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Copy of MH OT Timeline
Transcript of Copy of MH OT Timeline
(The Age, 1974) "There are four full-time and two part-time occupational therapists. There should be 20 full time."
(The Minus Children, 1973)
a stout ring was rivetted round his neck, from which a short chain passed to a ring made to slide upwards or downwards on an upright massive iron bar... Round his body a strong iron bar about two inches wide was rivetted... which being fashioned to and enclosing each of his arms, pinioned them close to his sides.... bars... passing over his shoulders, were rivetted to the waist bar both before and behind..." (Edward Wakefield to Select Committee in 1815)
26.12.1814 A fire at York Asylum killed four patients and prevented effective investigation of the asylum.
End of the war between Britain and France
The Moorfields Bethlem was replaced by one at St George's Fields, South London, in 1815. Following a Select Committee Report in 1807, the Government made an agreement with Bethlem's Governors that the new asylum should have two wings for 60 criminal lunatics. By 1852 Bethlem contained over 100 of the country's 436 criminal lunatics. They were moved to Broadmoor in 1863. The present Imperial War Museum is the administrative block of the Moorfields Bethlem. The dome was added in 1846.
Bethlem in 1844
James Bevans, "Architect of Grays Inn Square", put before the 1815 Select Committee on madhouses a "Panopticon Plan" for a proposed London Asylum, which was never built. This asylum had a chapel for the patients, whereas four other plans that Susan Piddock looked at, the new Bethlem, Wakefield, Hanwell and Devon did not. Under William and Mrs Ellis, however, religion and work, were features of Wakefield and Hanwell from the start.
6.7.1815 Suicide of Samuel Whitbread, leading Whig politician, social reformer and theatre goer. See 1818 and 1822
11.7.1815: First Report from the Select Committee of the House of Commons on Madhouses
Act regulating private asylums in Scotland
26.4.1816 to 11.6.1816: Further Reports from the Select Committee of the House of Commons on Madhouses
July 1816 John Haslam dimissed from Bethlem Hospital. Thomas Monro, the visiting physician, was also dismissed, but succeded by his son, Edward Thomas Monro (see 1852) in a joint appointment with Sir George Leman Tuthill.
Sunday 28.7.1816: Lancashire County Asylum (1st), Lancaster Moor opened. Administrative records start in 1810
1817 Friend's Asylum, Philadelphia opened in imitation of the Retreat
Jonathan Martin, the mad Methodist, attempted to shoot a Church of England Bishop. See 1829
30.7.1818 Pembroke House officially opened for East India Company Lunatics. Possibility that they to had been confined at Hoxton House previously.
English Heritage: Royal Naval Hospital, Haslar, Gosport, built 1745-1762 as the first hospital for Royal Naval sailors
August 1818 The Royal Naval Asylum. Haslar, opened at Gosport, near Portsmouth in 1818. The naval officers in Hoxton House were removed to Haslar. Relatives appreciated this as the treatment at Haslar was good, but were distressed when deductions from pensions were made as a contribution to costs (Hansard 16.7.1844). [The Naval Hospital opened at Yarmouth, in Norfolk in 1811 was very short lived as a hospital. However, it was used as an army lunatic asylum from 1844 to 1854 and became a Naval Lunatic Asylum in 1863/1869 [ Kathryn Morrison (7.1995) says "the former naval hospital at Great Yarmouth became the naval lunatic asylum in 1869, and special mental units were added to Haslar in 1908 - 1910, and to Plymouth in 1905"]
1.10.1818: Staffordshire County Asylum opened. Administrative records start in 1812.
2.11.1818 Suicide of Samuel Romilly, lawyer and radical MP who had been at the front of the campaign to reduce the number of capital offenses
23.11.1818: West Riding Yorkshire County Asylum, Wakefield opened. The Committee's minutes date from 1814
Bethlem was used by the army and navy for some of their lunatics. In 1819, the army converted Fort Clarence, Chatham (Rochester, Kent) to a military prison and lunatic asylum (separate parts). The asylum, like Pitt and Netley which succeeded it, was situated in a naval port where soldiers could be received from abroad. From there they might be moved to other asylums. Clarence, Pitt and Netley were the receiving asylums (or lunatic wards). Separate military asylums were created for long-term care and custody at Yarmouth (1846-1856) and Bow and Coton Hill. Military pensioners were also kept in non-military asylums throughout the country.
29.1.1820 Death of George 3rd, who had been confined at Windsor since December 1811
20.4.1820 Lincoln Lunatic Asylum opened. Originated in a bequest made in 1803
August 1820 Cornwall County Asylum opened. Notice of intention to build had been published in October 1810
1820-1821 Dundee Royal Lunatic Asylum opened. external link
Under the 1821 Irish Lunatic Asylums for the Poor Act, eight or nine District Asylums opened in Ireland (by 1835) at (eight of them) Armagh, Connaught, Carlow, Clonmel, Limerick, Londonderry, Maryborough, and Waterford
Dr Thomas Turner was Treasurer to the Physician's Commission from 1822. Turner became a Metropolitan Lunacy Commissioner in 1828 and a Lunacy Commissioner in 1845, eventullly retiring, aged 82, in 1855.
Monday 12.8.1822 Suicide of Robert Stuart, Viscount Castlereagh, the Foreign Secretary. An evening paper in London reported he had died of an attack of gout in the stomach. The Times, the following morning, reported that he had "been suffering under a nervous fever, accompanied by a depression of spirits". He "refused to have his bed made on Sunday night, expressing an apprehension of taking cold". "Yesterday morning... During the absence of his servant, it appears his Lordship had got possession of a razor or some sharp instrument, which he applied to his throat..." William Wilberforce thought that if Castlereagh, Romilly and Whitbread had been observers of the Sabbath they might not have collapsed under the strain. (Howse 1953 p.17)
Commencement of lectures on mental diseases by Alexander Morison (1779-1866). An outline of these was published in 1825. They are described by Hunter and Macalpine as "the first formal lectures on psychiatry". Morison was physician visitor to Surrey madhouses from (about) 1808/9/10, and (non-resident) physician to Hanwell from 1832, Bethlem from 1835 to 1853 and Surrey County Asylum from 1841. From about 1824, Nic Harvey (1996) says Morison developed an extensive private practice recommending and organising a full range of domestic and asylum care for private insane patients.
Gloucester County Asylum
Now known as Horton Road
George Combe's Elements of Phrenology published. Phrenology was the identification of an individual's faculties by feeling the shape of the skull. Franz Joseph Gall (1758-1828) was one of the first to carry out anatomical dissections of the human brain. He argued that mind was based on the brain, that different characteristics of mind would give different shapes to the surface of the brain (variations in the size of lobes) and that the shape of the brain imposed itself on the skull. Johann Kasper Spurzheim (1776-1832) combined this theory with the idea that the individual's environment should be adapted to his or her faculties. This could be done in institutions such as schools and asylums. Amongst those who followed the science of phrenology were the educational pioneer, Robert Owen, the medical journalist, Thomas Wakley and the medical superintendents of many lunatic asylums, including William Ellis, John Conolly and Samuel Gaskell. Phrenology provided the scientific basis on which moral management could be considered a medical issue. The Edinburgh Phrenological Society was established by George and Andrew Combe in 1820. Philadelphia Phrenological Society (the first in the USA) started in 1822. The London Phrenological Society was established by John Elliotson (and others) in 1823, In December of the same year, the Phrenological Journal (of Edinburgh) started (the first). In 1825, William Ellis established the Wakefield Phrenological Society. George Combe (1788-1858) bequethed his money to scientific education and, in 1906, it was used to fund a psychology lectureship and laboratory at Edinburgh University. John Stuart Mill (an associationist) argued in 1843 that the "latest discoveries in cerebral physiology" suggested that phrenology was untenable.
First Act regulating private asylums in Ireland
Dr John Bright was Secretary to the Physician's Commission from 1825. Replacing Richard Powell. Bright became a Metropolitan Lunacy Commissioner in 1828.
Siegburg asylum, near Bonn opened. This was the base of Dr Jacobi who wrote on the management and construction of asylums. Other asylums opening in central Europe in the 1820s were Prague (1822), Dusseldorf (1826), Hildesheim (1827) and Colditz (1829)
The autumn of 1826 saw the onset of John Stuart Mill's "dull state of nerves" which was cured by poetry.
29.6.1827: Report from the Select Committee on Pauper Lunatics in the County of Middlesex and on Lunatic Asylums presented by Robert Gordon
The madhouse and county asylums Acts that followed this report are an inter-related product of the concern about the management of Middlesex Pauper Lunatics. They are legislation by and for London (Middlesex) magistrates and the magistrates who built Hanwell were also an integral part of the Metropolitan Commission that regulated the private houses - including the large pauper houses.
Science Time Line 1828
1828 "Insanity is the scourge brought down on sinful men by the wrath of the Almighty" (George Man Burrows, opening words of Commentaries on the Causes, Forms, Symptoms, and Treatment, Moral and Medical, of Insanity 1828. Quoted Kraepelin 1918, pages 38- 39 (See 1811)
The 1828 County Asylums Act
The 1828 Madhouses Act established:
The Home Secretary's Metropolitan Commission:
Five physicians, including the Secretary and Treasurer of the Physician Commission; six Middlesex JPs and ten other honorary commissioners, were appointed by the Home Secretary in August 1828 to form a commission specifically to control London's madhouses. The medical commissioners were paid one pound an hour, the others were not paid.
A lawyer was appointed the Commission's Treasurer-Clerk (London Clerk) to establish an office and keep (national) registers.
New commissioners were appointed as and when necessary. With a few exceptions, the honorary ones needed replacing relatively often, but all but one of medical commissioners served until 1845 (and some beyond).
The commission was funded, in excess of licence receipts, by the national Treasury. It only licensed houses if it saw fit, and the Home Secretary could revoke a licence on its recommendation.
Quarterly licensing meetings were held, to which applicants had to submit, in advance, written details of proposed houses.
Commissioners (usually two medical and one honorary) visited each house at least four times a year and their reports were taken into account before the (annual) renewal of the licence.
The Westminster courts could no longer order visits and reports and did not have statutory access to registers. Instead the commission had power to release a patients on its own authority.
Biographies of Unpaid and Medical Commissioners begin in 1828
The Chart of the Metropolitan Commissioners begins in 1828
Guggenmoos school for deaf-mutes and cretins opened in Salzburg
1.1.1829 Suffolk County Asylum opened.
1.2.1829 Jonathan Martin, the mad Methodist, set fire to York Minster. See 1817 and "Methody parsons" in 1844..
August 1829 Chester County Asylum opened.
Therapeutic Optimism: The optimistic period in the history of asylums runs from about 1830 to around 1860. It was at its height in the 1840s. Asylums built under the 1808 and 1828 County Asylums Act tended to be left to the management of doctors. As the theories and techniques of managing lunatics in asylums developed, so did the belief that this asylum treatment itself was the correct, scientific way to cure lunacy.
Signs of the therapeutic change can be seen in the changing legislation. The 1828 Madhouses Act, unlike the 1774 Act, was concerned about conditions in asylums. These included the moral conditions. Official visitors were required to inquire about the performance of divine service and its effects. In 1832, this inquiry was extended to include "what description of employment, amusement or recreation (if any) is provided". (see law)
1830 revolution in France, riots in England
Wednesday 25.8.1830 The Superintendent of Bethlem, and current President of the London Phrenological Society, Dr Edward Wright was found at night with female patients. He denied wrong doing, but was dismissed after an inquiry.
"After Bethlem Wright spent some time in Syria where, according to one writer, 'he became rather spoiled for regular practice'. A fondness for grog always seemed to catch up with him. He had returned to London by 1834, but soon left for Australia.
