Confinement of the insane: Asylums

1. Confinement of the insane: Asylums

2. Two Explanations • Analyses that set the growth of asylums in the context of wider social changes, including the rise of capitalism, urbanisation and increasing ‘social control’. • Analyses that relate the growth of asylums to medical factors: reforms in the conditions of asylum life, claims for the role of the asylum in curing patients, and the rise of the power of medical practitioners.

3. Andrew Scull By the mid-nineteenth century… insanity had been transformed … into a condition which could be authoritatively diagnosed, certified, and dealt with by a group of legally recognised experts … the asylum was endorsed as the sole, officially approved response to the problems posed by mental illness.

4. Growth of asylums in England and Wales (Jones (1993) p. 116) Asylums Patients Av.No. 1827 9 1,046 116 1850 24 7,140 297 1860 41 15,845 386 1870 50 27,109 542 1880 61 40,088 657 1890 66 52,937 802 1900 77 74,004 961

5. John Conolly: Hanwell Asylum

6. Devon County Asylum, 1845

7. High Royds Hospital, Ilkley, built 1888

8. Claybury Asylum, Woodford, Essex, 1891

9. Claybury Asylum, Woodford, Essex, c.1893

10. Colney Hatch Asylum, entertainment for patients, 1853

11. Certificate of Insanity

12. Simple mania, West Riding Lunatic Asylum, Wakefield, c.1869

13. Confinement not cure Pauper patients % Curable 1844 County Asylums 4,244 15% Provincial Licensed houses 1,920 33% 1860 County Asylums 17,432 11% Provincial Licensed houses 2,356 15% 1870 County Asylums 27,890 8% Provincial Licensed houses 2,204 13%

14. Historiographical perspectives MICHEL FOUCAULT: • Asylum was one of a broader range of institutions that aimed to enforce social control. • Mad, along with immoral, dangerous and criminal, were social deviants who had to be segregated and confined. ANDREW SCULL: • Emphasis on economic factors. • Emergence of capitalist economy challenged social bonds and kinship ties. • Insane were a financial and emotional strain on families; unproductive member of the domestic household.

15. John Walton (1981)- Lancaster Asylum Case Study • Asylum not used in a systematic way to deal with the disorderly poor. • Little evidence that asylums were used to quell political or religious dissent. • Few admissions came through the law courts and police rarely involved. • ‘Impossible people’, violence, either self-harm or suicide, or directed towards family members was involved in over half the admissions. • Concluded that families only used asylums as a last, not first, resort.

16. Medical Factors • Redefining madness: boundaries of what constituted insanity were expanded to include heredity, ‘moral insanity’, general paralysis, old age etc. • Medical men: asylum = an institutional base • 1841 Association of Medical Officers of Asylums and Hospitals for the Insane (later Medico-Psychological Association) – collective identity. • Journal of Mental Science and treatise – exchange knowledge and experiences.

17. Medical Factors • From 1840s there was a growth in education and training. • Institutions increasingly conducted informal training. • Late C19th, the MPA introduced an exam for medical students in mental diseases.

18. Conclusion • Links between urbanisation and asylums are not straightforward. • Urban life did not necessarily break social bonds. • Admission was often a last, not first, result; families struggled to cope with long-term emotional strain of caring. • Confinement of the insane was an historical phenomenon deeply embedded in broader social change.

19. Interesting TV programme • Recommended viewing on Asylums: • Jonathan Miller, Madness, Episode 2 ‘Out of Sight’, 1991 • Available on YouTube • Part of a four-part series, but this is most relevant to this lecture.