Mental Health History Timeline
A Middlesex University resource by Andrew Roberts

Mental Health History Timeline

 
A mental health history including asylum and community care periods, with links to Andrew Roberts' book on the Lunacy Commission and other mental health writings, and the asylums index and word history. Centred on England and Wales, it reaches out to the rest of the world with links to the general timeline of science and society, America timeline, crime timeline, and the (embryo) sunrise, earthcor, and local London timelines. Seeks to include views from mental illness and learning disability (consumers, patients, users, clients) along with views on madness and disability. Also bibliographies and biographies of commissioners
introducing the lunacy commission lunacy

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Therapeutic periods
Genesis of asylums From 1377
Asylum Care From 1840
Community Care From 1940s

Jump to: pre-history   historical times   ancient Greece   1188   1285   1290   1350   1377   1403   1409   1464   1470   1495   1500   1518   1530   1536   1538   1546   1547   1557   1559   1570   1600   1601   1611   1615   1621   1630   1636   1649   1654   1655   1656   1660   1670   1690   1692   1696   1700   1713   1714   1723   1725   1728   1730   1738   1744   1746   1749   1751   1752   1754   1761   1762   1763   1765   1766   1767   1770   1774   1776   1777   1782   1784   1786   1787   1788   1789   1791   1792   1794   1796   1797   1800   1801   1806   1807   1808   1810   1811   1812   1813   1814   1815   1816   1817   1818   1819   1820   1823   1824   1825   1826   1827   1828   1829   1830   1831   1832   1833   1834   1835   1836   1837   1838   1839   1840   1841   1842   1843   1844   1845   1846   1847   1848   1851   1852   1853   1857   1858   1859   1860   1863   1864   1867   1870   1871   1872   1873   1876   1877   1880   1881   1882   1883   1884   1885   1886   1888   1890   1892   1895   1900   1905   1909   1910   1911   1912   1913   1914   1919   1920   1930   1933   1939   1940   1946   1947   1948   1950   1951   1953   1954   1955   1957   1958   1959   1960   1961   1962   1966   1967   1968   1970   1971   1972   1973   1974   1975   1976   1977   1978   1979   1980   1981   1982   1983   1984   1985   1986   1987   1988   1989   1990   1991   1992   1993   1994   1995   1996   1997   1998   1999   2000   2001   2002   2003   2004   2005   2006   2007

The government of asylums
1774 Physician Commission A local government unit
1828 Metropolitan Commission A local government unit
1842 Inquiry Commission Transitional
1845 Lunacy Commission A central government department
1913 Board of Control A central government department
1959: merged into Ministry of Health

Pre-history

Katherine Darton's Notes of the history of mental health care
(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."

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".

Historical times

The Disability Social History Project's
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

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
begins with the feigned madness of David who became king of the Jews (9th century BC)

Nebuchadnezzar or Nabonidus (whichever), in the 6th century BC,
is the earliest in Joan's mad monarchs series

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

Ancient Greece and Rome

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.

European hospitals heritage (PAPHE) chronology begins in 912
Michael Warren's health in Britain chronology
begins in 1066

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

1100 Date given for "an asylum exclusively for sufferers from mental diseases at Mets" (Metz, northern France) (Catholic Encyclopedia)

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

Noteworthy events in American Psychology begins with the founding of St Mary of Bethlem on 12.10.1247. (Not, of course, in America, and not receiving distracted persons until 1377). It reaches America in 1650

1284 Al- Mansuri Hospital, Cairo opened. At some time,
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"

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.

A timeline of Learning Disability Nursing starts with the Royal Prerogative

1292

"A lunatic who had burned a man's house was convicted by the justices but released on their authority."

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.

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)

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]


1377

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.

History of Bethlem before it was used for lunatics:

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."'

Bedlam weblinks

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

Zilboorg writes of some sixteenth century writers as "The first psychiatric revolution" and (Ackernecht 1968, p-) writes of the "magnificent developments of psychiatry" in the 16th century. The writers are: Cornelius Agrippa (1486-1535), Delia Porta, Cardano, Paracelsus, Lemnius, Reginald Scotus and Johannes Weyer (1515- 1588). Their achievement was to offer a natural alternative to ideas of demonic possession. Ackernecht argues that "the increase of witch hunting" and the natural (scientific) alternatives "are aspects of the Renaissance" due to the disintegration of mediaeval society.

Science Time Line 1518

1518
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.

External link to Royal College of Physicians history
Madhouses: See 1754

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)

1528: Copernicus

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:

"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

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".


1547

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

1377 1559

Bedlam shown on the earliest surviving map of London. This is a copper plate engraving of Moorfields, discovered in 1962, and bought by the London Museum.

The map is in pictures and was probably drawn in 1558 by the Dutch artist Anthonis van den Wyngaerrde in 1558, and engraved by Franciscus Hogenberg in 1559

[External Link to copy on the Rootsweb site. There is a clearer image of Bedlam on the London Museum web exhibit (archive copy)]

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

Ackernecht (1968, p.29) speaks of "magnificent developments of psychiatry" in the sixteenth century, fading out on the 17th. His judgement appears to be based on Michel Foucault's claim that absolutist governments resolved a social crisis by incarcerating all the poor.

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

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)

1621

visit Charles and Mary Lamb 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 France
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 see America
1655

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)

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.

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.

France 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)

1660

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)

Different dates: Sunday 6.1.1661 - Monday 7.1.1661 In the night another 5th Monarchy rising headed by Thomas Venner. (see Pepys)

1665

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]

1666

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.

blind mania
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.

Pay to View Insanity

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."

In Salem, a Quakeress known for signing with her nakedness,
is found to have a distempered mind
America

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.

Old Manor House. Clerkenwell Green Clerkenwell Green is on the road from London to Islington. Here, in 1672, James Newton cured his first patient "a woman, put to me by the churchwardens... who was much given to swear and tear, having a very sore breast, and many other grievous sores made by binding her in bed with cords, though she was with weakness not able to stand without hold, yet was she and all her sores perfectly cured in three weeks." By 1678, Newton had established a madhouse in the former Manor House of Clerkenwell. The "Madd House" is shown on Stow's 1720 map just on the edge of the built up area of London. (Hunter, R.A. and Macalpine, I. 1963 pp 200-201) See 1750

1679

Habeas Corpus Act

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.

Eighteenth Century Asylums

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:

"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."

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:

"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)

1713

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]

1723

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

1738

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

1744 Vagrancy Act

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

1746

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)

1751

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]

1758

"A Treatise on Madness By William Battie MD. Fellow of the Royal College of Physicians in London, And Physician to St Luke's Hospital"

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.

Mencap's history of changing attitudes
begins by discussing attitudes before and
after the industrial revolution

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.

1763

The 1774 Madhouse Act was based on the recommendation of the 1763 Select Committee of the House of Commons on Madhouses that history of the 
lunacy commission

"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.

1766

Manchester Lunatic Asylum opened

1767

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.]

1774

history of the 
lunacy commission The 1774 Madhouses Act established a
commission of the Royal College of Physicians
summary of the 
commissions
to license and visit private madhouses in the
London area. (see law)

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).

1777

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

St. Bonifacio, Florence opened. Described as "one of the first sites of humane care of people with mental illness". The first director, Vincenzo Chiarugi (born 20.2.1759) had been appointed by the Grand Duke Leopoldo I to plan the new hospital. (Italian link). (Ackernecht)

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"

insanity The king's behaviour (which we know about now) was what the layperson would call insane. The doctors argued that it was delirium - deranged behaviour produced by fever, and, therefore, not insanity. I suspect the public just thought the king had been very ill. It would be interesting to know when, and to what extent, a public perception formed of the king as having been mad. Even on his death, in 1820, one has to read the long obituary in the Annual Register very carefully to glean that his illness included any serious disturbance to his mental faculties. If you have any thoughts or evidence on this issue, please share them with me


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.

France 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

John van Wyhe's History of Phrenology on the Web begins in the early 1790s with Franz Joseph Gall's system of organology and brain anatomy in Vienna. (See Combe's Elements of Phrenology in 1824)

1790

"psychiatry as an organised, independent discipline dates back only as recently as the last decades of the 18th century" (External link to Henry Rollins' article "Psychiatry at 2000 - a Bird's Eye View"

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.

Parliament backed the scheme, 
as a prison plan, in 1794. 
Foundations were laid. But, 
in January 1803, Bentham was told
the Government could not find the funds
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


1792

Liverpool Lunatic Asylum opened

Daniel Hack Tuke claims that the only asylums for the insane open in England in 1792 were:
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.


1.2.1793 France declared war on Great Britain
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.
1794

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

Mary Lamb 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.

1797

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.

Dr John Mayo was Secretary to the Physician's Commission from 1797 to 1807. He was the first physician to be Secretary. Mr Wall the previous Secretary, was probably a lawyer. The Commission was subservient to the Westminster Courts and designed to facilitate the operations of Chancery, and enlarge its power. Keely, T.S. 1944 says that the staff involved in the Lord Chancellor's lunacy jurisdiction in 1798 included a Secretary of Lunatics a Clerk of the Custody of Idiots and Lunatics and five Commissioners for Lunatics

1798

The Education section of The Label Game begins in 1800 with Victor, the Wild Boy of Aveyron, and the efforts of Jean-Marc- Gaspard Itard to apply the ideas of John Locke and Abbé de Condillac to his education.
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]

1801

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.

April 1803 Resumed war between Britain and France
External link on the threat of invasion - archive. Work began on Fort Pitt, between Chatham and Rochester, in 1805 and on Fort Clarence in 1808 (external link). Which, in retrospect, seems rather late - Coastal defence of Britain seemed unnecessary after 1812. After the war, Clarence, and then Pitt, successively became military lunatic asylums.

Referring to about 1806, John Haslam said that naval and army lunatics were "pouring into" Bethlem as a result of the war. In 1808 the Navy's lack of provision for clothes at Hoxton House meant (some of?) its lunatics wore only a piece of blanket.

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)

One of the Surrey physician visitors was Sir Lucas Pepys. It seems to have been sometime in the following three years that Alexander Morison was appointed visiting physician

1808

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.

Dr Richard Powell was Secretary to the Physician's Commission from September 1808 to 1825, replacing John Mayo

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

Heinroth appointed associate professor of psychic therapy at Leipzig University. Like some other German romantics, he regarded insanity as God's punishment for sin.
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.

1812

Mixed reactions
to the
assasination: Coleridge and Charles Lamb
Monday 12.5.1812, about 5.15pm, Assassination of Spencer Perceval, the Prime Minister, by John Bellingham, an alleged lunatic who was rapidly hanged (Monday 18.5.1812). At his trial (Friday 15.5.1812) the arguments for his insanity were dismissed without time for witnesses to be called. With luddite attacks internally and war with Napoleon externally, dramatic action was necessary. William Cobbett was watching the crowd as Bellingham was hanged

"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"

Bellingham had come to London from Liverpool, where he lived with his wife, Mary, and three children. He married Mary Nevill, (from a Quaker family), about 1803. Funds were raised for her support after the execution.

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.

The St Neot's Assassin: BBC Cambridgeshire external link

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.

1813

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]

1814

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 Norris
7.6.1814 7.6.1814 Patient, William 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

1817 Friend's Asylum, Philadelphia opened in imitation of the Retreat America

Jonathan Martin, the mad Methodist, attempted to shoot a Church of England Bishop. See 1829

1818


English Heritage: Royal Naval Hospital, Haslar, Gosport, built 1745-1762 as the first hospital for Royal Naval sailors

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). In 1844 its principal medical officer was Sir W. Burnett, M.D., and it had 98 patients, 29 of whom were commissioned officers. The Naval Hospital opened at Yarmouth, in Norfolk about 1811 was used as a naval lunatic asylum from 1854, and enlarged substantially in 1863.

