in 1828
| 1.1.1829 Suffolk County Asylum opened. |
1.2.1829 Jonathan Martin, the mad Methodist, set fire to York Minster. See 1817 and "Methody parsons" in 1844..
| August 1829 Chester County Asylum opened. |
|
Therapeutic Optimism:
The optimistic period in the history of asylums runs from
about
1830
to
around
1860.
It was at its height in the
1840s.
Asylums built
under the
1808
and
1828
County Asylums Act tended to be left to the
management of
doctors. As the theories and techniques of managing lunatics
in asylums
developed, so did the belief that this asylum treatment itself
was the
correct, scientific way to cure lunacy.
Signs of the therapeutic change can be seen in the changing legislation. The 1828 Madhouses Act, unlike the 1774 Act, was concerned about conditions in asylums. These included the moral conditions. Official visitors were required to inquire about the performance of divine service and its effects. In 1832, this inquiry was extended to include "what description of employment, amusement or recreation (if any) is provided". (see law) |
| 1830 | revolution in France, riots in England |
Wednesday 25.8.1830 The Superintendent of
Bethlem, and current President
of the
London Phrenological
Society, Dr Edward Wright was
found at
night
with female patients. He denied wrong doing, but was
dismissed
after an
inquiry.
"After Bethlem Wright spent some time in Syria where, according to one writer, 'he became rather spoiled for regular practice'. A fondness for grog always seemed to catch up with him. He had returned to London by 1834, but soon left for Australia. |
1831
In January 1831, John Thomas Perceval, a son of
Spencer
Perceval, the
assassinated Prime Minister, was confined in
Brislington House Asylum. In May 1832 he was moved
to
Ticehurst Asylum. He may have been taken to
Brislington by his
brother,
Spencer junior, an enthusiastic Metropolitan Lunacy
Commissioner
and a Member of Parliament, who shared John Thomas's religious
enthusiasm.
Spencer Perceval was, at this time, campaigning for national
days of
fasting and humiliation. Soon after John Thomas was discharged
from
Ticehurst, he visited Esquirol in Paris to discuss the
reform of the
lunacy system. (Hunter and MacAlpine say this was "presumably
in 1835"). In
1838 he published the first volume of his book about the
treatment of the
insane, which contained the account of his own insanity and
the way he was
treated (see
extracts)
| Monday 16.5.1831 First Middlesex County Asylum at Hanwell opened. See Harriet Martineau's article, June 1834 |
October 1831 Cholera reached Britain (external link) - It returned in 1848 - 1853 - 1865. These cholera outbreaks were important in the development of the germ theory of diseases
in 1831 and 1832 "many thousands perished of this new disease...although it was a time of great political excitement, and a year of election riots, the people nowhere in England entertained the dreadful suspicions of occult poisoning which excited the populace to madness and to murder, not only in Hungary, but in Paris" (Farr, W. 25.7.1868, p.ix)
| 1832 | Parliamentary reform |
| 1.8.1832 Dorset County Asylum opened |
|
|
The
1832 Madhouses Act
established:
The Lord Chancellor's Metropolitan Commission: |
|
Appointment of the commissioners was transferred to the Lord Chancellor as custodian of the property of lunatics. The number of professionals was increased by the appointment of two barristers as legal commissioners, paid (under the 1833 Madhouses Amendment Act) at the same rate as the physicians. The honorary commissioners were reduced and, because legal commissioners could take their place, they were no longer essential for licensing and visiting. Although largely responsible to the Lord Chancellor, the commission retained some responsibility to the Home Secretary.
London's madhouses
Biographies of Legal Commissioners begin in 1832
| 1.1.1833 Kent County Asylum, Barming Heath, Near Maidstone opened |
1835
A Treatise on Insanity, by
James Cowles
Prichard
was the main textbook on the subject for many years. In it he
elaborated
the concept of moral
insanity that he had previously outlined in
articles.
1836
August? 1836
A Madman's Manuscript in
Charles Dickens' The Pickwick Papers
| 14.5.1837 New Leicestershire County Asylum opened |
In England and Wales, universal registration of births, deaths and marriages began in 1837. ""as the cause of death are recorded, the registers contained the particulars of every death" (Farr, W. 25.7.1868, p.x)
In 1837, John Elliotson, founder (1823/1824) of the London Phrenological Society, Professor of Practical Medicine at the (new) University of London and a founder of University College Hospital, was converted to mesmerism by the experiments of Baron Dupotet at Middlesex Hospital. The theory of mesmerism, at this time, was not psychological, but physical. Electricity was held to effect the "animal magnetism" within the human nervous system. Unlike phrenology, mesmerism did not gain medical credibility. Thomas Wakley was unconvinced, even by a personal demonstration at his home in August 1838. In the Winter of 1838, Elliotson resigned from University College when ordered to stop the practice. In 1843 he founded Zoist, a journal about "cerebral physiology and mesmerism and their applications for human welfare" and in 1846 his Harveian Oration (on mesmerism) at the Royal College of Physicians was the first to be given in English instead of Latin.
Thursday 20.6.1837 Death of William 4th. Victoria began reign. Rev William Barnett thought he had occasioned her death - but she came alive again.
21.10.1837 Editorial on The Regulation of Lunatic Asylums, from The London Medical Gazette reproduced on the Rossbret site
|
|
"In 1838, France passed a law mandating the internment of
lunatics at
public expense in every French department"
(Richard Keller 2001)
French text of Loi sur les aliénés number 7443 du 30 juin 1838 |
|
"The French legal code of 1838 relating to mental health administration...is the first comprehensive legislation in this field (a partial law had existed in England since 1828" according to Ackernecht (1968, p.50), who says the law was "designated" by Esquirol. This, he says, served as a model for similar legislation in Switzerland (also 1838), England (Ackernecht says 1842, but I think this would only apply to the 1845 laws) and Norway (1848) - click for my discussion of influence on English/Welsh legislation Also in 1838: Le Traité des maladies mentales considéré sous le rapport médical, hygiénique et médico-légal by Esquirol |
|
Railways made the national government of lunatic asylums and a national trade in pauper lunatics possible. In September 1838 the London to Birmingham Railway opened. The first main line in the world. 112.5 miles long from Camden to Birmingham, it linked to the Grand Junction at Curzun Street, Birmingham, and this linked to the Liverpool and Manchester north of Warrington, near Newton.
| At this junction, which all the trains from London to Liverpool or Manchester passed through, two officers of the New Poor Law (one no longer serving) established in 1843/1844 a private asylum to receive pauper lunatics from all over the country. (See 1846). |
|
1839
May 1839
John
Connolly
visited
Lincoln Asylum where Robert
Gardiner Hill
had
abolished mechanical restraint of patients in a small asylum.
On
appointment to
Hanwell,
Connolly
proceeded to abolish it in a large asylum. Several English
asylums were
practising non-restraint by
1844.
Select Committee
of
the House of
Commons Hereford Lunatic Asylum. A madhouse
proprietor tried
to work the system, and focused the attention of parliament
onto the
counties.
| 4.6.1839 First patients admitted to the Crichton Institution, Dumfries, Scotland (external link). The first asylum for Scotland south of Edinburgh and Glasgow. The building had a Bible for a foundation stone. |
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. Laws to make every part of England do this were passed
in
1845.
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.
1840 Major changes in London's three large private
pauper houses at
Hoxton -
Bethnal Green - and
Peckham.
The Metropolitan Commission's report for 1.6.1840 to
31.5.1841 says
10.4.1840 A date given for the start of the construction of
Pentonville Prison. It was opened in 1842. Another
source says
it took less than 18 months to construct. The
semi-radial plan has some
similarities to the
Devon County Asylum. The heating and ventilation system was
adopted by the
Derbyshire County Asylum (See
Conolly, J.
1847). The prison was known as the model prison as
providing a
pattern for future prisons. In 1835 and 1836, the Poor Law Commissioners
had published a variety of model workhouse plans (Outlined on
Peter Higginbotham's site.
A hospital that performed a similar function as
a model for hospitals was the
Royal Herbert (1865). It is
harder to pick a model asylum, but John Conolly
(1847) focused on the plans for the
Derbyshire County Asylum (1851)
1841
February 1841:
The London Statistical
Society
announced that it intended to collect lunatic asylum
statistics
during the year
13.2.1841 The first installment of
Charles Dickens'
Barnaby
Rudge: A Tale of the Riots of
'Eighty
ASYLUM CARE
1840s:
"the Commissioners have issued express direction that a
sufficient number of keepers shall in all cases be employed, so as to
obviate the necessity of personal restraint, except in extreme cases; and
they have also endeavoured to establish some system of classification"
(separating convalescent patients from violent or confirmed mania) "...
"these endeavours have been seconded by the proprietors and superintendents
of the three large houses, where classification is chiefly necessary...
these persons have lately bestowed much attention on this subject, and
have, in fact, incurred much expense... The number of keepers has been
greatly increased... a greater number of rooms has been appropriated to the
reception of patients, and, in some cases, new buildings have been
erected..." Since May 1840 "a considerable number of pauper lunatics" had
been moved from
Hoxton,
Bethnal Green and
Peckham to "the
Surrey County Asylum", and others to Hanwell - so the
total number of patients in London private asylums was falling, although
the Commission did not expect this trend to continue "not... from any
increase in insanity, but from... more case becoming public, and greater
care being bestowed on persons afflicted with the disease"
This became a model for similar communities.
(Jones and Tillotson)
"An idiot, eh?" said the gentleman, looking at Barnaby as he
spoke...
"There's nothing like flogging to cure that disorder. I'd make
a difference
in him in ten minutes, I'll be bound". "Heaven has made none
in more than
twice ten years, sir." said the widow mildly. "Then why don't
you shut him
up? We pay enough for county institutions, damn 'em. But thu'd
rather drag
him about to excite charity - of course."
| 14.6.1841 Surrey County Asylum opened - But see above |
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]
August 1841 Isabella Thackeray suffered from intense suicidal depression (following the birth of her third child, Minny Thackeray, in 1839). She spent the rest of her life in care as a mad woman. When Charlotte Bronte dedicated the second edition of Jayne Eyre to William Makepeace Thackeray, she did not know about his wife Isabella. [See Hilary Marland. Maternity and Madness: Puerperal Insanity in the Nineteenth Century - archive]
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.
|
Dickens
on USA
asylums
Hanwell in the USA |
|
1842
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 with moral management, led to the initial Bill being completely reformed into a Bill for a National Inquiry into the teatment of lunacy.
|
|
The
1842
Licensed Lunatic
Asylums Bill
proposed a
Barristers' Commission |
|
|
|
The
1842 Inquiry Act
established the
Inquiry Commission: |
|
The medical and legal commissioners jointly visited and reported on public asylums and licensed houses throughout England and Wales. Already much extended in response to the challenge of moral management, the inquiry became even more general in response to the national panic about dangerous lunatics when McNaughton was found insane in 1843. In 1844 the commission published a 300 page report with recommendations for changes in the law aimed at curing and controlling. It included a national register of the insane, controls on the discharge of lunatics, extended asylums provision and regular monitoring of lunatics not in asylums.
10.7.1842 Jabez Jackson, aged about 25, and Hannah Beardmore were married in Chesterfield. The birth of Jabez Columbus Jackson was recorded in the Belper district of Derbyshire in the December quarter of 1845. In 1851 Jabez senior was brought from Belper to become the Derbyshire County Asylum's first patient. He was then paralysed and had to be carried from the cart to a padded room, which was used because of his helplessness rather than his violence. His hips, back, shoulders and knuckles were "extensively excoriated" and was very sore. This was put down to his having been "the subject of mechanical restraint". Extreme debility and "paralysis about the sphincters of his bladder" made him unable to keep himself clean. He was said to be epileptic. The asylum was dedicated to non-restraint principals and by September 1851 Jabez was clean in his habits and working somewhere in the ward, kitchen or garden. In the summer of the following year he died. His son became a potter's printer in Staffordshire, married to Jane, a potter's transferer from Wales. They had two sons.
|
|
Annales médico-psychologiques du système nerveux founded by Baillarger and others in France. It is the oldest surving journal of psychiatry. (website) |
3.3.1843 Trial of Daniel McNaughton in the midst of revolutionary fear.
McNaughton was found insane. Later that year, the Metropolitan Commission's inquiry was extended to visit workhouses where dangerous idiots and lunatics might be living, but free to leave when they chose. In the following year it extended to Wales, where dangerous idiots and lunatics were reported to be living on outdoor relief. The fear engendered by McNaughton created the political will to build asylums for the lunatic poor and create a department of government to oversee their detention and treatment.
|
The 1844 Lunacy Report and the Census of the
Insane
The report was published early in July. On 12.7.1844, Ashley startled the Home Secretary by announcing that there were over 12,000 pauper lunatics outside asylums, many of them "absolutely dangerous"
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. |
|
| March 1845 Shropshire and Wenlock Borough County Asylum opened. Union with Montgomery (Wales) in 1846 made it the first County Asylum provided for Welsh patients |
| 19.5.1845: Sir Thomas Freemantle introduced the Bill that was to establish a Central Criminal Lunatic Asylum in Ireland. This was opened at Dundrum in 1850. Renamed the Central Mental Hospital in 1961, it has been described as "the oldest forensic secure hospital in Europe" [external link] |
| July 1845 Devon County Asylum opened |
|
|
Two linked Acts were introduced by Lord Ashley: |
|
The 1845 County Asylums Act compelled every county and borough in England and Wales to provide asylum treatment for all its pauper lunatics and Lord Ashley told Parliament that this would "effect a cure in seventy cases out of every hundred" (Hansard 6.6.1845 column 193).
|
The
1845 Lunacy
Act
established the Lunacy Commission:
The Act named eleven Metropolitan Commissioners as Lunacy Commissioners. Six (three medical and three legal) were to be employed full time at salaries of 1,500 pounds a year. The other five were honorary commissioners whose main function was to attend board meetings. The Permanent Chairman had to be an honorary commissioner, but otherwise they were not essential to the commission's operations. The only Metropolitan legal commissioner not appointed as a Lunacy Commissioner was named in the Act as Secretary. The Lunacy Commission had national authority, under the Lord Chancellor and Home Secretary, over all asylums (except Bedlam until 1853). It shared responsibility with the poor Law Commission/Board etc for pauper lunatics outside asylums. Its principle functions were to monitor the erection of a network of publicly owned county asylums, required under the 1845 County Asylums Act, and the transfer of all pauper lunatics from workhouses and outdoor relief to a public or private asylum; to regulate their treatment in private asylums, and (with the Poor Law Commission) monitor the treatment of any remaining in workhouses or on outdoor relief. The Lunacy Commission was also to monitor the regulation of county asylums and county licensed houses by JPs, and to regulate the conduct of hospitals for the insane. With the JPs it monitored the admission and discharge of patients from all types of asylum. It collected, collated and analysed data on the treatment of lunacy and advised on the development of lunacy law and policy. It also continued to license London's madhouses. |
| 1.8.1846 Oxfordshire and Berkshire County Asylum opened |
|
In the summer of 1846 it became scandalous public knowledge that officers of the Poor Law Commission (acting privately) had profited by the shortage of asylums by establishing a low cost asylum at Haydock Lodge in Lancashire for pauper lunatics from all over England and Wales. See Poor Law Commissioners and the Trade in Pauper Lunacy |
"Haydock Lodge is full of lunatics and we have Methody parsons
amongst
them".
| 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
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:
"I daresay you ... inclined your ear to gossip ... the mysterious lunatic kept there... is my wife ... Bertha Mason ... is mad; and she came of a mad family; idiots and maniacs through three generations. Her mother, the Creole, was both a madwoman and a drunkard! .. I invite you all to ... visit ___ In the deep shade ... a figure ran backwards and forwards ... whether beast or human being, one could not, at first sight, tell: it grovelled, seemingly, on all fours; it snatched and growled like some strange wild animal: but it was covered with clothing, and a quantity of dark, grizzled hair, wild as a mane, hid its head and face... A fierce cry ... the clothed hyena rose up, and stood tall on its hind-feet... The maniac bellowed: she parted her shaggy locks from her visage, and gazed wildly at her visitors ... that purple face ... those bloated features... 'she has no knife' ... 'One never knows ... she is so cunning' ... Mr Rochester flung me behind him: the lunatic sprang and grappled his throat viciously, and laid her teeth to his cheek... more than once she almost throttled him..." [etc]
November 1847 The Lunacy Commission release Mrs Henry Howard from confinement in a single house in Kensington.
