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:
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
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.
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.
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.
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.
The Cambridgeshire Association for the Care of the Feeble-Minded
inaugurated. At first it was a sub-committee of Charity Organisation
Society organised by Mrs. F. A. Keynes and Ida Darwin.
Pellagra shown by Joseph Goldberger (1874-1929) to be caused by a
nutritional deficiency and not by an infection.
It was then decided to equip special War Mental Hospitals where soldiers
would stay for up to a year (reduced to nine months) under observation and
treatment without certification.
Royal Commission on Venereal Diseases recommended free diagnosis and
treatment. It was estimated that 10 per cent of the population in large
cities were infected with acquired or congenital syphilis
Miss Lucy G. Fildes, Provisional National Council for Mental Health
listed as an appointee to the Committee on the Treatment of Children
Deprived
of a Normal Home Life
(National Archives)
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 important texts such as
Blacker (1946) and
Tredgold (1947). 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).
|
1952 First edition of
David Stafford-Clark's Psychiatry
Today published by Penguin. The inside cover blurb begins:
"For better or worse, psychiatry is news today: it is also
frequently a feature of entertainment on the films, on television, on the
radio, and provides a theme for books and a plot for plays. Although it is
one of the fundamental branches of medicine it has always received
notoriety more readily than fame, and seems all to often to promise more
than it can perform. What was once a forbidden mystery is in danger of
becoming a popular fad"
The corresponding blurb for the second edition in
1963 began.
"Since... the first edition of Psychiatry Today
was published, the general public for which it was specially written have
brought over 130,000 copies. It has been translated into French, Dutch,
Spanish, German, Italian, and Greek"
Chapter 7: A Consideration of Treatment "...the method of treatment
most closely associated in the public mind with psychiatry... is that of
psychotherapy". In this he includes "forms of reassurance, support,
understanding, and guidance" of varying depth - occupational therapy -
social measures, which are "the province of the trained psychiatric social
worker" - a "series of interviews" including "a complete life history of
the patient" - "periodic advice and supervision over some time" -
psychoanalysis and other forms of psychotherapy aimed at providing the
patient with insight - brief methods of analytical psychotherapy, including
hypnosis - group therapy. He then indicates that "in the opinion of most
psychiatrists" "physical methods have a greater part to play" in the
treatment of depression and schizophrenia. [See St David's 1956]
The discussion of physical treatment begins with general physical health
(for example, nutrition) and the treatment of physical disorders underlying
such mental illnesses as acute toxic confusional states and
general paralysis of the insane by
Penicillin. The drugs discussed are
sedatives (for abreactions and for continuous sleep treatment) -
amphetamine
- and
antabuse. The combination of
benzedrine and
ephedrine in treating children who wet their beds is discussed.
The three physical treatments that had "radically altered the whole
outlook" for patients suffering from depression and schizophrenia
"previously beyond the power of psychological medicine to control" were
electrical treatment - deep insulin treatment -
neuro-surgery
|
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) - See
Derby
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)
September 1953 was the centenary of Brentwood Mental Hospital, which
was renamed
Warley
Hospital. The centenary
was celebrated by a booklet, published in
May 1953.
September 1953 World Health Organisation report
The Community Mental
Hospital - "the need to provide more psychiatric hospital beds
is being over-emphasised at present in some countries of western Europe and
North America to the detriment of the provision of other services which
would reduce the need for the admission of patients into psychiatric
hospitals or alternatively reduce the length of stay of those patients who
must be admitted."
22.10.1953 Winston Churchill (UK Prime Minister) announced
a Royal Commission on the law relating to mental illness and mental
deficiency. The names of the Chairman and other members to be announced
later.
(Hansard)
1954
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.
Mind's Key Dates: 1954 "The first out-patient
nurses were appointed at
Warlingham Park Hospital, Croydon. Their duties included
visiting out-patients, supporting in-patients who had been discharged,
helping find jobs and accommodation for them, and being available to give
advice at out-patient clinics or therapeutic social clubs."
Royal Commission on the Law Relating to Mental Illness
and Mental Deficiency (1954 to
1957), under Lord Percy. 4.5.1954
First day of evidence: Ministry of Health and Board of
Control (jointly). The
National Council for Civil Liberties gave evidence on Day 22.
14.8.1954 to 21.8.1954 Third
World Federation for Mental Health congress held in Toronto,
Canada on the subject, "Mental Health in Public Affairs". In conjunction
with this, The International Association for Child Psychiatry held an
"International Institute on Child Psychiatry" on August 13th and 14th
with the theme "Emotional Problems of Children Under Six"
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.