Kathryn Morrison 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

Chatham Royal Military Asylum opened at Fort Clarence, Chatham (Rochester, Kent). (external link - archive) . In 1844 its principal medical officer was Andrew Smith M.D., and it had 70 patients, 21 of whom were commissioned officers. In 1847, about 20 lunatic soldiers were moved from Fort Clarence to Fort Pitt. (1867 List shows the Military Lunatic Hospital at Fort Pitt). The inmates were moved to a new army lunatic asylum at Netley in 1870. (external link). Parry Jones says that from 1846 to 1854 the Naval Hospital at Great Yarmouth was used as the Royal Military Lunatic Asylum. In 1854 its 19 officer inmates were moved to Coton Hill and the 69 soldiers and five women confined to Grove Hall

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

1821

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

Dr Thomas Turner was Treasurer to the Physician's Commission from 1822. Turner became a Metropolitan Lunacy Commissioner in 1828 and a Lunacy Commissioner in 1845, eventullly retiring, aged 82, in 1855.

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.

The first Gloucester Asylum 24.7.1823

Gloucester County Asylum
opened

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

Dr John Bright was Secretary to the Physician's Commission from 1825. Replacing Richard Powell. Bright became a Metropolitan Lunacy Commissioner in 1828.

Siegburg asylum, near Bonn opened. This was the base of Dr Jacobi who wrote on the management and construction of asylums. Other asylums opening in central Europe in the 1820s were Prague (1822), Dusseldorf (1826), Hildesheim (1827) and Colditz (1829)

1826

The autumn of 1826 saw the onset of John Stuart Mill's "dull state of nerves" which was cured by poetry.

1827

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.

Science Time Line 1828

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

history of the 
lunacy commission The 1828 Madhouses Act established:
The Home Secretary's Metropolitan Commission:
summary of the 
commissions

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.

Biographies of Unpaid and Medical Commissioners begin in 1828
The Chart of the Metropolitan Commissioners begins in 1828

1829

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

history of the 
lunacy commission The 1832 Madhouses Act established:
The Lord Chancellor's Metropolitan Commission:
summary of the 
commissions

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.

1833

1.1.1833 Kent County Asylum, Barming Heath, Near Maidstone opened

1834
history of the 
lunacy commission Under the 1834 Poor Law, workhouses for paupers were established in every part of England and Wales. In part, the growth of asylums and other institutions was a consequence of this Act, as many of those who became settled residents of the workhouses were children (schools needed), sick (hospitals needed), mentally ill or with a learning disability (lunatic asylums needed) or old (old people's homes needed).

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.

Statistics: Colonel William Henry Sykes, a founder member of the London Statistical Society, became an Honourary Metropolitan Commissioner in September 1835. A considerable interest in the scientific (statistical) analysis of the death rates in asylums developed over the following years.

1836

August? 1836 A Madman's Manuscript in Charles Dickens' The Pickwick Papers

1837

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

1838

France "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). the train from
London
The all rail route of 206 miles London to Liverpool took just over eight hours and this speed of travel made the national inquiry into the treatment of pauper lunatics, in 1842, possible. The railways and the electric telegraph, taking messages along the side of railway line may be the main reason why legislation in 1828 was for a Metropolitan Commission in Lunacy, and in 1845 for a national commission. (See reciprocal development)

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.



ASYLUM CARE 1840s:

In the hungry-forties of the 19th century many believed that by moving mentally unstable people from a community disturbed by poverty, depravity and social unrest to a closed, humane, but disciplined environment in a lunatic asylum early in the development of their insanity they could be cured and the accumulation of chronic lunatics on poor relief halted. 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

"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"

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

The Madhouse System published as a pamphlet by Richard Paternoster. Much had already been published as newspaper articles.

A community for epileptics founded at Bielfeld, in Germany.
This became a model for similar communities. (Jones and Tillotson)

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, about the 1780 no-popery riots, began to be published weekly in the Clock. Barnaby has charactersitics of idiocy and lunacy. In chapter forty seven, his mother and Barnaby met a "country gentleman" in the "commission of the peace" who tries to horse-whip Barnaby. The widow pleads that "her son was of weak mind".

"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
America

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.

history of the 
lunacy commission The 1842 Licensed Lunatic Asylums Bill proposed a
Barristers' Commission
summary of the 
commissions
as it was thought that county licensing and visiting was defective, it was proposed that the two legal commissioners should visit and report on county houses supplementary to the county visitors. The House of Commons rejected this proposal and an amended bill became the Inquiry Act.

history of the 
lunacy commission The 1842 Inquiry Act established the
Inquiry Commission:
summary of the 
commissions
Two medical and two legal commissioners were added to the commission, and the number of honorary commissioners further reduced. No new commissioners were appointed during the Inquiry. One of the new medical commissioners was a psychiatrist, the other a medical statistician.

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.

1843

France 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.

1844

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.

1845

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

history of the 
lunacy commission Two linked Acts were introduced by Lord Ashley: summary of the 
commissions

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).



history of the 
lunacy commission
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.

1846

1.8.1846 Oxfordshire and Berkshire County Asylum opened

Haydock Lodge leaflet 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]

this is not a passage that made Jayne Eyre my favourite novel

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

1848
Journal of Psychological Medicine and Mental Pathology, edited by Forbes Winslow (1810-1874). Quarterly?. 1848-1860.
Twelfth night dancing at Hanwell The first number was quoted in The Illustrated London News for 15.1.1848.

"Seven years have elapsed since the experiment of non-restraint has been fully tried in the Hanwell Asylum; and Dr Conolly, in the spirit of a Christian philosopher, thanks God, with deep and unfeigned humility, that nothing has occurred during that period to throw discredit on the great principles for which he has so nobly battled".

Twelfth night dancing at Hanwell
The Illustrated London News feature said that "Dr Conolly has just published a very interesting volume on The Construction and Government of Lunatic Asylums, and Hospitals for the Insane

Wednesday 1.3.1848 Somerset County Asylum opened

"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.

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 Derbyshire County Asylum opened

19.9.1851 Wiltshire County Asylum opened

1.12.1851 Monmouth, Hereford, Brecon and Radnor County Asylum opened

1852

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

1853

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

Society physician Dr Thomas Turner retiring, aged 82, from the Lunacy Commission, was replaced by a second asylum surgeon James Wilkes. Two asylum doctors and one society physician became the norm for the Commission.

District Asylums opened in Ireland at Mullingar and Sligo

1857
France 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.

"Hereditary taint" was used for a family in which at "intervals almost every form of madness appeared" in Wilkie Collins short story The Queen of Hearts (page 34). This was published as a collection 1.10.1859, but the original story may have been published in 1855. (external link)

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

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.

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.

I am not convinced that the medical and lunacy commissioners (Dr Eskell and Mr Abbott) in Hard Cash are modelled on actual commissioners. But if you want to speculate, consult the charts of commissioners
Yahoo weblinks: Charles Reade (1818-1884)

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.

Wednesday 10.2.1864 Date on a very long letter from Rosina Bulwer Lytton which appears to have been sent to Charles Reade. In 1880 it was published (she claimed without her permission) as the core of A Blighted Life, telling the account of her conflict with her husband and her confinement.

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.
Pathology laboratories: USA 1878 - Claybury

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.

1866

District Asylums opened in Ireland at Castlebar and Letterkenny

1867

1867 Metropolitan Poor Act

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.

The Metropolitan Asylums Board was abolished in 1930,
when its functions were transferred to London County Council

April 1867 The Lancet published an article by Joseph Lister (1827-1912) On the Antiseptic Principle of the Practice of Surgery. [Copy at Bartleby]

1868

District Asylums opened in Ireland at Ennis and Enniscorthy

1869

District Asylums opened in Ireland at Downpatrick and Monaghan

1870

"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)

[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)

"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

External links to biographies of Alfred Woodhurst and James Woodhurst of East London, who were admitted to Middlesex asylums.

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.

Music therapy at Worcestershire County Asylum

1879

Reverend Henry Hawkins and friends start the After-care Association for Poor and Friendless Female Convalescents on Leaving Asylums for the Insane. (external link to history). See 1894 - 1912 - 2005

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.

1882

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

1883

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 Pauper Lunatic Asylum
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.

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.

1885- 1886 Freud in France

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.

"all that which the keeper of the asylum has to regard is whether the statements which are made in the order are such as to justify him in exercising the powers given to him under the statute, of detaining in confinement the person committed to his charge."

The 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.

France 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.

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)

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 incurable. See Claybury figures for numbers discharged recovered (as distinct from dead) in 1901- 1902. The insane were sent to even larger asylums for custody, to be protected from exploitation whilst society was protected from them.

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

1890 Lunacy Act.

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, 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 p[atients in 1911. - (See 1927 list)

1891

5.6.1891: Census: The column asking about disability had a different heading.

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

1893

Claybury in Essex, the first compact arrow asylum, opened

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.

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

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

1899

"The Defective and Epileptic Children 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)

1900

beautiful baby 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"



31.3.1901: Census: The column asking about disability had a different heading.

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.

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)

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.

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.

Hidden

12.7.1905 Birth of John, youngest son of George (later King George 5th) and Mary. John died, aged thirteen on 18.1.1919. Prince John suffered from epilepsy and from learning difficulties that suggested he was mentally deficient. His existence was kept secret and, from 1916, he was cared for at Wood Farm, Wolferton, near Sandringham, Norfolk by a nurse Mrs 'Lalla' Bill and a male orderly. In February 1996 (?) a photograph of John wearing a sailor suit, holding hands with Queen Mary and his sister Mary, was discovered in a photograph album and later published in British newspapers. An internet biography of him was published by Britannia later in 1996 and a romanticised drama of his life The Lost Prince, written by Stephen Poliakoff, for BBC1 Television was broadcast in January 2003.

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)

1908

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.

1909

"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)

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."

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.

"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)

On 14.9.2004 a statue of Churchill in a straitjacket was used to protest against the stigma of severe mental illness.
Eugenics and sterilisation in the USA
meaning of eugenics.

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

After care association renamed Mental After Care Association for Poor Persons Convalescent or Recovered from Institutions for the Insane [I am not clear when it became just the Mental After Care Association]

1913 Asylums built under the 1913 Mental Deficiency Act 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.


the great war for civilisation
1914-1919

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.
Freud and War Neurosis (A Freud Museum link)

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)

The asylums during the war

Many asylums were used as troop hospitals. (external link: Military Hospitals in the United Kingdom)

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...
Are made of darkly stained or clouded glass:
...
The saddest crowd that you will ever pass.

But still we merry town or village folk
Throw to their scattered stare a kindly grin,
And think no shame to stop and crack a joke
With the incarnate wages of man's sin."

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 poem suggests that it also re-inforced belief in degeneration theory as the overall causal explanation.

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 fro the insane and removing much of the horror that still feeds the imagination of the lay public" (pages 143-144)

influenza epidemic "flu pandemic" America
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)

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




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.

See 1903 and 1922

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
See 1840s, 1890s, 1940s

1919 1920s 1930s
In the period between the two world wars, Freudian theory shed a faint glow of hope on the outskirts of the custodial asylum.

From shortly after the first world war moves were made

  • away from in-patient treatment
  • towards outpatient treatment,
  • towards treatment without certification
  • towards treatment near to patients' homes.
But these moves only touched the edge of the mental health system.

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.

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.

