Horrific History | Asylums and mental health care in Britain

There have been many horrific tales through history, from gruesome medical practices to bizarre punishments and even some very questionable cleaning habits. Today we will be looking at the horrific history of mental health care in Britain through the ages and the history of Britain’s asylums. Though mental health care is still something to be desired in the UK, at least things have progressed since the days of leeches and cold showers!

Asylums, known as lunatic or insane asylums, were an early version of psychiatric hospitals. Since their establishment, there have been various schools of thought on how best to treat patients, or as they were more commonly known, inmates, and it was the mental health crisis of a monarch that led to doctors realising that mental health conditions could be treated at all.

Mental health care continues to be a divisive subject in Britain,  but thankfully, the treatment of patients with mental health issues is getting better. Treatments for mental health issues, at the time known as lunacy, have been recorded since the Medieval times, when travelling Europeans wrote about their amazement at how well their Islamic counterparts treated ‘lunatics’. In Britain at this time, people who were considered to have mental health issues were housed in a variety of institutional settings, including Fool’s Towers, which were constructed in various towns, being left to live on the city walls or, if they were lucky in a monastery. From the medieval times onwards, it wasn’t uncommon to see people being kept in cages or being used as jesters to entertain rich nobles.

By the 17^th and 18^th centuries, Britain entered a period of time that became known as the Trade in Lunacy, where private “madhouses” were being set up at an astonishing rate compared to elsewhere in the world. One of the most infamous of these asylums became known as Bedlam…

Bedlam

Bedlam began as the Priory of Saint Mary of Bethlehem and was founded in 1247, making it the oldest centre devoted to psychiatric care in Europe. Initially, it was a priory and was run by monks working on behalf of Henry III to collect alms and support churches. Back then, the word 'Hospital' was used to describe any institution supported by charity that cared for the needy, and as such, the Priory would give sanctuary to the poor, as well as offering hospitality to visiting members of the clergy.

Prior to the dissolution of the monasteries, Henry VIII was convinced to cede the priory and its occupants to the City of London, allowing them to run the day to day admin. This saved it from the sacking of other buildings of its type and saw it start to focus more on looking after mentally ill patients. In fact, it is thought that Bethlehem was used to care for people with psychiatric problems from as early as 1377, but the first historical record of patients is from 1403, which reports that six male inmates were on site alongside a record of 4 pairs of manacles, 11 chains, 6 locks and 2 pairs of stocks. However, how often these were used is not certain. By 1460, it had fully transitioned into a hospital, though at the time, conditions including epilepsy, learning disabilities and dementia were all considered to be lunacy, so patients would range from being mentally ill to having seizures and other similar conditions.

The Priory of Saint Mary of Bethlehem has gone through several name and location changes over the years, and is known as Bethlem Royal Hospital, Bethlem Hospital and most notably, Bedlam, a word which means chaos and confusion. From its original site, which was expanded to house more patients, it has moved to Moorfields, also in London, where it was able to expand further and patients were allowed to use the grounds as part of their treatment, then finally to the outskirts of London. Today it is part of the National Health Service but it remains known for the many scandals surrounding the treatment of patients.

Despite being a hospital, Bedlam became one of the top tourist attractions for the city, visitors were able to pay an entry fee to come in and observe the patients, some even tormenting or assaulting them for a reaction. Thankfully, this mostly started to die out in the 1770s when tickets required a signature from one of the hospital’s governors, making it more difficult for the public to attend.

Later in the 1800s, a new wing was added to care for the criminally insane following an assassination attempt on George III (more on him later), which would house criminals until Broadmoor (more on there later too) would be established.

Bedlam wasn’t the only hospital of its kind in London, let alone elsewhere in the UK, but it remains famous for its dark history. Despite the number of asylums that had cropped up around Britain, specialist care was limited at this time, with people exhibiting disturbing or violent behaviour (or just being a woman with an opinion) being institutionalised without any real idea of what constituted madness. In fact, while you had to be considered insane to be admitted into a facility, there was no distinction between what was classified as a mental illness, someone who was criminally insane or someone who had a learning disability or other disability. The term was used to help the police crack down on vagrancy and the poor too, so there were many people confined to asylums that had no real need to be there.

