The administration of insanity in East London, 1800-1870

The policies and operational management practices for mentally dependent people devised by the Parish Vestry Trustees of the Poor and the Boards of Guardians in East London are examined for the period 1800 to 1870. The study is set within the rapidly changing socio-demographic context of an increasingly overcrowded, impoverished, mobile local population comprising the parishes in the Tower Division of the Ossulstone Hundred and for the old poor law period, the City of London. Documentary sources include the records of the Vestries, Trustees and Overseers of the Poor, the Boards of Guardians, the archives of the County Lunatic Asylums at Hanwell and Colney Hatch, contemporary records of the Metropolitan and later national Commissioners in Lunacy, the Poor Law Commission and its successor the Poor Law Board and local archival materials from the Borough Archives of Hackney and Tower Hamlets. A wealth of institutions for the insane had been established locally in the eighteenth century and earlier. Large privately owned pauper lunatic asylums and huge pauper farms determined an institutional solution to managing insanity at an earlier date than was generally the case elsewhere in England. The old poor law period was characterised by a flexible, individual approach to managing the insane using a mixed economy of private and public placements, the parishes showing considerable variation in their choice of placement. This diversity of approach between neighbouring districts of Boards of Guardians continued after the Poor Law Amendment Act of 1834, there being substantial continuity of practice before and after the Act in some districts. Financial and legal incentives gradually changed the placement policies of the Guardians, encouraging the use of the public asylums. Relations between the County Asylums and the Guardians, seen through the negotiations between Guardians officers, doctors and asylum staff, were often conducted through the language of dangerousness and the need to choose the most economic alternative. The Commissioners in Lunacy and the Poor Law Commissioners had only a modest impact on local policy and quality of local provision in workhouses but the culture of non-restraint and the moral stance of the Lunacy Commissioners and Hanwell Asylum may have influenced some Guardians policies. The Guardians lost much of their responsibility for the care of the insane when the Metropolitan Poor Act of 1867 gave birth to the Metropolitan Asylums Board and the new imbecile asylums. It is argued that the move away from local, individual planning and purchasing for each case to centralised, comprehensive planning for categories of classified paupers was not necessarily in the best interests of insane paupers

Civilian Lunatic Asylums During the First World War

This open access book explores the history of asylums and their civilian patients during the First World War, focusing on the effects of wartime austerity and deprivation on the provision of care. While a substantial body of literature on ‘shell shock’ exists, this study uncovers the mental wellbeing of civilians during the war. It provides the first comprehensive account of wartime asylums in London, challenging the commonly held view that changes in psychiatric care for civilians post-war were linked mainly to soldiers’ experiences and treatment. Drawing extensively on archival and published sources, this book examines the impact of medical, scientific, political, cultural and social change on civilian asylums. It compares four asylums in London, each distinct in terms of their priorities and the diversity of their patients. Revealing the histories of the 100,000 civilian patients who were institutionalised during the First World War, this book offers new insights into decision-making and prioritisation of healthcare in times of austerity, and the myriad factors which inform this

Rest and restitution : convalescence and the public mental hospital in England, 1919–39

Previous histories have tended to look beyond the asylum for innovations in early twentieth-century mental healthcare. In contrast, this thesis appraises the mental hospital as the nexus for a new approach to convalescent care and makes the case for a more integrated conception of institutional and community care in the interwar period. Despite a concentration of convalescent facilities in certain areas, this study argues that the period between 1919 and 1939 witnessed the emergence of a more standardised and coordinated model of care that traversed institutional boundaries. Consequently, it challenges a prevailing view that sees asylum care as separate from developments in borderline care in this period. It is demonstrated that public mental hospitals after 1919 widely added new convalescent villas within their grounds, whilst voluntary organisations diversified and extended their community-based cottage homes. This thesis explores the reasons for this expansion and seeks to explain the functions it served those who planned, managed and utilised mental convalescent homes. It is argued that those with professional interests in the mental hospital focused on the „modern‟ convalescent villa partly as a strategic response to the low status of mental hospitals in the 1920s, as well as to alleviate overcrowding, and oversee recovery in managed and healthful environments. The spatial and rhetorical connection between the admission hospital and the convalescent villa allowed these interests to claim they formed part of a broader movement of mental hygiene and early treatment. In contrast, patient representations of cottage homes offer an alternative perspective of convalescence as a holiday and break from social demands. Particular attention is paid to the case of the London County Council. The analysis focuses on descriptions of convalescent homes found in organisational records. These are compared with plans and photographs to make sense of the uses such homes served

An evaluation of an eccentric : Mathew Allen MD, chemical philosopher, phrenologist, pedagogue and mad-doctor, 1783-1845.