For many years, General Paralysis of the Insane had (sometimes) been treated by inducing a fever. From 1920 or earlier, experiments were carried out using malaria . See the 1924 reports on "The Malaria Treatment of Paretic Dementia". This may have become a standard treatment. (See Scalebor Park,   1929,   1941

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. MPU

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.

June 1922: A jury awarded enormous damages to an escaped mental patient in his case against a lunacy commissioner.

1923

The London County Council Mental Hospital called The Maudsley opened.

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.

Bleuler's Textbook of psychiatry authorised English edition by A.A. Brill London : Allen & Unwin

1924 Branthwaite Report on the diet of patients and Bond Report on nursing service in mental hospitals published by the Board of Control.

Review of Nervous and Mental Diseases see America
29.11.1924 Editorial in British Medical Journal suspected there were too many semi-popular books on psychoanalysis even though public interest was great. Reading them suggests psychoanalysis is fraught with danger because of the transference mechanism which could induce signs of violent love in the patient towards the analyst.

1924 to 1926

Royal Commission on Lunacy and Mental Disorder

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

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:

[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".

MUNICIPAL ELECTIONS,
November, 1927.

ALL MEMBERS OF THE NATIONAL ASYLUM-WORKERS' UNION ARE URGED TO WORK AND
Vote for the Labour Candidates

1928

24.3.1928 Charlotte Mew drank half a bottle of disinfectant, from which she died. [See also Poetry Links and, above, 1894 and 1915.

1929
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

Meagher's Report on treating General paralysis of the Insane by inducing malaria, published by the Board of Control

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

Science Time Line 1930

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 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

1931: Admission Units for "recent cases, wholly separate from the main building in which are housed patients of confirmed mental disorder"

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

1933

Science Time Line 1933

On 5.5.1933 the first residents of Borocourt Certified Institution for Mental Defectives moved into a converted Victorian mansion


Borocourt: See 1966, 1981

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

Laurence George Brock, chair of the Board of Control, published his committee's report on the voluntary sterilsation of mental defectives, with memoranda on what was happening elsewhere in the world.

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)
MPU 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.

1936

Wilson Report on hypoglycaemic shock treatment in schizophrenia published by the Board of Control, followed in 1938 by a report that also dealt with cardiazol shock treatment

External Link: Renato Sabbatini's article on The History of Shock Therapy in Psychiatry (archive) explains the relationships

24.9.1936 Lennox Castle Certified Institution for Mental Defectives (external link) opened in Dumbartonshire, Scotland. See also Glasgow archives: "It had 1,200 beds when it opened... and was the largest mental deficiency hospital in Britain"

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

"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)

- -

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


Second World War 1939-1945
Community Care


"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

The mass-production of Penicillin was developed in the United States from 1941. A recent medical website 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.

"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 above and below

Hospitals are for Healing:
The origin and context of community-care policies

Science Time Line 1945

26.7.1945: Election results: Labour Government (to 1951)

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 the textbooks. 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).

Science Time Line 1946

The 1946 National Health Service Act 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 in 1948

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.

Mencap History website

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 1958.

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. Its components were the Central Association for Mental Welfare (1898 National Association for the Care of the Feeble Minded), the National Council for Mental Hygiene (founded 1918) and the Child Guidance Clinic (founded 1927). The Association worked closely with the Ministry of Health and Board of Control.

Pre-frontal Leucotomy in a thousand cases Pre-frontal Leucotomy in a thousand cases by Isabel Wilson and E.H. Warland published by the Board of Control.

Science Time Line
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.

The first international classification of diseases, the Bertillon Classification of Causes of Death was brought in in 1898. Revisions came into effect in 1918 (ICD2), 1922 (ICD3), 1931 (ICD4), and 1940 (ICD5). In 1948 the International Classification of Diseases in its sixth revision was extended to include non-fatal diseases. The ninth revision was adopted in 1975, the tenth revision in 1989. The tenth revision included a supplementary classification of impairments, disabilities and handicaps. external link to decoder

World Federation for Mental Health founded in 1948 - External link to website

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

1950

1951

25.10.1951 Conservative government

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.

Science Time Line 1953

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)

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)

1954

Royal Commission on the Law Relating to Mental Illness and Mental Deficiency (1954 to 1957), under Lord Percy, appointed.

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.

it happened to Jack: In September 1954, Jack Archer, a leading character in the popular wireless soap The Archers, was admitted to a mental hospital after becoming more and more depressed. He came home to his family in time for Christmas. He was a much happier person. [See only hands or feet]

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

1955 onwards: Substantial sums of money for construction of new hospitals

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

The last burial in the Horton Hospitals' cemetery was in 1955. Unlike farms, the use of hospital cemeteries appears to have been a matter for local rather than national policy.

1957

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:

  • That mental disorder should be regarded "in much the same way as physical illness and disability" (paragraph 5)
  • That hospitals for mental illness should be run as nearly as possible like those for physical disorders.

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.

1958

[See 1946
only hands or feet: On the wireless, the Archers had featured a mental hospital in 1954. The Hurt Mind 1958 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]

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:

  • To allow admissions for psychiatric reasons to be, wherever possible, as informal as those for physical reasons.
  • To make councils responsible for the social care of people who did not need in-patient medical treatment.

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.

Dr Russell Barton's Institutional Neurosis outlining the symptoms of a disease that often (but not always) developed as a result of being in an institution. (See dictionary)

1960s

In the 1960s there was a breakdown in the
taboo of silence about mental health in the press and TV. Pioneers of this were TV programmes such as Man Alive which showed people with conditions usually regarded as taboo talking about their own experiences. Another famous example 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. "Psichiatria Democratica" was founded in 1974. The law that has beenn called "Basaglia's law" was paased in 1978

1960

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.."

January 1961 Long term planning of hospital services begun

March 1961: Enoch Powell's Water Tower Speech:

The full scope of the community care policy for the mentally il adopted in the 1960s was revealed in 1966 when the Minister of Health, Enoch Powell, opened a conference of the National Association for Mental Health with a speech on how his forthcoming Hospital Plan would affect psychiatric services.

The Percy Report contrasted community care with hospital care. Phrases like in the community have generally been used to mean outside hospital. However, from the Water Tower speech until the 1980s, community care policy was to have as its central feature, the transfer of hospital treatment from isolated mental hospitals to local hospitals. The two main features of the policy were:

  • That hospital treatment should be in Psychiatric Units in District General Hospitals.
  • That as much care and treatment as possible should be provided outside hospital.

April 1961: Official opening of Balderton Subnormality Hospital by Enoch Powell. [See policy]

January 1962: The Hospital Plan

April 1963: Health and Welfare [The community care equivalent to the Hospital Plan.

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

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

UNAFAM (Union des Amis et Familles de Malades Psychiques) formed in France

1964 Labour Government

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.

1966

5.6.1966 Mental Health Week
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

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.

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

The National Association for Mental Health (1969/1970 Annual Report) had a "perverse" regret that there had not been a scandal on the same scale as Ely in a hospital for the mentally ill whilst Crossman was Minister, to stimulate an "accelerated re-appraisal of their needs and progress". It was coming, but by the time the Whittingham Inquiry reported the government had already announced its intention to scrap the old asylums and replace them by "comprehensive psychiatric services" in each district.

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23.8.1969 Miss Janet F. Henderson of Craigiemichael, Innellan, Argyll, argued in a letter in TheTimes that

"There is no mystery about the cause of any deteriioration of conditions in any British mental hospital. In 1948 the progress toward better attitudes and circumstances was suddenly brought to a stop by the loss of the work of His Majesty's Commissioners in Lunacy. Their wide and intimate knowledge of each of these institutions throughout the country was available everywhere as expert advice, their criticism a powerful stimuls to improvement.

Their visits were always unannounced so that any attempt to cover up deficiencies was forestalled. (notices of patients' rights to complain viva voce or by writing to these Commissioners were posted up permanently in every ward.) All this wise protection was lost to patients when they were given over to the care of committees Management and Regional who, however well-intentioned, had all to often no practical experience of this pecuiarly difficult and complex hospitalisation, especially that involving realationships betwen patients and staff.

I cannot see any hope for improvement unless Mr Crossman restores promptly a similar peripatetic expert body"

The quality control functions of the Board of Control (previously Lunacy Commission) had been assumed by the Management Committees of the National Health Service. Its civil liberties functions had continued to 1959. The Hospital Advisory Service (1969) could be seen as reinstating independence for quality control advice and the Mental Health Act Commission (1983) as reinstating central civil liberties functions.

November 1969 Establishment of the Hospital Advisory Service, an independent arm of the Department of Health that advised the Secretary of State on the quality of care in hospitals - especially those for long-stay patients. In its first report (external link) it said its visits concentrated on hospitals for the mentally handicapped and the mentally ill, for geriatric and chronically ill patients. The main problem was a lack of co-ordination between hospital and community social service departments. In 1976 it became the Health Advisory Service, so that its reviews would cover community as well as hospital services.

Local hospitals for everyone -
Out with the distant asylum

Sir Keith Joseph's 1971-1972 Memorandum proposals for the replacement of mental illness hospitals by comprehensive local services.

In the late 1960s Hospital Boards were informed of a change in government thinking. Instead of just acute, short stay, psychiatric units, they were asked to provide a comprehensive service for all patients at District General Hospitals (Ham, C. 1981 p. 129). This changed thinking was incorporated into Hospital Services for the Mentally Ill in December 1971.

Fluphenazine (Modecate). The first long-acting anti-psychotic phenothazine was tested at All Saints Hospital, Birmingham. By one injection every few weeks it was now possible to ensure people were medicated even whilst living outside hospital. Patients needed to be readmitted only if they refused their injection. If a patient did not keep an appointment at the "Modecate clinic", a psychiatric community nurse would visit to see what was happening.


1970

June 1970 Conservative Government
From being a Labour Minister,
David Ennals became MIND's first Campaign Director.

1971 Science Time Line

1971 Statistics
In 1971 St Lawrences had 1,850 patients from all over London - mostly mentally handicapped - from young children to men and women who had grown old in the institution. (See 1870 and 1981)

1971

Royal College of Psychiatrists the new name for the Medico-Psychological Association

In the 1960s the British Consumers Association broke taboos with its Consumers Guide to Contraceptives. In 1971 it broke another taboo by making mental health a consumer issue, publishing Treatment and Care in Mental Illness

In April 1971 Local Education Authorities became responsible for the education of all mentally handicapped children, however severe their handicap, under the 1970 Education (Handicapped Children) Act. As a result of the Act some level of education had to be provided for every child from five to fifteen years old. As well as providing education for the children, this meant that parents of severely handicapped children were relieved of their care during the day. The Jay Report in 1979 thought this had had such an impact on the lives of families with severely handicapped children as to partly explain why far fewer children went into residential care in the 1970s.

Better Services White Papers
There were two Better Services White Papers. The one on Mental Handicap in 1971, and one on
mental illness in 1975.

June 1971: Better Services for the Mentally Handicapped
This White Paper proposed a U-turn in public policy - a pronounced shift in the balance of provision away from hospitals towards non-medical services in the community. Better Services for the Mentally Handicapped took the unprecedented step of setting targets for the number of places in hostels, schools and training centres that local councils would need to supply if the new policy was to be successful.