In January 1831, John Thomas Perceval, a son of Spencer Perceval, the assassinated Prime Minister, was confined in Brislington House Asylum. In May 1832 he was moved to Ticehurst Asylum. He may have been taken to Brislington by his brother, Spencer junior, an enthusiastic Metropolitan Lunacy Commissioner and a Member of Parliament, who shared John Thomas's religious enthusiasm. Spencer Perceval was, at this time, campaigning for national days of fasting and humiliation. Soon after John Thomas was discharged from Ticehurst, he visited Esquirol in Paris to discuss the reform of the lunacy system. (Hunter and MacAlpine say this was "presumably in 1835"). In 1838 he published the first volume of his book about the treatment of the insane, which contained the account of his own insanity and the way he was treated (see extracts)
Monday 16.5.1831 First Middlesex County Asylum at Hanwell opened. See Harriet Martineau's article, June 1834
October 1831 Cholera reached Britain (external link) - It returned in 1848 - 1853 - 1865. These cholera outbreaks were important in the development of the germ theory of diseases
in 1831 and 1832 "many thousands perished of this new disease...although it was a time of great political excitement, and a year of election riots, the people nowhere in England entertained the dreadful suspicions of occult poisoning which excited the populace to madness and to murder, not only in Hungary, but in Paris" (Farr, W. 25.7.1868, p.ix)
1832 Parliamentary reform
1.8.1832 Dorset County Asylum opened
The 1832 Madhouses Act established:
The Lord Chancellor's Metropolitan Commission:
Appointment of the commissioners was transferred to the Lord Chancellor as custodian of the property of lunatics. The number of professionals was increased by the appointment of two barristers as legal commissioners, paid (under the 1833 Madhouses Amendment Act) at the same rate as the physicians. The honorary commissioners were reduced and, because legal commissioners could take their place, they were no longer essential for licensing and visiting. Although largely responsible to the Lord Chancellor, the commission retained some responsibility to the Home Secretary.
The Metropolitan Commission in Lunacy from 1832
Biographies of Legal Commissioners begin in 1832
1.1.1833 Kent County Asylum, Barming Heath, Near Maidstone opened
The freedom from slavery celebrations
1834 Under the 1834 Poor Law, workhouses for paupers were established in every part of England and Wales. In part, the growth of asylums and other institutions was a consequence of this Act, as many of those who became settled residents of the workhouses were children (schools needed), sick (hospitals needed), mentally ill or with a learning disability (lunatic asylums needed) or old (old people's homes needed).
Between 1832 and 1834, Harriet Martineau (1802-1876) popularised the principles of self-reliance on which the new poor law was based in her monthly Illustrations of Political Economy stories. She also visited Hanwell Lunatic Asylum and published an eight page account of it in June 1834.
A Treatise on Insanity, by James Cowles Prichard was the main textbook on the subject for many years. In it he elaborated the concept of moral insanity that he had previously outlined in articles.
Statistics: Colonel William Henry Sykes, a founder member of the London Statistical Society, became an Honourary Metropolitan Commissioner in September 1835. A considerable interest in the scientific (statistical) analysis of the death rates in asylums developed over the following years.
See the formation of statistical societies
August? 1836 A Madman's Manuscript in Charles Dickens' The Pickwick Papers
14.5.1837 New Leicestershire County Asylum opened
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.
Thursday 20.6.1837 Death of William 4th. Victoria began reign. Rev William Barnett thought he had occasioned her death - but she came alive again.
news for 19.7.1837
21.10.1837 Editorial on The Regulation of Lunatic Asylums, from The London Medical Gazette reproduced on the Rossbret site
"In 1838, France passed a law mandating the internment of lunatics at public expense in every French department" (Richard Keller 2001)
French text of Loi sur les aliénés number 7443 du 30 juin 1838
"The French legal code of 1838 relating to mental health administration...is the first comprehensive legislation in this field (a partial law had existed in England since 1828" according to Ackernecht (1968, p.50), who says the law was "designated" by Esquirol. This, he says, served as a model for similar legislation in Switzerland (also 1838), England (Ackernecht says 1842, but I think this would only apply to the 1845 laws) and Norway (1848) - click for my discussion of influence on English/Welsh legislation
Also in 1838: Le Traité des maladies mentales considéré sous le rapport médical, hygiénique et médico-légal by Esquirol
Railways made the national government of lunatic asylums and a national trade in pauper lunatics possible. In September 1838 the London to Birmingham Railway opened. The first main line in the world. 112.5 miles long from Camden to Birmingham, it linked to the Grand Junction at Curzun Street, Birmingham, and this linked to the Liverpool and Manchester north of Warrington, near Newton. At this junction, which all the trains from London to Liverpool or Manchester passed through, two officers of the New Poor Law (one no longer serving) established in 1843/1844 a private asylum to receive pauper lunatics from all over the country. (See 1846).
The all rail route of 206 miles London to Liverpool took just over eight hours and this speed of travel made the national inquiry into the treatment of pauper lunatics, in 1842, possible. The railways and the electric telegraph, taking messages along the side of railway line may be the main reason why legislation in 1828 was for a Metropolitan Commission in Lunacy, and in 1845 for a national commission. (See reciprocal development)
External link to local history about the Birmingham to Newton railway
Railways and criminals
May 1839 John Connolly visited Lincoln Asylum where Robert Gardiner Hill had abolished mechanical restraint of patients in a small asylum. On appointment to Hanwell, Connolly proceeded to abolish it in a large asylum. Several English asylums were practising non-restraint by 1844.
Select Committee of the House of Commons Hereford Lunatic Asylum. A madhouse proprietor tried to work the system, and focused the attention of parliament onto the counties.
4.6.1839 First patients admitted to the Crichton Institution, Dumfries, Scotland (external link). The first asylum for Scotland south of Edinburgh and Glasgow. The building had a Bible for a foundation stone.
ASYLUM CARE 1840s:
In the hungry-forties of the 19th century many believed that by moving mentally unstable people from a community disturbed by poverty, depravity and social unrest to a closed, humane, but disciplined environment in a lunatic asylum early in the development of their insanity they could be cured and the accumulation of chronic lunatics on poor relief halted. Laws to make every part of England do this were passed in 1845.
But the creation of a Lunacy Commission, justified by this ideal, was not a conscious plan worked out in advance by reforming politicians and professionals, but the result of people rising to meet forces that took them by surprise. Forces that were, once again, symbolised by a bullet.
See also 1890
Science Time Line 1840
1840 Major changes in London's three large private pauper houses at Hoxton - Bethnal Green - and Peckham. The Metropolitan Commission's report for 1.6.1840 to 31.5.1841 says
"the Commissioners have issued express direction that a sufficient number of keepers shall in all cases be employed, so as to obviate the necessity of personal restraint, except in extreme cases; and they have also endeavoured to establish some system of classification" (separating convalescent patients from violent or confirmed mania) "... "these endeavours have been seconded by the proprietors and superintendents of the three large houses, where classification is chiefly necessary... these persons have lately bestowed much attention on this subject, and have, in fact, incurred much expense... The number of keepers has been greatly increased... a greater number of rooms has been appropriated to the reception of patients, and, in some cases, new buildings have been erected..." Since May 1840 "a considerable number of pauper lunatics" had been moved from Hoxton, Bethnal Green and Peckham to "the Surrey County Asylum", and others to Hanwell - so the total number of patients in London private asylums was falling, although the Commission did not expect this trend to continue "not... from any increase in insanity, but from... more case becoming public, and greater care being bestowed on persons afflicted with the disease"
10.4.1840 A date given for the start of the construction of Pentonville Prison. It was opened in 1842. Another source says it took less than 18 months to construct. The semi-radial plan has some similarities to the Devon County Asylum. The heating and ventilation system was adopted by the Derbyshire County Asylum (See Conolly, J. 1847). The prison was known as the model prison as providing a pattern for future prisons. In 1835 and 1836, the Poor Law Commissioners had published a variety of model workhouse plans (Outlined on Peter Higginbotham's site. A hospital that performed a similar function as a model for hospitals was the Royal Herbert (1865). It is harder to pick a model asylum, but John Conolly (1847) focused on the plans for the Derbyshire County Asylum (1851)
The Madhouse System published as a pamphlet by Richard Paternoster. Much had already been published as newspaper articles.
A community for epileptics founded at Bielfeld, in Germany.
This became a model for similar communities. (Jones and Tillotson)
February 1841: The London Statistical Society announced that it intended to collect lunatic asylum statistics during the year
13.2.1841 The first installment of Charles Dickens' Barnaby Rudge: A Tale of the Riots of 'Eighty, about the 1780 no-popery riots, began to be published weekly in the Clock. Barnaby has charactersitics of idiocy and lunacy. In chapter forty seven, his mother and Barnaby met a "country gentleman" in the "commission of the peace" who tries to horse-whip Barnaby. The widow pleads that "her son was of weak mind".
"An idiot, eh?" said the gentleman, looking at Barnaby as he spoke... "There's nothing like flogging to cure that disorder. I'd make a difference in him in ten minutes, I'll be bound". "Heaven has made none in more than twice ten years, sir." said the widow mildly. "Then why don't you shut him up? We pay enough for county institutions, damn 'em. But thu'd rather drag him about to excite charity - of course."
14.6.1841 Surrey County Asylum opened - But see above
Asylum doctors: 19.6.1841 circular from Samuel Hitch MD of the Gloucestershire County Asylum to other asylum officers, which led to 44 out of 83 doctors agreeing to belong to an asylum officers association. [ External link to Royal College of Psychiatrists website]
asylum doctors in the USA
August 1841 Isabella Thackeray suffered from intense suicidal depression (following the birth of her third child, Minny Thackeray, in 1839). She spent the rest of her life in care as a mad woman. When Charlotte Bronte dedicated the second edition of Jayne Eyre to William Makepeace Thackeray, she did not know about his wife Isabella. [See Hilary Marland. Maternity and Madness: Puerperal Insanity in the Nineteenth Century - archive]
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.
Dickens on USA asylums
Hanwell in the USA
The 1842 Licensed Lunatic Asylums Bill was brought into Parliament on 17.3.1842 by Granville Somerset, as a government measure. He had the half-hearted support of Lord Ashley, the de facto chair of the Metropolitan Commission and was opposed by Thomas Wakley MP. The medical opposition inside and outside Parliament, and Ashley's conversion to the new system of non-restraint with moral management, led to the initial Bill being completely reformed into a Bill for a National Inquiry into the teatment of lunacy.
The 1842 Licensed Lunatic Asylums Bill proposed a
as it was thought that county licensing and visiting was defective, it was proposed that the two legal commissioners should visit and report on county houses supplementary to the county visitors. The House of Commons rejected this proposal and an amended bill became the Inquiry Act.
The 1842 Inquiry Act established the
Two medical and two legal commissioners were added to the commission, and the number of honorary commissioners further reduced. No new commissioners were appointed during the Inquiry. One of the new medical commissioners was a psychiatrist, the other a medical statistician.
The medical and legal commissioners jointly visited and reported on public asylums and licensed houses throughout England and Wales. Already much extended in response to the challenge of moral management, the inquiry became even more general in response to the national panic about dangerous lunatics when McNaughton was found insane in 1843. In 1844 the commission published a 300 page report with recommendations for changes in the law aimed at curing and controlling. It included a national register of the insane, controls on the discharge of lunatics, extended asylums provision and regular monitoring of lunatics not in asylums.
10.7.1842 Jabez Jackson, aged about 25, and Hannah Beardmore were married in Chesterfield. The birth of Jabez Columbus Jackson was recorded in the Belper district of Derbyshire in the December quarter of 1845. In 1851 Jabez senior was brought from Belper to become the Derbyshire County Asylum's first patient. He was then paralysed and had to be carried from the cart to a padded room, which was used because of his helplessness rather than his violence. His hips, back, shoulders and knuckles were "extensively excoriated" and was very sore. This was put down to his having been "the subject of mechanical restraint". Extreme debility and "paralysis about the sphincters of his bladder" made him unable to keep himself clean. He was said to be epileptic. The asylum was dedicated to non-restraint principals and by September 1851 Jabez was clean in his habits and working somewhere in the ward, kitchen or garden. In the summer of the following year he died. His son became a potter's printer in Staffordshire, married to Jane, a potter's transferer from Wales. They had two sons.