Women in asylums

Like we said earlier, being a woman who spoke up for themselves was considered an act of lunacy and many women were institutionalised purely for speaking out against their husbands or for acting in a way that was deemed unruly in society. It also didn’t help that until the Married Women’s Property Act, a married woman’s property automatically became her husband’s, so getting their wives declared insane, was a great way for men to accumulate wealth and property.  Men, particularly husbands, brothers and fathers, would send the women in their lives to mental institutions as a way of silencing them and profiting from any property they might have.

The discussion around women in institutions and the general misogyny of the time became especially prevelant following a number of high profile court cases, where women were committed and then sued their families. Author Wilkie Collins is said to have based his book the Woman in White on the case of Louisa Nottidge, who found herself being detained in an asylum after inheriting money and daring to spend it setting up a religious commune. Another high profile example was the case of Rosina Bulwer Lytton, otherwise known as Lady Lytton, who was detained in an institution after her marriage broke down and her husband wanted her out of the way.

Treatment

As you can imagine, treatment for mental health conditions at this time were very different to what is prescribed today and with a number of inmates not actually suffering from any conditions, can be described as nothing short of torture for no good reason. Some of the most common treatments included:

Rotational Therapy

This involved a patient being tied to a chair which was then suspended from the ceiling and rotated at speed, sometimes more than 100 times a minute. Naturally, this would lead to vomiting and vertigo, which were said to be a way of purging insanity.

Starvation

Beatings
Blood Letting
Ice baths

These treatments were so bad that many facilities would refuse to admit anyone that they believed to be too weak to withstand them. Many died in the process of being treated and excavations on former sites of Bethlem Hospital have uncovered several mass graves.

These treatments were not just used on members of the public who were unfortunate enough to end up in an asylum, they were used on royalty too, most notably King George III.

George III

George III also under went starvation, ice baths, induced vomiting and the application of arsenic powder to cause burns while being treated for his mental health. Although he remains the longest reigning and living king in British history, he is more widely remembered for being Mad King George and throughout his life he suffered from several episodes of mental unwellness.

The first indication that there was something wrong appeared in 1765 when he was in his late twenties. Though he did recover, he suffered further relapses in 1782 and 1788. By 1811, he was said to have become permanently insane and lived in relative seclusion at Windsor Castle. Contemporaries have said that they believe his condition was a severe form of Bipolar Disorder which became exacerbated by developing dementia and becoming deaf and blind as he got older.

George III’s main doctor was Francis Willis, a former clergyman who owned his own asylum in Lincolnshire and who believed that the root cause of mental illness was over excitement and so attempted to cure the king by controlling his behaviour. In order to do this, he would have servants sit on him, gag him, make him wear a straitjacket, separating him from his family and only allowing him to use cutlery at dinner if he behaved in an approved manner. The king did recover from this bout of illness and Willis was awarded a large stipend which he used to open a second asylum. The king would relapse in 1801 and 1804 before suffering a final mental breakdown in 1811.

George III wasn’t the only monarch that suffered from mental health issues, Henry VI would have several mental breakdowns, starting in 1453, which led to his defeats in the War of the Roses. He was later murdered in 1471.

Broadmoor

Following the opening of a ward for the criminally insane at Bethlem, Broadmoor was established in 1863 and continues to be infamous to this day. Initially known as the Broadmoor Criminal Lunatic Asylum, it remains England’s oldest high security psychiatric hospital. Its first patient was a woman who was admitted for infanticide, the first male patients arrived in 1864, with the hospital split into four blocks for men and one for women. Further blocks were added in 1902.

Over the years, Broadmoor has been used as both a hospital and a Prisoner of War camp, which housed mentally ill German soldiers during the war. The hospital has an alarm system which is based on the Air Raid Sirens used across London in the Blitz. It was installed in 1952 after a patient escaped and killed a local child and alerts members of the public to stay indoors and be aware while recovery takes place. Much like Bethlem, Broadmoor has been known for its less than pleasant treatments over the years, though today it uses a variety of therapies, including medication and occupational therapy. Many of the patients’ art work is on display throughout the hospital and elsewhere, including artist Richard Dadd’s work. He was admitted in the 1850s, firstly at Bethlem and then at Broadmoor. His work is also on display at the Scottish National Portrait Gallery.
To this day, Broadmoor is wrongly believed to be a prison, many patients are sent there following a criminal conviction and nearly all staff are members of the Prison Officers Association, rather than a health care association, however it is maintained as a hospital and covers four NHS regions.

Today, places like Broadmoor, which retains its Victorian appearance, and Bethlem are much nicer to live in than they were when they were first built – thankfully hospitals are much less horrific now!

Stay tuned for more horrific history!