Campaign for Mentally Handicapped People

The White Paper fell short of what members of Crossman's working group desired. One of them, Peter Townsend, published his disagreements in the Sunday Times on 27.6.1971, the week after the paper was published. He believed the hospitals should have been phased out altogether and that the proposed 25 bed hostels for those who left hospital were:

"a system of minor isolated barracks put up by local authorities in pale imitation of the larger Victorian barracks which are at present run by the hospital authorities"

Townsend wanted mentally handicapped people to live in small houses resembling private housing. A similar position was taken by the Campaign for Mentally Handicapped People (CMH), a group started in 1971 in the belief that people with a mental handicap:

  • had a right to live lives as close as possible to those of other people

  • should participate as much as possible in the decisions that affect their lives

  • should use the same services as everyone else

    This policy of normalising the lives of disadvantaged and stigmatised groups has since been called normalisation. It is the converse of the Social Darwinist policy of segregation. Social theory, though not social reality, had turned full circle

    December 1971: Hospital Services for the Mentally Ill
    This stated that the development of psychiatric methods, and increase in psychiatric units, had brought things to a point where it was thought possible:
      to accelerate developments...towards the eventual replacement of the large separate mental hospitals by a service based on general hospitals"

    People go into hospital ... and they are cured

    "Psychiatry is to join the rest of medicine... the treatment of psychosis, neurosis and schizophrenia have been entirely changed by the drug revolution. People go into hospital with mental disorders and they are cured, and that is why we want to bring this branch of medicine into the scope of the 230 district general hospitals that are planned for England and Wales"

    This statement is credited to Keith Joseph by Kathleen Jones. It is not in Hansard for 7.12.1971, as referenced, and (in the 1980s) Keith Joseph could not recall saying it (which is not surprising). It may have been taken from a newspaper report.


    1972 "touchy-feely"

    January 1972. The film Family Life told a story of Janice who, as a consequence of family conflict, received two types of psychiatric treatment. Group therapy helped her, but drugs and electroconvulsive therapy broke her spirit. The film (and the television play that preceded it) dramatised the theories of Ronald Laing and David Cooper.

    Kathleen Jones' A History of the Mental Health Services. See 1955 and 1960

    William Ll. Parry Jones: The Trade in Lunacy. A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries. Good reading for anyone who wants to know about the range of private houses: good and bad, rich and poor etc. I use this regularly for the asylums index

    possibilities of listening In 1969 Patients and their hospitals: a survey of patients' views of life in general hospitals by Winifred Raphael had been published. It had used confidential questionnaires distributed to patients by participating hospitals. "Many people doubted whether psychiatric patients could in a similar way comment on their care and surroundings" (A.C.Dale, 1977 Foreword). Nevertheless, questionnaires were designed and patients in nine mental hospitals were polled, leading to the publication of Psychiatric hospitals viewed by their patients in 1973. Eleven more hospitals sent in survey results which were incorporated into the second edition in 1977. [See 1954, 1958, 1960s, 1966] In the meantime, some mental patients felt sufficiently confident to join and form protests

    This way to the previous scandal   previous scandals
    THE WHITTINGHAM HOSPITAL REPORT.

    February 1972: Whittingham Hospital, just outside Preston in Lancashire, had 3,200 beds in 1953 and 2,045 in 1971. It was one of England's largest mental hospitals, though shrinking as active psychiatry was moved to District General Hospitals in Preston. Allegations of ill-treatment and the conviction of a male nurse for the manslaughter of a patient, led to an inquiry, which reported that for many of Whittingham's patients "the therapeutic revolution of the 1950s" never happened. Almost half had no occupation during the day, but sat around "becoming cabbages". On one ward, 126 patients were cared for by just six nurses. Doctors did not visit long stay wards, but concentrated on acute work and their work outside the hospital. The inquiry conclude that the English mental health system was dividing into "well staffed 'acute' units and 'long stay dumps'".

    This way to the next scandal   next scandal

    Patients join protest

    The establishment of Psychiatric Units in General Hospitals was also squeezing out community therapy. Community therapy aimed to develop patient self-determination. It was perhaps, not surprising, that squeezing led to patients taking part in the protest.

    3.3.1972: "800 people crowded into a meeting at Sidney Webb college on 3rd March to discuss the threatened closure of the Paddington Day Clinic, a therapeutic community. The opening of a psychiatric unit in a nearby general hospital has been given by the Regional Hospital Board as the reason for making the hospital redundant. The patients and staff of the P.D.H. have formed a protest group to oppose this proposal because they feel the work done in this hospital is concerned with increasing the individuals awareness of the problem rather than blotting out the symptoms it may produce". First paragraph of an article signed by Nicky Road, Anna Chadwick and Keith Venables in Politics of Psychology Newsletter 12.3.1972

     

    October 1972: Services for Mental Illness Related to Old Age

    Mental patients unite

    SUMP (Scottish Union of Mental Patients) formed by Tommy Ritchie and Robin Farqhuarson. This was the first union of psychiatric patients in the United Kingdom that I know of.

    In December 1972, a group of people in the London area produced a pamphlet on The Need for a Mental Patients's Union arguing that "psychiatry is one of the most subtle methods of repression in advanced Capitalist society". This was circulated to psychiatric hospitals and various places where ex-patients were likely to congregate, together with notices of a meeting to be held during March 1973 to discuss the formation of a union.

    1973

    MPU Wednesday 21.3.1973
    About 100 people attended a meeting at Paddington Day Hospital to discuss forming a mental patient's union (MPU). The majority were patients or ex-patients. Most lived in London, including people who had previously formed the Scottish Union of Mental Patients. People were present who had tried to form a Union in Oxford and a message was received from another group in Leeds. The MPU was formed with full membership reserved for patients and ex-patients.

    The large attendance was substantially due to an item on the Today programme in which Michael Sheils interviewed Andrew Roberts, one of the ex-patients involved. Today originally asked a social worker to speak. They were told that the speaker for the group would have to be a mental patient. We waited a few hours whilst they decided if they could risk this.

    A working party of some two dozen full members was formed and not long after set up office in a London squat. This nucleus was given the task of producing a statement of the union's intent and drafting a proposed organisational framework for MPU.

     
    Better Services in Harder Times:

    The end of sustained economic growth and Labour's shift in emphasis to positive community care in Better Services for the Mentally Ill (1975)

    Economic crisis and cuts: Community care policies from 1961 to 1972 assumed continuous economic growth, from which they would be financed. The Arab- Israeli war of October 1973, and the Arab oil embargo, signalled a long period of economic problems. The (Conservative) government responded with drastic cuts in health and welfare capital expenditure, and the cuts were continued and later increased by the subsequent Labour government.

    1974 We are people first see America

    February 1974 Labour Government

    1974: Mind Report: Co-ordination or Chaos?

    Secure accommodation

    April 1974: Interim report of the Butler Committee. As a result of this, a network of Regional Psychiatric Secure Units was planned for England and Wales. (external link)

    By the 1970s, Broadmoor was seriously overcrowded. On a visit, I looked through a window and saw a sea of short haircuts so close that one could have walked across the room from one head to another. Partly to relieve this pressure, a new "Special Hospital", called Park Lane, was built on land next to Moss Side. The first 35 patients moved in in 1974.

    1974 Richard Hunter and Ida Macalpine's Psychiatry for the Poor. 1851 Colney Hatch Asylum-Friern Hospital 1973. A medical and social history. continued their history of psychiatry in a completely different form. "in the story of this one hospital, Drs Hunter and MacAlpine have managed to encapsulate the whole history of psychiatric care for the masses between 1851 and 1973" (David Delvin, General Practitioner 7.11.1975). To my mind, the best book if you want to know "what asylums were like". To look at the asylum from the patient's point of view, you could read Tongue Tied by Joseph Deacon and A Mad People's History of Madness. For patients views on this site see Joan Hughes on Rubery Hill and Valerie Argent on Essex Hall and her friends in Hackney Hospital. There is also an outsider's view of Broadmoor.

    1975

    February 1975: Barbara Castle's Mencap speech

    October 1975: Butler Committee Report and

    Better Services for the Mentally Ill

    Castles in the Air

    The ninety one page White Paper Better Services for the Mentally Ill was nicknamed Castles in the Air by COPE when it was presented by Barbara Castle, the Secretary of State at the Department of Health and Social Security, in October 1975. It was long term strategic document, pointing out the general direction the Government wanted services to take, prefaced with a statement that little progress could be made until the economic situation improved.

    Its emphasis was on providing a comprehensive range of local services in place of asylums, before asylums closed:

    "... our main aim is not the closure or rundown of the mental illness hospitals as such; but rather to replace them with a local and better range of facilities. It will not normally be possible for a mental hospital to be closed until the full range of facilities described has been provided throughout its catchment area and has shown itself capable of providing for newly arising patients a comprehensive service independent of the mental hospital. Moreover, even then, it will not be possible to close the hospital until it is no longer required for the long stay patients admitted to its care before the local services came into operation" (par.11.5)

    The elements of community care before the 1980s included hospitals. The local psychiatric unit was considered part of the community. Community care was a package of local provision, distinct from the distant asylum care. During the 1980s, care in the community came to mean care outside hospital, as distinct from care in hospital. In the 1990s, support in the community moved towards meaning care outside hospitals, hostels or day centres. Notice, however, the development of secure units which substituted, in part, for the custodial provision in the old asylums.
    click for origin of the term community care
    This diagram, that I drew just before the change took place, shows the facilities provided by the National Health Services and Local Authorities that should be part of the community care packet. Underneath I drew a Bargain Basement which contained the possibility of alternative provision by the voluntary sector. In the 1980s and 1990s, the bargain basement grew and developed a private sector department.

    1976

    1976 Peak in mental hospital admissions (falling since)

    The actual numbers in hospital had been falling since 1954

    Between 1970 and 1975 the population of mental illness hospitals was reduced from 107,977 to 87,321. The population of mental handicap hospitals was reduced from 55,434 to 49,683 (In-Patient Statistics 1975, tables A8 and B10).

    The statistics were said to reflect the success of care in the community, but some argued that the fall had been achieved by discharging patients to families ill-equipped to cope with them, to private hotels that exploited them or, in some cases, onto the streets.

    Better Services for the Mentally Ill acknowledged that such things happened, and said:-

    "the public... cannot be expected to tolerate under the name of community care the discharge of chronic patients without... after-care... who perhaps spend their days wandering the streets or become an unbearable burden on the lives of their relatives... Such situations do not occur very frequently; but where they do, the whole concept of community care is placed at risk" (par.2.27)

    This way to the previous scandals   previous scandals
    THE BIRMINGHAM SCANDAL.

    On January 12th 1976, the Daily Mirror sensationally questioned the claim that discharge from hospital without inadequate care was infrequent. It ran a feature by John Pilger sub-headed:

    Dumped on the streets and in the slums -
    5000 people who need help

    Birmingham was headlined as

    The city of lost souls

    A West Midlands Health Official said the DHSS had "applied the screws" to mental hospitals to "decant" patients. Pilger commented that "to be decanted is to be dumped", if you have not got families or friends to take you. The Midlands organiser of MENCAP told him:

    "In a few years... you'll be able to see them dying in the streets"

    Pilger's report showed a seamier side to this policy. In Birmingham, an array of guest houses, hotels and boarding houses flourished on the trade in ex-patients. One landlady told Pilger:

    "We pick them off the streets or the hospital rings us up and says 'can you take a few?'"

    She had

    "a cupboard filled with... prescribed tablets... to keep them quiet".

    Although this was one of the better hotels, residents still sat all day

    "looking blankly at each other... or at the television" [or went] "to St Agnes's hall to stuff toys - 'occupational therapy'"

    In one of the worst establishments patients had been slept

    "nine in the attic some of them less than four feet from the ceiling" [and fed on "two slices of bread and dripping and a third of a sausage roll"

    A councillor reported seeing guests

    "with scabies and lice. They had dirty clothes and ten men had no vests and underpants"

    A Birmingham Social Services' spokesman said it was not uncommon to find "disturbed and frightened people" wandering about the railway station:

    "having just arrived with a travel warrant from hospitals as far afield as London and Scotland. The word seems to have got out that Birmingham has places that will take them."