| John Conolly's The Construction and Government of Lunatic Asylums |
Journal of
Psychological Medicine and Mental
Pathology,
edited by
Forbes Winslow (1810-1874). Quarterly?. 1848-1860.
|
|
Wednesday 1.3.1848
Somerset County Asylum
opened
|
June? 1848 Volume seven of The half-yearly abstract of the medical sciences (January to June 1848), edited by William Harcourt Ranking, included, for the first time, a "A Report on the Recent Progress of Psychological Medicine". This was written by Charles Lockhart Robertson
"The cholera reached London in the new epidemic form about October 1848" (Farr, W. 25.7.1868, p.ix). See Ashley
| Tuesday 14.11.1848 North Wales (5 counties) County Asylum opened |
Anna Wheeler died about 1848. It was alleged by Edward Bulwer-Lytton that she died insane. (source)
1849
29.8.1849 On the Mode of Communication of Cholera by John
Snow, M.D
(external copy), setting out the theory of transmission in the
water supply rather than directly from patient to patient, or by
polluted air. The importance of the polluted air theory of
disease transmission, before Snow's publications of 1849 and
1854, is
evident in John Conolly's (1847)
The Construction and Government of Lunatic
Asylums, where much attention is paid
to clean air and
little to clean water.
|
The New County Lunatic Asylum now building at
Mickleover near Derby
There are many persons now living who can remember passing the gates of old Bethlehem and hearing, as they passed, the cut of the lash and the screams of its victims. That was the old treatment inspired by the "wisdom of our ancestors". ... within these few years, men have arisen who have paid more regard to the dictates of common sense and common humanity, than to the routine of tradition - ... - and have considered that insanity is a physical disease, to be treated as a disease and not as a crime, and that it would be just as reasonable to lash a man who could not run when both his legs were broken, as to flog him for not being reasonable when his faculties of reasoning were gone. The Architect of the building, under consideration informed himself of these circumstances, and has been, we believe the first to design an Asylum which shall facilitate and be adapted to the recent treatment of the insane by means of kindness, companionship, and watchfulness, rather than coercion, punishment, and confinement.
|
1851
Medical and social institutions distinguished: A French
law of
7.8.1851 (loi du 7 Août 1851 relative à
l'organisation des
secours
hospitaliers) distinguished between a hôpital
(for
treatment)
and a hospice -
See dictionary
(Discussed at
external link)
| 1.1.1851 Lancashire County Asylums (2nd and 3rd), Rainhill and Prestwich, opened. As a result, Lancashire magistrates were able to close Haydock Lodge. It reopened shortly afterwards as an entirely private patient asylum. This did not last for long. Pauper patients returned to Haydock Lodge in 1854 |
| 1851: Census: A column asking about disability introduced. It had mental disability added in 1871. This heading is from the 1861 census, but I believe it is the same as in 1851. I have, however, seen census forms for the same year with different wording. |
|
| 17.7.1851 Second Middlesex County Asylum at Colney Hatch opened |
| 21.8.1851 Jabez Jackson entered the Derbyshire County Asylum as its first patient. Ellen Riggott arrived on 31.10.1851. |
|
19.9.1851
Wiltshire County Asylum
opened
1.12.1851 Monmouth, Hereford, Brecon and Radnor County Asylum opened |
| District Asylums opened in Ireland at Cork, Kilkenny and Killarney |
|
30.6.1852
Warwickshire County Asylum
opened
9.8.1852 Lincolnshire County Asylum opened 11.8.1852 Worcestershire County Asylum opened 13.12.1852 Hampshire County Asylum opened |
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
|
17.1.1853
Buckinghamshire County Asylum
opened
23.9.1853 Essex County Asylum opened When these opened, every county in England and Wales, except four, had (jointly or singly) an asylum for pauper lunatics. Four counties without probably had contracts with licensed houses. There was a lull in the opening of new asylums after 1853. The building of asylums for the remaining four was probably prompted by the 1853 County Asylums Act |
| A District Asylum opened in Ireland at Omagh |
|
Scotland
Introducing the 1853 Lunacy Bills, the Earl of Shaftesbury lamented that he could not
"extend the bills to Ireland and Scotland, for I believe that not in any country in Europe, nor in any part of America, is there any place in which pauper lunatics are in such suffering and degraded state as those in Her Majesty's Kingdom of Scotland" 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) The Act established The General Board of Commissioners in Lunacy for Scotland (1859-1913) which became the General Board of Control for Scotland (1913 -1960) and then the Mental Welfare Commission for Scotland. Mental Welfare Commission website. At the time of the Report, there were asylums established by Royal Charter at Aberdeen, Dundee, Edinburgh, Glasgow, Montrose, Dumfries, and Perth and a pauper asylum at Elgin. The Act required the construction of publicly financed District Asylums throughout Scotland. |
In September 1853 it was officially announced that a cholera epidemic was claiming victims in London and other parts of the country (external link)
1854
Haydock Lodge private asylum in
Lancashire
relicensed to receive pauper patients. It continued to do so
at least until
the 1880s. Increasingly, however, the private side of the
business was
developed and, by about 1900, Haydock Lodge advertised itself
as "for the upper
and middle
classes only"
11.12.1854 Second, much enlarged edition, of John Snow's
On the Mode of Communication of Cholera
(external copy)
1855
| District Asylums opened in Ireland at Mullingar and Sligo |
|
|
Bénédict Auguste Morel's Traité des dégénérescences physiques, intellectuelles et morales de l'espèce humaine et des causes qui produisent ces variétés maladives became the classic text of degeneration theory. |
English 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.
| 1858-1859 Patients moving into the Durham County Asylum as it was constructed |
| 1859 | click for table of private asylums receiving paupers |
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"
|
27.5.1859
Suusex County Asylum
opened
Northumberland County Asylum also opened in 1859 |
John Stuart Mill's On Liberty criticised the operation of writs de lunatico inquirendo:
"the man, and still more the woman ...[who indulges] in the luxury of doing as they like... [is] in peril of a commission de lunatico, and of having their property taken from them and given to their relations"
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]
| 1860 Three Counties: Bedford, Hertfordshire and Huntingdonshire County Asylum (Arlesey) opened |
| 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. |
Edgar Sheppard (born Worcester about 1820) was medical
superintendent of
the male department of
Colney Hatch from 1862 to 1881. In
this enormous
asylum he became well known for innovations, including daily
Turkish Baths
as therapy on a large scale, an asylum band, theatre,
concerts, readings,
lectures and a revival of restraint...
His method of locking dirty and destructive patients in side rooms "in a nude state" for weeks at a time where they "slept on the floor without either bed or pillow, being supplied only with strong quilted rugs", packing violent patients in wet sheets, or retraining them by belts, wrist straps and locked gloves, was condemned "in the strongest manner" by the commissioners in lunacy (..1867;..1870;..1862) and led one of their members to blackball Shepherd at the Royal College of Physicians" [of which he is not listed as a member] (Hunter and Macalpine 1974 p.84) He was appointed King's College Hospital's first professor of psychological medicine in 1871 and published his seven lectures as Lectures on madness in its medical, legal, and social aspects in 1873. His continued support for restraint led to his not being appointed as a Lord Chancellor's Visitor in 1875 |
| 1862 Cumberland and Westmoreland asylum Carlise opened. This completed the programme of building a public pauper lunatic asylum (jointly or singly) for every county in England and Wales. |
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.
Royal Victoria (Military) Hospital at Netley, on Southampton
Water, opened - Its asylum opened in 1870. The new
Yarmouth Naval
Lunatic Hospital opened.
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.
7.4.1864 Louis Pasteur (1822-1895) lectured at the Sorbonne against
the theory of spontaneous generation of disease and in favour of contagion
by
germs - External links on
spontaneous generation experiments -
Pasteur's experiments. Identification of
micro-organisms: see
malaria 1880 -
tuberculosis
1882 -
cholera (1854 - 1884)
- bacilliary dysentery
1897
- syphilis
1905.
1.11.1865 The
Royal Herbert Hospital opened. This military hospital (physical
diseases) was the first built on the
pavilion plan favoured by Florence Nightingale. It may have
influenced the
echelon plan that became the main style for asylums.
There were outbreaks of
cholera in England in the autumn of 1865. The
disease abated, but there was a localised (but substantial) outbreak in
London in July 1866
(Farr, W. 25.7.1868, pp xii-xiii). The London
outbreak was significant in that
it had been thought cholera could be controlled in London.
The report of William Farr showed why this had not happened and
confirmed the effectiveness of clean water supplies.
Yahoo
weblinks: Charles
Reade (1818-1884)
Pathology laboratories:
USA 1878 -
Claybury
| District Asylums opened in Ireland at Castlebar and Letterkenny |
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. To deal with the sick poor suffering from
smallpox,
fever,
or insanity, London became one Metropolitan Asylum District under
the Board, which first met on 22.6.1867.
The Board proposed two new asylums for
chronic lunatics
and idiots at Leavesden and
Caterham. Fever and smallpox hospitals were built at Stockwell
in south-west London and Homerton in north-east London.
April 1867 The Lancet published an article by Joseph Lister
(1827-1912) On the
Antiseptic Principle of the Practice of Surgery.
[Copy at Bartleby]
when its functions were transferred to London County
Council
| District Asylums opened in Ireland at Ennis and Enniscorthy |
| District Asylums opened in Ireland at Downpatrick and Monaghan |
1869 Sedative effects of chloral hydrate explored by the German pharmacologist Oskar Liebreich (1839-1908). It was tried in Warley (Essex - UK) in 1870. Kraepelin in 1918 describes the effects of this and similar drugs on wards for the insane.
|
15.11.1869 Charlotte Mew born. Her grandfather's firm designed asylums for Essex - Sussex - and Dorset. Her earliest published work (1894) concerns mental debility in the family. Her brother, Henry, was confined in an asylum before 1890 and her youngest sister, Freda, was certified insane in 1898. See 1901 - 1902 - 1909 - 1913 - 1915 - 1916 - 1924 - 1928 - Poetry Links - 1.3.1958 |
1870
[The journal Brain was established in 1878. In
1895,
Frederick Mott was appointed to
head a
central laboratory for London County Asylums at
Claybury]
October 1870
St Lawrence's, Caterham,
Surrey and
Leavesden,
Abbots Langley,
Watford, Hertfordshire opened. Each with 1,500 beds. These
two custodial asylums were designed to relieve London's other
asylums and
workhouses of incurable lunatics at the least possible
expense.
(See
1971 and
1981)
"The time has come when the immediate business
which lies
before everyone who would advance our knowledge of mind,
unquestionably is
a searching scrutiny of the bodily conditions of its
manifestations in
health and disease" (Henry Maudsley in
Body and Mind)
"In May 1871 there were 1,600 patients at
Leavesden and nearly
1,400 at Caterham. Not only did this ease the strain on
workhouse
accommodation, but a great number of incurable and harmless
cases were able
to be removed from the two large
Middlesex County Asylums...
nevertheless, the
Home Secretary had to ask Middlesex to build another..."
(Hodgkinson, R.
1966)
| 2.4.1871: Census: In 1871 (See 1870 Act) the established column about disability also asked if the person was "imbecile or idiot" or "lunatic". The disability column continued until 1911 (not 1921), but the wording was varied in 1891 and 1901. |
|
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 | murder |
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.
Lunacy Law Reform Association founded. In 1879 listed at 61, Berners-street, Oxford-street. - Office days: Tuesdays, Thursdays, and Saturdays from 2 till 4 p.m. Subscription: Essential to membership, amount optional. Object: To obtain increased safeguards against wrongful incarceration of the sane, with ameliorations in the treatment of lunatics. Kathleen Jones says that Louisa Lowe was secretary of the "Lunacy Laws Amendment Association", which supported Georgina Weldon
1876
The Hunting of the
Snark - an
Agony in Eight Fits, by Lewis Carroll, published
J. Langdon Down, On the education and training of the
feeble in mind
A reprint of a paper read at the
Social Science Congress of 1867 (printed the same
year
in the Transactions of the National Association for the
Promotion of
Social Science) published H.K. Lewis, London, 1876.
(17 plus 8 pages. Printed paper cover)
1877
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"
1878
April 1878
Brain Volume 1, issue 1.
Editors: Drs.
Bucknill,
Crichton Browne, Ferrier, and
Hughlings-Jackson.
|
Reverend Henry Hawkins and friends start the After-care Association for Poor and Friendless Female Convalescents on Leaving Asylums for the Insane. See 1893 - 1894 - 25.2.1913 - Mental After Care Association name - 1926 - 1932 - 1939 - 1950s - 1983 - 2005 (became "Together"). (external link to History) - Leaflets about: Henry Hawkins - history - The archives are kept in the Contemporary Medical Archives Centre in the Library at the Wellcome Institute for the History of Medicine (ref SA/MAC) - Current address and contact details |
|
1880 - 1882 Dr Joseph Breuer (1842-1925)
and his patient
Bertha Pappenheim or "Anna O"
(1859-1936) invent the "talking cure".
At this time Freud was a medical student raising money for his studies by translating from English into German. Read his 1909 account of what Breur and Anna O. did |
2.8.1881 40th anniversary of the
Medico-Psychological
Association. Daniel
Daniel Hack Tuke
outlined the progress of psychological medicine.
| Daniel Hack Tuke's Chapters in the History of the Insane in the British Isles. His history, the first draft of which was published in 1854 is the first attempt a comprehensive one that I know, and the last until the work of Kathleen Jones |
|
The Subliminal Self
The development of ideas about levels of consciousness and the unconscious mind was associated with theories about the spiritual |
|
| 13.2.1882 Charcot presented a paper on the diverse nervous states determined by the hypnotisation of hysterics (Sur les divers états nerveux déterminés par l'hypnotisation chez les hystériques) to Le Académie des Sciences in Paris. The acceptance, by the Academy, of his paper was also the acceptance of hypnosis as a scientific practice and of diseases of the mind as distinct from mental disorders caused by physical disorders. See also 1885 and 1887 |
|
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. -
In 1960 Ronald Laing published
a criticism of the disease approach to psychosis
in which he
used Kraepelin as the example.
|
|
| Cane Hill Asylum, Surrey, opened in 1883. It was enlarged to accommodate 2,000 patients by the end of the 1880s. Click on the picture for more information. The picture is from a postcard in the collection of Nigel Roberts. It has "J.T.Carey's real photos... Cane Hill, Asylum. 5024" written at the base of the card. The same picture appears on the urban explorations site with a note that it was taken in 1912. |
1884
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.
May 1884
Robert Koch and his team returned to Berlin from Calcutta
where they had isolated the
cholera bacillus. Koch was received as a national hero. See
Who first discovered vibrio cholera? (external link)
which
argues
that Koch's (re-) discovery of the cholera bacillus began to turn the tide
of international scientific opinion away from the
miasma theory. However, the article is not clear if the issue
was water (rather than air) transmission or the
germ theory of the cause of the disease.
Paraldehyde Vincenzo Cervello's "Recherches cliniques et
physiologiques sur la paraldehyde" was published in Archives italiennes
de biologie in 1884. It is, therefore, after this date that it
became the sedative "so useful for the noisy and troublesome patient that
it tended to br over-used in hospitals... given intramuscularly (10-15 cc)
in the treatment of acute and grave psychoses.."
(Sargant and Slater
1963)
1885
1885: 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.