Chlorpromazine was the first of the modern range of psychiatric drugs -
anti-psychotics - ant-depressants and minor tranquillisers - that control
distressing symptoms rather than just sedating patients. Although the
dominance of drug-treatment in psychiatry starts with chlorpromazine, it
took a decade or more to become established. See
1968
1955
1955 onwards: Substantial sums of money for construction of
new
hospitals
1955 to 1962: "Community methods of treatment and ward
management" established at
Claybury Hospital in Essex.
The Association of Parents of Backward
Children changed its name to the
National Society for
Mentally Handicapped Children in 1955. The society's history says it
shortened its name to Mencap in 1969, but I have not found this name used
in 1970s references, although it was in use in 1981 ("Mencap - The National
Society for Mentally Handicapped Children and Adults").
|
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
|
Meprobamate (Miltown) launched in the United States in 1955.
Effects described in Cosmopolitan as "safe and quick, Miltown does
not deaden or dull the senses, and is not habit forming. It relaxes the
muscles, calms the mind, and gives people a renewed ability to enjoy life"
(source)
1.3.1955: Charity known (from 1979) as The Tudor Trust established
by a gift of
shares in the construction company, George Wimpey.
(external source)
In 2006/2007 it helped
to fund the
National Survivor User Network
2.9.1955
Christopher Mayhew, Labour MP and Television presenter,
took the hallucinogenic drug Mescaline as part of a BBC Panorama
documentary that was never broadcast.
(weblink)
1956
|
St David's Hospital Carmarthen 1956-1958
"I saw the doctor in charge and was foolish enough to tell him about my
voices... I was... moved to a ... ward where patients were given
insulin.
Before moving I had read on the walls of the admission ward, notices about
rights of appeal to the local M.P., but decided this would be a waste of
time.
... the lady psychiatrist ... tried very hard to persuade me to sign a
"voluntary form". This seemed a farce to me and I refused."
"my shouting and yelling disturbed the other patients... I was forcibly
stripped (except for a sanitary towel!), fighting and struggling, turned
over and
injected in the buttocks. The last I remember was someone saying
"Sit on
her". Then I passed out."
"I was given about 4
E.C.T.s and about
4 to 6 weeks insulin. I said I was
not going to physically fight... The (man) doctor said 'Doesn't she think
she ought to feel grateful for having treatment?'"
"I expected psychiatrists to talk to their patients". [See
Stafford-Clark 1952] "I hardly ever saw
(five times in two years) the man in charge of me, except passing in the
corridor."
Nurses did far more than they were paid to do, taking patients to their own
homes, to the pictures etc. There was much kindness in this hospital, but
it has taken me years to get over it, and the fear of going back is
strong".
|
|
A survey by the
Institute of Community Studies of over 80
Bethnal Green patients who were sent to
Long Grove, on the other side of London, in 1956 and 1957.
Enid Mills' interviews with them and their relatives show what happened,
their reactions and impressions. She describes and discusses the
difficulties
of changing from a remote mental hospital system to a community service
centred on local hospital such as the St Clement's Observation Unit (as it
was before 1959).
|
21.2.1956 Twenty-four year old
Kathleen
Rutty
discharged from certification as a mental defective by the High Court,
following a writ of habeas corpus from the
National Council for Civil Liberties. Kathleen was out on
licence from Rampton. Under her licence she was barred from
having boy-friends, or going to the cinema or to a dance. Afterwards she
said "Now there will be no more fear that someone will be looking over my
shoulder to see if I break the rules"
(Roxan 1958 pages 226 and 231).
Peter Whitehead was discharged directly from Rampton in
December, whilst a writ was before the High Court.
"there had been some publicity about
Rampton... 1956 or 1957 - I'm not sure which... exactly what was
going on I'm not sure... We were not, of course, allowed to see the write-
ups, so I cannot be certain... A hockey match was put on" [for the
journalists] and a whole lot of other bull... the institution fooled the
News of the World, but not the Empire News" (Noele Arden 1977,
page 82)
1957
Breaking through the taboo
of silence
On the wireless, the
Archers
had featured a mental
hospital in 1954.
The Hurt Mind, in
January 1957 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]
The five episodes were 1.1.1957
"Put Away" - 8.1.1957 "Breakdown" -
15.1.1957 "Psychological Treatment" - 22.1.1957 "Physical Treatment" -
29.1.1957 "Your Questions Answered". The BBC monitored the effects of the
series, with a survey of viewer's attitudes before and after. This was
published in May 1957: The Hurt Mind: An Enquiry Into Some of the
Effects of Five Television Broadcasts about Mental Illness and its
Treatment. Audience Research Report, B.B.C. May, 1957.
In books, a mental patient could look you
straight in the eye
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.