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

Abstract

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