(online history at Royal College of
Psychiatrists) [See
1891 Nursing Certificate] -
May 1902 exam -
Model Answers 1928]
1886
The 1886
Idiots
Act allowed rates to be raised for building an
"idiot
asylum" or "mental deficiency colony".
1887
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.
The statute law at issue here (and in several previous cases)
was that
access to the courts over the substantive issues of a
confinement had been
removed in
1845.
The 1889
Lunatics Law
Amendment Act provided for the truth of allegations
to be tested
legally before the confinement.
"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."
|
| Une Lecon Clinique a la Salpetrie, a painting by Andre Brouillet, in 1887, shows Jean Martin Charcot demonstrating on Blanche Wittmann (the lady fainting). Click on the picture to see why her faints were a turning point. - See also 1882 |
|
1888
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. Some, such as the
Ewell Colony, were short lived. 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, Surrey (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.
(Jones and Tillotson)
1889
April? 1889
1888 Local Government Act came into force and English and Welsh
asylums past from the magisterial control of the Justices of the Peace to
the democratically elected control of newly created county and borough
councils.
|
Sometime before 1890, Henry Herne Mew was certified insane and confined in an asylum. As it was before the 1889 Lunacy Laws Amendment Act came into force, and as he was a private patient, his detention would not have required the approval of a magistrate. |
|
Science Time Line 1885
See
1840s,
1920s,
1940s
1890s: By the end of the 19th century the failure of asylum therapy had convinced people that insanity is largely (but not entirely) incurable. At Claybury, in 1901-1902, there were 426 admissions, 201 deaths and 148 patients were "discharched recovered". The insane were sent to even larger asylums for custody, to be protected from exploitation whilst society was protected from them. "In spite of this", Alexander Walk says, many improvements followed the asylums becoming the responsibility of County and County Borough Councils in 1888.
|
Postmortems were carried out on the brains of the majority of
patients who
died in the asylum in search of the cerebral lession that many
thought was
the basis of all insanity. This cross-section is from a
collection of
clinico-pathological photographs taken at
Colney
Hatch Asylum between 1890 and 1910. (Hunter and
Macalpine
1974 p.244) say that it shows multiple tumours and
that such
cases accounted for the high mortality amongst newly admitted
patients.
See below, 1895.
"In the 19th century nearly 10% of them died within 3 months of admission from advanced systemic or cerebral disease causing mental symptoms initially" |
1890
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 -
here
for 1890
- here for emergency
procedures
under the 1890 Act).
The law
respecting the admission of private patients under the Act is
outlined in
a
booklet for the private asylum at
Haydock Lodge.
Section 207 placed such severe restrictions on the granting of
licences as
to virtually prevent new private asylums or the enlargement of
established
ones.
Section 255 allowed the county and borough asylums to
build wards or
separate buildings for private patients. Private units were
built at the
new
Isle of Wight County Asylum and
Derby Borough Asylum, at
Dorset County Asylum and at
Park Prewett,
Hampshire, amongst others. London County
Council made
provision for private patients at
Claybury and
The Manor, Epsom.
Shropshire had 28 private class patients in 1911. - Registers of
private patients at
Netherne (Surrey) survive from 1909 to 1919 -
The West Riding of Yorkshire provided a separate asylum
(Scalebor
Park) exclusively for private patients.
(See 1927 list)
Section 55 provided for a pauper lunatic to be "absent on trial" with an
"allowance" "not exceeding the charge in the asylum" . Provisions for the
absence on trial of private patients were also made. Section 57 provided
for the "boarding-out" of pauper lunatics with relatives or friends. [See
25.2.1913]
| "Add to [the number of criminals] the number of indoor paupers and lunatics ... 78,966 - and we have an army of nearly two million: belonging to the submerged classes. To this there must be added at the very least, another million, representing those dependent upon the criminal, lunatic and other classes... and the more or less helpless of the class immediately above the houseless and starving. This brings my total to three millions, or, to put it roughly to one-tenth of the population." (William Booth, 1890, in his chapter on The Submerged Tenth) - See 1904-1908 - 1929 - 1943 |
| 5.6.1891: Census: The column asking about disability had a different heading. |
|
1891 "Examination for the Nursing Certificate" of the Medico- Psychological Association established. [See 1885 Nursing Handbook
1892
Special Schools
Leicester Education Authority
the first in England to provide special instruction for
backward
and weak-minded children.
The National Society for the Employment of Epileptics (NSEE)
was launched
in 1892
Prince of Wales Hospital Fund for London started 1892 - A royal patron
raising money for London's voluntary hospitals. It became the the King
Edward's Hospital Fund for London in 1902. The National Health Service
made many of its functions redundant after
1948 and it developed a new role developing "good practice in
the NHS".
(source)
| Claybury in Essex, the first compact arrow asylum, opened |
After care association established its first residential care-
home, at Redhill in Surrey, with room for nine people.
1894
After care association renamed
After Care Association for Poor Convalescents on Leaving
Asylums for the
Insane as it now helps men as well as women.
|
A short story
Passed is the first known published work of
Charlotte
Mew. The writer, walking in a poor area of London
(Clerkenwell?), visits a
church. She sees a gospel that the priest at the alter does
not:
"Two girls holding each other's hands came in and stood in deep shadow behind the farthest rows of high-backed chairs by the door. The younger rolled her head from side to side; her shifting eyes and ceaseless imbecile grimaces chilled my blood. The other, who stood praying, turned suddenly (the place but for the flaring alter lights was dark) and kissed the dreadful creature by her side. I shuddered, and yet her face wore no look of loathing nor pity. The expression was a divine one of habitual love. She wiped the idiot's lips and stroked the shaking hands in hers, to quiet the sad hysterical caresses she would not check. It was a page of gospel which the old man with his back to it might never read. A sublime and ghastly scene." The description may shock (See also 1916), but compare with Jayne Eyre in 1847 and the Care of Children Committee in 1946. The outstanding difference is the compassion. 23.8.1894 "Thyroid feeding in insanity : a summary of thirty cases treated by thyroid extract in the Derby Borough Asylum" by S. Rutherford Macphail and Lewis Campbell Bruce read at the annual meeting of the Caledonian Medical Society, at Inverness. It was published in Cretins and idiots: a short account of the progress of the institutions for their relief and cure Glasgow : Alex. Macdougall, 1894. Freda Mew received thyroid treatment in 1902. The treatment was advocated for cases of insanity where doctors had run out of options, and not just for cases of thyroid deficiency. It is an early form of treatment by fever. See later development of malarial treatment. There are similarities with the later use of insulin in that a good result was patients eating and putting on weight. |
1895
Frederick Mott was appointed in charge of the
London County
Council Asylums' new central
Pathological Laboratories at Claybury. His
Archives of
Neurology from the Pathological Laboratory of the London
County Asylums,
Claybury, Essex was published from 1899
Thursday 8.11.1895 Meeting of the Scottish Division of the
Medico-Psychological Association in Edinburgh at which Lewis C. Bruce read
a paper on "The Effect of Thyroid Feeding in some
Forms of Insanity"
(offline). In the discussion, he commented
1896
The National Association for Promoting the Welfare of the
Feeble-minded founded. See
1898 - See
16.10.1909 -
Later became National Association
for the Care of the Feeble Minded - See 1912 - Promoted formation of
Central
Association for the Care of
the Mentally Defective in 1913.
April 1896 "The fact has long been recognised that improvement or
recovery from mental disease not uncommonly coincides with, or follows, a
fever or other physical disorder." J. Keay, District Asylum, Inverness. "A
Study of Forty-four cases of Fever occurring in the Insane".
Journal of Mental Science
1897
Richard von Krafft-Ebbing injected
syphilis into nine patients suffering from
General Paralysis
Of the
Insane. None of the patients said they had ever had
symptoms of
syphilis, but they did not develop syphilis sore after the
injection,
suggesting they had had syphilis in the past.
(external link)
(Or 1884? External Link)
In Japan,
Kiyoshi Shiga identified the
bacteria responsible for one form of
dysentery - the form that was often found in asylums and,
therefore, known as
asylum dysentery.
1898
10.6.1898 Meeting on behalf of
The National Association for
Promoting
the Welfare of the Feeble-minded held at Stafford
House. Association office: 49, Victoria Street, S.W. (See
British Medical Journal report 18.6.1898
"At present he only advocated thyroid treatment in patients who
had not benefited by the ordinary routine treatment of insanity. In such
cases it is only just to give the patient a chance of recovery by inducing
a feverish condition and hoping for a beneficial result during the reaction
subsequent to the fever."
(Journal of Mental Science - offline).
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Freda Mew (19) became insane early in November 1898. She was admitted to the new private block of the Isle of Wight Asylum on 4.2.1899 and remained in the asylum until her death (78) on 1.3.1958. Her case notes survive for 1898 to 17.11.1909 - After which she is largely lost to history. |
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1899
"The
Defective and Epileptic
Children Act of 1899 empowered local authorities to
spend money on
children suffering from these handicaps, and opened the way
for colony
schools. The Act of
1914, which was mandatory on local authorities,
improved the
position still further."
(Jones and Tillotson p.6)
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In Interpretation of Dreams, Sigmund Freud interpreted the symbolism of dreams in a way that he presented as a scientific exploration of the unconscious mind. |
| In 1900 it was decided that the new asylum for Belfast, at Purdysburn would be constructed as detached villas around the country house that was to be its core. This is one of the earliest examples in Britain and Ireland of a move away from a large unified building as the asylum. In the United States of America, Maryland had begun constructing a "cottage" plan asylum in 1896. |
"We often hear it said that the care we bestow on the hopelessly sick, the insane, and the feeble-minded is in opposition to what Darwin taught about the Survival of the Fittest, and that it does harm; but Darwin perceived that it is of such importance to a community that feelings of unselfish affection and public spirit should be strengthened by having to care for the weak, that this more than makes up for any injury done to the efficiency of a community by the artificial preservation of lives not strong enough to fight their own battles" Caroline A. Martineau Voices of Nature and Lessons from Science The Sunday School Association, Essex Hall, Essex Street, Strand, WC. (Second edition) pages 119-120"
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22.3.1901 Death of Henry Herne Mew, aged 34, from tuberculosis, in Peckham asylum. Charlotte Mew's In Nunhead Cemetery may grieve his death and celebrate his life. |
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31.3.1901: Census: The column asking about disability had a different heading. |
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October 1901 Francis Galton lectured on The Possible Improvement of the Human Breed under the existing conditions of Law and Sentiment. G. R. Searle, (1976 page 20) calls this "launching his project of race improvement". The initial concern was about physical deterioration. - Contrast above. See Eugenics - 1904 - 1907 - 1910 - 1922 - 1931 - 1933 - 1947 -
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4.2.1902 Freda Mew under Thyroid treatment |
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May 1902 Five hundred and forty-three people in England, Wales, Scotland and Ireland, applied to take the May examination for the Nursing Certificate of the Medico- Psychological Association. Twelve withdrew, 352 passed and 179 failed. Examinations were also held in November. The questions were about: the composition of fresh air - the construction of the pelvis, and the organs within it - the urine of patients - suicidal attempts by patients - special risks of injury to which epileptic patients are liable - bedsores - treating attacks of apoplexy; syncope (fainting); and choking - feeding paralytic and helpless patients - guarding against and discovering escapes; precautions against homicidal impulses; and "special observation" - poisons and cases of suspected poisoning.
25.7.1902 Annual Meeting of the Medico-Psychological Association, Liverpool. T. S. Clouston, M.D., opened a discussion on the "possibility of providing suitable means of treatment for incipient and transient mental diseases in our great general hospitals."
Friday 1.8.1902 Dr. F. W. Mott (London) opened a discussion on Syphilis as a Cause of Insanity... "Dr Mott concluded by adopting, for the purposes of raising a discussion, the thesis, No syphilis, no general paralysis". (external link See below and 1916)
1903 Sidelights on Convict Life: Broadmoor "There are something like 120 women now confined in Broadmoor, out of a total of less than 200, who had murdered their own child or children. In fact, homicide, with attempts to murder and maim, would appear to be the crime to which the great majority of criminally-inclined lunatics are most prone" (See 1919 and 1922)
26.6.1903 Croydon Mental Hospital (not "Lunatic Asylum") opened
Late 1903 A pamphlet of about 30? pages: Proposed sterilisation of certain mental and physical degenerates. An appeal to asylum managers and others by Robert Reid Rentoul, a Liverpool doctor, (born Ireland 1855, died Liverpool 1925) published: Walter Scott Publishing Company, London, 1903. A brief notice in the British Medical Journal in 9.1.1904 may be the first time that journal used "sterilisation" in this sense as distinct from sterilising milk (etc). The appendices to the pamphlet are 1. Marriage law. State of Minnesota, U.S.A., chapter 234, s.f. no. 185 - 2. Marriage of degenerates. Extract from the annual report of Dr. F.H. Craddock. 3. Extract from a woman's letter. 4. Doctor Lombroso on the increase of insanity. - See 19041908 - 1910 - USA 1907 - USA 1909 - 1913 - 1933 - 1934 - USA 1959 - 2004 -
16.9.1904 Francis Galton addressed a Sociological Society meeting (chaired by Karl Pearson) on eugenics. "From then onwards eugenics quickly developed into a political movement" (G. R. Searle, 1976 page 80). He spoke again in February 1905.
Picture postcard of County Asylum Annexe Lancaster postmarked Lancaster 6.15 pm 25.10.1904. One of several asylum postcards in the collection of Nigel Roberts. |
1905 The spirochaete responsible for syphilis 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.
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.
Picture postcard of Napsbury (opened 1905) that is thought to date from the first world war, when Napsbury was a war hospital. |
Autumn 1907 The Eugenics Education Society founded. It changed its name to the Eugenics Society in 1909. By October 1908 its President was Francis Galton.
David Heron: "A first study of the statistics of insanity and the inheritance of the insane diathesis" Eugenics Laboratory Memoirs; 2 London: Dulau.
Departmental Committee on the Operation of the Law Relating to Inebriates and Their Detention in Reformatories and Retreats: In England and Wales about 20 licensed retreats [homes] and 13 reformatories [asylums], as well as others not licensed. At about the same time, Scotland had three licensed retreats and six reformatories and Ireland one retreat and two reformatories. (external link)
Picture postcard of Portsmouth Borough Asylum postmarked 1907 copied from Stephen Pomeroy's website. Other postcards of asylum's about this time include Lancaster (1904) - Cane Hill (1912) - Napsbury (1914-1918?) |
English translation from German: The Sexual Life of Our Time In its Relations to Modern Civilisation by Iwan Bloch (First German edition was in 1907). The authorised readership of the English edition was, for many years, restricted to lawyers and doctors.
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Sometime in 1908:
A Mind that Found Itself
July/August 1908 Opening of Observation Hospital - "Acute Hospital for the treatment of persons who fear they may become Insane" - in the grounds of the Hudson River State Hospital for the Insane. |
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September 1908 Alfred Frank Tredgold (1870-1952) Mental
Deficiency (Amentia). Published: London : Bailliere, Tindall and Cox.
391 pages: 26 plates. Also published New York : Wood, 1908. [In 1908
Tredgold also published a 17 page pamphlet Some account of the report
and recommendations of the Royal Commission on the care and control of the
feeble-minded, 1908. Tredgold's A Text-Book of Mental Deficiency
(Amentia) (title from 1937) was "largely re-written" in 1929. A twelfth
edition Tredgold's Mental Retardation, revised by others, was
published in 1979.
Tredgold argued that there is "a clear relationship
between amentia and other forms of mental abnormality and disease". He
argued that "family history inquiries show that defectives, persons
suffering from pre-senile forms of dementia, and others suffering from
psychoses and psychoneuroses often come from the same stocks... in many
instances these various conditions may be merely different clinical
manifestations of one and the same germ abnormality"
(Seventh edition, 1947, page 370)
1909
16.10.1909 Morning Post
"there exist to-day, apart from certified
lunatics who are under restraint, 150,000 mentally defective persons, and
of these no less than 66,000 are considered to be " urgently in need of
provision, either in their own interest or for the public safety." It is
difficult to express with sufficient force the gravity of the danger to
national life which the existence of these persons uncontrolled in any
sufficient manner implies. For from these unfortunate men and women the
ranks of paupers, drunkards, and criminals are continually recruited."
