Confinement of the insane: Confinement of the insane: AsylumsAsylums

Two ExplanationsTwo Explanations

• Analyses that set the growth of asylums in the Analyses that set the growth of asylums in the context of wider social changes, including the context of wider social changes, including the rise of capitalism, urbanisation and increasing rise of capitalism, urbanisation and increasing ‘social control’.‘social control’.

• Analyses that relate the growth of asylums to Analyses that relate the growth of asylums to medical factors: reforms in the conditions of medical factors: reforms in the conditions of asylum life, claims for the role of the asylum asylum life, claims for the role of the asylum in curing patients, and the rise of the power of in curing patients, and the rise of the power of medical practitioners.medical practitioners.

Andrew ScullAndrew Scull

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

Growth of asylums in England and Wales Growth of asylums in England and Wales (Jones (1993) p. 116)(Jones (1993) p. 116)

AsylumsAsylums Patients Patients Av.NoAv.No..

18271827 99 1,0461,046 116116

18501850 2424 7,1407,140 297297

18601860 4141 15,84515,845 386386

18701870 5050 27,10927,109 542542

18801880 6161 40,08840,088 657657

18901890 6666 52,93752,937 802802

19001900 7777 74,00474,004 961961

John Conolly: John Conolly: Hanwell AsylumHanwell Asylum

Devon County Devon County Asylum, 1845 Asylum, 1845

High Royds Hospital, Ilkley, built 1888High Royds Hospital, Ilkley, built 1888

Claybury Asylum, Woodford, Essex, 1891Claybury Asylum, Woodford, Essex, 1891

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

Colney Hatch Asylum, entertainment for patients, 1853Colney Hatch Asylum, entertainment for patients, 1853

Certificate of Certificate of InsanityInsanity

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

Confinement not cureConfinement not curePauper patients Pauper patients % Curable% Curable

18441844

County Asylums County Asylums 4,2444,244 15%15%

Provincial Licensed housesProvincial Licensed houses 1,9201,920 33%33%

18601860

County Asylums County Asylums 17,43217,432 11%11%

Provincial Licensed housesProvincial Licensed houses 2,3562,356 15%15%

18701870

County Asylums County Asylums 27,89027,890 8%8%

Provincial Licensed housesProvincial Licensed houses 2,2042,204 13%13%

Historiographical perspectivesHistoriographical perspectives

MICHEL FOUCAULT: MICHEL FOUCAULT:

• Asylum was one of a broader range of Asylum was one of a broader range of institutions that aimed to enforce social institutions that aimed to enforce social control.control.

• Mad, along with immoral, dangerous and Mad, along with immoral, dangerous and criminal, were social deviants who had to be criminal, were social deviants who had to be segregated and confined.segregated and confined.

ANDREW SCULL:ANDREW SCULL:

• Emphasis on economic factors.Emphasis on economic factors.

• Emergence of capitalist economy challenged Emergence of capitalist economy challenged social bonds and kinship ties.social bonds and kinship ties.

• Insane were a financial and emotional strain Insane were a financial and emotional strain on families; unproductive member of the on families; unproductive member of the domestic household.domestic household.

John Walton (1981)- Lancaster Asylum John Walton (1981)- Lancaster Asylum Case StudyCase Study

• Asylum not used in a systematic way to deal with the disorderly Asylum not used in a systematic way to deal with the disorderly poor.poor.

• Little evidence that asylums were used to quell political or religious Little evidence that asylums were used to quell political or religious dissent.dissent.

• Few admissions came through the law courts and police rarely Few admissions came through the law courts and police rarely involved.involved.

• ‘‘Impossible people’, violence, either self-harm or suicide, or directed Impossible people’, violence, either self-harm or suicide, or directed towards family members was involved in over half the admissions. towards family members was involved in over half the admissions.

• Concluded that families only used asylums as a last, not first, resort.Concluded that families only used asylums as a last, not first, resort.

  

Medical FactorsMedical Factors

• Redefining madness: boundaries of what Redefining madness: boundaries of what constituted insanity were expanded to include constituted insanity were expanded to include heredity, ‘moral insanity’, general paralysis, heredity, ‘moral insanity’, general paralysis, old age etc.old age etc.

• Medical men: asylum = an institutional baseMedical men: asylum = an institutional base

• 1841 Association of Medical Officers of 1841 Association of Medical Officers of Asylums and Hospitals for the Insane (later Asylums and Hospitals for the Insane (later Medico-Psychological Association) – collective Medico-Psychological Association) – collective identity.identity.

• Journal of Mental Science Journal of Mental Science and treatise – and treatise – exchange knowledge and experiences.exchange knowledge and experiences.

Medical FactorsMedical Factors

• From 1840s there was a growth in education From 1840s there was a growth in education and training.and training.

• Institutions increasingly conducted informal Institutions increasingly conducted informal training.training.

• Late C19th, the MPA introduced an exam for Late C19th, the MPA introduced an exam for medical students in mental diseases.medical students in mental diseases.

ConclusionConclusion

• Links between urbanisation and asylums are not Links between urbanisation and asylums are not straightforward.straightforward.

• Urban life did not necessarily break social bonds.Urban life did not necessarily break social bonds.

• Admission was often a last, not first, result; Admission was often a last, not first, result; families struggled to cope with long-term families struggled to cope with long-term emotional strain of caring.emotional strain of caring.

• Confinement of the insane was an historical Confinement of the insane was an historical phenomenon deeply embedded in broader social phenomenon deeply embedded in broader social change.change.

Interesting TV programmeInteresting TV programme

• Recommended viewing on Asylums:Recommended viewing on Asylums:

• Jonathan Miller, Madness, Episode 2 ‘Out of Jonathan Miller, Madness, Episode 2 ‘Out of Sight’, 1991Sight’, 1991

• Available on YouTubeAvailable on YouTube

• Part of a four-part series, but this is most Part of a four-part series, but this is most relevant to this lecture.relevant to this lecture.