Annales médico-psychologiques du système nerveux founded by Baillarger and others in France. It is the oldest surving journal of psychiatry. (website)
3.3.1843 Trial of Daniel McNaughton in the midst of revolutionary fear.
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 1844 Lunacy Report and the Census of the Insane
The report was published early in July. On 12.7.1844, Ashley startled the Home Secretary by announcing that there were over 12,000 pauper lunatics outside asylums, many of them "absolutely dangerous"
English and Welsh asylums with paupers in 1844
Forms of diseases
Non-restraint The 1844 Report recorded public and private asylums employing the non-restraint system (see 1839) and others that used mechanical restraint, but were not using any at the time of their visit. The non- restraint asylums were: Lincoln, Northampton, Hanwell, Lancaster, Gloucester, Haslar and Suffolk in the public sector, Fairford and Denham Park in the private. The new Haydock Lodge private asylum was also committed to non-restraint. Asylums not committed to non-restraint, but where non was in use when the Commissioners visited were: Cornwall, Dorset, Nottingham, Norfolk, The Retreat at York and Radcliff Infirmary. The Lancet in 1842 contained that on 10.6.1842 no patient in Bethlem Hospital was under restraint.
Science Time Line 1845
See 1840s, 1890s
March 1845 Shropshire and Wenlock Borough County Asylum opened. Union with Montgomery (Wales) in 1846 made it the first County Asylum provided for Welsh patients
19.5.1845: Sir Thomas Freemantle introduced the Bill that was to establish a Central Criminal Lunatic Asylum in Ireland. This was opened at Dundrum in 1850. Renamed the Central Mental Hospital in 1961, it has been described as "the oldest forensic secure hospital in Europe" [external link]
July 1845 Devon County Asylum opened
Two linked Acts were introduced by Lord Ashley:
The 1845 County Asylums Act compelled every county and borough in England and Wales to provide asylum treatment for all its pauper lunatics and Lord Ashley told Parliament that this would "effect a cure in seventy cases out of every hundred" (Hansard 6.6.1845 column 193).
The 1845 Lunacy Act established the Lunacy Commission:
The Act named eleven Metropolitan Commissioners as Lunacy Commissioners. Six (three medical and three legal) were to be employed full time at salaries of 1,500 pounds a year. The other five were honorary commissioners whose main function was to attend board meetings. The Permanent Chairman had to be an honorary commissioner, but otherwise they were not essential to the commission's operations. The only Metropolitan legal commissioner not appointed as a Lunacy Commissioner was named in the Act as Secretary.
The Lunacy Commission had national authority, under the Lord Chancellor and Home Secretary, over all asylums (except Bedlam until 1853). It shared responsibility with the poor Law Commission/Board etc for pauper lunatics outside asylums. Its principle functions were to monitor the erection of a network of publicly owned county asylums, required under the 1845 County Asylums Act, and the transfer of all pauper lunatics from workhouses and outdoor relief to a public or private asylum; to regulate their treatment in private asylums, and (with the Poor Law Commission) monitor the treatment of any remaining in workhouses or on outdoor relief.
The Lunacy Commission was also to monitor the regulation of county asylums and county licensed houses by JPs, and to regulate the conduct of hospitals for the insane. With the JPs it monitored the admission and discharge of patients from all types of asylum. It collected, collated and analysed data on the treatment of lunacy and advised on the development of lunacy law and policy. It also continued to license London's madhouses.
1.8.1846 Oxfordshire and Berkshire County Asylum opened
In the summer of 1846 it became scandalous public knowledge that officers of the Poor Law Commission (acting privately) had profited by the shortage of asylums by establishing a low cost asylum at Haydock Lodge in Lancashire for pauper lunatics from all over England and Wales. See Poor Law Commissioners and the Trade in Pauper Lunacy
"Haydock Lodge is full of lunatics and we have Methody parsons amongst them".
November or December 1846: General rules for County Asylum construction circulated to Asylum Committees by the Lunacy Commission
Louisa Nottidge was confined in Moor Croft House asylum in 1846 but released on the orders of the Lunacy Commissioners eighteen months later (external link)
20.5.1847 Death of Mary Lamb who spent the last decade of her life being cared for in a single house in St John's Wood.
Wednesday 7.4.1847 East and North Riding and York Yorkshire County Asylum opened
October 1847 Charlotte Bronte's Jane Eyre published. It contains an entirely unsympathetic image of a mad wife confined in the attic by a husband defrauded into marrying her in ignorance of her tainted inheritance:
"I daresay you ... inclined your ear to gossip ... the mysterious lunatic kept there... is my wife ... Bertha Mason ... is mad; and she came of a mad family; idiots and maniacs through three generations. Her mother, the Creole, was both a madwoman and a drunkard! .. I invite you all to ... visit ___ In the deep shade ... a figure ran backwards and forwards ... whether beast or human being, one could not, at first sight, tell: it grovelled, seemingly, on all fours; it snatched and growled like some strange wild animal: but it was covered with clothing, and a quantity of dark, grizzled hair, wild as a mane, hid its head and face... A fierce cry ... the clothed hyena rose up, and stood tall on its hind-feet... The maniac bellowed: she parted her shaggy locks from her visage, and gazed wildly at her visitors ... that purple face ... those bloated features... 'she has no knife' ... 'One never knows ... she is so cunning' ... Mr Rochester flung me behind him: the lunatic sprang and grappled his throat viciously, and laid her teeth to his cheek... more than once she almost throttled him..." [etc]
this is not a passage that made Jayne Eyre my favourite novel
Yahoo weblinks: Charlotte Brontee (1816-1855)
November 1847 The Lunacy Commission release Mrs Henry Howard from confinement in a single house in Kensington.
John Conolly's The Construction and Government of Lunatic Asylums
Journal of Psychological Medicine and Mental Pathology, edited by Forbes Winslow (1810-1874). Quarterly?. 1848-1860. The first number was quoted in The Illustrated London News for 15.1.1848.
"Seven years have elapsed since the experiment of non-restraint has been fully tried in the Hanwell Asylum; and Dr Conolly, in the spirit of a Christian philosopher, thanks God, with deep and unfeigned humility, that nothing has occurred during that period to throw discredit on the great principles for which he has so nobly battled".
The Illustrated London News feature said that "Dr Conolly has just published a very interesting volume on The Construction and Government of Lunatic Asylums, and Hospitals for the Insane
Wednesday 1.3.1848 Somerset County Asylum opened
June? 1848 Volume seven of The half-yearly abstract of the medical sciences (January to June 1848), edited by William Harcourt Ranking, included, for the first time, a "A Report on the Recent Progress of Psychological Medicine". This was written by Charles Lockhart Robertson
17.8.1848 Norwegian parliament passed Act for the Treatment and Care of the Mentally Ill. The act was the work of Fredrik Holst and Herman Major. Norway's first lunatic asylum, the Gaustad Asylum, was established in 1855. (external source)
"The cholera reached London in the new epidemic form about October 1848" (Farr, W. 25.7.1868, p.ix). See Ashley
Tuesday 14.11.1848 North Wales (5 counties) County Asylum opened
Anna Wheeler died about 1848. It was alleged by Edward Bulwer-Lytton that she died insane. (source)
29.8.1849 On the Mode of Communication of Cholera by John Snow, M.D (external copy), setting out the theory of transmission in the water supply rather than directly from patient to patient, or by polluted air. The importance of the polluted air theory of disease transmission, before Snow's publications of 1849 and 1854, is evident in John Conolly's (1847) The Construction and Government of Lunatic Asylums, where much attention is paid to clean air and little to clean water.
The New County Lunatic Asylum now building at Mickleover near Derby
There are many persons now living who can remember passing the gates of old Bethlehem and hearing, as they passed, the cut of the lash and the screams of its victims. That was the old treatment inspired by the "wisdom of our ancestors".
... within these few years, men have arisen who have paid more regard to the dictates of common sense and common humanity, than to the routine of tradition - ... - and have considered that insanity is a physical disease, to be treated as a disease and not as a crime, and that it would be just as reasonable to lash a man who could not run when both his legs were broken, as to flog him for not being reasonable when his faculties of reasoning were gone.
The Architect of the building, under consideration informed himself of these circumstances, and has been, we believe the first to design an Asylum which shall facilitate and be adapted to the recent treatment of the insane by means of kindness, companionship, and watchfulness, rather than coercion, punishment, and confinement.
first patient 1851
Medical and social institutions distinguished: A French law of 7.8.1851 (loi du 7 Août 1851 relative à l'organisation des secours hospitaliers) distinguished between a hôpital (for treatment) and a hospice - See dictionary (Discussed at external link)
1.1.1851 Lancashire County Asylums (2nd and 3rd), Rainhill and Prestwich, opened. As a result, Lancashire magistrates were able to close Haydock Lodge. It reopened shortly afterwards as an entirely private patient asylum. This did not last for long. Pauper patients returned to Haydock Lodge in 1854
1851: Census: A column asking about disability introduced. It had mental disability added in 1871. This heading is from the 1861 census, but I believe it is the same as in 1851. I have, however, seen census forms for the same year with different wording.
17.7.1851 Second Middlesex County Asylum at Colney Hatch opened
21.8.1851 Jabez Jackson entered the Derbyshire County Asylum as its first patient. Ellen Riggott arrived on 31.10.1851.
19.9.1851 Wiltshire County Asylum opened
1.12.1851 Monmouth, Hereford, Brecon and Radnor County Asylum opened
District Asylums opened in Ireland at Cork, Kilkenny and Killarney
30.6.1852 Warwickshire County Asylum opened
9.8.1852 Lincolnshire County Asylum opened
11.8.1852 Worcestershire County Asylum opened
13.12.1852 Hampshire County Asylum opened
Critical report by the Lunacy Commission on Bethlem Hospital. The physician, Edward Thomas Monro, refused to resign, so was made "consulting physician". When he died, in 1856, it ended the four generation Monro dynasty at Bethlem
17.1.1853 Buckinghamshire County Asylum opened
23.9.1853 Essex County Asylum opened
When these opened, every county in England and Wales, except four, had (jointly or singly) an asylum for pauper lunatics. Four counties without probably had contracts with licensed houses. There was a lull in the opening of new asylums after 1853. The building of asylums for the remaining four was probably prompted by the 1853 County Asylums Act
A District Asylum opened in Ireland at Omagh
Introducing the 1853 Lunacy Bills, the Earl of Shaftesbury lamented that he could not
"extend the bills to Ireland and Scotland, for I believe that not in any country in Europe, nor in any part of America, is there any place in which pauper lunatics are in such suffering and degraded state as those in Her Majesty's Kingdom of Scotland"
In September 1854, Dorthea Lynde Dix came to England, stayed with Samuel Tuke at York, and then visited Scotland. By visits and intimations that she would report to London, she caused alarm. To make sure she got her case in first, she caught the night train to London and reported to the Home Secretary the next morning. Shortly afterwards a Royal Commission was appointed to enquire into the asylums and lunacy law of Scotland (1855). This was followed by the 1857 Lunacy and Asylums Bill, Scotland. (Hunter, R.A. and Macalpine, I. 1963 pages 911-912)
The Act established The General Board of Commissioners in Lunacy for Scotland (1859-1913) which became the General Board of Control for Scotland (1913 -1960) and then the Mental Welfare Commission for Scotland. Mental Welfare Commission website.
At the time of the Report, there were asylums established by Royal Charter at Aberdeen, Dundee, Edinburgh, Glasgow, Montrose, Dumfries, and Perth and a pauper asylum at Elgin. The Act required the construction of publicly financed District Asylums throughout Scotland.
In September 1853 it was officially announced that a cholera epidemic was claiming victims in London and other parts of the country (external link)
1854 to 1856 Crimean War
Haydock Lodge private asylum in Lancashire relicensed to receive pauper patients. It continued to do so at least until the 1880s. Increasingly, however, the private side of the business was developed and, by about 1900, Haydock Lodge advertised itself as "for the upper and middle classes only"
11.12.1854 Second, much enlarged edition, of John Snow's On the Mode of Communication of Cholera (external copy)
Society physician Dr Thomas Turner retiring, aged 82, from the Lunacy Commission, was replaced by a second asylum surgeon James Wilkes. Two asylum doctors and one society physician became the norm for the Commission.
District Asylums opened in Ireland at Mullingar and Sligo
1857 Bénédict Auguste Morel's Traité des dégénérescences physiques, intellectuelles et morales de l'espèce humaine et des causes qui produisent ces variétés maladives became the classic text of degeneration theory.
"Hereditary taint" was used for a family in which at "intervals almost every form of madness appeared" in Wilkie Collins short story The Queen of Hearts (page 34). This was published as a collection 1.10.1859, but the original story may have been published in 1855. (external link)
English asylum doctors clashed over how to deal with wet beds. The ideas of Samuel Gaskell laid the foundations of psychiatric nursing, but this interference with the autonomy of asylum superintendents was a threat to the British Constitution.