[Reprinted as a leaflet by the The Oxford branch of the
National Association for Promoting the Welfare of the Feeble-minded
]
"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)
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17.11.1909 Freda Mew showing signs of recovery. She "has a funny way of getting up suddenly and dancing across room or airing court - has been up daily and is all the better for it." [Last entry in recovered case notes] |
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1910
Rampton Hospital, Nottinghamshire, opened as
England's second Criminal Lunatic Asylum. In
1920
it became a
State Institution for mentally defective
people
considered dangerous.
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.
Work not
published until 1922. A
particular concern for Chesterton was the extension of the traditionally
limited concepts of lunatic and idiot to include a much wider section of
the population who are "feeble-minded" -
See 1909, for example
"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)
Eugenics
and
sterilisation in the USA
meaning
of
eugenics.
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Are talking treatments the way out of
therapeutic pessimism?
Tuesday 19.4.1910 There is a "general idea that nothing is done in the way of treatment in asylums" - "treatment does not appear to have yielded many results: the recovery rate has not increased during the past thirty years." Dr Street, of Haydock Lodge, advocated "a higher form of moral treatment than the usual occupation, recreation and amusement; a more intimate knowledge of the mental condition of every patient, and particularly a more frank and open method of dealing with it. He believed in discussing a patient's mental symptoms freely with him, whether they were delusions or suicidal inclinations". |
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 Phil Watkins' COHSE History site
1911
Eugen Bleuler, (1857-1939) Dementia praecox, oder Gruppe
der
Schizophrenien published Leipzig. [Translated into English
in 1950 as
Dementia praecox: or, The group of schizophrenias. (In
1910 Bleuler
had coined the word
schizophrenie, from Greek words
for split
and mind, as an alternative to
dementia praecox). See 1923
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)
1912
1912? Phenobarbitone (luminal) introduced into the treatment of
epilepsy.
April 1912 - Asylum chapels Of the 94 lunatic asylums in England and
Wales, only seven were without a chapel. Two because they are at present
incomplete and two are old and small asylums. The West Riding of Yorkshire
was resisting providing chapels at the
Menston,
Storthes
Hall
and
Scalebor Park asylums.
(See Hansard)
17.5.1912 Debate on second reading of the Feeble-Minded Persons
Control Bill - "to put it briefly, the object of this Bill is to
regularise the lives, and, if possible, to prevent the increasing
propagation of half-witted people"... "if the only class of persons you can
bring into this Bill are those who are dangerous to themselves and to
others, you exclude from the purview of the Bill the bulk of the feeble-
minded and specially those whom associations such as the
National
Association for the Care of the Feeble-Minded are anxious to
deal with. We
know the great interest that is aroused in this question particularly in
regard to illegitimacy."
(Hansard)
From 1913, local authorities
could provide free treatment for people suffering from
tuberculosis. I believe some of this was provided by adding
verandas to asylum wards (as at
Brentwood in Essex). In the early 1970s I was shown how the bed
space of the original
Derby County Asylum had been tripled, first by converting
galleries to dormitories and then by adding verandas for people with
tuberculosis.
25.2.1913 Annual Meeting of the
After-Care Association at
which
Dr C. Hubert Bond, "Commissioner in Lunacy" read a paper on
"After-care in cases of mental disorder, and the desirability of its
more extended scope"
(Abstract on Royal College of Psychiatrists website) - About
7,000 people were discharged from public asylums in England and Wales each
year. After-care would benefit all of them, but for least 1,500 it was
"urgently required". However, only about a quarter were being helped by the
Association. He proposed branches of the
Association corresponding to each local lunacy authority and that asylums
notify the local branch of discharges and trial discharges. He suggested
the Association's rules be amended to allow it to help patients on trial
under
section 55 of the Lunacy Act. The income from such patients
would assist the Association's finances.
13.6.1913 Special Committee of the
After-Care Association commented that
"funds would be better employed helping trial cases than many of those on
whom they are at present spent".
1913 or 1914
After care association renamed Mental After Care
Association
for Poor Persons Convalescent or Recovered from Institutions
for the
Insane [Although not clear when it became just the Mental
After Care Association, the short title is used in 1927]
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1913 Asylums built under the 1913 Mental Deficiency Act (Royal Assent 15.8.1913) were not hospitals, but "colonies" designed to separate defectives from the gene- pool of the nation. In 1934, the Brock Committee recommended voluntary sterilisation as a cheaper means to the same end. See the collection of forms used under the Act. The 1913 Mental Deficiency Act also established The Board of Control. This was the old Lunacy Commission with extended functions with respect to mental deficiency. The Board of Control continued to regulate the mental health system until 1959, but with reduced responsibilities after the National Health Service Act. 15.11.1913 The National Association for the Care of the Feeble Minded called a meeting at Denison House, London, S.W. of representatives of organisations "engaged in voluntary philanthropic work for defectives". This constituted a Central Association for the Care of the Mentally Defective which would work with the Board of Control and local authorities throughout the country. Leslie Scott (1869-1950), a conservative MP and lawyer with knowledge of the new Act, was President and Chairman of the Association from 1913 to 1947. Evelyn Fox (15.8.1874- 1.6.1955) was its honorary secretary. Its name changed to the Central Association for Mental Welfare in 1922 (Ruth Rees Thomas, 1971/- , Oxford DNB, under Evelyn Fox). In 1947, Leslie Scott and Evelyn Fox became founders of the National Association for Mental Health, into which the Central Association for Mental Welfare merged. (See British Medical Journal report 22.11.1913 - (Jones, K. 1972 p.267) - Oxford DNB under Fox and Scott. |
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Autumn 1913 Charlotte Mew offered to address envelopes for the new Medico-Psychological Clinic "to provide... different forms of treatment, both medical and psychological... for functional nervous diseases". |
Pellagra shown by Joseph Goldberger (1874-1929) to be caused by a nutritional deficiency and not by an infection.
15.7.1914
"Law Made Lunacy" in Truth
22.7.1914
"The Insufficiency of the Petition" in Truth
29.7.1914
"Madhouse Horrors" in Truth
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the great war for civilisation
One side of a medallion, found with others, in the attic |
World War Part One: Science Time Line
1914-
1919
Bert Roberts signed up in the Royal Army Medical Corps very
early in
hostilities. His fiancee, Lily McKenzie, often saw the postman
as she left
for work in the morning. There were no letterboxes. He had to
knock to
deliver the letters. One morning he looked green and he told
her he was
close to turning his job in: "They have gone over the top at
Gallipoli".
His hand held a bundle of brown envelopes containing the
official messages
of the dead, the missing and the injured to deliver to
Dickenson Street,
Warrington. [British landings at Gallipoli were on 25.4.1915.
The British
withdrew 9.1.1916.]
The twentieth century's first encounter with mass slaughter on a world wide scale was traumatic.
The
World War
One Document
Archives'
medical
titles on
psychiatry
include
Shell Shock and its Lessons by
Grafton Elliot
Smith and Tom Hatherley Pear. Manchester University Press,
1917.
The Oxford book of Twentieth Century Words lists shell-shock from 1915, defining it as "a severe neurosis originating in trauma suffered under fire. A term particularly associated with World War 1, in which soldiers on the Western Front were subjected to a seemingly incessant barrage of shell-fire". It compares it with bomb-happy (1943) in the second world war. But shell-shock was used by the medical profession, whereas bomb-happy was colloquial. (See later rejection of shell-shock as a medical term) |
At the start of the 1914 war, Charles Stanford Read says, any officer or private showing what might be "psychotic" symptoms was sent to "D" Block, Netley, the Mental Division of the Royal Victoria Hospital. "Convoys of such cases reached there from France, Belgium, Italy, Salonika, Palestine, Mesopotamia, Egypt, and India. The first cases
"were dealt with according to the ordinary King's Regulations, which necessitated discharge from the army because of insanity and transference to their district asylum, where their status was no different from the other inmates."
It was then decided to equip special War Mental Hospitals where soldiers would stay for up to a year (reduced to nine months) under observation and treatment without certification.
January 1915 Army Council estimated an additional 56,000 beds would
be required to cope with wounded and sick troops. The Asylum War
Hospitals Scheme, worked out with the
Board of Control, moved civilian inmates out of certain asylums
to provide accommodation for military medical, surgical and (from
February) mental casualties.
(Read, C.S. 1920 -
Cullen, S. -
and
Barham, P.
2004, pp 44-45)
The asylums during the warMany asylums were used as troop hospitals. (external link: Military Hospitals in the United Kingdom) Conditions in some asylums during the war were very bad - leading to a high death rate (See Brentwood below) Hospitals (asylums?) during world war one: - Military: - See Netley - Naval: See Haslar War Mental Hospitals: "The dropping of the word asylum was specially undertaken to obviate, if possible, the stigma that might be felt to attach to the name, which stigma does exist, rightly or wrongly." (Read, C.S. 1920) - See civil use 26.6.1903 - 1920 - 1930 - |
10.11.1915 Royal Assent for the 1915 Naval and Military War Pensions Act - See below - See Charlotte Mew
Royal Commission on Venereal Diseases recommended free diagnosis and treatment. It was estimated that 10 per cent of the population in large cities were infected with acquired or congenital syphilis
The successful identification of General Paralysis of the Insane as an end product of syphilis raised hopes of finding an organic cause for all mental illnesses (See Frederick Mott). The following poem suggests that it also re-inforced belief in degeneration theory as the overall causal explanation.
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May 1916 Publication of the major volume of
Charlotte Mew's poetry (The Farmer's
Bride) whose dialogues with insanity included this in
On the Asylum Road
"Theirs is the house whose windows...
But still we merry town or village folk
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10.12.1916 Labour leader, George Barnes, became the first Minister of Pensions. The Ministry of Pensions was created to handle the payment of war pensions to former members of the Armed Forces and their dependants. Pensions to ex-service lunatics were used to create the category "service patients" who were paid for from public funds, but counted as private patients. See 18.8.1919 - Citizen Soldier - 2.2.1921 - 1.1.1922 - 16.2.1922 - 1.1.1927
1917 525 patients died in Brentwood County Asylum during the year. This was only ten less than the number of admissions. By 1919 the number of deaths had fallen to 346.
1917 Malarial treatment of general paralysis Julius Wagner-Jauregg (1857-1940), in Austria, injected nine people suffering from General Paralysis of the Insane with the infectious blood of malaria patients. The theory was that the consequent fever would cure the G.P.I. and this appeared to be the case. Subsequently, experiments were carried out in many countries. See the 1924 reports on "The Malaria Treatment of Paretic Dementia". This may have become a standard treatment. See Scalebor Park, 1924, Horton 1924, Brentwood 1926 Nobel prize 1927 1929, Penicillin 1941 - 1963
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Emil Kraepelin's Hundert Jahre
Psychiatrie : ein
Beitrag zur Geschichte menschlicher Gesittung [One Hundred
Years of
Psychiatry: A contribution to the history of human
civilisation], written
1917, published in Berlin by Springer in 1918.
115 pages,
illustrated. This was
translated into English by Wade Buskin and published in
1962 as
One Hundred Years of Psychiatry. The translation
contains a short
epilogue by H. Peter Laqueur, MD, reflecting on the
years 1917-1962.
Kraepelin wrote "in Germany in the middle of a raging war" (p.154). A single paragraph, towards the end of the book, praises chemicals in the control of patient behaviour (after "protracted baths")
"We should not fail to note that the solution of many difficulties faced by the older doctors is the contribution of the chemical industry which in the last decade has created an imposing list of new soporifics and sedatives. The first sedative was chloral hydrate, recommended by Liebreich. Almost every other drug with similar effects was first manufactured and administered in Germany. Such agents are rightly considered expedients, however, and their use opens the door to many dangers. Still, for countless patients they are an immeasurable blessing, and they are mainly responsible for bringing the quiet atmosphere of the hospital into the wards for the insane and removing much of the horror that still feeds the imagination of the lay public" (pages 143-144) |
1918
Encephalitis lethargica followed the flu pandemic. This
affected up to
five million people worldwide. One third died quickly, one
third recovered,
the remainder bore the aftereffects for years or decades.
Encephalitis
lethargica "vanished" in 1928. - External links: Encephalitis
lethargica:
BBC -
History of narcolepsy -
Can the flue cause Parkinson's
Disease? -
Lancet 1956
Said to have killed 250,000 people in the United Kingdom
and 40 million
people world wide. (And there were plenty of other things
killing people at
this time -
See Charlotte's web)
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In 1919 Siân Busby's great-grandmother, Beth Wood (1878-1957) drowned two of her children and was sent to Broadmoor. The murder and the shame affected the whole family down to the present with fears about hereditary insanity and an inability to parent. The Cruel Mother: A Family Ghost Laid to Rest (2004), an investigation of what happened, is partly the author's attempt to cope with the consequences.
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Margaret Macdowall: Simple beginnings in the training of
mentally
defective children London: Local Government Press Co. (R.
T. Leach),
1919 116 pages: illustrated. bibliography and index
Science Time Line 1920
1919 1920s 1930s
From shortly after the first world war moves were made
18.8.1919 Right of patients classified as
"service patients" to wear
their own clothes - Others wore "pauper clothes" -
Reported Hansard
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.
1920 The Board of Control took over
Rampton as the first English
State Institution for mentally defective people
considered dangerous. Broadmoor now specialised in the
insane as part of
the Home Office prison
system and Rampton was part of the Board of Control's remit to
control
mental
deficiency.
"from about 1920 onwards, the term
"mental hospital" came into general use, though it did
not
receive legal recognition until
1930." (Alexander Walk
1962
24.3.1920
"Lunacy Law Scandals" in Truth
12.4.1920
Question in the House of Commons about "Military
Hospitals (Asylums)" -
Ashurst -
Ewell -
Springfield - and
Winwick were still military hospitals.
Maudsley -
Maghall -
Monyhull
- and
Craigleith were Ministry of Pensions Hospitals, but Maudsley was
due to be
handed back to the London County Council in July 1921.
See
1840s,
1890s,
1940s
But these moves only touched the edge of the mental health
system.
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Link to Jonathan Toms' review of
Peter Barham's Forgotten
Lunatics of
the
Great War, a book that argues that the concept of citizen
soldier
help to change the public perspective on the mentally ill.
"in the aftermath of the war... ex-servicemen were drawn into recording
their embittered experience at the hands of official agencies such as the
war pensions authorities"
(p.7)
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12.12.1920 Question in the House of Commons suggesting the £7,900,000 spent each year on asylums could be reduced if councils ran run hospitals for early uncertifiable mental cases entirely unconnected with lunacy administration.
1921 Ernst Kretschmer (1888-1964) published
Körperbau und
Charakter
(body-build and character), translated into English as
Physique and
Character arguing that body types match characters and
pre-dispositions
to types of mental illness.
1921 Montagu Lomax The experiences of an asylum doctor : with
suggestions for asylum and lunacy law reform, based on his experiences
at Prestwich.
A
"popular edition" was
published in 1922.
1921
Cassel Hospital admitted its first patient. External link to
web archive
2.2.1921 Letter in The Times from
G.K. Chesterton (and
others?) saying that the treatment of mentally distressed servicemen had
"opened the eyes of the public to the fact that the life of patients in
asylums is often one of prolonged misery"
(Barham, P. 2004 p.358)
1922
Eugenics and Other Evils Essays by
G.K. Chesterton,
published
London: Cassell. 1922. Re-published New York by Dodd, Mead and Company
1927.
"bulk of preliminary notes about the science of Eugenics were written before the war".
1.1.1922
number of ex-service men classified as
"service patients" by the Ministry
of Pensions, by asylum.