    Hundreds were said to be "just wandering". The Salvation Army hostel said "up to 30%" of the people it took in "from the streets" were ex-patients. "The overwhelming majority" of those who queued "in the cold every night" outside a Catholic refuge were "psychiatric patients".

    Whose fault was it? According to Pilger, Birmingham Social Services blamed the hospitals and the hospitals blamed Social Services.

    This way to the next scandal   next scandal

    A debate in the House of Commons on better services for mentally ill people was moved for by the Conservative opposition in January 1976. Shortly before the debate, the shadow health minister, Norman Fowler, asked Cecil Parkinson MP to form a Conservative Party policy group on the progress that had and could be made towards community based services for mentally ill and mentally handicapped people. It was an issue of special interest to Mr Parkinson because his constituency, Hertfordshire South, contained three large hospitals for mental illness and two for mental handicap, only one of which served the constituency - the others received their patients from North London.

    Parkinson's group drew on considerable expertise from outside party politics. It met regularly for three years and completed its investigations in spring 1979, just as the Conservative Party moved from opposition into Government.

    February 1976 The film One Flew Over the Cuckoo's Nest dramatised the 1962 novel by Ken Kesey about the way asylums change the personalities of people who become their in-patients. The novel and film popularised the theories of Erving Goffman, in Asylums (1961)

    March 1976:
    Priorities for Health and Personal Social Services
    A Consultative Circular on Joint Planning and Finance was issued at the end of March.

    Priorities was, amongst other things, an effort to advance such causes as Better Services for the Mentally Ill by giving them more money at the expense of other areas.

    The 1975 White Paper had said that investment on the scale needed to achieve its ends would not be possible "over the next three or four years" (par. 11.5), but by giving deprived sectors priority of general and acute hospital provision, Priorities proposed a rate of development which, "if maintained", would enable the Better Services aims to be achieved over most of the country within twenty-five years.

    1977

    Beech Tree House, Hertfordshire, was established by the Spastics Society in 1977 to demonstrate that even the most severely disturbed children from mental handicap hospitals could be successfully educated given sufficient resources and the right approach.

    May 1977 HC(77)17 second circular on Joint Care Planning

    SEPTEMBER 1977 THE WAY FORWARD

    1978

    "In Italy a new National Health Service (NHS), providing free health care to all Italian citizens, replaced the existing national insurance system. The new NHS also incorporated the public psychiatric system, which had just undergone a radical reform under Law 180. According to this law, all psychiatric hospitals were closed to new admissions (and, after three years, also to readmissions) and were replaced with community-based services and psychiatric units based in general hospitals. The new system was intended to provide care and support to all types of patients, without back-up from public mental hospitals, where only existing long-stay in- patients could remain" (external source)

    April 1978: Children Living in Long Stay Hospitals

    May 1978: The Warnock Report

    On Our Own. Patient-Controlled Alternatives to the Mental Health System by Judi Chamberlin gave Judi's "patient's view of the mental health system", an account of her own treatment, and an account of communities run by their users. The book drew on the work of colleagues in Mental Patients' Liberation groups in North America, but also used some United Kingdom material. Judi Chamberlin

    see America

    1979 Science Time Line

    1979

    The Borocourt Hospital League of Friends donated an outdoor play area for severely handicapped patients to use in good weather. It was a wirenetting fence surrounding a spacious area with a large cedar tree and toys for patients to play on.

    March 1979 The Jay Report

    May 1979 Thatcher Government

    The New Conservatives and market forces:
    Their confusion followed by clarity - followed by my confusion



    Spring 1979; The
    Parkinson Report (see 1976) was produced for the Conservative Party, but it was kept secret until 1981. The report strongly endorsed community care and called for a determined programme of hospital closures, linked to a statutory duty and financial incentives for councils to make community provision.

    It said that, although all governments since 1959 were committed to community care policy, there was little real progress in creating services in the community. Amongst hospital staff, they found considerable resistance to the policy and "a strongly held belief that successive governments had not meant what they said."

    Cecil Parkinson suggested that the policy had been discredited "because it is not really being implemented". Patients left the hospitals, but the money and skills stayed in them, so patients went into the community without the support they needed.

    JULY 1979: NHS COMMISSION ON THE NATIONAL HEALTH SERVICE REPORT

    DECEMBER 1979 PATIENTS FIRST

    [December 1979?] National Development Group for Mental Handicap to be axed as a "QUANGO".

    1980s
    In the 1980s and 1990s there were major changes in what community care means. It no longer meant care outside hospital in an overall system where hospital plays a major role. It no longer meant replacing distant asylums by treatment in local psychiatric hospitals. It came to mean providing services for people who continue to live in their own homes, and continually cutting back on any kind of institutional provision, whether in a hospital, a hostel or a day centre. The keynote of the decades was set by the Parkinson Report, made in
    1979, but kept secret until 1981.

    January 1980: The Nodder Report published: Working Group on Organisational and Management Problems of Mental Illness Hospitals. Set up in March 1977. Held it last meeting in February 1979. The delay in publication was due to the change in government and, for the same reason, there was a "substantial gap... between the agreed committee draft and the report as published".

    Although about half the 200 or so Health Districts had a District General Hospital Psychiatric Unit giving "a fairly comprehensive service" to at least part of the district (par.4), many of the others either had no local psychiatric service or a very selective one.

    On the other hand, 50 of the 103 mental hospitals with over 200 beds served three or more Health Districts, only 13 served a single district and 21 were actually outside any of the districts they served. The situations some of these hospitals were in was "so complex as to defy any hope of an efficient management structure. So, a "first essential" was to reduce the complexity.

    The committee recommended a strategy of first developing comprehensive local services in districts furthest away from a mental hospital and from there moving towards a situation where the mental hospital only served the district in which it was situated. (pars 4.9 to 4.10)

    January 1980 Jenkin promises "priority"

    MAY 1980: THE FUTURE PATTERN OF HOSPITAL PROVISION [DHSS Consultation Paper]

    DECEMBER 1980: MENTAL HANDICAP: PROGRESS, PROBLEMS AND PRIORITIES

    October 1980 MIND CONFERENCE

    DECEMBER 1980 PROGRESS, PROBLEMS AND PRIORITIES: (A review of mental handicap services since the 1971 White Paper)

    1981 Science Time Line

    1981 Statistics
    By 1981, deaths and discharges from St Lawrences had reduced the number of patients to 1,300. It was one of seven English hospitals with the least money to spend on patients. (See 1870 and 1971 and Silent Minority (below))

    The International Year for Disabled People

    1981 Special Education Act

    February 1981: Care in Action
    This way to the previous scandal   previous scandals

    10.6.1981: Silent Minority
    This television documentary was shown in peak viewing hours with a warning that some of the scenes might prove disturbing. The scenes were of what happened out of view in two understaffed hospitals for the mentally handicapped,
    St Lawrences and Borocourt. The hospitals had cooperated with making it "in the hope of conveying...the message that hospitals for the mentally handicapped are seriously understaffed and under-financed", but one of the messages of the documentary was that hospital asylums were the wrong place for mentally handicapped people to live.

    Silent Minority concentrated its attention on the most severely disabled patients - those that Government policy still believed would always need "the special facilities of hospital care". It contrasted the understaffed wards at St Lawrences - where children were clean, fed and dressed, but bored and lonely - with
    Beech Tree House.

    It suggested that the intensive education of children in a small unit at Beech Tree House prevented them becoming disturbed, frightened and frightening adults like some who were in a
    wire compound during daylight hours at Borocourt. Many of the Borocourt patients were sedated with Largactil - but, even so, the hospital had seven seclusion rooms. A man described by the hospital as "one of its most aggressive patients" was said on the television programme to have spent almost six months in almost continuous solitary confinement. A member of staff claimed that, as a result of solitary confinement, the patient seemed "on the edge of almost total madness".

    Press headlines gave the impression that Government Ministers reactions to Silent Minority were apoplectic - Film Biased, says Jenkin (The Guardian 11.6.1981) - Fowler raps 'Biased Silent Minority Film' (Nursing Mirror 4.11.1981)

    Ministers' reactions contained more positive elements, the most important of which was that the Under Secretary of State, George Young, insisted his civil servants put some urgency into producing the Green Paper Care in the Community.

    The effect of Silent Minority that seemed most important to me was its effect on the public, but a friend who lobbies governments disagreed with me when I wrote that "Silent Minority probably did more to create a popular demand for community care than a decade of official policy statements". She was more conscious of what goes on in government. I just experienced what was happening in Hackney.

    Relatives and friends of mentally handicapped people from Hackney living miles from home in St Lawrences, and other asylums around London, had simmered with anger and anxiety about them for several years. Silent Minority helped to bring their concern to the boil, and in January 1982 families, professionals, voluntary groups and articulate local people with a mental handicap formed HAMHP (Hackney Action for Mentally Handicapped People) to press for local services that would give all mentally handicapped people from Hackney a chance to live as part of our own community.

    Silent Minority can still be seen. It can be bought or rented from Concord Video and Film Council. On their web site, click on education, then learning difficulties, and scroll down.

     

    Care in the Community and the Parkinson Report

    July 16th 1981:
    Care in the Community was the title of a Green Paper that suggested ways of moving money and care from the National Health Service to local councils and voluntary associations. It was a way of implementing the (hitherto secret) Parkinson Report, and seven days later the Conservative Political Centre published The Right Approach to Mental Health, an edited summary of the Parkinson Report.

    Care in the Community began by saying:

      "Most people who need long-term care can and should be looked after in the community. That is what most of them want for themselves and what those responsible for their care believe to be best".
    Care in the Community applied especially to mentally handicapped, mentally ill and elderly patients (in that order).

    It suggested that 20,000 long-term patients (15,000 in mental handicap hospitals and 5,000 in mental illness hospitals) could be discharged "immediately" if funds could be switched from the Health Service to local authorities (paragraphs 3.1. and 3.2).

    Opinions were sought on seven possible ways of moving money and patients. On July 28th 1982 the Government said it had decided to adopt three main proposals:
    • The maximum period for which the NHS could pay for schemes under joint finance would be extended from seven to thirteen years for projects to move people out of hospital, and the NHS would be able to pay 100% of the money for up to ten years.
    • District Health Authorities would be allowed to make guaranteed annual payments to councils and voluntary bodies for ex-patients they provided for in the community.
    • Fifteen million pounds would be set aside from joint fiance money to develop and assess a series of pilot projects.
    1982

    Although numbers in the old style hospitals had fallen considerably, by 1982 the only mental illness hospitals to close were St Ebbas, Epsom (converted to a mental subnormality hospital in 1962) and The Holloway Sanatorium, Virginia Water, Surrey (closed December 1980). In November 1982, the only definite closure proposals were a plan to close Banstead and concentrate services at Horton in 1986; and proposals by North East Thames Regional Health Authority to close two of its six large mental hospitals (not then identified, but Claybury and Friern were chosen) by 1992. The only large mental handicap hospital planned to close was Darenth Park. (Information mainly from D. Glassborow, DHSS Mental Health Division, 18.11.1982)

    Draft of closures to March 1994
    1962
    St Ebbas, Epsom (conversion to a mental subnormality hospital)
    1980
    The Holloway Sanatorium, Virginia Water, Surrey (December 1980)
    1985
    Exminster, Devon 1985
    The Lawn, Lincoln 1985
    1986
    Banstead October 1986
    Coppice Hospital, Nottinghamshire 1986
    1987
    Saxondale, Nottinghamshire 1987
    1988
    Horton Road, Gloucester 1988
    Naburn, York 1988
    1989
    Pastures, Derbyshire 1989?
    1990
    St John's, Lincolnshire 1990
    Whitecroft, Isle of Wight 1990
    1991
    Mendip Hospital, Somerset 1991
    1992
    Long Grove - April 1992
    Cane Hill 1992
    St Augustine's, Kent 1992
    Herrison, Dorset 1992
    1993
    Moorhaven, Devon 1993
    Friern - 1993
    Rubery Hill, Birmingham 1993
    1994
    Hellingly, Sussex (1994)
    Glenside, Bristol (1994)
    St Mary's, Burghill, Hereford (1994)

    Most the 1994 closures are still on the March 1994 list of ones that are open:
    Brookwood (1994)
    Netherne (1994)
    Mapperley Hospital, Notttingham (1994)
    Clifton, York 1994
    Hollymoor, Birmingham

    Closure index: See 1994 - 1995 - 1999 - 2002 - 2006 -

    Peter Sedgwick's Psychopolitics, published in 1982, criticised the anti-psychiatry movement of the 1960s/1970s theoretically and politically. Sedgwick's political criticism of the Myth of Mental Illness idea was that it undermined efforts to secure community care resources for those who suffer from mental distress.

