Get an in­sight into the trou­bled lives of an­ces­tors with men­tal health is­sues and the hospi­tals where they were treated

Who Do You Think You Are? Magazine - - CONTENTS - Michelle Higgs

The shock of a fam­ily be­reave­ment, ex­treme fi­nan­cial wor­ries and stress caused by over­work: just a few of the rea­sons why our an­ces­tors were ad­mit­ted to lu­natic asy­lums.

They were as vul­ner­a­ble to men­tal ill­ness as we are to­day but the dif­fer­ence lies in the way in which they were treated and ac­com­mo­dated.

Be­fore the mid-18th cen­tury, there was just one pub­lic lu­natic asy­lum in the UK – Lon­don’s Beth­lem Hos­pi­tal (col­lo­qui­ally known as Bed­lam).

There were also many pri­vate ‘mad­houses’ for those who could af­ford to pay for treat­ment, but they were run as com­mer­cial en­ter­prises with lit­tle re­gard for pa­tient care. From 1808, au­thor­i­ties in Eng­land and Wales were en­cour­aged to build county asy­lums for pau­per pa­tients but it was not made com­pul­sory un­til 1845. Be­fore then, and af­ter­wards when there were in­suf­fi­cient places, men­tally ill pau­pers were fre­quently ac­com­mo­dated in work­house wards.

The Com­mis­sion­ers in Lu­nacy were es­tab­lished for Lon­don in 1828, and for the rest of Eng­land and Wales in 1844. They in­spected asy­lums and other premises hous­ing ‘lu­natics’ with no prior no­tice, and had the power to pros­e­cute, with­draw li­censes and im­prove con­di­tions of care and treat­ment. The Com­mis­sion­ers in­sisted on proper pa­tient records be­ing kept and doc­u­men­ta­tion of all cases of phys­i­cal co­er­cion or re­straint. This pro­vides a very de­tailed set of records for asy­lums and their pa­tients.

By 1850, there were 24 county and bor­ough asy­lums in Eng­land and Wales, hous­ing an av­er­age of just un­der 300 pa­tients each. This in­creased to 66 asy­lums by 1890, with places for an av­er­age of more than 800 pa­tients.

Run by the state

In Scot­land be­fore 1855, there were seven large men­tal hospi­tals and a net­work of pri­vate men­tal hospi­tals hous­ing an av­er­age of 25 pa­tients each. In that year, the Royal Com­mis­sion on Lu­nacy in Scot­land found ev­i­dence of ne­glect and ill-treat­ment, plus prof­i­teer­ing in the pri­vate homes. Sub­se­quent leg­is­la­tion led to new asy­lums be­ing built that were run by the state as part of the

By 1850, there were 24 county and bor­ough asy­lums in Eng­land and Wales with an av­er­age of 300 ‘lu­natics’ each

Poor Law, and ad­min­is­tered by the parish. By 1910, there were 19 such asy­lums.

You may have found your an­ces­tor listed on the census as an asy­lum pa­tient or there could be a fam­ily story about some­one in your tree be­ing men­tally ill.

It might shock or sad­den you to find that he or she spent some time in a lu­natic asy­lum; how­ever, the records of such pa­tients pro­vide a rich source of in­for­ma­tion about fam­ily back­grounds, the sup­posed cause of their in­san­ity and the treat­ment that was pro­vided.

The key piece of in­for­ma­tion you’ll need is the name of the asy­lum that your fore­bear stayed in with some ap­prox­i­mate dates. You can then search the Hospi­tals Records Data­base found at ( na­tion­ hos­pi­tal­records). This lists the records that have sur­vived for hospi­tals in the UK (in­clud­ing asy­lums), to­gether with their lo­ca­tion. Most asy­lum records are held in lo­cal ar­chives so you will need to visit to con­sult them.

On­line records

How­ever, an in­creas­ing num­ber are be­ing put on­line. The Well­come Li­brary is con­tribut­ing ar­chives from its own col­lec­tions to a joint pro­ject to digi­tise more than 800,000 pages of ma­te­rial re­lat­ing to psy­chi­atric in­sti­tu­tions, men­tal health or­gan­i­sa­tions and in­di­vid­u­als across the UK.