9.2.1922 "charges similar to the charges made by
Dr Lomax are being repeated almost daily by responsible persons
in the public Press; that some 6,000 ex-service men are being detained
under the system thus openly attacked"
(Charles Loseby MP. Hansard)
15.2.1922
Question in the House of Commons suggesting
a Royal Commission.
16.2.1922
Hansard: Partial explanation of what a
"Service Patient" is.
27.3.1922
Letter from Courtauld Thompson about the foundation of a
National Council for Mental Hygiene.
4.5.1922 Founding meeting of a National Council for Mental
Hygiene in Great Britain.
(British Medical Journal report) - See
October 1929 and
November 1946
June 1922: A jury awarded enormous damages to an
escaped mental
patient in
his case
against a lunacy
commissioner.
31.7.1922
Ministry of Health Departmental Committee on the
Administration of Public Mental Hospitals
31.1.1923 The London County Council Mental Hospital called
The
Maudsley opened.
"The Maudsley which will be opened by the L.C.C. on January 31, is the first municipal institution for early treatment of lunacy and scientific research into causes of insanity." (British Journal of Nursing, 27.1.1923, p.60) Medical School later Institute of Psychiatry See external history |
1923 John Thomson, M.D. (editor of "Edinburgh Hospital Reports")
Opening
doors: a little book for the mothers of babies who are long in
learning to
behave like other children of their age Edinburgh and
London: Oliver &
Boyd, 1923. Twenty pages.
1923
Bleuler's
Textbook of psychiatry authorised English edition by
A.A. Brill
London : Allen & Unwin
1923 The Handbook for Mental Nurses being the seventh edition
of the
Handbook for the instruction of attendants
on the insane by the
Medico-Psychological
Association, with a new title. A further revision was begun in
1932 but the eighth edition
did not appear until
1954
12.7.1923
6,900 patients receiving treatment for war neurosis
12.7.1923
House of Commons discussion of men who have sex with children -
"if it cannot be proved that they were mentally deficient at the age of
three they cannot be classified under the Mental Deficiency Act as being
mentally deficient. I heard the other day of a man of 63 who for 40 years
had lived a life of continually committing these offences, being repeatedly
sent to prison, and released, and then committing the offence again. He had
done that continuously for 40 years. That man ought to be looked upon as a
mental degenerate and treated as such". (Margaret Wintringham)
| 1924 Ministry of Pensions Mental Hospital opened at Storthes Hall in Yorkshire. |
1924 Branthwaite Report on the diet of patients and Bond Report on nursing service in mental hospitals published by the Board of Control.
May 1924 "The treatment of general paralysis of the insane by malaria" by Henry J. Macbride and W. L. Templeton published. The paper had been delivered on 12.12.1923. Summary - See Malaria treatment
Tuesday 24.6.1924 composition and the terms of reference of the Royal Commission on Lunacy and Mental Disorder published. Reported 1926
Thursday 26.6.1924 Valentine McEntee asked for "adequate facilities be given to the inmates of asylums to bring to the notice of the Royal Commission circumstances and conditions which, owing to the secrecy prevailing in lunacy institutions, do not usually come under the cognisance of the medical officers in charge thereof". (Hansard)
|
|
|
December 1924 Charlotte Mew met Siegfried Sassoon and the Untermeyers. Louis Untermeyer later described her as an exceedingly reticent and hermit-like poet. |
1925
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
21.5.1925
Question in the House of Commons about grant
for councils running hospitals for early uncertifiable mental cases.
Nurse Jessie Millar dismissed from
"Garlands Mental Hospital" for striking Elizabeth
Foster (aged
70), a feeble patient who was "constantly getting in and out
of bed", on
the head with a stick of firewood. At Carisle, on 14.11.1925,
Jessie Millar
was fined £2 and 10/- costs. "For the defence, it was
stated that the
nurse lost her patience through nervous exhaustion. She had to
attend
during the day to a mother who had since died, and during the
night she had
the care of 31 patients"
(Asylum Workers Magazine December 1925)
Report of the Royal Commission on Lunacy and Mental
Disorder
Summary from Michael Warren:
1926 Mental After Care
Association providing for 400 people in
"cottage
homes"
and 150 people with work placements. Another 1,450 received home
visits.
Hydrotherapy: At
Warley, "Hydrotherapy became a vogue in 1926 that lasted until
the war" - In the management of "turbulent patients" the main resources
mentioned by
MacPhail in 1928 are seeking the cause, separation and/or
seclusion,
continuous baths and sedation. A "continuous bath, with the use
of a cover to the open bath, with an aperture therein for the patient's
head" was one of the five means of "mechanical restraint" permitted by the
Board of Control.
1926 An appeal to
The Commonwealth Fund (New York) by Cyril Burt and Amy Strachey,
(born Amy Simpson 1866) "Mrs St Loe Strachey" for funds to start training
psychiatric social workers at the London School of Economics
(see below)
and support for
Child Guidance.
[argued] that there is no clear distinction between mental and
physical
illness,
defining mental illness as "the inability of the patient to
maintain his
social equilibrium"; recommended a community service based on
the treatment
of patients in their own homes wherever possible with a strong
preventive
element; certification should be a last resort, not a
preliminary to
treatment; there should be no distinction in the methods of
certification
used for private and pauper patients; local authorities should
established
outpatient clinics, provide observation beds in general
hospitals and fund
after-care services provided by voluntary agencies; mental
hospitals should
not exceed 1000 beds [See also voluntary boarders] "The keynote of
the past has been detention. The keynote of the future should
be prevention
and treatment".
| AIM25 contains "material relating to the Mental Health Course, 1926-1957, including papers of the Child Guidance Council, the Commonwealth Fund and the Mental Health Training Committee; material on the teaching of Statistics and Computing Methods, Insurance, Social Studies, Latin American Studies, Management and Management Studies." - A grant is recorded to "London, University of, 1926- 1968" in the Commonwealth Fund archives. |
The East London Child Guidance Clinic, funded by the Jewish Health Organisation, opened in 1927 (evening consultations). The London Child Guidance Clinic or Canonbury Child Guidance Clinic, funded by The Commonwealth Fund, was founded in Islington in 1929 and the Notre Dame Child Guidance Clinic opened in Glasgow in 1931. See Child Guidance Council
1927 A Text-Book of Psychiatry for Students and Practitioners by D.K. Henderson and R.D. Gillespie first published - (extracts)
1927 statistics
1.1.1927 74 County Mental Hospitals and 24 County Borough Mental
Hospitals in England and Wales = 98 Mental Hospitals. The total number of
patients was 110,701. 101,031 were "rate-aided". 9,670 were "Private
(including all Criminal patients)". The majority of the private patents
were ex-service men. There were 2,888 females in the private patient column
and 6,782 men. 5,376 of the men were ex-service men. 4,898 were "paid for
by the Ministry of Pensions, and classed as
'Service' patients". 478 were
"paid for by the Board of Control, and classed as 'ex-service' patients.
(1.1.1927 List)
|
October 1927 Announcement that Julius Wagner- Jauregg was awarded the Nobel prize in medicine was for his "discovery of the therapeutic value of malaria inoculation in the treatment of dementia paralytica" (weblink). The next psychiatric Nobel was Moniz in 1949 |
|
MUNICIPAL ELECTIONS,
November, 1927. ALL MEMBERS OF THE NATIONAL ASYLUM-WORKERS' UNION ARE URGED TO WORK AND Vote for the Labour Candidates |
1928
1928 The Child Guidance Council [An explanatory leaflet]
published by the
Child Guidance Council (London). See
1935 -
1937
-
Provisional National Council for Mental
Health. See also
Child Guidance
25.2.1928 Joan
Hughes born
1928 - 1932 - 1940 - 1944
| 24.3.1928 Charlotte Mew drank half a bottle of disinfectant, from which she died. |
1929
Meagher's
Report on treating
General Paralysis of the Insane
by inducing
malaria, published by the Board of Control
1929 With money from
The Commonwealth Fund, a Diploma in Mental Health started at the
London School of Economics to train Psychiatric Social Workers. The fund's
Director, Barry Smith, had written in 1928 that "the training of
psychiatric social workers is an essential and fundamental part of [a]
child guidance program."
(source)
January 1929:
Our Baby - For
Mothers and Nurses page 126 lists
Idiocy under
Congenital Defects:
"This is a term for mental weakness which dates from birth. It varies in degree from a mere feebleness of intellect, to a state in which the mind seems wholly absent. Should a child fail to answer to most of the tests of normal progress given on page 88, it must be considered backward, and the child should be taken to a doctor, as systematic training should be begun very early, considerable improvement being then almost always possible. (See list of recommended books page 177)" The relevant recommended books are MacDowall and Thomson. As far as I can tell from library lists, there was not much more available. |
Wood Report
on Mental
Deficiency published by the Board of Control
Let us assume that we could segregate as a separate community all the
families in this country containing mental defectives of the primary
amentia type. We should find that we had collected among them a most
interesting social group. It would include, as everyone who has extensive
practical experience of social service would readily admit, a much larger
proportion of insane persons, epileptics, paupers, criminals (especially
recidivists), unemployables, habitual slum dwellers, prostitutes,
inebriates and other social inefficients than would a group of families not
containing mental defectives. The overwhelming majority of the families
thus collected will belong to that section of the community which we
propose to term the " social problem " or " subnormal " group. This group
comprises approximately
the lowest 10 per cent in the social scale of most communities"
30.10.1929 to 2.11.1929 Conference on Mental Health
convened
by the Joint Committee of the
National Council for Mental
Hygiene and
the
Tavistock Square Clinic. Held in Westminster. [See
Lord,
J.R.
1929/1930
Minutes of the Home and School Council of Great Britain, 1929-1950s held by
Institute of Education, University of London.
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
"the majority of the
feeble-minded are to be found within a
relatively small social group, a group which may be described as the
subnormal or social problem group, representing
approximately 10 per cent
of the whole population. Most of the parents in this subnormal group are
themselves of poor mental endowment, and would no doubt have been classed,
when children, among the dull or retarded. Similarly the dull children of
the present generation, who form a large majority amongst children in this
subnormal group, are the potential parents of many feeble-minded
in the
next generation. Therefore, from the standpoint of the prevention of many
social evils it is of the utmost importance that the problems of the
education and social care of the borderline
retarded child should be
effectively tackled....
|
The 1930
Mental
Treatment Act
Royal Assent 10.7.1930 The 1930 Mental Treatment Act modernised, without replacing, the Lunacy Laws. It reorganised the Board of Control, made provision for voluntary treatment and psychiatric outpatient clinics and modernised the terms used. The intention appears to have been to make voluntary treatment available for all classes, not just those who could afford fees:
"I think it is a great charter for the poor of this country, and for the first time it gives the poor as great a chance as the rich. I think the Bill gets away from the spirit of detention to that of prevention and treatment." (Dr. J. H. Morris-Jones, M.C. Labour - Denbigh, the last speaker in the Debate on the third reading in the House of Commons)
However, a 1939 Guide to Middlesex County says of voluntary patients under the Act: "these private fee-paying patients in the majority of cases pay a higher maintenance rate than that received for the rate-aided patients". (Radcliffe, C.W. 1939 pages 153-154) 22.7.1930 and 23.7.1930 The Board of Control held a Conference on bringing into effective operation the powers conferred by the Mental Treatment Act. The report was called Mental Treatment
|
The last of the (large) mental hospitals to be built in
England or Wales
were the new Bethlem in south London (Kent),
Shenley, in Hertfordshire, and
Runwell, in
Essex. No new ones were built after the second world war.
Mental deficiency
colonies (then hospitals) continued to be built. The last to
open was
Bryn-y-Neuadd in
1971.
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. 9.7.1930 Formal opening
of the new
hospital by Queen Mary.
Moss
Side,
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.
1931
Hedley Report on colonies for mental
defectives published by the Board of Control
1931:
Admission Units for "recent cases, wholly
separate from
the main building in which are housed patients of confirmed
mental
disorder"
Carlos Paton Blacker (1895-1975) was General Secretary of the Eugenics
Society from 1931 to
1952. See
1942 -
1944 -
Historical background to community
care -
1946 -
1952
1932 The
Mental After-Care Association provided a part time social worker
for
Brentwood Mental Hospital from 1932 to 1944.
1932-1933 Robina Scott Addis (1900-1986) took
LSE course in Mental Health, qualifying as a psychiatric social
worker. Followed by a
Commonwealth Fund Fellowship for research into enuresis - which
possibly meant a year in he USA. From 1934 to 1939 she worked in London
Child Guidance Clinics.
During the war she was a Welfare Officer for
the
Mental Health Emergency Committee. - From
1951 she worked at
the National Association for Mental health's HQ in London.
papers -
(Wellcome biography)
1933
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 1933, less than six months after their election,
they passed
the
Law for the Prevention of Genetically Diseased
Offspring
(see
external link).
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
1934
1934 Laurence George Brock, chair of the Board of Control,
published his
committee's report on the
voluntary sterilisation of mental
defectives,
with memoranda on what was happening elsewhere in the world.
May 1934 King George 5th opened
Shenley
Mental
Hospital in Hertfordshire. Middlesex County
planned this in the
neighbouring county as a small town in
the countryside, composed as a network of villas of 20
to 45 beds,
with 2,000
patients and 500 staff. The Middlesex Colony at Shenley, on
land to the
north of the main Shenley Hospital estate, had been opened by
the Minister
of Health in 1933. Its reception hall was opened during
Jubilee Week
in 1935.
(Radcliffe, C.W. 1939 pages
153-154)
1959 comment: "It is obviously useless to
sterilise
idiots and imbeciles, as was widely done in Germany... from 1933
to 1940,
because they do not in any case have offspring except in the rarest cases"
(Penrose 1959, p. 102) - But not so "obvious" at the time
(see below)
|
On this 1980s Ordnance Survey map, I believe the hospital to the west of London Colney is Napsbury, opened in 1905. This was the first of the Middlesex in Hertfordshire mental hospitals and colonies. That to the south of the map is Shenley, and north of that Shenley Colony. Please tell me if I am wrong. Leavesden was north of Abbotts Langley, further west. Hill End, Hertfordshire's own Mental Hospital, was near St Albans to the north. The MP for this area in the 1970s and 1980s was Cecil Parkinson. A report of the Parkinson Committee, published in part in 1981, triggered the closure of the mental hospitals. |
1935
Child Guidance Council Executive Committee minutes November 1935 to June
1937 held by Warwick University, Modern Records Centre
- See
Child Guidance [?] -
Feversham 1936 -
new
constitution
1936
Metropolitan observation units In 1936 there were six observation
wards in general hospitals run by the London Council Council. These were at
Fulham - St Pancras -
St Clements - St Alfege's (Greenwich) - St Francis (SE22?) - St
John's (Wandsworth?).
In 1936, 6,233 patients were admitted to the London observation wards of
whom 3,117 were transferred to mental hospitals (only 10 per cent of these
went as voluntary patients) and 1,054 discharged to the care of relatives.
(source)
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
1936 "The
London Child Guidance Clinic" (Islington - Canonbury) "trained
educational psychologists, social workers and child psychiatrists. Each
year three fellowships in child psychiatry were advertised - they were
half-time fellowships for one year".
John Bowlby was appointed to one in 1936.
(Bowlby, J.
19.10.1977) - See
1951 -
A Two Year-old Goes to Hospital
8.4.1936 Lord Feversham chaired a preliminary meeting of a committee
of representatives (two from each?) from the
National
Council for Mental Hygiene - the
Central Association for Mental Welfare
- the Child Guidance
Council and the
Home and School Council of Great Britain.