    Mental Health and Civil Liberties

    We Can Speak for Ourselves. Self-Advocacy by Mentally Handicapped People, by Paul Williams and Bonnie Shoultz. This American book said that mentally handicapped people usually had decisions made for them about every detail of their lives, but that through the Self-Advocacy Movement many were learning to formulate their own needs, to put forward their demands and to campaign to win them.

    A Mad People's History of Madness compiled by Dale Peterson. The British authors included are Margery Kempe, George Trosse, Alexander Cruden, Samuel Bruckshaw (1774), William Cowper, Urbane Metcalf, John Thomas Perceval, Marcia Hamilcar (1910), Thomas Hennell (1938), John Cunstance (1952) and Morag Coate (1965)

    1983 1983 Representation of the People Act


    1983 newspaper cartoon -

    Preserved by my father.

    Challenge - The Good News Paper. February 1983

    1983 Mental Health Act. Under the 1959 Mental Health Act it is legally unclear whether a legal order to detain in hospital, against a person's wishes, empowers the hospital to impose medical treatments. If it does (which was generally accepted), there were no controls in the Act of the treatments imposed. The 1983 Act places legal controls on the application of medical treatments, particularly surgery, electro-convulsive therapy and mood- altering drugs.

    Section 114 introduced the approved social worker (ASW), specially trained and qualified in mental health. An approved social worker (rather than any social worker) was qualified to make applications for formal admission.

    Section 117 imposed a duty on local Social Services Authorities as well as Health Authorities to provide aftercare services for some mentally disturbed patients who have ceased to be detained and who leave hospital.

    Section 121 established the Mental Health Act Commission See discussion of need for in 1976 and 1978, 1981; provisons in 1983 and way the commission interpreted these (1985) - jump forward -

    20.9.1983: Hackney Workers Educational Association introductory lecture on Mental Distress in Old Age given by Dr Tony Whitehead from Brighton. Building on in depth consultation with users, carers and providers the series ran for over a year and published and interim report in June 1984 and a final report in November 1985

    1984

    Valerie Argent's poem Inner Circle was written in a psychiatric ward at Hackney Hospital.
    MIND Annual Conference
1984

    1985

    Report of House of Commons Select Committee on Community Care

    MIND Annual Conference 1985: From Patients to People

    Speaking from Experience

    MIND Annual Conference
1985

    1986 Disabled Persons Services Consultation and Representation Act. Under this Act, Social Services must assess the needs of disabled people on request for certain welfare services and local authorities must provide to meet those needs if they decide it is necessary. Including provision or help over telephone, television, radio, library facilities, holidays, recreation, access to education, transport to and from services, social rehabilitation and adjustment, occupational, social, cultural and recreational activities. Disabled means "Blind, Deaf or dumb or who suffer from mental disorder of any description or who are substantially and permanently handicapped by their illness, injury or congenital deformity"

    Empowerment In 1986 the compilers of the Oxford Dictionary noticed that an old (1690) Quaker word had re-entered the vocabulary with a secular meaning. Individuals and groups were being "empowered" to be stronger and more confident in controlling their life and claiming their rights. The word must have spread quickly: The 1985-1986 Report of City and Hackney Community Health Council, for example, was called Empowering the Users of the Health Service. "Developments in mental health services", it said, will not work well unless they are supported by the people that use them and so the CHC believes they should have a say in planning them and a continuing say in how they are run". A similar theme ran through all issues.

    October 1986 Banstead Hospital closed


    1988

    26-29.9.1988 Common Concerns: International Conference on User Involvement in Mental Health Services held at The University of Sussex under the auspices of MIND and Brighton Health Authority. Participants included Mike Lawson, a founder member of the Mental Patients Union and of Survivors Speak Out and Judi Chamberlin, author of On Our Own - Patient controlled Alternatives to the Mental Health System. The conference was an important step towards the coming out of mental patients - It was also marked of an early stage in the development of the term "user involvement". The term survivor/user action is used by Pater Campbell (2006)
    No conference with such a title now would be taken seriously with so few openly declared patients on the platform.


    1989
    David Ennals was President of MIND from 1989 to 1995

    Banstead Hospital demolished

    1990 National Health and Community Care Act: The "purchaser/provider" split sprang from this Act. From 1991 health and social services were divided into units that bought services or provided them. Social Services Departments had to set up "arms length" inspection units. establish a complaints procedure and (by April 1991) prepare a Community Care Plan. Users became entitled to a Community Care Assessment of needs.

    A kind of market: Within the National Health Service and Local Social Services and along with voluntary and private organisations, the government tried to create a market to achieve the rewards promised by the new followers of Adam Smith, but with the basic services remaining in public ownership and control. The arrangements within the NHS were known as the "internal market".

    Health Authorities now "commissioned services" from GPs, NHS "Trusts", voluntary and private providers. Hospitals were rearranged as different Trusts, including some "Mental Health Trusts" or "Mental Health and Learning Disability Trusts". Some GPs became "GP fundholders". A similar division took place in Social Services

    For me, the most memorable feature of the period was that I could not work out who was who or who was responsible for what. Unfortunately, government has learnt the advantages of a fog of confusion.

    1991 Survivors' Poetry founded by Frank Bangay and others. From Dark to Night, an anthology edited by Frank Bangay, Hilary Porter and Joe Bidder, was published by the Survivors Press in 1992. In 1999, an illustrated collection of Frank Bangay's poems Naked Songs and Rhythms of Hope (1974 to 1999) was co-published by Spare Change Books, Box 26, 136-138 Kingsland High Street, Hackney, London, E8 2NS and Survivors Poetry, (then at 34 Osnaburgh Street, London, NW1 3ND). In 2001 A True Voice Singing, a CD of Frank Bangay reading fifteen of his poems to musical backgrounds, was published by CORE Arts. Frank Bangay can often be heard performing at the Krazy Kats n Dogs Klub

    1992

    17.12.1992 Jonathan Zito murdered by Christopher Clunis on Finsbury Park station. It was an unprovoked murder of a complete stranger. Christopher Clunis was a mental patient. The Zito Trust was established in 1994.

    Murders by patients are often blamed on "community care". I have not murdered anyone. Is community care responsible for that?

    1993

    Homeless mentally ill people not ex-patients of the asylums. Who are they? Publication of a study by J. Leff following 278 patients who were discharged from two long-stay mental hospitals in north London, as part of closure programme. It was argued that as only seven patients (1%) were lost to follow-up, possibly becoming homeless, homeless psychiatric patients were not the result of hospital closure programmes. Paper on East Anglia University website has been removed, but see bibliography

    1994

    Summer 1994 In Listen To Me - Communicating the Needs of People with Profound Intellectual and Multiple Disabilities Pat Fitton shared what her daughter, Kathy, had taught her.

    October 1994: In Finding a Place: A Review of Mental Health Services for Adults, the Audit Commission found that the favoured policy, of individual, locally based care within the community, was "struggling".

    See closure index
    Lords Hansard 26.10.1995 : Column WA128 Mental Illness Hospitals: In-Patients
    Lord Mottistone asked Her Majesty's Government:
    How many patients were, or are, cared for (on closure or now, if not yet closed) in each of the hospitals named in Table 2 of the Survey of English Mental Illness Hospitals March 1994-Monitoring the Closure of the "Water Towers".
    Baroness Cumberlege: The information available centrally is given in the table.
    NHS Hospitals in Table 2 of the Survey of English Mental Illness Hospitals March 1994-Monitoring the Closure of the "Water Towers":
    Numbers of In-patients at 31.3.1994
    Hospital In-patients all ages
    Barnsley Hall Hospital 57     [Worcestershire - 1903-1996]
    Clifton Hospital 100     [Yorkshire 1847-1994]
    Coney Hill Hospital 168     [Gloucestershire 1884-mid 1990s]
    Hollymoor Hospital 185     [Birmingham 1905?-1995]
    Mapperley Hospital 195     [Nottingham 1880-December 1994]
    St. Francis Hospital (Nottingham) 38     [???]
    St. George's Hospital (Stafford) 147     [1818-???]
    St. Crispin Hospital 121     [Northampton 1876-???]
    Scalebor Park Hospital 35     [Yorkshire 1902-1995]
    Central Hospital 95     [Warwickshire
    Claybury Hospital 361     [Essex 1893-1997]
    Countess of Chester Hospital 179     [Cheshire 1829- continuing]
    Hill End Hospital 153     [Hertfordshire 1899-1997]
    Maidstone Hospital 115     [Kent
    Netherne Hospital 57     [Surrey 1909-1994]
    Princess Royal Hospital 154     [Sussex
    Roundway Hospital 99     [Wiltshire
    St. George's Hospital (Morpeth) 312     [Northumberland
    St. Mary's Hospital (Northumberland) 247     [
    St. Matthew's Hospital 157     [Staffordshire 1864-1995
    Stanley Royd Hospital 277     [Yorkshire 1818-1995]
    Tone Vale Hospital 117     [Somerset 1897-
    Tooting Bec Hospital 96     [London 1903-1995]
    Whittingham Hospital 153     [Preston, Lancashire 1873-2002 MSU continuing]
    St. Nicholas' Hospital (Newcastle) 214     [
    Brookwood Hospital 311     [
    Carlton Hayes Hospital 249     [
    Littlemore Hospital 172     [Berkshire 1846-
    Middlewood Hospital 116     [Yorkshire 1872-1999]
    Napsbury Hospital 419     [Hertfordshire 1905-1999
    Shenley Hospital 424     [Hertfordshire 1934-
    The Royal London Hospital (St Clements) 99     [London
    Warlingham Park Hospital 143     [Croydon 1903-1999]
    All Saints Hospital 261     [Birmingham 1850-2000]
    Parkside Hospital 249     [Cheshire 1871-2002]
    Knowle Hospital 184     [1852-1996 RSU continuing]
    Fair Mile Hospital 212     [
    De la Pole Hospital 246     [Hull ]
    Fairfield Hospital 415     [
    Fulbourn Hospital 301     [Cambridgeshire
    Goodmayes Hospital 401      [Still open 2006]
    High Royds Hospital 346     [Yorkshire
    Horton Hospital 329     [London
    Lancaster Moor & Ridge Lea Hospitals 314     [Lancashire
    Park Prewett Hospital 245     [Hampshire
    Runwell Hospital 320     [1936- Essex - Still open 2006]
    Severalls Hospital 218     [
    St. Edward's Hospital 254     [Staffordshire
    St. Lawrence's Hospital 206     [Cornwall
    Warley Hospital 534     [Essex
    Winterton Hospital 375     [Durham
    Bexley Hospital 241     [Kent
    Cherry Knowle Hospital 320     [Sunderland
    Garlands Hospital 182     [Carlisle
    Rauceby Hospital 173     [Lincolnshire
    Towers Hospital 163     [Leicester
    Winwick Hospital 398     [Lancashire
    Graylingwell Hospital 249     [Sussex
    St. Andrew's Hospital (Norwich) 168     [Norfolk
    Springfield Hospital 429     [Still open 2006]
    St. James' Hospital 204     [Portsmouth - Still open 2006]
    St. Luke's Hospital 140     [Middlesbrough - Still open 2006]
    St. Clement's Hospital (Ipswich) 190     [Still open 2006]
    Stone House Hospital 98     [Kent 1866- Still open 2006]
    Wonford House Hospital 116     [Devon 1801-
    Highcroft Hospital 132     [Birmingham
    West Park Hospital 358     [Epsom 1903-2002/2005?]
    Barrow Hospital 212     [Bristol
    Bootham Park Hospital 107     [Yorkshire 1777 -
    Ealing Hospital 327     [London 1831 - continuing
    Hellesdon Hospital 258     [Norfolk - Still open 2006]
    Henderson Hospital 24     [Surrey
    Kingsway Hospital 285     [Derbyshire 1888 - Still open 2006]
    Lynfield Mount Hospital 119     [Yorkshire 1910/1948 -
    Maudsley Hospital 217     [1915/1923 - Still open 2006
    Old Manor Hospital 145     [Wiltshire 1813? -
    Prestwich Hospital 337     [Lancashire 1851 -
    Royal Shrewsbury Hospital (Shelton) 197     [Shropshire 1845- Still open 2006]
    St. Martin's Hospital 120     [Kent - Still open 2006]
    Sundridge Hospital 48     [Kent
    The Bethlem Royal Hospital 180     [Kent Still open 2006
    Warneford Hospital 70     [Oxfordshire Still open 2006