17.7.1858 Rosina Bulwer-Lytton, estranged wife of novelist and cabinet minister Edward Bulwer-Lytton, and daughter of Anna Wheeler, released from Inverness Lodge asylum, Brentford, where she had been confined at the request of her husband. The release followed a newspaper scandal. (source)
External link to Knebworth House, the Lytton family home
During 1858 two patients in private asylums were found to be sane by commissions of lunacy. One was Mrs Turner at Acomb House near York, the other Mr Ruck at Moor Croft House, Middlesex.
1858-1859 Patients moving into the Durham County Asylum as it was constructed
1859 click for table of private asylums receiving paupers
April and August 1859 and July 1860: Three reports from a Select Committee of the House of Commons "on the operation of the Acts and Regulations for the care and treatment of lunatics and their property"
27.5.1859 Suusex County Asylum opened
Northumberland County Asylum also opened in 1859
John Stuart Mill's On Liberty criticised the operation of writs de lunatico inquirendo:
"the man, and still more the woman ...[who indulges] in the luxury of doing as they like... [is] in peril of a commission de lunatico, and of having their property taken from them and given to their relations"
26.11.1859 to 25.8.1860 Wilkie Collins The Woman in White, about a villainous confinement in an asylum, serialised in Charles Dicken's All the Year Round. The book was dedicated to Bryan Waller Procter [Lunacy Commisioner]
Yahoo weblinks: Wilkie Collins (1824-1889)
1860 Three Counties: Bedford, Hertfordshire and Huntingdonshire County Asylum (Arlesey) opened
Therapeutic Pessimism: The pessimistic period in asylum history developed during the second half of the nineteenth century. Medical theory was strongly influenced by social darwinist beliefs that insanity is the end product of an incurable degenerative disease carried in the victim's inherited biology, and the experience of asylums, and reanalysis of their statistics, undermined the earlier beliefs in their therapeutic value. In the late 19th and 20th centuries, the pessimistic period in asylum history ran gently into a backwater period. Most progress in mental health policy took place outside the asylums, in specialist hospitals like the Maudsley, or in outpatient departments, and the asylums became the quiet back wards where chronic patients live.
Edgar Sheppard (born Worcester about 1820) was medical superintendent of the male department of Colney Hatch from 1862 to 1881. In this enormous asylum he became well known for innovations, including daily Turkish Baths as therapy on a large scale, an asylum band, theatre, concerts, readings, lectures and a revival of restraint...
His method of locking dirty and destructive patients in side rooms "in a nude state" for weeks at a time where they "slept on the floor without either bed or pillow, being supplied only with strong quilted rugs", packing violent patients in wet sheets, or retraining them by belts, wrist straps and locked gloves, was condemned "in the strongest manner" by the commissioners in lunacy (..1867;..1870;..1862) and led one of their members to blackball Shepherd at the Royal College of Physicians" [of which he is not listed as a member] (Hunter and Macalpine 1974 p.84)
He was appointed King's College Hospital's first professor of psychological medicine in 1871 and published his seven lectures as Lectures on madness in its medical, legal, and social aspects in 1873. His continued support for restraint led to his not being appointed as a Lord Chancellor's Visitor in 1875
1862 Cumberland and Westmoreland asylum Carlise opened. This completed the programme of building a public pauper lunatic asylum (jointly or singly) for every county in England and Wales.
Broadmoor Criminal Lunatic Asylum opened, in Crowthorne, Berkshire. The criminal lunatics from Bethlem were moved to Broadmoor in 1864 and Bethlem became a hospital for the 'superior class'. Pauper patients were presumably moved to the City of London Lunatic Asylum which opened at Dartford, Kent on 16.4.1866.
Royal Victoria (Military) Hospital at Netley, on Southampton Water, opened - Its asylum opened in 1870. The new Yarmouth Naval Lunatic Hospital opened.
March 1863-December 1863 Charles Reade's Hard Cash also about a villainous confinement in an asylum, appeared as installments in Charles Dickens's magazine All the Year Round.
I am not convinced that the medical and lunacy commissioners (Dr Eskell and Mr Abbott) in Hard Cash are modelled on actual commissioners. But if you want to speculate, consult the charts of commissioners
Yahoo weblinks: Charles Reade (1818-1884)
20.5.1864 John Clare died in Northampton Asylum in 1864. During the many years he spent there, he wrote some of the most beautiful poetry ever spoken in English. Bird's Nests is one of his last poems. See also The Nightingale
Wednesday 10.2.1864 Date on a very long letter from Rosina Bulwer Lytton which appears to have been sent to Charles Reade. In 1880 it was published (she claimed without her permission) as the core of A Blighted Life, telling the account of her conflict with her husband and her confinement.
7.4.1864 Louis Pasteur (1822-1895) lectured at the Sorbonne against the theory of spontaneous generation of disease and in favour of contagion by germs - External links on spontaneous generation experiments - Pasteur's experiments. Identification of micro-organisms: see malaria 1880 - tuberculosis 1882 - cholera (1854 - 1884) - bacilliary dysentery 1897 - syphilis 1905.
Pathology laboratories: USA 1878 - Claybury
1.11.1865 The Royal Herbert Hospital opened. This military hospital (physical diseases) was the first built on the pavilion plan favoured by Florence Nightingale. It may have influenced the echelon plan that became the main style for asylums.
There were outbreaks of cholera in England in the autumn of 1865. The disease abated, but there was a localised (but substantial) outbreak in London in July 1866 (Farr, W. 25.7.1868, pp xii-xiii). The London outbreak was significant in that it had been thought cholera could be controlled in London. The report of William Farr showed why this had not happened and confirmed the effectiveness of clean water supplies.
District Asylums opened in Ireland at Castlebar and Letterkenny
1867 Metropolitan Poor Act
Metropolitan Asylums Board set up to oversee relief to London's sick and infirm poor, so that the workhouses could be freed to discipline the able-bodied. To deal with the sick poor suffering from smallpox, fever, or insanity, London became one Metropolitan Asylum District under the Board, which first met on 22.6.1867. The Board proposed two new asylums for chronic lunatics and idiots at Leavesden and Caterham. Fever and smallpox hospitals were built at Stockwell in south-west London and Homerton in north-east London.
The Metropolitan Asylums Board was abolished in 1930,
when its functions were transferred to London County Council
April 1867 The Lancet published an article by Joseph Lister (1827-1912) On the Antiseptic Principle of the Practice of Surgery. [Copy at Bartleby]
District Asylums opened in Ireland at Ennis and Enniscorthy
District Asylums opened in Ireland at Downpatrick and Monaghan
1869 Sedative effects of chloral hydrate explored by the German pharmacologist Oskar Liebreich (1839-1908). It was tried in Warley (Essex - UK) in 1870. Kraepelin in 1918 describes the effects of this and similar drugs on wards for the insane.
15.11.1869 Charlotte Mew born. Her grandfather's firm designed asylums for Essex - Sussex - and Dorset. Her earliest published work (1894) concerns mental debility in the family. Her brother, Henry, was confined in an asylum before 1890 and her youngest sister, Freda, was certified insane in 1898. See 1901 - 1902 - 1909 - 1913 - 1915 - 1916 - 1924 - 1928 - Poetry Links - 1.3.1958
Science Time Line 1870
German academic psychiatry
"The time has come when the immediate business which lies before everyone who would advance our knowledge of mind, unquestionably is a searching scrutiny of the bodily conditions of its manifestations in health and disease" (Henry Maudsley in Body and Mind)
[The journal Brain was established in 1878. In 1895, Frederick Mott was appointed to head a central laboratory for London County Asylums at Claybury]
October 1870 St Lawrence's, Caterham, Surrey and Leavesden, Abbots Langley, Watford, Hertfordshire opened. Each with 1,500 beds. These two custodial asylums were designed to relieve London's other asylums and workhouses of incurable lunatics at the least possible expense. (See 1971 and 1981)
"In May 1871 there were 1,600 patients at Leavesden and nearly 1,400 at Caterham. Not only did this ease the strain on workhouse accommodation, but a great number of incurable and harmless cases were able to be removed from the two large Middlesex County Asylums... nevertheless, the Home Secretary had to ask Middlesex to build another..." (Hodgkinson, R. 1966)
2.4.1871: Census: In 1871 (See 1870 Act) the established column about disability also asked if the person was "imbecile or idiot" or "lunatic". The disability column continued until 1911 (not 1921), but the wording was varied in 1891 and 1901.
22.11.1872 Louisa Lowe's case before Queen's Bench in which she charged the Lunacy Commission with concurring in her improper detention at Brislington House and The Lawn, Hanwell.
21.5.1873 On a visit to Fisherton House in Wiltshire, Robert Wilfred Skeffington Lutwidge, uncle of Lewis Carol, and a Lunacy Commissioner, was murdered by William M'Kave, a patient.
Lunacy Law Reform Association founded 1873. "The first report of the Lunacy Law Reform Association" London 1874. (external link) - In 1879 listed at 61, Berners-street, Oxford-street. - Office days: Tuesdays, Thursdays, and Saturdays from 2 till 4 p.m. Subscription: Essential to membership, amount optional. Object: To obtain increased safeguards against wrongful incarceration of the sane, with ameliorations in the treatment of lunatics. Kathleen Jones says that Louisa Lowe was secretary of the "Lunacy Laws Amendment Association", which supported Georgina Weldon [They appear to be different societies]
31.10.1874 British Medical Journal: "LUNACY LAW REFORM ASSOCIATION. The Council of the above Society have just issued their first report, in which they make a series of charges all round, of brutal cruelty, political influience, anid criminal negligence on the part of medical men in signing lunacy certificates." offline)
The Hunting of the Snark - an Agony in Eight Fits, by Lewis Carroll, published
External links to biographies of Alfred Woodhurst and James Woodhurst of East London, who were admitted to Middlesex asylums.
J. Langdon Down, On the education and training of the feeble in mind A reprint of a paper read at the Social Science Congress of 1867 (printed the same year in the Transactions of the National Association for the Promotion of Social Science) published H.K. Lewis, London, 1876. (17 plus 8 pages. Printed paper cover)
The third Middlesex County Asylum was opened at Banstead, in Surrey, in 1877, thus continuing the trend (evident in the location of Metropolitan Asylums Board asylums) of sending people to asylums far from their home. Under community care policies, in the late 1950s and early 1960s, special measures had to be taken to enable relatives in inner London boroughs to visit patients in distant hospitals.
12.2.1877 House of Commons appointed a committee under Thomas Dillwyn "to inquire into the operations of Lunacy Law so far as regards security afforded by it against violations of personal liberty"
The Lancet fact-finding commission on "The Care and Cure of the Insane"
April 1878 Brain Volume 1, issue 1. Editors: Drs. Bucknill, Crichton Browne, Ferrier, and Hughlings-Jackson.
Music therapy at Worcestershire County Asylum
Reverend Henry Hawkins and friends start the After-care Association for Poor and Friendless Female Convalescents on Leaving Asylums for the Insane. See 1893 - 1894 - 25.2.1913 - Mental After Care Association name - 1926 - 1932 - 1939 - 1950s - 1983 - 2005 (became "Together"). (external link to History) - Leaflets about: Henry Hawkins - history - The archives are kept in the Contemporary Medical Archives Centre in the Library at the Wellcome Institute for the History of Medicine (ref SA/MAC) - Current address and contact details
In the 1880s, a committee of women worked to "find temporary homes in cottages and other homes and look for potential placements in service for women coming out of asylums". By 1889, 143 cottage homes had been inspected and about 50 people a year were being helped, from 18 different asylums in England and Scotland. The Association also placed "some people at risk of becoming insane" in cottage homes
Psychology laboratory and suicide study
1880 - 1882 Dr Joseph Breuer (1842-1925) and his patient Bertha Pappenheim or "Anna O" (1859-1936) invent the "talking cure".
At this time Freud was a medical student raising money for his studies by translating from English into German. Read his 1909 account of what Breur and Anna O. did
2.8.1881 40th anniversary of the Medico-Psychological Association. Daniel Daniel Hack Tuke outlined the progress of psychological medicine.