Committee formed to inquire into
the extent of mental disorder in England and Wales and the measures taken
to deal with it by statutory and voluntary agencies. The inquiry was
conducted with the sympathy and assistance of the Board of Control and
other parts of central and local government. It reported in
1939
March 1937 circular letter about a new
Child Guidance Council Constitution and membership (Warwick
University, Modern Records Centre) - Also Child Guidance Council
"Memorandum re Amalgamation prepared for the
Feversham Committee" (dated March 1937)
Monday 19.7.1937 to 24.7.1937 (Second) International Congress
on Mental Hygiene held in Paris. On the Monday morning, Clifford Beers,
"secretary-general of the
International Committee for Mental Hygiene
reported on the activities of the committee since the first congress in
1930 and Dr George Genil
Perrin, secretary-general of the congress, made a brief report. The themes
of the afternoon session were Eugenics and Sterilization in Relation
to Mental Hygiene, and Mental Hygiene in Relation to Sex. Ernst Rudin spoke
first on the "Condition and Role of Eugenics in the Prevention of Mental
Diseases". He argued that "the only method of extirpating hereditary mental
disorders was by preventing the propagation of tainted sex-cells". Bernard
Sachs complained to to Beers that Rudin was "the most outspoken and rabid
Nazi protagonist... who heads a whole group of men who are now openly
making eugenic doctrines conform with the race purity doctrines of the
present German regime". The choice of speakers, however, was not something
that Beers had any control over.
(
Psychiatric Quarterly Volume 12, Number 1. March 1938
and
Dain, 1980)
1937 Official opening of
Runwell Hospital,
Wickford, Essex. (Jones, K.
1960
p.357) says that this already had a "patient-population of
1,010".
Administrative records in Newham Public Libraries start in
1934.
General records start in 1937. Kathleen Jones (who does
not mention
Shenley)
says
April 1938 Rome: "S.E.", a thirty nine year old man diagnosed
schizophrenic, was chosen by Ugo Cerletti as the first human to have
convulsions artificially induced by an electric shock through the brain.
The origin of Electro-Convulsive Therapy. See
Europe below.
6.7.1938 The
President of the The Royal Medico-Psychological Association
spoke of the change in psychiatry from pessimism to opimism since Maudsley
published The Pathology of Mind in 1879:
29.7.1938 to 2.8.1938 10th International Medical Congress for
Psychotherapy held at Baliol College, Oxford - Its first meeting in an
English speaking country. Sargant and Slater
1963 (page 165) say that reports were presented of the trial of
insulin coma treatment in several countries. Manfred Sakel had
carried out
the experiments putting schizophrenic patients into an insulin coma
since 1927. See 1947 -
1948 -
1950 -
1952 -
St David's 1956 -
Croydon
1956 - 1963 -
1968 -
2009
"Runwell was a completely new hospital - the first
to be
planned since the First World War, designed to embody new
ideas in mental
treatment. Larger than
Bethlem, it had at the time of
opening in
1937 a patient-population of 1,010; but this total was broken
down into
small units, each largely self-contained. Runwell is the only
English
mental hospital to be built entirely on the villa system -
Small one - or
two - storey blocks with flat roofs were scattered over a wide
are of
garden and parkland. Parole patients, who required relatively
little
supervision, were housed in units for twenty to twenty-five
persons...
Separate blocks were constructed for patients' clubs, where
resocialisation
through group methods could be tried out; and a research wing
was built and
equipped for the examination of the biochemical and
neurological bases of
mental disorder" (Jones, K.
1960 pages 130-131)
"
The great
work of Sigmund Freud has cast a brilliant, if necessarily unequal light
upon
the dark places of psycho-pathology.
General paralysis would now appear to be largely under our control.
Schizophrenia is being attacked with renewed hope since recent therapeutic
knowledge and research have brought insulin and cardiazol and other agents
to our aid.
Wider fields spread before the psychiatrist than ever before. In out-
patient
dispensaries, in child guidance clinics, in juvenile courts he finds an
increasing
welcome. Psychological factors in industry, in unemployment, in the
aetiology
of war invite his co-operation."
| The following is a typed copy of the medical register entry for a patient who died at Saxondale Hospital, Nottinghamshire in 1939. This, like other medical registers, uses a code for the type of illness and the cause of the illness. To work out what the codes mean, see 1925 forms |
|
Aetioolgical
Features:
Principle L2 Form of Mental Illness: L16 |
|
Jubilee book for Middlesex divides care of mental defectives into community care and institutional care
"In 1939, Kalinowski began a tour to advertise ECT" [Electro- Convulsive-Therapy] "around the globe, visiting the Netherlands, France, Switzerland, England, and the United States." (Sabbatini) - It was introduced at Warley in 1941. In 1957 it was described on television as an exciting new advance in medicine, and this created a consumer demand for it.
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 death camps,
notably
Auschwitz 2 (Birkenau), Belzec, Chelmno, Majdanek, Sobibor,
and Treblinka.
See
entry into Belsen (concentration camp) 1945
|
January 1939 Mental Welfare Price 10d - Annual Subscription
Post Free 3/6 - January 1939 - Vol. 20, No.1 - Published by the Central
Association for Mental Welfare Incorporated - 24 Buckingham Palace Road,
London, S.W.1
Early 1939? A Mental Health Emergency Committee established by voluntary organisations to address the "problems of mental health, mental deficiency, and community care in time of war". Address 24, Buckingham Palace Road. [Address of the Central Association for Mental Welfare] (Hansard 29.2.1940) |
July? 1939 The Voluntary Mental Health Services: The Report of the Feversham Committee published by the committee. 16 introductory pages. 268 main pages. - "Mental Health Council - Feversham Committee's Proposal" Yorkshire Weekly Herald 28.10.1939 headline to article on the report of the committee, which it said was published "yesterday"
Second World War 1939-1945
Sunday 3.9.1939 Britain declared war on Germany
Hospitals during world war two: -
Belmont -
Sutton -
Netherne - Surrey -
Hellesdon - Norfolk -
Rooksdown House - Hampshire
Having been sent to Northampton as a
Mental Health Emergency Committee Welfare Officer to care for
child evacuees, after
Dunkirk,
Robina Addis cared for
adults billeted in the Northampton area who were psychiatric casualties
The Blitz, sustained bombing of London and other British cities
7.9.1940 to 10.5.1941.
Community
Care
"The Emergency Medical Service was introduced as soon as war
broke out, and gave central government a right of direction over both
voluntary and municipal hospitals which it had never before possessed.
Patients were discharged or evacuated from the hospitals in central London
in preparation for a wave of air-raid casualties which did not materialise"
(Geoffrey Rivett)
|
The mass-production of Penicillin was
developed in the
United
States from 1941. A
recent medical website
(archive)
describes General
Paralysis of the Insane as "a syndrome of madness and weakness
occurring in
tertiary
syphilis,
which is now
very rare because of treatment with penicillin". Penicillin's
use in
connection with general paralysis is after 1945.
The annual death rate (England and Wales) fell steadily from 2.272 in 1901 to 68 in 1957. (Hare, E.H. 1959). Although treatments by malaria or penicillin do not show any marked influence of the curve of the decline, I would think the statement that it has become rare because of treatment with penicillin is correct. |
In one industrial concern more than three times as many work-
days per man were lost in 1941-1942 owing to neurosis than had been
lost in a pre-war year.
(Aubrey Lewis 4.3.1942)"
| Long-term hospital patients were moved to residential homes to make room for injured soldiers. By 1942 the Mental After Care Association (MACA) was running fifty homes. The war established the residential care-home model and, by the 1950s, MACA had several of its own properties, where up to 50 people lived as many as five to a room. |
4.3.1942 Memo from Aubrey Lewis to the Director General of the Emergency Medical Services - Surprisingly few cases of overt neurosis had resulted from the air attacks, but psychiatric stresses appeared to be increasingly felt, especially in industry. Called for an investigation of the extent of neurosis and allied states, and the facilities for consultation and rehabilitation.
April 1942 Term Lack of moral fibre (LMF) adopted by the
Royal Air Force to stigmatize aircrew who refused to fly without a medical
reason.
21.10.1942:
Carlos Paton Blacker was seconded to the Ministry of Health
as
adviser on population and medico-social problems to undertake. with the
Medical Research Council, a survey to obtain information on the adequacy of
psychiatric out-patient facilities to deal with the psychiatric troubles of
a civilian population subjected to more than three years of war. The
publication of the Beveridge report in December 1942, however,
suggested that the survey might also consider "how the psychiatric services
of this country might be improved after the war." (Bolby)
1942?
Mental Health Emergency Committee became the Provisional
National Council for Mental Health, divided into 13 areas, based on Civil
Defence Regions [??] - Provisional National Association for Mental Health
Annual Report 1943/1944 and Provisional National Council for Mental Health
(incorporating...
Child Guidance Council...): Ad hoc Committee on the
extension of clinical training (Play Therapy) ['Inter-clinic Comm'] minutes
February 1944 to May 1944, held by Warwick University, Modern Records
Centre.
| "They Called It Shell-Shock: Approximately one-third of the men invalided from the army have been discharged on psychiatric grounds. In the last war they called it shell-shock. The term was used to cover almost all types of psychological illness arising in association with, or as a result of, enemy action. The true significance of psychological factors was not appreciated. It was assumed that these disorders were the results of actual damage to the brain or nervous system caused by the effects of high explosives, and comparable in their origin and effects to actual head injury and concussion. It was a confusing and unfortunate term and is not now accepted as a diagnosis. For psychiatry has come a long way since then, and its influence in the Army is very considerable. There are ten special Army mental hospitals with, so far as possible, one Army Psychiatrist to fifty patients, and up to about four hundred patients. These beds have never been completely filled, though some hospitals have had a big and quick turnover. The average stay in hospital is about six weeks.... " (Major) Anthony Cotterell R.A.M.C. [Royal Army Medical Corp] Hutchinson, no date, but probably about 1943 |
Our Towns: A close-up - A study made in 1939-1942 - with
recommendations by the Hygiene Committee of the Women's Group on Public
Welfare, chair Amy Sayle, (in association with National Council of Social
Service). Preface by Margaret
Bondfield.
With this group are the 'problem families' always on the edge of pauperism
and crime, riddled with mental and physical defect, in and out of the
courts for child neglect, a menace to the community, of which the gravity
is out of all proportion to their numbers"
3.2.1943 Neurosis Questionnaire distributed to Regional
investigators.
15.11.1943 Final report on neurosis questionnaires received back
from regional investigators.
December 1944
Carlos Paton Blacker signed his preface to
Neurosis and the Mental Health Services
Miss Lucy G. Fildes, Provisional National Council for Mental Health
listed as an appointee to the Committee on the Treatment of Children
Deprived
of a Normal Home Life
(National Archives)
26.7.1945: Election results: Labour Government (to 1951)
September 1945 International conference in Zurich of S. E. P. E. G.;
Semaines internationales d'eïtude pour l'enfance victime de la
guerre. International Study Weeks for Child Victims of the War.
Robina Addis was [the?] British representative.
"The effect of evacuation was to flood the dark places with
light and bring home to the national consciousness that the
'submerged tenth' described by
Charles Booth still exists in our towns like a hidden
sore, poor, dirty, crude in its habits, and an intolerable and degrading
burden to decent people forced by poverty to neighbour with it.
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
|
Hospitals are for Healing:
The origin and context of community-care policies |
1940s and 1950s: Historical Background to Community
Care
The therapeutic asylums planned in the
1840s
failed monumentally, the monuments being a network of large
asylums full of
long-stay patients with little or no hope of rehabilitation.
In post war
Britain the National Health Service inherited these asylum
which still
stood in open countryside outside the towns, or had been
engrossed by the
expanding suburbs.
Post war Britain provided a new moral culture for disabled people. Eugenics and social darwinism were discredited by their association with the Nazi policies and extermination camps. The fears of "racial degeneracy" that had shaped pre-war public policy for mental defectives were no longer acceptable, even though they still dominated important texts such as Blacker (1946) and Tredgold (1947). In the absence of an acceptable conceptual framework, mental defect became a health issue. The 1946 National Health Service Act defined a hospital as an institution for "the reception and treatment of persons suffering from illness or mental defectiveness" (section 79) and transferred local authority hospitals to the Minister of Health (section 6).
March 1946 National Health Service Bill introduced
April (or earlier) 1946
Neurosis and the Mental Health
Services by
C. P. Blacker, 218 pages, published by Oxford University Press,
1946. Price, 21/- "The influence of the
report of the Feversham Committee will be apparent to all
readers" (Author's Preface, p.vii)
November 1946 The 1946
National
Health Service Act passed. This stripped the
Board of Control
of nearly all its functions except those of providing an
inspectorate of
mental hospitals, especially with respect to compulsory
detention, and managing Rampton and Moss Side. The Act came
into force on
1.7.1948
|
Mind History website
[Date of foundation (below) is the date the three constituent bodies formerly merged. - Confirmed by Rachael Twomey at the Mind Information Office]
25.11.1946 Foundation of the National Association for Mental Health (now Mind). This was a combination of existing organisations, partly merged in 1939 as the Mental Health Emergency Committee for war-time coordination. This had become the Provisional National Council for Mental Health. Its components were the Central Association for Mental Welfare (formed in 1896 as the National Association for the Care of the Feeble Minded), the National Council for Mental Hygiene (founded 1922) and the Child Guidance Council (foundation date uncertain). Only the National Council for Mental Hygiene "had any real interest in the mentally ill" (Mary Applebey 1976). The Association worked closely with the Ministry of Health and the Board of Control. - See Mind and the Users Voice -
"The grandmother of it all was Dame
Evelyn Fox"
(Mary Applebey 1976) - In 1971 there was a pastel
portrait, made after her death, in the council room of the National
Association for Mental Health at 39 Queen Anne Street (DNB)
Conferences (and AGMs): 1961 - 1973 move and AGM - 1974 - 1975 - 1975 - rights - 1976 - 1976 AGM - 1977 - 1978 - 1980 - 1981 - 1982 - 1983 - description of target audience - October 1984 - 1984 - [World Mental... July 1985] - 28.11.1985 - 1985 - NW Mind at Crawshawbooth - 1986 Conference - 1986 AGM - planning for 1987 - 1987 - [International 26.9.1988] - 1988 - (See also 1988) - 1989 - 1990 - 1991 - 14.11.2002 - 16.3.2006 - 6.9.2006 - 6.11.2007 -
Archives: See National Association for Mental Health (later Mind) collection in the papers of Robina Addis |
Photograph is enlarged from the back cover of the 1952 edition of
Psychiatry Today
|
1946? David Stafford-Clark (17.3.1916-9.9.1999) began studying at
the
Maudsley Hospital. At some time, Allen Lane of
Penguin Books
enquired about
a writer for a popular book on
psychiatry.
Aubrey Lewis recommended David Stafford-Clark, who finished
writing
Psychiatry Today in July 1951.