    79 hospitals in this list. 23 previously closed. Total 102. Lists do not include Welsh Hospitals (7?)

    1995

    See closure index
    20.2.1995 Government asked in the House of Lords, how it judged the strength of local and family opposition to the proposed closure of the following long-stay hospitals for mentally handicapped people: Cell Barnes Hospital, St Ebbas Hospital, Turner Village Hospital, Llanfrechfa Grange Hospital, Northgate Hospital, Prudhoe Hospital, Meanwood Park Hospital, Ida Darwin Hospital, Calderstones Hospital, Leybourne Grange Hospital, Tilworth Grange Hospital, Clarefield Hospital.

    Spring 1995: Home at Last: How two young women with profound intellectual and multiple disabilities achieved their own home.

    1996

    1997

    May 1997 Blair Government

    New Labour - New Community Care

    1998

    Care in the community?: a history of the reprovision programme of Friern Hospital

    May 1998: Audit Commission published Home Alone: The Housing Aspects of Community Care

    December 1998 Health Secretary, Frank Dobson's "Care in the community has failed" statement. It is the misfortune of politicians that their most outrageous statements are remembered for ever. This one must rank alongside Margaret Thatcher's "There is no such thing as society". The statement is prominent in Modernising Mental Health Services. Safe, sound and supportive. As this also says that community care had brought "many beneficial changes", and as it shows no intention of abandoning community care, I would interpret it to mean that care in the community has failed for some, and in some respects and so the government was bringing in a new model of community care which would address the problems.

    1999

    National service framework for mental health: modern standards and service models

    Outside the walls of the asylum : the history of care in the community, 1750-2000

    September 1999: Audit Commission published Children in Mind: Child and Adolescent Mental Health Services

    See closure index
    A written answer originally given on 17.7.1997, but updated 16.11.1999 by Secretary of State, Alan Milburn, identified hospitals listed as having recently been, or currently, the subject of consultation which could lead to the full closure. The psychiatric hospitals on this list included: Fulbourn , Goodmayes, Horton, Napsbury, Runwell, Shenley, Warley, Belmont, St. Andrew's, St. Mary's, Winterton Hospitals, All Saints, Ida Darwin, Sundridge Hospital, Highcroft, Monyhull, St. Edward's, Stallington,

    2000

    Henry Rollins' article "Psychiatry at 2000 - a Bird's Eye View

    Community Care in the Making: A History of the Mental After Care Association 1879-2000

    January 2000: Audit Commission published Forget Me Not: Mental Health Services for Older People

    Spring 2000: Rossbret (hosted by Rootsweb) workhouse and hospitals (including asylums) mailing list established. (archives). Supported by people engaged in family history, the list and its website reflect a major change in social attitudes from the days when a relative in an asylum was a closely guarded secret.   More social history links

    1.6.2000 Press Release: Mental Health Czar begins the process of Reform for Mental Health Services   National Clinical Directors   Louis Appleby

    22.11.2000 Press release: "Survivors Add New Voices to Dark Chapter in Medical History"

    2001

    Valuing People: A New Strategy for Learning Disability for the 21st Century Department of Health March 2001. The first white paper for people with learning disability since Better Services for the Mentally Handicapped in June 1971.

    • It says we should all be citizens with legal and civil rights.

    • It supports independence.

    • It supports having more choice.

    • It supports being included.

    About May 2001 New, purpose built and clinically designed, mental health unit, Sevenacres, opened at Newport on the Isle of Wight.

    October 2001 Launch of "Well?" The Scottish Executive's National Programme for Improving the Mental Health and Well-Being of Scotland's Population. See Well? on the web

    2002

    Draft Mental Healh Bill published - Keep up to date with this external link to Mind's Parliament Page

    Valuing People with Profound and Multiple Learning Disabilites

    January 2002 Jeremy Jones of Norwich began his website - See also 1902 Medical Dictionary and 1962 history of mental hospitals

    20.2.2002 Sue Lou began her journal

    Geraldine Bedell, The Observer Sunday 7.4.2002:

    "Today, fewer than 20 of the original 120 Victorian asylums remain"

    See closure index

    25.6.2002: House of Commons Mental Health Debate
    Liam Fox on Conservative reforms since Lord Ashley
    David Hinchliffe: Community Care has not failed

    October 2002 The 'see me' campaign launched to challenge stigma and discrimination around mental ill-health in Scotland


    Viktoria Smith's website was online from October 2002 to March 2004

    Bexley Water Tower blown up 27.11.2002 Ceremonial blowing up of the water tower of Bexley Hospital. The plunger on the explosives was pressed by Linda Noyes, who trained as a nurse at Bexley Hospital. Click on the picture for partial archive of news release. Click here for a poem that Debbie Mayes wrote (22.12.1998) about being a patient in Bexley.

    "Executives have taken over the asylum: the fate of 71 psychiatric hospitals" by Robert Chaplin and Steve Peters, Psychiatric Bulletin 2003 analyses a sample of pre 1961 hospitals (closed and open) and shows that a large percentage of those preserved have been converted to luxury housing

    January 2003 Making Things Happen Better, the first annual report of the Learning Disability Task Force will be available online soon (we hope!). It is available free by phoning 0808 8081111 and you can read a Guardian Review online

    January 2003: Mind's key dates in the history of mental health and community care updated. The chronology starts in 1601. It has very extensive material about recent mental health history, compiled by George Stewart, Mind Information Unit 1998-2003

    Spring 2003: First publication of The Naked Bird Watcher by Suzie Johnston. The second and updated edition (ISBN 0954809203) was published in August 2004 by The Cairn.

    "The sanity birds glided seamlessly through my dream... Then one bird fell. Screaming it dropped from the clouds... Then another. And another, until the screaming was unbearable and even the clouds hurried to leave."

    website about Suzie Johnston

    May 2003 Start of three year Royal College of Psychiatrists study investigating the community lives of people who previously lived in a mental hospital. The "Living Project" will explore the social environment which replaced the fixed structures of a closed psychiatric hospital, investigating the problems ex-patients may experience, such as poverty and social exclusion. It hopes to provide a better understanding of the everyday lives of people with serious mental illness who live in the community

    On Sunday 4.5.2003 Gordon Tozer took a break from his work on the world of asylums to photograph what is left of Coney Hill Mental Hospital in Gloucestershire

    Click on the ruin to see Coney Hill as it was


    Gloucestershire Primary Mental Health is part of the structure of community care that has replaced the asylum.

    Click on the ruin to see
Coney Hill as it was

    October 2003:

    Annette Crawford elected vice chair of Mencap's national assembly

    Commission for Equality and Human Rights to replace Disability Rights Commission, Commission for Racial Equality and Equal Opportunities Commission. (Mind's response)

    10.12.2003 Placed Amongst Strangers The Mental Health Act Commission's Tenth Biennial Report. The Guardian report compares the Mental Health Act Commission to the Lunacy Commission. Visit the commission's website. The report takes its name from a passage from John Perceval

    "Instead of my understanding being addressed and enlightened, and my path being made as clear and plain as possible, in consideration of my confusion, I was ... placed amongst strangers, without introduction, explanation or exhortation..." John Perceval (1840) A Narrative of the Treatment Experienced by a Gentleman, During a State of Mental Derangement

    2004

    16.1.2004 Draft Comprehensive and Integral International Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities

    2.2.2004 BBC One Inside Out story alleges psychiatric patients "absconding" in large numbers. Make sure you read the Readers' Comments.

    May 2004 Mencap launches Ask Mencap website.

    14.6.2004 Results of Mencap's Breaking Point consultation published

    22.6.2004 The Guardian corrects itself for saying "the elderly and disabled" and announces that "This week is learning disability week".

    Friday 13.8.2004:
    Andrew Roberts finished his thirty-one year thesis on the Victorian Lunacy Commission

    August 2004 Film Afterlife stars Paula Sage whose "possible film roles" are "limited by her Down's Syndrome". "Paula is also competing in the 2005 Special Olympics in Netball"

    14.9.2004 Rethink put Winston Churchill in a straitjacket to protest against the public stigma on severe mental illness. In 1910 Churchill urged sterilisation so that "the sources from which the stream of madness is fed should be cut off". The point of the straitjacket campaign, however, was that Churchill suffered from severe depression and Recast thought Britain would have suffered if he had been prevented from running the country during the second world war.

    January 2005 Mad Mary Lamb: Lunacy and Murder in Literary London by Susan Tyler Hitchcock will be published. This is a biographical companion to the writings of a madhouse patient who, having murdered her mother, was released to the community and became story teller and poet to generations of children.

    January 2005 When Jean Johnson's daughter, Suzie, had a mental breakdown at university she insisted on carrying on and succeeded in graduating. Then came another breakdown, even more devastating, and Jean had the fight of her life to understand what was happening to the daughter she loved. In To Walk on Eggshells, Jean shares what she discovered. Suzie has already told her story.

    January 2005: Survivors' history People met in London to create a history and archive of mental health users/survivors

    February 2005 Edward Shorter A Historical Dictionary of Psychiatry published by Oxford University Press.

    19.7.2005: Together - the relaunch of MACA

    July 2005 Hackney Action on Learning Difficulty, founded 1982 held its last monthly meeting - We ran out of money - Click here to see if we survive

    26.8.2005: Person-centred planning leads to improved life experiences for people with learning disabilities, though not all, says new report

    28.9.2005: first ever national survey about the lives of people with learning difficulties

    2006

    The Equalities Bill, going through the UK Parliament, would establish a "Commission for Equality and Human Rights" in place of the Equal Opportunities Commission, The Commission for Racial Equality and the Disability Rights Commission

    Spring 2006 Asylum to Action Paddington Day Hospital , Therapeutic Communities and Beyond by Helen Spandler. See also the MPU website.