Daniel Hack Tuke's Chapters in the History of the Insane in the British Isles. His history, the first draft of which was published in 1854 is the first attempt a comprehensive one that I know, and the last until the work of Kathleen Jones
The Subliminal Self
The development of ideas about levels of consciousness and the unconscious mind was associated with theories about the spiritual
13.2.1882 Charcot presented a paper on the diverse nervous states determined by the hypnotisation of hysterics (Sur les divers états nerveux déterminés par l'hypnotisation chez les hystériques) to Le Académie des Sciences in Paris. The acceptance, by the Academy, of his paper was also the acceptance of hypnosis as a scientific practice and of diseases of the mind as distinct from mental disorders caused by physical disorders. See also 1885 and 1887
8.4.1882 British Medical Journal " AMENDMENT OF THE LUNACY LAWS.- A meeting, convened by the Lunacy Law Amendment Society for the purpose of furthering their views, took place this week at the Holborn Town Hall, Mr Torrens occupying the chair.- Mr. Commissioner Miller moved the first resolution:- "That the lunacy laws are highly unsatisfactory, and urgently need reform." He said that the present system of incarcerating a man as a lunatic, upon the certificate of two medical men, required altering. He contended that the soundness of the medical opinions should be tested by public examination, as no man's opinion was worth having unless it would stand the test of skilful cross- examination.- Mr Moseley, in seconding the motion, denied that it would be casting a stigma upon a person should he be publicly examined for the purpose of ascertaining whether he is a lunatic or not, Was it fair to the public that a family, in which there was hereditary insanity, should not be known to have that taint? Ought persons to be allowed to contract marriages with them? For his own part, he considered secrecy as contrary to the public welfare; while, again, proprietors of public asylums had a direct pecuniary interest in still keeping patients after recovery. After some further discussion, the resolution was passed, as were all others calling for an inquiry into the lunacy laws, and adopting a petition to the Houses of Parliament." offline)
25.4.1882 Proposal in UK Parliament that "That all lunatics ought to be committed to the keeping of the State". Negatived.
Emil Kraepelin (1856-1926) published Kompendium der Psychiatrie (later editions: Psychiatrie: Ein Lehrbuch für Studierende und Ärzte - Psychiatry: A Textbook for Students and Doctors) which established an orthodox classification of psychiatric diseases based on clusters of symptoms (syndromes) with underlying physical causes. Kraepelin regarded each mental disorder as distinct from all others, having its own aetiology, symptoms, course and outcome. His major groups were dementia praecox and manic-depressive psychosis. - In 1960 Ronald Laing published a criticism of the disease approach to psychosis in which he used Kraepelin as the example.
Cane Hill Asylum, Surrey, opened in 1883. It was enlarged to accommodate 2,000 patients by the end of the 1880s. Click on the picture for more information. The picture is from a postcard in the collection of Nigel Roberts. It has "J.T.Carey's real photos... Cane Hill, Asylum. 5024" written at the base of the card. The same picture appears on the urban explorations site with a note that it was taken in 1912.
1883 Association for the Care of Girls founded in Cambridge to help and protect vulnerable girls.
Mrs Georgina Weldon sued Dr Forbes Winslow over an attempt to examine her and have her confined in an asylum at her husband's request. This case was a prelude to the 1890 Lunacy Act, which required alleged lunatics to be examined before a magistrate. The confinement of Elizabeth Packard in the United States relates to similar changes there.
The second Gloucester County Asylum opened at Coney Hill.
May 1884 Robert Koch and his team returned to Berlin from Calcutta where they had isolated the cholera bacillus. Koch was received as a national hero. See Who first discovered vibrio cholera? (external link) which argues that Koch's (re-) discovery of the cholera bacillus began to turn the tide of international scientific opinion away from the miasma theory. However, the article is not clear if the issue was water (rather than air) transmission or the germ theory of the cause of the disease.
See malaria 1884
Paraldehyde Vincenzo Cervello's "Recherches cliniques et physiologiques sur la paraldehyde" was published in Archives italiennes de biologie in 1884. It is, therefore, after this date that it became the sedative "so useful for the noisy and troublesome patient that it tended to br over-used in hospitals... given intramuscularly (10-15 cc) in the treatment of acute and grave psychoses.." (Sargant and Slater 1963)
1885: First edition of Handbook for the instruction of attendants on the insane. Prepared by a sub-committee of the Medico-Psychological Association. 64 pages. Baillière & Co.: London. (online history at Royal College of Psychiatrists) [See 1891 Nursing Certificate] - May 1902 exam - Model Answers 1928]
1885- 1886 Freud in France
13.6.1886 Bavarian king and his psychiatrist drown
25.6.1886 The 1886 Idiots Act allowed rates to be raised for building an "idiot asylum" or "mental deficiency colony".
13.1.1887 The case of Louisa Lowe against Charles Henry Fox for confining her, reached the House of Lords. She lost the case and had to pay costs. Lord Halsbury, in giving judgement, said "we have nothing to do with the truth or falsehood of the statements" in the certificates of the doctors or the order for the person's detention.
"all that which the keeper of the asylum has to regard is whether the statements which are made in the order are such as to justify him in exercising the powers given to him under the statute, of detaining in confinement the person committed to his charge."
The statute law at issue here (and in several previous cases) was that access to the courts over the substantive issues of a confinement had been removed in 1845. The 1889 Lunatics Law Amendment Act provided for the truth of allegations to be tested legally before the confinement.
Une Lecon Clinique a la Salpetrie, a painting by Andre Brouillet, in 1887, shows Jean Martin Charcot demonstrating on Blanche Wittmann (the lady fainting). Click on the picture to see why her faints were a turning point. - See also 1882
After care association Scrapbook 2: 1888-1902 SA/MAC H1/2
Following the 1888 Local Government Act (which created London County Council), the old Surrey County Asylum in south London became a Middlesex County Asylum and the London County Council took over from Middlesex a project to build an asylum at Claybury, in Essex. Claybury Asylum opened in 1893.
Colonies for epileptics were opened in different parts of England and Scotland from 1888. Some, such as the Ewell Colony, were short lived. Eleven were still operating as epileptic colonies in 1962: the Maghull Homes, near Liverpool (founded 1888); Meath Home, Godalming (1892); Chalfont Colony (1894); Lingfield Training Colony, Surrey (1897); St. Elizabeth's, Hertfordshire (1903); David Lewis Colony, Cheshire (1904); Langho Colony near Blackburn (1905), Bridge of Weir Colony, Renfrewshire, Scotland (1906); St David's Hospital, Edmonton (1916); St Faith's Hospital Brentwood (by 1930), and Cookeridge Hall, Leeds. (Jones and Tillotson)
April? 1889 1888 Local Government Act came into force and English and Welsh asylums passed from the magisterial control of the Justices of the Peace to the democratically elected control of newly created county and borough councils.
30.7.1889 House of Lords debate proposed notices of rights in asylums
Sometime before 1890, Henry Herne Mew was certified insane and confined in an asylum. As it was before the 1889 Lunacy Laws Amendment Act came into force, and as he was a private patient, his detention would not have required the approval of a magistrate.
Science Time Line 1885
See 1840s, 1920s, 1940s
1890s: By the end of the 19th century the failure of asylum therapy had convinced people that insanity is largely (but not entirely) incurable. At Claybury, in 1901-1902, there were 426 admissions, 201 deaths and 148 patients were "discharched recovered". The insane were sent to even larger asylums for custody, to be protected from exploitation whilst society was protected from them. "In spite of this", Alexander Walk says, many improvements followed the asylums becoming the responsibility of County and County Borough Councils in 1888.
Postmortems were carried out on the brains of the majority of patients who died in the asylum in search of the cerebral lession that many thought was the basis of all insanity. This cross-section is from a collection of clinico-pathological photographs taken at Colney Hatch Asylum between 1890 and 1910. (Hunter and Macalpine 1974 p.244) say that it shows multiple tumours and that such cases accounted for the high mortality amongst newly admitted patients. See below, 1895.
"In the 19th century nearly 10% of them died within 3 months of admission from advanced systemic or cerebral disease causing mental symptoms initially"
1890 Lunacy Act.
The 1890 Lunacy Act was a major consolidating Act that remained the core of English and Welsh Lunacy Legislation until it was repealed by the 1959 Mental Health Act
New rules for private admissions
The major change associated with the Act (actually made in 1889) was that it said private patients, apart from chancery lunatics (whose cases were dealt with by the Court of Chancery) should not be detained without a judicial order from a Justice of the Peace specialising in such "reception orders". Pauper patients already required an order from the magistrates to be detained - although that provision was probably originally an authorisation of public funds rather than a safeguard of liberties as the reception order was intended to be. (Click here to read the summary of the law about admission to an asylum from 1828 - here for 1890 - here for emergency procedures under the 1890 Act). The law respecting the admission of private patients under the Act is outlined in a booklet for the private asylum at Haydock Lodge.
Restricted growth of private asylums
Section 207 placed such severe restrictions on the granting of licences as to virtually prevent new private asylums or the enlargement of established ones.
Public provision for private lunatics
Section 255 allowed the county and borough asylums to build wards or separate buildings for private patients. Private units were built at the new Isle of Wight County Asylum and Derby Borough Asylum, at Dorset County Asylum and at Park Prewett, Hampshire, amongst others. London County Council made provision for private patients at Claybury and The Manor, Epsom. Shropshire had 28 private class patients in 1911. - Registers of private patients at Netherne (Surrey) survive from 1909 to 1919 - The West Riding of Yorkshire provided a separate asylum (Scalebor Park) exclusively for private patients. (See 1927 list)
Absence on trial and boarding out
Section 55 provided for a pauper lunatic to be "absent on trial" with an "allowance" "not exceeding the charge in the asylum" . Provisions for the absence on trial of private patients were also made. Section 57 provided for the "boarding-out" of pauper lunatics with relatives or friends. [See 25.2.1913]
Sanity and Insanity by Charles Mercier
"Add to [the number of criminals] the number of indoor paupers and lunatics ... 78,966 - and we have an army of nearly two million: belonging to the submerged classes. To this there must be added at the very least, another million, representing those dependent upon the criminal, lunatic and other classes... and the more or less helpless of the class immediately above the houseless and starving. This brings my total to three millions, or, to put it roughly to one-tenth of the population." (William Booth, 1890, in his chapter on The Submerged Tenth) - See 1904-1908 - 1929 - 1943
5.6.1891: Census: The column asking about disability had a different heading.
1891 "Examination for the Nursing Certificate" of the Medico- Psychological Association established. [See 1885 Nursing Handbook
Tuke's Dictionary of Psychological Medicine
Special Schools Leicester Education Authority the first in England to provide special instruction for backward and weak-minded children.
The National Society for the Employment of Epileptics (NSEE) was launched in 1892
Prince of Wales Hospital Fund for London started 1892 - A royal patron raising money for London's voluntary hospitals. It became the the King Edward's Hospital Fund for London in 1902. The National Health Service made many of its functions redundant after 1948 and it developed a new role developing "good practice in the NHS". - lost source - 1999 web archive - 1999 history - full web archive - See 1980s and "social care"
Claybury in Essex, the first compact arrow asylum, opened
After care association established its first residential care- home, at Redhill in Surrey, with room for nine people.
After care association renamed After Care Association for Poor Convalescents on Leaving Asylums for the Insane as it now helps men as well as women.
A short story Passed is the first known published work of Charlotte Mew. The writer, walking in a poor area of London (Clerkenwell?), visits a church. She sees a gospel that the priest at the alter does not:
"Two girls holding each other's hands came in and stood in deep shadow behind the farthest rows of high-backed chairs by the door. The younger rolled her head from side to side; her shifting eyes and ceaseless imbecile grimaces chilled my blood. The other, who stood praying, turned suddenly (the place but for the flaring alter lights was dark) and kissed the dreadful creature by her side. I shuddered, and yet her face wore no look of loathing nor pity. The expression was a divine one of habitual love. She wiped the idiot's lips and stroked the shaking hands in hers, to quiet the sad hysterical caresses she would not check. It was a page of gospel which the old man with his back to it might never read. A sublime and ghastly scene."
The description may shock (See also 1916), but compare with Jayne Eyre in 1847 and the Care of Children Committee in 1946. The outstanding difference is the compassion.