An anonymous obituary in The Times (10.9.1999) said "Stafford-Clark did more than almost anyone to dispel long-held prejudices about "lunacy" and "mental deficiency" and to remove the stigma from being mentally ill". |
|
Out of sight - Out of mind - Stigma and
taboo
The stigma of disability was intense. In the early 1940s, for example, a mother who attempted to meet other parents of handicapped children to form a playgroup had her advertisement refused by her local paper because of the "shame and disgrace" of having a handicapped child. In 1946 The Association of Parents of Backward Children (now Mencap) was formed by parents concerned about the lack of support to help them maintain a child at home, and the isolation and poor facilities of the deficiency hospitals that were the main alternative. [For changing names, see below) Mencap History website archive 2001-2006 - current link The 1946 Report of the Care of Children Committee complained about the "motley collection" of people it found in workhouses. In one room, with children of workhouse inmates, there was "a Mongol idiot, aged four, of gross appearance, for whom there was apparently no accommodation elsewhere. A family of five normal children, aged about six to fifteen... were sleeping in the same room as a three year old hydrocephalic idiot, of very unsightly type, whose bed was screened of in the corner... We found a number of institutions in which normal children were sleeping with low grade mentally defective children..." (Cmnd 6922 paragraphs 140 and 142). Compare the revulsion expressed with 1847, 1894 and 1916. Some of the same may have been involved in the refusal to show patients faces in The Hurt Mind in 1957. However, The Hurt Mind and the previous 1954 Archers programme, were deliberate efforts to break through the taboo of silence on mental health issues. |
|
pre-frontal leucotomy and insulin coma - See
Warley 1946
1947 Pre-frontal Leucotomy in a thousand cases by Isabel Wilson and E.H. Warland published by the Board of Control. about 1947 to 1953 A period during which "practically every mental hospital in the country" (England and Wales) used insulin coma treatment. (Sargant and Slater 1963 p.170 commenting on 44 deaths from the treatment reported to the Board of Control in that period (W. Maclay, 1953 "Deaths due to treatment" Proceedings of the Royal Society of Medicine 46, 13)
|
National Association for Mental Health "Film Visiting Committee" formed in 1947 to "help in relation to producing, and also in avoiding inaccurate presentations which would tend to vulgarise psychology and give the public a false idea of its possibilities" (Mental Health, 1967, 7 (2), 47, quoted Crossley, N. 2005 p.78. This joined forces with members of the British Film Council in 1948. Eventually gave rise to the Mental Health Film Council (Crossley, N. 2005 p.78)
|
"Euthanasia:... with regard to the 80,000 or more
idiots and
imbeciles in the country... These are... incapable of being
employed...
their care and support absorbs a large amount of the time,
energy, and
money of the normal population... many... are utterly
helpless, repulsive
in appearance, and revolting in manners... In my opinion it
would be an
economical and humane procedure were their existence to be
painlessly
terminated... It is doubtful if public opinion is yet ripe for
this to be
done compulsorily; but I am of the opinion that the time has
come when
euthanasia should be permitted at the request of a parent or
guardian"
A Text-Book of Mental Deficiency (Amentia) by
A. F. Tredgold,
Consulting Physician to University College Hospital, London.
Seventh
edition 1947. Page 491. See
1933 and Historical background to community care
|
|
The 1947 Annual Report of the National Council for Civil
Liberties
refers to a woman released from a mental ward after the NCCL proposed
applying for a writ of Habeas Corpus as she appeared to have never been
certified. Another woman was made a voluntary patient after NCCL began
enquiries, and released herself. Both women had had illegitimate children.
"Not until after the Second World War did the Council concern itself with the most important liberty of all - the loss of total liberty when a person is wrongfully imprisoned in a gaol or institution. The first mental deficiency case which came to the Council's notice was brought to them in 1947 by a retired solicitor's clerk who, enraged by the circumstances of a young girl unrelated to himself, waged such an excellent one man war that the girl was freed before the Council needed to list a finger. The second was brought to the Council's notice by a clergyman, the third by a London legal advice centre... [in 1958 there were] 860 mental deficiency cases on the Council's files, of which more than eighty concern patients... in Rampton.." (Roxan 1958, p.224) See 1951 - Peter Whitehead 1.11.1954 - Royal Commission 1954 - Peter Whitehead 1955 - 1956 - Roxan 1958 - |
Science Time Line 1948
See
1930
and
1966.
July 1948
National Health Service Act came into
operation
The National Health Service (NHS) took over from county
councils and
boroughs
the major responsibility for mental health. The reforms of the
1920s and
1930s
had only touched the edge of the mental health system. The
main
inheritance of the National Health Service was a system of
over 100
asylums, or "mental
hospitals", with an average population of over 1,000 patients
in each.
The integration of the mental hospitals into the National Health Service was possibly the most decisive factor leading to a general move away from institutional policies in the 1950s. See 1959. Andrew Scull (1977, chapter 5) refers to studies of individual English mental hospitals, including Mapperley Hospital, Nottingham where inpatient numbers fell from 1948 due to changes in administrative policy, including avoiding admission altogether and early discharge of those who were admitted. In-patient numbers at Mapperley fell from 1,310 in 1948 to 1,060 in 1956. They were down to 870 (with annexes) in 1960.
[See archive - international archive]
(On the Mental Illness Concerns All (mica) web site)
11.8.1948 to 21.8.1948 "Der Monster Kongress" (Anna Freud's description) in which 2.500 representatives of 42 countries met in London during ten days to evaluate what had been learnt about mental health during the war and to plan for peace. This is counted as the founding congress of the World Federation for Mental Health - External link to website - The founding meeting was held in London. See 1951 - 1954 - 1961 - 1968 - 1973 - 1977 - 1979 - 1981 - 1983 - Brighton 1985 - 1987 - 1989 - Mexico 1991 - [First World Mental Health Day] - 1993 - 1995 - 1997 - 1998 - 1999 - 2001 - 2003 - 2005 - 2007 - 2009 -
|
1.10.1949 Full implementation of post-war open door policy at Dingleton Hospital. Melrose, Scotland. "It appears to be the first mental hospital with open doors in the world" (Ted Hayes). The medical superintendent, Macdonald Bell (G.M. Bell) published a paper "A mental hospital with open doors" describing it in an early issue of the International Journal of Social Psychiatry, 1955, 1 pages 42 to 48). The open door system was also adpted in England at Mapperley, Warlingham Park and other hospitals |
1949 Foundation of the Mental Health Trust and the Mental Health Research Fund. These merged in 1972 to form the Mental Health Foundation (website) - information on charity - Database of Archives of Non-Governmental Organisations. The Research Fund was started by Dr Derek Richter (1907-1995) because there was so little research in the field. Dr Richter was at the Neuropsychiatric Research Centre, Cardiff from 1950 to 1983. - Published histories 1984 and 2009 - website archive from 1.6.1997
|
See
Wagner Jauregg in
1927
|
October 1949 Announcement that the Nobel Prize for physiology or medicine for 1949 would be shared by Walter Rudolf Hess of Switzerland for "for his discovery of the functional organization of the interbrain as a coordinator of the activities of the internal organs" and Egas Moniz of Portugal "for his discovery of the therapeutic value of leucotomy in certain psychoses". See Controversial Psychosurgery Resulted in a Nobel Prize by Bengt Jansson on the Nobel website. |
|
By the 1950s, the
Mental After Care Association (MACA)
had several of its own properties, where up to 50 people lived as many as
five to a room.
"residential homes in the 1950s and 1960s were more homely than the old hospitals, but seem institutional by today's standards." (Together History Leaflet) MACA's first hostel offering short-term care opened in Ipswich in 1961. |
Mind's Key Dates: "1950s Day hospitals began to be established, increasing flexibility in psychiatric services and reducing the use of hospital beds. Hostels and therapeutic social clubs were set up to provide support for discharged patients. The introduction of neuroleptic drugs helped to shorten the length of new admissions to hospitals and encouraged the discharge of many into the community. Some new district psychiatric services were developed in general hospitals, ceasing to use beds in the regional mental hospitals, providing a model for future changes."
|
18.9.1950-27.9.1950
Le Premier Congrès International de Psychiatrie Paris |
|
|---|
Sargant and Slater 1963 (page 165) say that the value of insulin coma treatment was "generally accepted" at the Congress "as the best available treatment of early schizophrenia". They say this "began to alter radically" in 1953 "with the use of the new tranquilising drugs, such as chlorpromazine"
Second World Federation for Mental Health congress held in Mexico
25.10.1951 Conservative government in United Kingdom
1951 John Bowlby's Maternal Care and Mental Health published in Geneva by the World Health Organisation, in London by Her Majesty's Stationery Office and in New York by Columbia University Press. An abridged version: Child Care and The Growth of Love (2nd edition, 1965) was published by Penguin.
|
1951: 50,000 Outside the Law: an examination of the treatment of
those certified as mentally defective published by the
National Council
for Civil Liberties (NCCL). 40 pages. Second impression in
1952.
National Council for Civil Liberties history website - an Open University website The pamphlet dealt with 200 cases of alleged wrongful certification and detention. It said the law was being administered "in a far from humane manner" and that patient labour in institutions, and release on licence to employers, created an economic motive to continue certification. |
1951 Mary Applebey became Director of the National Association for
Mental Health in place of the original General Secretary: Miss M C Owen and
the Medical director since 1947: Dr Alfred Torrie
1951 Robina
Addis moved from Northampton to London to became Head of the
National Association for Mental Health's Social Services
Department. From 1954 to 1965 she was Deputy General Secretary.
|
|
Social Psychiatry: A Study of Therapeutic Communities by Maxwell Jones and others, foreword by Aubrey Lewis, published London: Tavistock Publications, 1952. Republised in the USA in 1953 as The Therapeutic Community - A New Treatment Method in Psychiatry
|
1952 First edition of
David Stafford-Clark's Psychiatry
Today published by Penguin. The inside cover blurb begins:
"For better or worse, psychiatry is news today: it is also frequently a feature of entertainment on the films, on television, on the radio, and provides a theme for books and a plot for plays. Although it is one of the fundamental branches of medicine it has always received notoriety more readily than fame, and seems all to often to promise more than it can perform. What was once a forbidden mystery is in danger of becoming a popular fad" The corresponding blurb for the second edition in 1963 began. "Since... the first edition of Psychiatry Today was published, the general public for which it was specially written have brought over 130,000 copies. It has been translated into French, Dutch, Spanish, German, Italian, and Greek" Chapter 7: A Consideration of Treatment "...the method of treatment most closely associated in the public mind with psychiatry... is that of psychotherapy". In this he includes "forms of reassurance, support, understanding, and guidance" of varying depth - occupational therapy - social measures, which are "the province of the trained psychiatric social worker" - a "series of interviews" including "a complete life history of the patient" - "periodic advice and supervision over some time" - psychoanalysis and other forms of psychotherapy aimed at providing the patient with insight - brief methods of analytical psychotherapy, including hypnosis - group therapy. He then indicates that "in the opinion of most psychiatrists" "physical methods have a greater part to play" in the treatment of depression and schizophrenia. [See St David's 1956] The discussion of physical treatment begins with general physical health (for example, nutrition) and the treatment of physical disorders underlying such mental illnesses as acute toxic confusional states and general paralysis of the insane by Penicillin. The drugs discussed are sedatives (for abreactions and for continuous sleep treatment) - amphetamine - and antabuse. The combination of benzedrine and ephedrine in treating children who wet their beds is discussed. The three physical treatments that had "radically altered the whole outlook" for patients suffering from depression and schizophrenia "previously beyond the power of psychological medicine to control" were electrical treatment - deep insulin treatment - neuro-surgery
The major changes in the 1963 edition were the introduction of the drugs
chlorpromazine (and
derivatives) -
meprobamate (and derivatives) - and the
antidepressants
|
1953 Mental £millions. Almost half the National Health Service's hospital beds were for mental illness or mental defect. Hospitals generally were in old buildings, but those for mental illness included some of the worst buildings. From 1953 the government set aside substantial, if inadequate, sums of money for their improvement - The Mental £ millions. Spending on this sector in West Yorkshire reached a peak of 37% of the hospital budget in 1955/1956. Government thinking appears to have been precipitated into community care policies by the prospect of spending even larger sums on renovating the old asylums.
End of Hospital Farms: The Ministry of Health decided that hospitals were not to continue farming or market gardening (Laidlaw, E.F. 1994 p.151) - See Derby
Autumn 1953 An article (not in the Lancet) described the three British mental hospitals with open door policies: Dingleton Hospital in Scotland, Mapperley, Nottingham and Warlingham Park Hospital, Croydon. David Clark became medical superintendent at Fulbourne, Cambridgeshire on 1.8.1953. He began by re-locking the admission ward that a consultant had opened. In the spring of 1954 he visited Warlingham Park to investigate the new methods. (external link to the relevant chapter of his book) . In 1954 out-patient nurses were appointed at Warlingham Park to visit out- patients and in-patients who had been discharged. (external link to Mind's key dates). Saxondale (Nottingham County) also introduced the open door system and Graylingwell, West Sussex, is mentioned as one of the hospitals that David Clark visited. (Some information from an email from Ted Hayes in Canada, who is researching open door policy)
September 1953 World Health Organisation report The Community Mental Hospital - "the need to provide more psychiatric hospital beds is being over-emphasised at present in some countries of western Europe and North America to the detriment of the provision of other services which would reduce the need for the admission of patients into psychiatric hospitals or alternatively reduce the length of stay of those patients who must be admitted."
22.10.1953 Winston Churchill (UK Prime Minister) announced a Royal Commission on the law relating to mental illness and mental deficiency. The names of the Chairman and other members to be announced later. (Hansard)
1954: Peak of numbers resident in English and Welsh Mental Hospitals. In the hospitals that pioneered community care, the numbers had been falling since 1948. Now the movement to avoid hospital admission and shorten in-patient stay began to effect overall numbers.
Mind's Key Dates: 1954 "The first out-patient nurses were appointed at Warlingham Park Hospital, Croydon. Their duties included visiting out-patients, supporting in-patients who had been discharged, helping find jobs and accommodation for them, and being available to give advice at out-patient clinics or therapeutic social clubs."
Royal Commission on the Law Relating to Mental Illness and Mental Deficiency (1954 to 1957), under Lord Percy. 4.5.1954 First day of evidence: Ministry of Health and Board of Control (jointly). The National Council for Civil Liberties gave evidence on Day 22.
14.8.1954 to 21.8.1954 Third World Federation for Mental Health congress held in Toronto, Canada on the subject, "Mental Health in Public Affairs". In conjunction with this, The International Association for Child Psychiatry held an "International Institute on Child Psychiatry" on August 13th and 14th with the theme "Emotional Problems of Children Under Six"
Chlorpromazine. This drug started being sold in 1954 or 1955. In America it was called Thorazine, in the United Kingdom, Largactil. It was the first of the anti-psychotic phenothiazines. In a "psychotic", as opposed to a "neurotic" illness, the patient is held to have lost contact with reality. The phenothiazines controlled the symptoms of many patients without having the sedative effects of previous drugs. They controlled, not cured, and were sometimes called "chemical straight-jackets". Use of phenothiazines could make the established movement towards community care easier and less risky. Their effect, in this respect, became clearer with the introduction of long acting phenothiazines in the 1970s.
1955 onwards: Substantial sums of money for construction of new hospitals
1955 to 1962: "Community methods of treatment and ward management" established at Claybury Hospital in Essex.
| Kathleen Jones Lunacy, Law and Conscience. 1744-1845 begins her attempt to create a comprehensive history - The first since Daniel Hack Tuke's Chapters in the History of the Insane in the British Isles. See 1960 and 1972 |
Meprobamate (Miltown) launched in the United States in 1955. Effects described in Cosmopolitan as "safe and quick, Miltown does not deaden or dull the senses, and is not habit forming. It relaxes the muscles, calms the mind, and gives people a renewed ability to enjoy life" (source)
1.3.1955: Charity known (from 1979) as The Tudor Trust established by a gift of shares in the construction company, George Wimpey. (external source) In 2006/2007 it helped to fund the National Survivor User Network
2.9.1955 Christopher Mayhew, Labour MP and Television presenter, took the hallucinogenic drug Mescaline as part of a BBC Panorama documentary that was never broadcast. (weblink)
|
St David's Hospital Carmarthen 1956-1958
"I saw the doctor in charge and was foolish enough to tell him about my voices... I was... moved to a ... ward where patients were given insulin. Before moving I had read on the walls of the admission ward, notices about rights of appeal to the local M.P., but decided this would be a waste of time. ... the lady psychiatrist ... tried very hard to persuade me to sign a "voluntary form". This seemed a farce to me and I refused." "my shouting and yelling disturbed the other patients... I was forcibly stripped (except for a sanitary towel!), fighting and struggling, turned over and injected in the buttocks. The last I remember was someone saying "Sit on her". Then I passed out." "I was given about 4 E.C.T.s and about 4 to 6 weeks insulin. I said I was not going to physically fight... The (man) doctor said 'Doesn't she think she ought to feel grateful for having treatment?'" "I expected psychiatrists to talk to their patients". [See Stafford-Clark 1952] "I hardly ever saw (five times in two years) the man in charge of me, except passing in the corridor." Nurses did far more than they were paid to do, taking patients to their own homes, to the pictures etc. There was much kindness in this hospital, but it has taken me years to get over it, and the fear of going back is strong". |
|
A survey by the
Institute of Community Studies of over 80
Bethnal Green patients who were sent to
Long Grove, on the other side of London, in 1956 and 1957.