This thesis re-evaluates the early nineteenth-century treatment of insanity and evaluates, for the first time, the work amongst the insane of Matthew Allen MD It is written in the form of a biography, the primary source of which is the unpublished manuscript Memoirs of Oswald Allen held in the York Reference Library. Other relevant documents and letters have been found in the Essex County Record Office and in archives in Lincoln, Northampton, Dundee, York and Holborn. A variety of literary sources in libraries across the country and books which Allen wrote have been used. The thesis is eight chapters in length and divided into four chronological parts. It contributes to the history of psychiatry at an important, but often neglected period and provides details of a man whose name has been previously known only because of his connection with major literary figures. For the first time information is brought together to reveal his contribution to the treatment of the insane and his involvement with other aspects of culture. He is revealed as a pioneer rather than a genius. He sought for causes of insanity and effective counteractions and showed his increasing belief in psychological over physical causes He maintained faith in the efficacy of Moral Treatment even when under pressure from his colleagues to focus on other stratagems. Allen's childhood and youth were affected by an obscure religious sect. His personality was deeply flawed. He was gaoled twice and suffered two bankruptcies. He nearly cured one poet while bringing another to the verge of mental collapse. His personal struggles aided his understanding of insanity but finally led to his own professional downfall. The conclusion is that the principles for which he stood in treating the insane were early, but genuine, precursors to modem psychiatric practice, often obscured by later nineteenth-century attitudes and treatments

Hysterical Women: Moral Treatment of Female Patients in the Fremantle Lunatic Asylum, 1858 – 1908

From 1858 to 1908, at least 452 women were admitted to the Fremantle Lunatic Asylum. Through an exploration of nineteenth-century theories of moral treatment, new insights into female patient experiences will allow for greater understanding of Fremantle’s working-class women in the nineteenth and early twentieth centuries, including those behaviours that were considered insane. The appraisal of moral treatment techniques also allows for a new investigation into the enforcement of nineteenth-century, socially-accepted ideas of womanhood. In its three parts, using patient records, case books, and other sources, this thesis examines understandings of women’s insanity as they evolved in nineteenth-century Britain. It determines how Western Australia responded to such understandings in the provision of care to “insane” women. It also interrogates evidence of patient treatment in the Fremantle Lunatic Asylum in order to determine how moral treatment was implemented and experienced in the care of female patients. Finally, this thesis reveals that the application of moral treatment was used without regard to patient circumstance and diagnosis, and had varied outcomes for women. Evidence within this thesis is explored through a feminist lens. I make a unique contribution to scholarship through analysis of new data, and socio-biographical case study investigations of the women admitted to the asylum. The thesis creates new understandings between female lunacy, morality, and the expectations of womanhood in nineteenth-century Western Australia

Managing the Mad: Lunacy Provision and Social Control in Kent, 1774–1874.

PhD ThesesThis thesis examines lunacy provision in Kent between 1774 and 1874 from the perspective of the anti-psychiatrists of the 1960s and 70s. It is a regional study that seeks to demonstrate the coercive bedrock of the discipline of psychiatry as evident from the treatment and care of the insane in previous centuries. Similarities and differences between local and national circumstances are investigated as are the manifold forms of the mixed economy of care on offer: private, public, military, voluntary and community-based. Four of the seven chapters are devoted to the origins and workings of the county lunatic asylum at Maidstone which opened in 1833 and was until 1875 the main receptacle for pauper lunatics in the area. Throughout I juxtapose the lunacy reformers’ avowed motive of humanitarian concern with the brutal everyday reality of social control. Citing extensively the works of writers such as Foucault, Laing, Goffman and Szasz, I contend that the Kentish authorities responsible for lunacy provision were more preoccupied with modifying deviant behaviour than alleviating suffering: correction, and with it often custody, were more important than cure and care. In line with the stance of the original anti-psychiatrists I hold both modern psychiatry and its eighteenth and nineteenth century antecedents to be essentially morally compromised, purporting to represent the individual patient’s best interests whilst serving the state’s agenda of order and social conformit

The Cost of Insanity in Nineteenth-Century Ireland

This open access book is the first comparative study of public, voluntary and private asylums in nineteenth-century Ireland. Examining nine institutions, it explores whether concepts of social class and status and the emergence of a strong middle class informed interactions between gender, religion, identity and insanity. It questions whether medical and lay explanations of mental illness and its causes, and patient experiences, were influenced by these concepts. The strong emphasis on land and its interconnectedness with notions of class identity and respectability in Ireland lends a particularly interesting dimension. The book interrogates the popular notion that relatives were routinely locked away to be deprived of land or inheritance, querying how often “land grabbing” Irish families really abused the asylum system for their personal economic gain. The book will be of interest to scholars of nineteenth-century Ireland and the history of psychiatry and medicine in Britain and Ireland