23.8.1894 "Thyroid feeding in insanity : a summary of thirty cases treated by thyroid extract in the Derby Borough Asylum" by S. Rutherford Macphail and Lewis Campbell Bruce read at the annual meeting of the Caledonian Medical Society, at Inverness. It was published in Cretins and idiots: a short account of the progress of the institutions for their relief and cure Glasgow : Alex. Macdougall, 1894. Freda Mew received thyroid treatment in 1902. The treatment was advocated for cases of insanity where doctors had run out of options, and not just for cases of thyroid deficiency. It is an early form of treatment by fever. See later development of malarial treatment. There are similarities with the later use of insulin in that a good result was patients eating and putting on weight.
Lanark County Asylum, Hartwood, Lanarkshire, Scotland, opened. (external link)
Frederick Mott was appointed in charge of the London County Council Asylums' new central Pathological Laboratories at Claybury. His Archives of Neurology from the Pathological Laboratory of the London County Asylums, Claybury, Essex was published from 1899
Thursday 8.11.1895 Meeting of the Scottish Division of the Medico-Psychological Association in Edinburgh at which Lewis C. Bruce read a paper on "The Effect of Thyroid Feeding in some Forms of Insanity" (offline). In the discussion, he commented
"At present he only advocated thyroid treatment in patients who had not benefited by the ordinary routine treatment of insanity. In such cases it is only just to give the patient a chance of recovery by inducing a feverish condition and hoping for a beneficial result during the reaction subsequent to the fever." (Journal of Mental Science - offline).
The National Association for Promoting the Welfare of the Feeble-minded founded. See 1898 - See 16.10.1909 - Later became National Association for the Care of the Feeble Minded - See 1912 - Promoted formation of Central Association for the Care of the Mentally Defective in 1913.
April 1896 "The fact has long been recognised that improvement or recovery from mental disease not uncommonly coincides with, or follows, a fever or other physical disorder." J. Keay, District Asylum, Inverness. "A Study of Forty-four cases of Fever occurring in the Insane". Journal of Mental Science
Richard von Krafft-Ebbing injected syphilis into nine patients suffering from General Paralysis Of the Insane. None of the patients said they had ever had symptoms of syphilis, but they did not develop syphilis sore after the injection, suggesting they had had syphilis in the past. (external link) (Or 1884? External Link)
In Japan, Kiyoshi Shiga identified the bacteria responsible for one form of dysentery - the form that was often found in asylums and, therefore, known as asylum dysentery.
Lebanon Hospital for the Insane, Asfuriyeh, founded. Planned (1896) as "the first home for the insane in Bible Lands" its catchment area was Lebanon, Syria and the Middle East. [external link]
10.6.1898 Meeting on behalf of The National Association for Promoting the Welfare of the Feeble-minded held at Stafford House. Association office: 49, Victoria Street, S.W. (See British Medical Journal report 18.6.1898
Freda Mew (19) became insane early in November 1898. She was admitted to the new private block of the Isle of Wight Asylum on 4.2.1899 and remained in the asylum until her death (78) on 1.3.1958. Her case notes survive for 1898 to 17.11.1909 - After which she is largely lost to history.
"The Defective and Epileptic Children Act of 1899 empowered local authorities to spend money on children suffering from these handicaps, and opened the way for colony schools. The Act of 1914, which was mandatory on local authorities, improved the position still further." (Jones and Tillotson p.6)
Science Time Line 1900
In Interpretation of Dreams, Sigmund Freud interpreted the symbolism of dreams in a way that he presented as a scientific exploration of the unconscious mind.
In 1900 it was decided that the new asylum for Belfast, at Purdysburn would be constructed as detached villas around the country house that was to be its core. This is one of the earliest examples in Britain and Ireland of a move away from a large unified building as the asylum. In the United States of America, Maryland had begun constructing a "cottage" plan asylum in 1896.
"We often hear it said that the care we bestow on the hopelessly sick, the insane, and the feeble-minded is in opposition to what Darwin taught about the Survival of the Fittest, and that it does harm; but Darwin perceived that it is of such importance to a community that feelings of unselfish affection and public spirit should be strengthened by having to care for the weak, that this more than makes up for any injury done to the efficiency of a community by the artificial preservation of lives not strong enough to fight their own battles" Caroline A. Martineau Voices of Nature and Lessons from Science The Sunday School Association, Essex Hall, Essex Street, Strand, WC. (Second edition) pages 119-120"
22.3.1901 Death of Henry Herne Mew, aged 34, from tuberculosis, in Peckham asylum. Charlotte Mew's In Nunhead Cemetery may grieve his death and celebrate his life.
31.3.1901: Census: The column asking about disability had a different heading.
October 1901 Francis Galton lectured on The Possible Improvement of the Human Breed under the existing conditions of Law and Sentiment. G. R. Searle, (1976 page 20) calls this "launching his project of race improvement". The initial concern was about physical deterioration. - Contrast above. See Eugenics - 1904 - 1907 - 1910 - 1922 - 1931 - 1933 - 1947 -
4.2.1902 Freda Mew under Thyroid treatment
May 1902 Five hundred and forty-three people in England, Wales, Scotland and Ireland, applied to take the May examination for the Nursing Certificate of the Medico- Psychological Association. Twelve withdrew, 352 passed and 179 failed. Examinations were also held in November. The questions were about: the composition of fresh air - the construction of the pelvis, and the organs within it - the urine of patients - suicidal attempts by patients - special risks of injury to which epileptic patients are liable - bedsores - treating attacks of apoplexy; syncope (fainting); and choking - feeding paralytic and helpless patients - guarding against and discovering escapes; precautions against homicidal impulses; and "special observation" - poisons and cases of suspected poisoning.
25.7.1902 Annual Meeting of the Medico-Psychological Association, Liverpool. T. S. Clouston, M.D., opened a discussion on the "possibility of providing suitable means of treatment for incipient and transient mental diseases in our great general hospitals."
Friday 1.8.1902 Dr. F. W. Mott (London) opened a discussion on Syphilis as a Cause of Insanity... "Dr Mott concluded by adopting, for the purposes of raising a discussion, the thesis, No syphilis, no general paralysis". (external link See below and 1916)
1903 Sidelights on Convict Life: Broadmoor "There are something like 120 women now confined in Broadmoor, out of a total of less than 200, who had murdered their own child or children. In fact, homicide, with attempts to murder and maim, would appear to be the crime to which the great majority of criminally-inclined lunatics are most prone" (See 1919 and 1922)
26.6.1903 Croydon Mental Hospital (not "Lunatic Asylum") opened
Late 1903 A pamphlet of about 30? pages: Proposed sterilisation of certain mental and physical degenerates. An appeal to asylum managers and others by Robert Reid Rentoul, a Liverpool doctor, (born Ireland 1855, died Liverpool 1925) published: Walter Scott Publishing Company, London, 1903. A brief notice in the British Medical Journal in 9.1.1904 may be the first time that journal used "sterilisation" in this sense as distinct from sterilising milk (etc). The appendices to the pamphlet are 1. Marriage law. State of Minnesota, U.S.A., chapter 234, s.f. no. 185 - 2. Marriage of degenerates. Extract from the annual report of Dr. F.H. Craddock. 3. Extract from a woman's letter. 4. Doctor Lombroso on the increase of insanity. - See 19041908 - 1910 - USA 1907 - USA 1909 - 1913 - 1933 - 1934 - USA 1959 - 2004 -
16.9.1904 Francis Galton addressed a Sociological Society meeting (chaired by Karl Pearson) on eugenics. "From then onwards eugenics quickly developed into a political movement" (G. R. Searle, 1976 page 80). He spoke again in February 1905.
Picture postcard of County Asylum Annexe Lancaster postmarked Lancaster 6.15 pm 25.10.1904. One of several asylum postcards in the collection of Nigel Roberts.
See also: fancy postcard: "Portsmouth Boro' Asylum"
1905 The spirochaete responsible for syphilis identified. The Wasserman reaction provided a test for it in 1906. This was first used at Colney Hatch Asylum in 1912. Of forty patients diagnosed as suffering from General Paralysis of the Insane, 38 gave a positive reaction. Using the test it was calculated that one tenth of the male patients suffered from General Paralysis of the Insane. In the last half of the 19th century, when other conditions were included because of similar symptoms, the percentage had been calculated as one in five. (Hunter and Macalpine 1974 p.211)
Mental Deficiency: The mid-19th century asylums were developed to treat insanity. However, although congenital idiots and imbeciles were not considered treatable, many were sent to lunatic asylums for custody or control. As the century developed, they tended to be sent to the new, cheap, asylums. Those who were considered physically and morally harmless often stayed with their families, were placed with a substitute family or were kept in workhouses.
Fear of racial degeneracy dominated policy in the early 20th century. It was feared that a "submerged tenth" of the population would outbreed the rest. The Royal Commission on the Care and Control of the Feeble Minded (1904-1908) reported that mental defectives were often prolific breeders and allowing them so much freedom led to delinquency, illegitimacy and alcoholism. They rejected sterilisation as a solution, and called for separation and control.
See Dictionary: Social Darwinism
12.7.1905 Birth of John, youngest son of George (later King George 5th) and Mary. John died, aged thirteen on 18.1.1919. Prince John suffered from epilepsy and from learning difficulties that suggested he was mentally deficient. His existence was kept secret and, from 1916, he was cared for at Wood Farm, Wolferton, near Sandringham, Norfolk by a nurse Mrs 'Lalla' Bill and a male orderly. In February 1996 (?) a photograph of John wearing a sailor suit, holding hands with Queen Mary and his sister Mary, was discovered in a photograph album and later published in British newspapers. An internet biography of him was published by Britannia later in 1996 and a romanticised drama of his life The Lost Prince, written by Stephen Poliakoff, for BBC1 Television was broadcast in January 2003.
Picture postcard of Napsbury (opened 1905) that is thought to date from the first world war, when Napsbury was a war hospital.
Autumn 1907 The Eugenics Education Society founded. It changed its name to the Eugenics Society in 1909. By October 1908 its President was Francis Galton.
David Heron: "A first study of the statistics of insanity and the inheritance of the insane diathesis" Eugenics Laboratory Memoirs; 2 London: Dulau.
Departmental Committee on the Operation of the Law Relating to Inebriates and Their Detention in Reformatories and Retreats: In England and Wales about 20 licensed retreats [homes] and 13 reformatories [asylums], as well as others not licensed. At about the same time, Scotland had three licensed retreats and six reformatories and Ireland one retreat and two reformatories. (external link)
Picture postcard of Portsmouth Borough Asylum postmarked 1907 copied from Stephen Pomeroy's website. Other postcards of asylum's about this time include Lancaster (1904) - Cane Hill (1912) - Napsbury (1914-1918?)
English translation from German: The Sexual Life of Our Time In its Relations to Modern Civilisation by Iwan Bloch (First German edition was in 1907). The authorised readership of the English edition was, for many years, restricted to lawyers and doctors.
Sometime in 1908: A Mind that Found Itself
July/August 1908 Opening of Observation Hospital - "Acute Hospital for the treatment of persons who fear they may become Insane" - in the grounds of the Hudson River State Hospital for the Insane.
1908 Report of the Royal Commission for the Care and Control of the Feeble-minded
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.
September 1908 Alfred Frank Tredgold (1870-1952) Mental Deficiency (Amentia). Published: London : Bailliere, Tindall and Cox. 391 pages: 26 plates. Also published New York : Wood, 1908. [In 1908 Tredgold also published a 17 page pamphlet Some account of the report and recommendations of the Royal Commission on the care and control of the feeble-minded, 1908. Tredgold's A Text-Book of Mental Deficiency (Amentia) (title from 1937) was "largely re-written" in 1929. A twelfth edition Tredgold's Mental Retardation, revised by others, was published in 1979.