Enid Mills' interviews with them and their relatives show what happened, their reactions and impressions. She describes and discusses the difficulties of changing from a remote mental hospital system to a community service centred on local hospital such as the St Clement's Observation Unit (as it was before 1959). |
21.2.1956 Twenty-four year old Kathleen Rutty discharged from certification as a mental defective by the High Court, following a writ of habeas corpus from the National Council for Civil Liberties. Kathleen was out on licence from Rampton. Under her licence she was barred from having boy-friends, or going to the cinema or to a dance. Afterwards she said "Now there will be no more fear that someone will be looking over my shoulder to see if I break the rules" (Roxan 1958 pages 226 and 231). Peter Whitehead was discharged directly from Rampton in December, whilst a writ was before the High Court.
"there had been some publicity about Rampton... 1956 or 1957 - I'm not sure which... exactly what was going on I'm not sure... We were not, of course, allowed to see the write- ups, so I cannot be certain... A hockey match was put on" [for the journalists] and a whole lot of other bull... the institution fooled the News of the World, but not the Empire News" (Noele Arden 1977, page 82)
1957
The five episodes were 1.1.1957
"Put Away" - 8.1.1957 "Breakdown" -
15.1.1957 "Psychological Treatment" - 22.1.1957 "Physical Treatment" -
29.1.1957 "Your Questions Answered". The BBC monitored the effects of the
series, with a survey of viewer's attitudes before and after. This was
published in May 1957: The Hurt Mind: An Enquiry Into Some of the
Effects of Five Television Broadcasts about Mental Illness and its
Treatment. Audience Research Report, B.B.C. May, 1957.
In books, a mental patient could look you
straight in the eye
May 1957: Royal Commission on the Law Relating to Mental
Illness
and Mental Deficiency
(1954 to
1957)
reported
The key themes of the
Percy Report
were:
Percy wanted mental disorder to be a normal health issue. Part
of making it
normal was absorbing the Board of Control into the Ministry of
Health.
See do we need a
commission for
mental
health? for extracts.
8.7.1957 House of Commons debate on the Report of the Royal
Commission on the Law relating to Mental Illness and Mental Deficiency.
(Hansard).
"The second general mental health debate that there has been in this House
in the last twenty-seven years"
(Christopher Mayhew)
15.10.1957 Lifeline, with
David Stafford-Clark, first televised by
the BBC
(source). This series of programmes continued
to 1963. See 1959 -
1961 -
1962 -
Antidepressants Both Iproniazid (Marsalid), the first
Monoamine Oxidise Inhibitor, and Imipramine (Tofranil), the
first tricyclic antidepressant, were introduced into psychiatry in
1957
(Sargant and Slater
1963). The oldest Monoamine Oxidise
Inhibitor still in general use is Phenelzine (Nardil). William
Sargant (1960 onwards) suggested Nardil as the treatment of choice
for reactive depression. My memory suggests that these antidepressants were
coming into general use from about 1963.
1958
This is my much battered copy. Bought second hand from Allan Saville's
bookshop in Billericay - It was read and marked by fellow patients at
Ingrebourne in 1963 and later.
On the wireless, the
Archers
had featured a mental
hospital in 1954.
The Hurt Mind, in January 1957 was the
first television
programme to do with a mental hospital.
Christopher Mayhew
persuaded the
BBC to record this film. The camera's were
not allowed to
film patients' faces,
only their hands or feet. Christopher Mayhew was
the only one who was allowed to be filmed in person. [See
filmed demented]
looking you straight in the eye David Roxan's
Sentenced Without Cause told the story of
Peter Whitehead's successful struggle for freedom and the letter
writing campaign it fuelled amongst patients in Rampton.
Peter Whitehead's photograph, taken from a newspaper, was the
frontispiece.
|
|
1.3.1958 Freda Kendall Mew died, aged 78 at Whitecroft Hospital, Newport. She had lived there for almost sixty years. She had received no communications for very many years. |
|
1959
By 1959 only 12% of admissions to mental illness hospitals
were compulsory, and the trend was towards shorter periods of
in-patient
treatment and towards outpatient treatment. Whilst in 1930
there had been
practically no outpatients, by 1959 there were 144,000
attendances at
outpatient clinics. ( Maclay, W.S. 1961, p.98)
It is the above change that people are generally referring to
when they
speak of the therapeutic revolution of the 1950s.
|
Two years after the Percy Report, the 1959 Mental Health Act sought to create a legal framework within which the hospital treatment of mental disorder could approximate as closely as possible to that of physical illness. Its two main objectives were:
The 1959 Mental Health Act abolished the Board of Control. The 1959 Mental Health Act excluded promiscuity or other immoral conduct (alone) as grounds for detention. Section 4 (5) of the 1959 Act says: "Nothing in this section shall be construed as implying that a person may be dealt with under this Act as suffering from mental disorder ... by reason only of promiscuity or other immoral conduct"The 1890 Lunacy Act's grounds for confinement were that the person is a "lunatic, idiot or person of unsound mind". The 1959 Act uses a similar catch-all phrase: "any other disorder or disability of mind" - but the exclusion clause restricts it. Between the 1890 Act and the 1959 Act there was a great expansion in the power to confine people on moral grounds. This was under the 1913 Mental Deficiency Act which brought in the concept of moral defect and feeble minded. The 1957 Percy Report explained that, in practice, these concepts had been applied to people of normal intelligence who behaved unconventionally.
|
1959 Dr Russell Barton's Institutional Neurosis outlined the symptoms of a disease that often (but not always) developed as a result of being in an institution. (See dictionary)
In 1959 BBC Lifeline included programmes on Leucotomy "Surgery of the brain" - "Fear" - "Hypnosis" as a means of examining the unconscious - a discussion with L. S. Penrose about the "Mongoloid child" - and "Battle for the mind" about the techniques used by "orators as diverse as Hitler and John Wesley".
1960s
In 1960s there was a breakdown in the
taboo of
silence about mental health in the press and TV. Radio had sowed
seeds in 1954.
On television, the seeds were sown by
The Hurt Mind, in January 1957 and the
Lifeline
series from October 1957 to 1963.
Man Alive (1965? on) showed people with conditions
usually regarded as taboo talking about their own experiences. A famous
example in the press was an
Observer reporter, John Gale, who had a mental breakdown,
re-covered and
was re-instated to his position as a feature and news
reporter. He
described his subjective experiences in an
Observer
feature
in 1966.
Along with the new openness about mental illness came the
possibility of
open debate. In America,
The Myth of Mental
Illness
(1961), by
Thomas Szasz was published. It contained a theoretical basis
for arguing
that the states of mind described as "mental illness" are not
"illness" but
actions for which the mentally distressed person must be held
responsible.
[See
Mental Health and Civil
Liberties].
In France
Michel
Foucault's
Histoire de la
Folie told the history of unreason in an age of
reason in a way
that the English speaking world was not yet ready for.
(extracts)
-
In Italy Franco Basaglia (1924-1980) was in charge of the Gorizia
psychiatric hospital, near Trieste from 1961. He moved to
Trieste
in 1970.
"Psichiatria Democratica" was founded in 1974. The law that has
been called "Basaglia's law" was passed in
1978, the same year that a press conference caused a media
sensation by announcing the closure of Trieste's old asylum. Franco
Basaglia spoke at a Europe wide
"Alternatives to Mental Hospitals" conference, shortly before
his death. Members of Psichiatria
Democratica visited London, Sheffield and Manchester in
April 1984, stimulating the creation of "Asylum - a magazine for
democratic psychiatry" in 1986.
|
Kathleen Jones Mental Health and Social Policy
1845-1959. See 1955 and 1972
R. D. Laing's The Divided Self: An Existential Study in Sanity and Madness. Alfred Hitchcock's black and white film Psycho ... in a lonely hotel, vicious murders take place... "This young man... being dominated by an almost maniacal woman was enough.." In 1960 BBC Lifeline included programmes on "Hallucinations and delusions" (were Joan of Arc and Francis of Assisi suitable cases for psychiatric treatment?) - and "Obsessive compulsions" in which David Stafford-Clark spoke to former patients. |
April 1961: Official opening of Balderton Subnormality Hospital by Enoch Powell. [See policy]
|
4.5.1961 to 24.5.1961 An exhibition "Bristol in the Evolution
of mental health. 1696-1961" at the Royal West of England Academy - "the
first of its kind and scope to be held in Great Britain".
|
1961 Fourth World Federation for Mental Health congress held Paris.
In 1961 BBC Lifeline included programmes on Epilepsy "The sacred disease" (an electrical storm in the brain which still carries stigma and fears) - the problems of an autistic child, called "Schizophrenia in children" - and several programmes on the unconscious, especially as uncovered by hypnosis, including a woman who "meets and talks in the studio to people who exist only in her own mind" -
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January 1962: The Hospital Plan
Envisaged: cutting mental illness beds from 151,899 (in 1960) to 99,090 by 1975 increasing mental handicap beds from 59,840 (in 1960) to 63,620 by 1975 a "considerable" increase in psychiatric units in general hospitals - for short stay (three months or less) patients (outlined in circular HM(61)25) even greater reductions in the number of mental illness beds with alternative community provision. closure of thirteen of the existing 109 mental illness hospitals with 400 or more beds by 1975 possible closure of another nine of the large hospitals after 1975 leaving 87 to continue indefinitely. Most long term care would be in these old hospitals. The size of most would be reduced, but 25 would still have 1,000 or more beds by 1975. Oxford region planned wards for medium or long stay patients near District General Hospitals Sheffield Region planned to build Crookhill Hall, a "new psychiatric hospital at Conisbrough" (in the countryside outside Doncaster) for 420 patients and, later, "a long-stay psychiatric hospital at Sheffield", as well as (eventually) closing three of its nine large hospitals. [It changed its mind on Crookhill Hall (Hansard 1.3.1965)] |
|
26.9.1962 to 28.9.1962 Third British Congress on the History
of Medicine and Pharmacy. The papers for this were published as The
Evolution of Hospitals in Britain, edited by F. N. L. Poynter,
Librarian, The Wellcome Historical Medical Library, in 1964. The paper on
"Mental Hospitals", by Alexander Walk, M.D., D.P.M., "late Physician
Superintendent, Cane Hill Hospital, Coulsden" has been made available by
Jeremy Jones at
http://jeremyjones.0catch.com/EVOLUTMH.DOC - |
In 1962 BBC Lifeline included three programmes on "Children under stress"
| 1963 Richard Hunter and Ida Macalpine's Three Hundred Years of Psychiatry 1535-1860 "This book is...an endeavour to present original sources and through them trace clinical and pathological observations, nosologies, theories and therapies, and the care of the insane as well as social and legal attitudes to mental illness" (pp ix-x). Over 1,000 pages of documents, scrupulously indexed, each with a detailed historical introduction. Richard Hunter and his mother provided foundations for every other historian to build on. History subsequent to 1860 was covered, in a different way, by Psychiatry for the Poor in 1974 |
1963 UNAFAM (Union des Amis et Familles de Malades Psychiques) formed in France
|
1963 Second edition of
David Stafford-Clark's Psychiatry
Today published by Penguin, taking into account "important new
techniques" developed in the "ten years" since first publication
(1952).
The main change in the treatments section since 1952 is the new prominence
for drug treatment. The drugs discussed (not indexed) are
|
April 1963: Health and Welfare [The community care equivalent to the Hospital Plan.
June 1963 Mental Health Film Council founded (see above) "following a meeting called by the National Association of Mental Health to bring together "representatives of organisations involved in the use or distribution of mental health films". The First Chairman was Kenneth Robinson MP. Became Mental Health Media in the 1990s - website history
| "Because general paresis is now so easily treatable by neurologists, it is a pleasure to omit the whole chapter relating to it from the present edition. We look forward to seeing how an efficient physical treatment such as penicillin can put an end to a disease which caused so much mental illness and so much misery for generation after generation. We are sure that this pattern will be repeated again and again, as more and more mental disorders become simply and easily treated by medical methods" (Sargant and Slater 1963), page ix |
15.10.1964 Labour Government
4.11.1965? First Man Alive on BBC Televison. People sometimes allowed to speak openly about taboo subjects such as agoraphobia - phobias - suicide
1966 statistics
In 1966 there were 107 mental illness and 66
mental handicap "hospitals and units with 200 or more beds".
(Hospital Statistics 1975, pp 5+7).
In 1966
Borocourt Subnormality Hospital
was a well
equipped one. Few subnormality hospitals had anything but
Victorian type
institutional wards, but the largest Borocourt one had only 30
beds. In the
late 1960s Oxford Regional Health Authority spent 1.25 million
pounds at
Borocourt on nine completely new wards, upgrading old wards
and building a
school, a gymnasium and a workshop.
|
The Mental Health Association of Ireland began in 1966, with this logo. It kept the logo when it became Mental Health Ireland. But, in 2008, it decided the logo must change. The World Federation for Mental Health held is congress in Dublin in 1995. |
12.1.1966 BBC Man Alive programme "The Frightened Ones" about agrophobia, in "which victims talk about their illness and a doctor and a psychiatrist discuss what can be done for them".
The Observer Colour Supplement began a three part coverage on changing attitudes to madness down the centuries. The third part was John Gale's personal account. As it became acceptable for professional writers who had been mental patients to describe the experience in print, so some people's minds turned to the possibilities of listening to patients in mental hospitals.
| 1967 | Declaration of a summer of love |
Stanley Solomon Segal, Headmaster, Franklin Delano Roosevelt School, London. No child is ineducable - Special Education - Provision and Trends Commonwealth and International Library. Pergamon Educational Guides. 332 pages.
3.5.1967 Man Alive programme "Living with Fear" talked to "some of the half million people in Britain who suffer from apparently illogical phobias - including fear of birds, dogs, visitors and leaves."
24.5.1967 Man Alive programme "A case of suicide" looked at "how people who commit suicide might have been helped to stay alive by those near them and those who have had to live with the suicide of someone near to them."
| 1967-1969 HOSPITAL SCANDALS: |
The 1960s concentrated attention and resources on the treatment of short term mental illness. There was a corresponding neglect of long-stay patients, along with a failure to implement the community care side of the new policies. The scandals of the late 1960s and 1970s shone a light on the consequences.
1967 Sans-Everything - A Case to Answer
1968 Report of Government Inquiry into the Sans
Everything allegations
Sans-Everything was a collection of articles edited by Mrs Barbara Robb that dealt with the condition of elderly residents in institutions. It included accounts of individual cases of ill-treatment in psychiatric and geriatric care. The official report into its allegations substantiated many of them.
The establishment in 1972 of a Health Service Commissioner ("Ombudsman") to investigate complaints of individual ill-treatment, followed suggestion made by Professor Abel-Smith in Sans-Everything
July 1967: Allegations of misconduct at Ely
26.2.1968
Shelton Hospital Fire
December 1968 Police investigate Farleigh Hospital
March 1969 Ely Hospital Inquiry Report
June 1970 Farleigh Hospital Inquiry appointed
November 1970 Farleigh Hospital Inquiry Report signed
February 1971
Whittingham Hospital Inquiry appointed
April 1971 Farleigh Hospital Inquiry Report presented
October 1971 Whittingham Hospital Inquiry Report signed
February 1972 Whittingham Hospital Inquiry Report published
5.7.1972 Fire at Coldharbour
The light shone into mental subnormality (handicap) hospitals with the publication of official reports into Ely Hospital, Cardiff, in 1969; Farleigh Hospital, Somerset and Coldharbour Hospital, Sherbourne, Dorset, in 1971.
Richard Crossman, Secretary of State at the time, responded to Ely as a personal challenge. He launched a programme of additional resources to the mental handicap hospitals, established (November 1969) a Hospital Advisory Service to visit hospitals - especially long-stay ones - and advise him on their condition, and started a re-appraisal of plans that eventually surfaced as the white paper Better Services for the Mentally Handicapped