The ma­te­rial dates from the 18th to the 20th cen­turies and in­cludes pa­tient records such as reg­is­ters and case notes; pho­to­graphs; ad­min­is­tra­tive doc­u­ments; hos­pi­tal staff data; art­work and pub­li­ca­tions pro­duced by pa­tients and staff.

Bear in mind that asy­lum col­lec­tions are rarely com­plete so there may be no records for your an­ces­tor. Also, records less than 110 years old con­tain­ing in­for­ma­tion about named in­di­vid­u­als are usu­ally closed to the pub­lic. It may be pos­si­ble, though, to see more re­cent records if you can prove a re­la­tion­ship to the pa­tient.

There are three main types of record: ad­mis­sion reg­is­ters; dis­charge reg­is­ters; and pa­tient case­books and/or case files. The ear­li­est records from the

mid-18th cen­tury are sim­ply lists of names plus last known ad­dress, dates of ad­mis­sion and dis­charge, and pos­si­bly a rea­son given for dis­charge.

From the 1840s on­wards, the records be­come more de­tailed. More in­for­ma­tion is pro­vided about the pa­tient in­clud­ing oc­cu­pa­tion, mar­i­tal sta­tus, age, phys­i­cal de­scrip­tion, re­li­gion and education.

De­tails are also given about when the men­tal ill­ness first started and the name of the per­son who brought the pa­tient to the asy­lum. This was

Later casebook vol­umes from the 1870s on­wards may con­tain pho­tos of pa­tients

usu­ally a spouse or par­ent so this in­for­ma­tion can help to build up a pic­ture of fam­ily re­la­tion­ships. Asy­lum pa­tients were bathed on ar­rival and a de­tailed record was made of their med­i­cal and phys­i­cal con­di­tion. Af­ter a med­i­cal ex­am­i­na­tion, the type of men­tal ill­ness that the pa­tient was suf­fer­ing from was noted down. This might in­clude melan­cho­lia, ma­nia, de­men­tia or amen­tia (id­iocy and im­be­cil­ity). In the dis­charge reg­is­ters, there is fre­quently a note about whether leave was granted to go home for a short time, and if the pa­tient was cured, im­proved or the same when dis­charged.

Pa­tient case­books

The pur­pose of Vic­to­rian lu­natic asy­lums was to cure the men­tally af­flicted where pos­si­ble, not sim­ply to in­car­cer­ate them. In many cases, time away from the stresses and strains of daily life with fresh air, work ther­apy and reg­u­lar food was all that was needed to im­prove the men­tal well-be­ing of a pa­tient.

Pa­tients’ case­books will con­tain reg­u­lar re­ports about their be­hav­iour and health over the pe­riod of time they were in the asy­lum. It may also men­tion the med­i­ca­tion pre­scribed, whether they were moved to a dif­fer­ent ward as a re­sult of an im­prove­ment in health, and if they took part in any work ther­apy or leisure ac­tiv­i­ties.

Later vol­umes from the 1870s on­wards may con­tain pho­to­graphs of pa­tients.

Agnes Khull, aged 48, was ad­mit­ted to Beth­lem on 5 May 1877, de­scribed as a woman in ‘re­duced cir­cum­stances’ with no oc­cu­pa­tion, suf­fer­ing with acute melan­cho­lia. The rea­son was a “want of self-con­trol in the use of nar­cotics & stim­u­lants and in ab­stain­ing from food, act­ing upon a weakly con­sti­tu­tion”. Her case file states she took chlo­ral “nightly & con­stantly”. As a re­sult, poor Agnes was ex­pe­ri­enc­ing delu­sions, be­liev­ing that “holes have been made in the walls & that peo­ple are watch­ing her through th­ese”. She had even “turned against her near­est friends”. Af­ter suf­fer­ing with­drawal symp­toms from the chlo­ral, Agnes was “much im­proved in both mind & body” by Oc­to­ber. She re­cov­ered and was re­leased “af­ter leave” on 23 Jan­uary 1878.

The grounds of Beth­lem Hos­pi­tal in Lon­don, 1811. Beth­lem records dat­ing from 1638-1932 can be found on Find­my­past

Beth­lem Hos­pi­tal in Moor­fields, Lon­don, in 1860

Left: A med­i­cal case his­tory and pho­to­graph of Con­stance But­ter­worth, a pa­tient at the Hol­loway Sana­to­rium from De­cem­ber 1900 to Novem­ber 1901

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