Tredgold argued that there is "a clear relationship between amentia and other forms of mental abnormality and disease". He argued that "family history inquiries show that defectives, persons suffering from pre-senile forms of dementia, and others suffering from psychoses and psychoneuroses often come from the same stocks... in many instances these various conditions may be merely different clinical manifestations of one and the same germ abnormality" (Seventh edition, 1947, page 370)
"one person in every 118 of our population is mentally defective, being either mad, idiotic, or feeble-minded" (Francis Galton The Problem of the Feeble-Minded An abstract of the report of the Royal Commission, with commentaries. Quoted Jones, K. 1960, p.65)
external link to Body Politic site on Francis Galton
Freud in America
16.10.1909 Morning Post "there exist to-day, apart from certified lunatics who are under restraint, 150,000 mentally defective persons, and of these no less than 66,000 are considered to be " urgently in need of provision, either in their own interest or for the public safety." It is difficult to express with sufficient force the gravity of the danger to national life which the existence of these persons uncontrolled in any sufficient manner implies. For from these unfortunate men and women the ranks of paupers, drunkards, and criminals are continually recruited." [Reprinted as a leaflet by the The Oxford branch of the National Association for Promoting the Welfare of the Feeble-minded ]
17.11.1909 Freda Mew showing signs of recovery. She "has a funny way of getting up suddenly and dancing across room or airing court - has been up daily and is all the better for it." [Last entry in recovered case notes]
Rampton Hospital, Nottinghamshire, opened as England's second Criminal Lunatic Asylum. In 1920 it became a State Institution for mentally defective people considered dangerous.
Gilbert Keith Chesterton began writing against eugenics in 1910
Work not published until 1922. A particular concern for Chesterton was the extension of the traditionally limited concepts of lunatic and idiot to include a much wider section of the population who are "feeble-minded" - See 1909, for example
14.2.1910 to 23.10.1911 Winston Churchill Home Secretary. Churchill was a strong supporter of sterilisation. His proposals for the forcible sterilisation of 100,000 moral degenerates were considered too extreme and so sensitive that they were kept secret until 1992.
"The unnatural and increasingly rapid growth of the feeble- minded classes, coupled with a steady restriction among all the thrifty, energetic and superior stocks constitute a race danger which it is impossible to exaggerate. I feel that the sources from which the stream of madness is fed should be cut off and sealed up before another year has passed" (Winston Churchill to Prime Minister Asquith, 1910, quoted by Clive Ponting, in The Guardian Outlook 20.6.1992)
On 14.9.2004 a statue of Churchill in a straitjacket was used to protest against the stigma of severe mental illness.
Eugenics and sterilisation in the USA
meaning of eugenics.
Are talking treatments the way out of therapeutic pessimism?
Tuesday 19.4.1910 There is a "general idea that nothing is done in the way of treatment in asylums" - "treatment does not appear to have yielded many results: the recovery rate has not increased during the past thirty years." Dr Street, of Haydock Lodge, advocated "a higher form of moral treatment than the usual occupation, recreation and amusement; a more intimate knowledge of the mental condition of every patient, and particularly a more frank and open method of dealing with it. He believed in discussing a patient's mental symptoms freely with him, whether they were delusions or suicidal inclinations".
10.7.1910 George Gibson, an attendant at Winwick Asylum, and other disgruntled Lancashire asylum workers, formed the National Asylum Workers Union, which soon spread through the United Kingdom, including Ireland, with a branch secretary in most asylums. The union affiliated to the Labour Party in 1914 and was active in Labour Party affairs. It became the Mental Hospital and Institutional Workers' Union in 1930. In 1946 it merged with the Hospital and Welfare Services Union to form COHSE, the Confederation of Health Service Employees. Since 1993 it has been UNISON Phil Watkins' COHSE History site
1910-1911 Abnormal Psychology
" With regard to insane criminals, it must be remembered that every form of mental alienation assumes a specific criminality." (Lombroso Ferrero 1911)
After care association Scrapbook 4: 1911-1927 SA/MAC H1/4
Eugen Bleuler, (1857-1939) Dementia praecox, oder Gruppe der Schizophrenien published Leipzig. [Translated into English in 1950 as Dementia praecox: or, The group of schizophrenias. (In 1910 Bleuler had coined the word schizophrenie, from Greek words for split and mind, as an alternative to dementia praecox). See 1923
8.7.1911 The first national conference of the National Asylum Workers Union was held at Pitmans Hotel, Birmingham Delegetes came from Winwick Asylum, Banstead, Bexley, Bodmin, Caterham, Cardiff, Chester, Claybury, Exminster, Hellingly, Lancaster, Leavesden, Macclesfield, Maidstone, Menston, Norwich, Prestwich, Rainhill, Storthes Hall, Wakefield and York. Apologies were received from Abergavenny, Talgarth, Colney Hatch, Darenth, Hanwell, Aylesbury, Haywards Heath, and Narboro. (Michael Walker, Unison)
negative images of feeble minded
Science Time Line 1912
1912? Phenobarbitone (luminal) introduced into the treatment of epilepsy.
April 1912 - Asylum chapels Of the 94 lunatic asylums in England and Wales, only seven were without a chapel. Two because they are at present incomplete and two are old and small asylums. The West Riding of Yorkshire was resisting providing chapels at the Menston, Storthes Hall and Scalebor Park asylums. (See Hansard)
17.5.1912 Debate on second reading of the Feeble-Minded Persons Control Bill - "to put it briefly, the object of this Bill is to regularise the lives, and, if possible, to prevent the increasing propagation of half-witted people"... "if the only class of persons you can bring into this Bill are those who are dangerous to themselves and to others, you exclude from the purview of the Bill the bulk of the feeble- minded and specially those whom associations such as the National Association for the Care of the Feeble-Minded are anxious to deal with. We know the great interest that is aroused in this question particularly in regard to illegitimacy." (Hansard)
From 1913, local authorities could provide free treatment for people suffering from tuberculosis. I believe some of this was provided by adding verandas to asylum wards (as at Brentwood in Essex). In the early 1970s I was shown how the bed space of the original Derby County Asylum had been tripled, first by converting galleries to dormitories and then by adding verandas for people with tuberculosis.
25.2.1913 Annual Meeting of the After-Care Association at which Dr C. Hubert Bond, "Commissioner in Lunacy" read a paper on "After-care in cases of mental disorder, and the desirability of its more extended scope" (Abstract on Royal College of Psychiatrists website) - About 7,000 people were discharged from public asylums in England and Wales each year. After-care would benefit all of them, but for least 1,500 it was "urgently required". However, only about a quarter were being helped by the Association. He proposed branches of the Association corresponding to each local lunacy authority and that asylums notify the local branch of discharges and trial discharges. He suggested the Association's rules be amended to allow it to help patients on trial under section 55 of the Lunacy Act. The income from such patients would assist the Association's finances.
13.6.1913 Special Committee of the After-Care Association commented that "funds would be better employed helping trial cases than many of those on whom they are at present spent".
1913 or 1914 After care association renamed Mental After Care Association for Poor Persons Convalescent or Recovered from Institutions for the Insane [Although not clear when it became just the Mental After Care Association, the short title is used in 1927]
1913 Asylums built under the 1913 Mental Deficiency Act (Royal Assent 15.8.1913) were not hospitals, but "colonies" designed to separate defectives from the gene- pool of the nation. In 1934, the Brock Committee recommended voluntary sterilisation as a cheaper means to the same end. See the collection of forms used under the Act.
The Directory of Lunacy Commissioners 1774-1912 finishes here
The 1913 Mental Deficiency Act also established The Board of Control. This was the old Lunacy Commission with extended functions with respect to mental deficiency. The Board of Control continued to regulate the mental health system until 1959, but with reduced responsibilities after the National Health Service Act.
15.11.1913 The National Association for the Care of the Feeble Minded called a meeting at Denison House, London, S.W. of representatives of organisations "engaged in voluntary philanthropic work for defectives". This constituted a Central Association for the Care of the Mentally Defective which would work with the Board of Control and local authorities throughout the country. Leslie Scott (1869-1950), a conservative MP and lawyer with knowledge of the new Act, was President and Chairman of the Association from 1913 to 1947. Evelyn Fox (15.8.1874- 1.6.1955) was its honorary secretary. Its name changed to the Central Association for Mental Welfare in 1922 (Ruth Rees Thomas, 1971/- , Oxford DNB, under Evelyn Fox). In 1947, Leslie Scott and Evelyn Fox became founders of the National Association for Mental Health, into which the Central Association for Mental Welfare merged. (See British Medical Journal report 22.11.1913 - (Jones, K. 1972 p.267) - Oxford DNB under Fox and Scott.
Autumn 1913 Charlotte Mew offered to address envelopes for the new Medico-Psychological Clinic "to provide... different forms of treatment, both medical and psychological... for functional nervous diseases".
Pellagra shown by Joseph Goldberger (1874-1929) to be caused by a nutritional deficiency and not by an infection.
First publication of Rachel Grant Smith's experiences:
15.7.1914 "Law Made Lunacy" in Truth
22.7.1914 "The Insufficiency of the Petition" in Truth
29.7.1914 "Madhouse Horrors" in Truth
the great war for civilisation
One side of a medallion, found with others, in the attic
World War Part One: Science Time Line 1914- 1919
Bert Roberts signed up in the Royal Army Medical Corps very early in hostilities. His fiancee, Lily McKenzie, often saw the postman as she left for work in the morning. There were no letterboxes. He had to knock to deliver the letters. One morning he looked green and he told her he was close to turning his job in: "They have gone over the top at Gallipoli". His hand held a bundle of brown envelopes containing the official messages of the dead, the missing and the injured to deliver to Dickenson Street, Warrington. [British landings at Gallipoli were on 25.4.1915. The British withdrew 9.1.1916.]
The twentieth century's first encounter with mass slaughter on a world wide scale was traumatic.
The World War One Document Archives' medical titles on psychiatry include Shell Shock and its Lessons by Grafton Elliot Smith and Tom Hatherley Pear. Manchester University Press, 1917.
Freud and War Neurosis (A Freud Museum link)
The Oxford book of Twentieth Century Words lists shell-shock from 1915, defining it as "a severe neurosis originating in trauma suffered under fire. A term particularly associated with World War 1, in which soldiers on the Western Front were subjected to a seemingly incessant barrage of shell-fire". It compares it with bomb-happy (1943) in the second world war. But shell-shock was used by the medical profession, whereas bomb-happy was colloquial. (See later rejection of shell-shock as a medical term)
At the start of the 1914 war, Charles Stanford Read says, any officer or private showing what might be "psychotic" symptoms was sent to "D" Block, Netley, the Mental Division of the Royal Victoria Hospital. "Convoys of such cases reached there from France, Belgium, Italy, Salonika, Palestine, Mesopotamia, Egypt, and India. The first cases
"were dealt with according to the ordinary King's Regulations, which necessitated discharge from the army because of insanity and transference to their district asylum, where their status was no different from the other inmates."
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.
January 1915 Army Council estimated an additional 56,000 beds would be required to cope with wounded and sick troops. The Asylum War Hospitals Scheme, worked out with the Board of Control, moved civilian inmates out of certain asylums to provide accommodation for military medical, surgical and (from February) mental casualties. (Read, C.S. 1920 - Cullen, S. - and Barham, P. 2004, pp 44-45)
The asylums during the war
Many asylums were used as troop hospitals. (external link: Military Hospitals in the United Kingdom)
Conditions in some asylums during the war were very bad - leading to a high death rate (See Brentwood below)
Hospitals (asylums?) during world war one: -
Military: - See Netley - Naval: See Haslar
War Mental Hospitals: "The dropping of the word asylum was specially undertaken to obviate, if possible, the stigma that might be felt to attach to the name, which stigma does exist, rightly or wrongly." (Read, C.S. 1920) - See civil use 26.6.1903 - 1920 - 1930 -
September 1915 County of Middlesex War Hospital, Napsbury
10.11.1915 Royal Assent for the 1915 Naval and Military War Pensions Act - See below - See Charlotte Mew
November 1915 Latchmere Special Hospital for (Army) Officers "if markedly psychotic, they were transferred to a special hospital set apart for this purpose near Richmond, Surrey". (Read, C.S. 1920 p.46)
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
The successful identification of General Paralysis of the Insane as an end product of syphilis raised hopes of finding an organic cause for all mental illnesses (See Frederick Mott). The following poem suggests that it also re-inforced belief in degeneration theory as the overall causal explanation.
May 1916 Publication of the major volume of Charlotte Mew's poetry (The Farmer's Bride) whose dialogues with insanity included this in On the Asylum Road
"Theirs is the house whose windows...
