FOCUS ON: LUNATIC ASYLUM RECORDS
Get an insight into the troubled lives of ancestors with mental health issues and the hospitals where they were treated
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 ( nationalarchives.gov.uk/ 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.
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.
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