    23.3.2006 UK Government Press Release: New shorter Bill to amend existing Mental Health Act - Mental Health Alliance response

    Thursday 13.4.2006 Survivor's Poetry launched the full volume of David Kessel's Collected Poems (1970-2006 "O the Windows of the Bookshop Must be Broken" with emotional readings, by David himself, at the Poetry Cafe. Also launched: Lee Wilson: You've got an eyelash and readings from Dino Campana - Selected Works by the translator Christina Viti.

    See closure index
    8.11.2006 Email from Peter Cracknell of http://www.countyasylums.com listing the county and borough asylums and public and subscription hospitals stiil open as psychiatric hospitals:

    Eleven English and four Welsh that were county or borough hospitals before the inception of the National Health Service. Seven other surviving hospitals were voluntary hospitals, or otherwise not county or borough asylums, before the inception of the National Health Service. Each of these currently has in-patient facilities still using the main asylum buildings. Excluded from the list are any where the site remains only in partial use such as villas in grounds or a fraction of main complex. Two, marked red, are due to close within one year. Others, marked brown, are proposed for closure.

    Goodmayes Hospital, Essex
    Hellesdon Hospital, Norwich
    Kingsway Hospital, Derbyshire
    Runwell Hospital, Essex
    St Clement's Hospital, Ipswich
    St James' Hospital, Portsmouth
    St Luke's Hospital, Middlesbrough
    St Martin's Hospital, Canterbury
    Royal Shrewsbury Hospital (Shelton)
    Springfield Hospital, London
    Stone House Hospital

    Wales

    Cefn Coed Hospital, Swansea
    Glanrhyd hospital, Glamorgan
    St Cadoc's hospital, Newport
    Whitchurch hospital, Cardiff

    Seven other English hospitals

    The Bethlem Royal Hospital
    Maudsley Hospital
    The Retreat, York [Not NHS]
    Bootham Park Hospital, York
    Wonford House Hospital, Exeter
    Warneford Hospital
    St Andrew's Hospital Northampton [Not NHS]

    Two hospitals use approximately half or more of the asylum property to include inpatient services:

    St Nicholas' Hospital (Newcastle)
    St Bernard's Hospital, London

    21.11.2006 Innovative Approaches in Mental Health Research Seminar at the Royal College of Psychiatrists. By clicking on the title link you can download all the soundtrack and slides. Participants included the Service User Research Enterprise (SURE) - Helen Parr on a film by LUNA - Lisa Blackman on research she was enabled to do by the Hearing Voices Network - John Curran on SPEKTRA, the Cultural Consultancy Service (See pdf factsheet on Mental Health and Ethnicity) - Peter Barham on his book Forgotten Lunatics of the Great War - Tom Craig from the Institute of Psychiatry - and Sue Estroff from the University of North Carolina. -

    The Department of Health's "What's New" webpage includes details of the new Mental Health Bill.

    2007

    Tuesday 20.3.2007 Social exclusion, social inequality and mental health A one-day seminar funded by the Economic and Social Research Council at The University of Manchester. By clicking on the title link you can download all the presentations.

    Friday 30.3.2007 3rd Annual UWE Bristol, History of Health and Social Care Conference Health and Welfare in the Spaces of Confinement

    Friday 28.9.2007 The life world and emotional wellbeing A one-day seminar funded by the Economic and Social Research Council at The University of Nottingham

     


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    1290: King's prerogative

    1312: Pardon

    1377 Bethlem

    1436: Margery Kempe

    1495 Syphilis

    1518 Physicians

    1538 London streets

    1601 Poor Law

    1621 Anatomy of Melancholy

    1636 Hobbes on motion and matter

    1654 community care

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    1676 Moorfields' Bethlem

    1690 Locke on reason and madness

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    18th century asylums

    1714 Vagrancy Act

    1738 Cruden's escape

    1746 St Patrick's, Dublin

    1749 nervous vibrations

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    1755 Rousseau back to primitive

    1774 madhouse medical inspection

    1788-1789: Royal madness treated and cured

    1792: all-seeing eye

    1796: Mary Lamb

    Gunshot and state asylums

    1800 Criminal Lunatics Act

    1808 County Asylums Act

    1812: Prime Minister shot dead

    1812: Philadelphia tranquilliser

    1815 St George's Bethlem

    1823: Lectures on mental diseases
    Gloucester asylum

    Phrenology

    1828 Home Office controls inspectors

    1832 Lord Chancellor controls inspectors

    1834 Poor Law

    Mesmerism

    Railway and telegraph

    non-restraint

    1840s Social unrest and asylum hope

    1841 Asylum statistics

    1841 Asylum doctors UK

    1842 National Inquiry

    1843: Daniel McNaughton fails to kill Peel

    1844 National Inquiry Report

    1844 Asylum doctors USA

    1845 Ashley's Acts and the Lunacy Commission

    1846 Haydock Lodge scandal

    1847: tainted blood

    Scotland 1853-1857

    Liberties

    Asylum nursing

    1863 Broadmoor Criminal Lunatic Asylum

    1867 Metropolitan Asylums Board

    1870 St Lawrence's and Leavesden

    1873 Murder

    1888 Epileptic Home

    1890s Asylum despair

    1900 Freud's dreams

    1905 Wasserman's test

    Mental Deficiency

    Sterilisation

    1910 Rampton State Institution

    1913 Mental Deficiency Act and The Board of Control

    1915: Shell-shocked

    1918: Chloral Hydrate effects

    Between world wars: Psychoanalytic glimmers

    1930: Voluntary fee-paying

    1930: Bethlem Royal

    1930s Moss Side State Institution

    1933 Borocourt Certified Institution for Mental Defectives

    Eugenics

    1939-1945 not Shell Shock now

    1940s The asylum inheritance

    1946 National Health Service Act

    1948 National Health Service inherits asylums

    Fighting stigma

    1949 Scotland pioneers open doors

    1953 Mental £millions

    1954 Percy Inquiry into Mental Health Law

    Anti-psychotic drugs

    1957 Percy Report favours community care

    1959 Mental Health Act

    Breaking taboos

    local hospitals

    Asylum scandals

    Long acting drugs

    1971 Better Services for the Mentally Handicapped

    1973 mental patient's union (MPU)

    1974 Park Lane Special Hospital

    1975 Castles in the air

    1976 Birmingham scandal

    1979 Thatcher's (secret) Parkinson Report

    1981 Silent Minority

    1982 Little closed

    1983 Mental Health Act

    1986 Disabled Persons Services Act

    Empowerment

    1990 National Health and Community Care Act

    1991 Survivors' Poetry

    2001 Valuing People

    25.6.2002 Debate

    2003 Making Things Happen Better

    2005 Survivors' history




    Click on the icons to visit my university:

    School of
Health and
Social
Science

    Middlesex
University Centre
for Psychoanalysis
web site

    School of
Health and Social
Science






    Citation: see the referencing suggestion for advice on citing entries on this page.

    Have you tried the ABC Study Guide? try the ABC Study Guide

    or ABC Study Links?






    Mad Mary Lamb on Susan Tyler Hitchcock's web site
    Mad Mary Lamb: Lunacy and Murder in Literary London by Susan Tyler Hitchcock



    website about Suzzy Johnston
    ... a positive account of living with mental illness now





    Asylum to Action -
    Paddington Day Hospital , Therapeutic Communities and Beyond by Helen Spandler





    Listen to Me














    Information on Anna Wheeler and Rosina Bulwer Lytton from Kiera Chapman,
    whose
    Victorian Fiction website you may wish to visit




    to 31.3.2007: 259,990
    to 11.12.2006: 245,801
    to 16.7.2006: 215,674
    First four years: 13.6.2002 to 12.6.2006 (estimated): 211,502
    to 31.5.2006: 208,100
    to 31.12.2005: 162,913
    to 8.11.2005: 146,466
    to 18.9.2005: 129,975
    to 20.7.2005: 120,748
    on 20.3.2005: passed 100,000
    to 13.3.2005: 98,512
    to 31.12.2004: 86,454
    to 30.11.2004: 82,717
    to 22.10.2004: 76,084
    First two years: 13.6.2002 to 12.6.2004: 62,549
    to 7.4.2004: 55,145
    to 2.3.2004: 50,069
    to 25.12.2003: 42,569
    First eighteen months: 13.6.2002 to 13.12.2003: 41,849 unique visitors
    13.6.2002 to 16.9.2003: 30,652 unique visitors
    First year of counting: 13.6.2002 to 12.6.2003: 24,097 unique visitors
    You are all so welcome - Please come again.


    The icon above is for Extreme Tracking statistics. I put it there on 18.12.2002. On 14.1.2003, on the 28th day, it recorded 1,588 new visitors, including 11 who visited on Christmas Day. (It recorded 24 on Christmas Day 2003 - 32 in 2004 - 67 in 2005 - 29 in 2006). Thank you for coming, and may 2003 - 2004 - 2005 - 2006 - 2007 be a good time for all your mental healths. On Sunday 16.3.2003 (almost 3 months from the start) it recorded 6,308 new visitors. The highest daily being 132. The average daily since start being 70.

    [There was a subsequent peak of 138 on Wednesday 23.4.2003. New peaks of 175 on Tuesday 16.9.2003 [1000 new visitors in the week], and 180 on Monday 29.9.2003, 197 on Tuesday 4.11.2003. Then 219 on Tuesday 12.10.2004 and 230 on Thursday 14.10.2004] [November 2004 exceeded 5,000 visitors (a month) for the first time: over 5,286. The daily average since 18.12.2002 reached 100. The maximum daily visit was 262 on 29.11.2004. 14.3.2005: 286, which I expected to be the peak in the 2005 spring, but 5.4.2005 just reached 300. Outside the Christmas period, there are usually over 1000 visitors a week until the summer (June, July, August) when there are between 700 and 1,000. It went above 1500 in weeks 10 (1540), 14, 15 (1604), 16?, 17 of 2005, and again after week 36. (1619 in week 37, 2,117 in week 40, 2,985 in week 46 of 2005. Already up to 2,094 in week 1 of 2006). Day peak: 308 on 13.9.2005: 377 on 6.10.2005: 506 on 7.11.2005: 536 on 15.11.2205: 539 on 16.11.2205. This remains the daily peak. There was a substantial drop in the number of visitors (compared to previous years) in the autumn of 2006. 186 on 27.11.2006 was the highest day I actually noted, but there were probebaly higher days earlier in the month. August 2005: 4074; 2006: 4569 - September 2005: 7193; 2006: 6627 - October 2005: 10519; 2006: 7737 - November 2005: 11598; 2006: 7722]

    April 2005 6559
    April 2006 8176

    May 2005 5709
    May 2006 7515

    June 2006 3957
    June 2006 5339

    July 2005 3375
    July 2006 4240

    August 2005 4074
    August 2006 4569

    September 2005 7193
    September 2006 6627

    October 2005 10519
    October 2006 7737

    November 2005 11598
    November 2006 7722

    December 2005 7622
    December 2006 2978

    January 2006 9396
    January 2007 3933

    February 2006 9381
    February 2007 4754

    March 2006 10857
    March 2007 3850

    22.5.2003: 11,940 new visitors since 18.12.2002. [Add this to the 10,716 below, that is 22,656 since 13.6.2002].

    For six months I had a Dejacey counter here. On 17.12.2002, Dejacey closed all their counters down because of abuse by some users. I had, however taken notes of what it recorded: On Friday 13.12.2002, six months from starting using it, it recorded 10,716 new visitors. (There had also been 11,854 people revisiting). Thank you for coming, I hope you found something to interest you.