Are made of darkly stained or clouded glass:
The saddest crowd that you will ever pass.
But still we merry town or village folk
Throw to their scattered stare a kindly grin,
And think no shame to stop and crack a joke
With the incarnate wages of man's sin."
10.12.1916 Labour leader, George Barnes, became the first Minister of Pensions. The Ministry of Pensions was created to handle the payment of war pensions to former members of the Armed Forces and their dependants. Pensions to ex-service lunatics were used to create the category "service patients" who were paid for from public funds, but counted as private patients. See 18.8.1919 - Citizen Soldier - 2.2.1921 - 1.1.1922 - 16.2.1922 - 1.1.1927
1917 525 patients died in Brentwood County Asylum during the year. This was only ten less than the number of admissions. By 1919 the number of deaths had fallen to 346.
1917 Malarial treatment of general paralysis Julius Wagner-Jauregg (1857-1940), in Austria, injected nine people suffering from General Paralysis of the Insane with the infectious blood of malaria patients. The theory was that the consequent fever would cure the G.P.I. and this appeared to be the case. Subsequently, experiments were carried out in many countries. See the 1924 reports on "The Malaria Treatment of Paretic Dementia". This may have become a standard treatment. See Scalebor Park, 1924, Horton 1924, Brentwood 1926 Nobel prize 1927 1929, Penicillin 1941 - 1963
Emil Kraepelin's Hundert Jahre Psychiatrie : ein Beitrag zur Geschichte menschlicher Gesittung [One Hundred Years of Psychiatry: A contribution to the history of human civilisation], written 1917, published in Berlin by Springer in 1918. 115 pages, illustrated. This was translated into English by Wade Buskin and published in 1962 as One Hundred Years of Psychiatry. The translation contains a short epilogue by H. Peter Laqueur, MD, reflecting on the years 1917-1962.
Kraepelin wrote "in Germany in the middle of a raging war" (p.154). A single paragraph, towards the end of the book, praises chemicals in the control of patient behaviour (after "protracted baths")
"We should not fail to note that the solution of many difficulties faced by the older doctors is the contribution of the chemical industry which in the last decade has created an imposing list of new soporifics and sedatives. The first sedative was chloral hydrate, recommended by Liebreich. Almost every other drug with similar effects was first manufactured and administered in Germany. Such agents are rightly considered expedients, however, and their use opens the door to many dangers. Still, for countless patients they are an immeasurable blessing, and they are mainly responsible for bringing the quiet atmosphere of the hospital into the wards for the insane and removing much of the horror that still feeds the imagination of the lay public" (pages 143-144)
influenza epidemic "flu pandemic"
Said to have killed 250,000 people in the United Kingdom and 40 million people world wide. (And there were plenty of other things killing people at this time - See Charlotte's web)
Encephalitis lethargica followed the flu pandemic. This affected up to five million people worldwide. One third died quickly, one third recovered, the remainder bore the aftereffects for years or decades. Encephalitis lethargica "vanished" in 1928. - External links: Encephalitis lethargica: BBC - History of narcolepsy - Can the flue cause Parkinson's Disease? - Lancet 1956
11.11.1918 Armistice signed. Firing stopped on all fronts.
In 1919 Siân Busby's great-grandmother, Beth Wood (1878-1957) drowned two of her children and was sent to Broadmoor. The murder and the shame affected the whole family down to the present with fears about hereditary insanity and an inability to parent. The Cruel Mother: A Family Ghost Laid to Rest (2004), an investigation of what happened, is partly the author's attempt to cope with the consequences.
See 1903 and 1922
Margaret Macdowall: Simple beginnings in the training of mentally defective children London: Local Government Press Co. (R. T. Leach), 1919 116 pages: illustrated. bibliography and index
18.8.1919 Right of patients classified as "service patients" to wear their own clothes - Others wore "pauper clothes" - Reported Hansard
Saturday 27.9.1919 The Westminster Gazette published The Cenotaph by Charlotte Mew
Ministry of Health Act 1919 established a Minister of Health to secure the health of the people including the treatment of physical and mental defects. By an Order in Council of 1920 the Minister took over the Home Secretary's powers under the lunacy and mental deficiency laws. These included appointing the non- legal members of the The Board of Control.
Science Time Line 1920
See 1840s, 1890s, 1940s
1919 1920s 1930s
In the period between the two world wars, Freudian theory shed a faint glow of hope on the outskirts of the custodial asylum. Talking treatments (not necessarily influenced by Freud) were an aspect of change in psychiatry that encouraged out-patient treatment. New physical treatments may have encouraged the idea of shorter stays in hospital.
From shortly after the first world war moves were made
away from in-patient treatment
towards outpatient treatment,
towards treatment without certification
towards treatment near to patients' homes.
But these moves only touched the edge of the mental health system.
1920 The Board of Control took over Rampton as the first English State Institution for mentally defective people considered dangerous. Broadmoor now specialised in the insane as part of the Home Office prison system and Rampton was part of the Board of Control's remit to control mental deficiency.
"from about 1920 onwards, the term "mental hospital" came into general use, though it did not receive legal recognition until 1930." (Alexander Walk 1962
24.3.1920 "Lunacy Law Scandals" in Truth
12.4.1920 Question in the House of Commons about "Military Hospitals (Asylums)" - Ashurst - Ewell - Springfield - and Winwick were still military hospitals. Maudsley - Maghall - Monyhull - and Craigleith were Ministry of Pensions Hospitals, but Maudsley was due to be handed back to the London County Council in July 1921.
Link to Jonathan Toms' review of Peter Barham's Forgotten Lunatics of the Great War, a book that argues that the concept of citizen soldier help to change the public perspective on the mentally ill.
"in the aftermath of the war... ex-servicemen were drawn into recording their embittered experience at the hands of official agencies such as the war pensions authorities" (p.7)
There is a cultural conflict between the concept of citizen patient - compatible, for example, with the provision of asylums by socialist local councils such as Goodmayes, and the apparent science of eugenics and the threat to the race of degenerates. A partial resolution of the conflict could be achieved by distinguishing real degenerates (including real lunatics) from the others. See, for example, Eugenics and Other Evils by G.K. Chesterton
24.5.1920: Joseph Deacon born
29.4.1920 First private conference on lunacy reform, Minerva Cafe
Minerva Cafe, 144 High Holborn, London. The Women's Freedom League club room and vegetarian restaurant.
19.5.1920 Second private conference on lunacy reform, Minerva Cafe - Followed by formation of the National Council for Lunacy Reform. "objects: to promote research into the causes of mental instability; to investigate the present system of care and treatment, and its results; to secure the provision of hostels for early cases; to safeguard the liberty of the subject; to reduce the burden of ever-increasing asylum expenditure; and to educate public opinion on the subject of mental disorder.". Members included J. E. Parley and Montagu Lomax. (Hervey, N.B. 1986) - Nic Hervey gives its addresses as 32/33 Avenue Chambers, Southampton Row - 90 Avenue Chambers - and 44 Wimpole Street. He says it became the National Society for Lunacy Reform
1920 Ernest Parley Life in a madhouse Independent Labour Party (Great Britain). Pamphlets. New Series ; No.27. 24 pages
12.12.1920 Question in the House of Commons suggesting the £7,900,000 spent each year on asylums could be reduced if councils ran run hospitals for early uncertifiable mental cases entirely unconnected with lunacy administration.
Linda Woolf's Chronology of the Holocaust begins in 1920 when the Nazi platform was drafted.
1921 Ernst Kretschmer (1888-1964) published Körperbau und Charakter (body-build and character), translated into English as Physique and Character arguing that body types match characters and pre-dispositions to types of mental illness.
1921 Montagu Lomax The experiences of an asylum doctor : with suggestions for asylum and lunacy law reform, based on his experiences at Prestwich. A "popular edition" was published in 1922.
1921 Cassel Hospital admitted its first patient. External link to web archive
2.2.1921 Letter in The Times from G.K. Chesterton (and others?) saying that the treatment of mentally distressed servicemen had "opened the eyes of the public to the fact that the life of patients in asylums is often one of prolonged misery" (Barham, P. 2004 p.358)
Eugenics and Other Evils Essays by G.K. Chesterton, published London: Cassell. 1922. Re-published New York by Dodd, Mead and Company 1927. "bulk of preliminary notes about the science of Eugenics were written before the war".
1.1.1922 number of ex-service men classified as "service patients" by the Ministry of Pensions, by asylum.
9.2.1922 "charges similar to the charges made by Dr Lomax are being repeated almost daily by responsible persons in the public Press; that some 6,000 ex-service men are being detained under the system thus openly attacked" (Charles Loseby MP. Hansard)
15.2.1922 Question in the House of Commons suggesting a Royal Commission.
16.2.1922 Hansard: Partial explanation of what a "Service Patient" is.
22.2.1922 "The care of the insane : an address delivered at the Guildhouse, Eccleston Square, on February 26th, 1922 by Maude Royden ; with a foreword by Dr. Montagu Lomax". Published by the National Society for Lunacy Reform.
1922 Rachel Grant Smith, (pseudonym) The Experiences of an Asylum Patient ... With an introduction and notes by Montagu Lomax. London : G. Allen & Unwin
27.3.1922 Letter from Courtauld Thompson about the foundation of a National Council for Mental Hygiene.
4.5.1922 Founding meeting of a National Council for Mental Hygiene in Great Britain. (British Medical Journal report) - See October 1929 and November 1946
June 1922: Begining of Harnett v Bond and Adam case in which a jury awarded enormous damages to an escaped mental patient in his case against a lunacy commissioner.
31.7.1922 Ministry of Health Departmental Committee on the Administration of Public Mental Hospitals
Infanticide Act (See 1903 and 1919)
31.1.1923 The London County Council Mental Hospital called The Maudsley opened.
"The Maudsley which will be opened by the L.C.C. on January 31, is the first municipal institution for early treatment of lunacy and scientific research into causes of insanity." (British Journal of Nursing, 27.1.1923, p.60)
Medical School later Institute of Psychiatry See external history
1923 John Thomson, M.D. (editor of "Edinburgh Hospital Reports") Opening doors: a little book for the mothers of babies who are long in learning to behave like other children of their age Edinburgh and London: Oliver & Boyd, 1923. Twenty pages.
1923 Bleuler's Textbook of psychiatry authorised English edition by A.A. Brill London : Allen & Unwin
1923 The Handbook for Mental Nurses being the seventh edition of the Handbook for the instruction of attendants on the insane by the Medico-Psychological Association, with a new title. A further revision was begun in 1932 but the eighth edition did not appear until 1954
The National Society for Lunacy Reform may have started in 1923. But see National Council for Lunacy Reform - See Royal Commission evidence "National Society for Lunacy Reform" - See "National Society for Lunacy Law Reform" 1929 - 1931 - Dr James Samuel Risien Russell (1863-1939) chaired the "National Society for Lunacy Reform" in the 1920s. His his private practice was at 44 Wimpole Street from the 1900s. His web biography says "he was often a witness in legal cases involving lunacy, notably Harnett v. Bond (1924-5)".
12.7.1923 6,900 patients receiving treatment for war neurosis
12.7.1923 House of Commons discussion of men who have sex with children - "if it cannot be proved that they were mentally deficient at the age of three they cannot be classified under the Mental Deficiency Act as being mentally deficient. I heard the other day of a man of 63 who for 40 years had lived a life of continually committing these offences, being repeatedly sent to prison, and released, and then committing the offence again. He had done that continuously for 40 years. That man ought to be looked upon as a mental degenerate and treated as such". (Margaret Wintringham)
17.11.1923 "Asylum reform: an address: (delivered at a conference in Mortimer Hall, London, on November 17th, 1923) by Montagu Lomax." Published: London: National Society for Lunacy Reform, 1923.
1924 Ministry of Pensions Mental Hospital opened at Storthes Hall in Yorkshire.
1924 Branthwaite Report on the diet of patients and Bond Report on nursing service in mental hospitals published by the Board of Control.
3.3.1924 Hansard: Calls for a Royal Commission following Harnett v Bond and Adam case.
May 1924 "The treatment of general paralysis of the insane by malaria" by Henry J. Macbride and W. L. Templeton published. The paper had been delivered on 12.12.1923. Summary - See Malaria treatment
June 1924 Joint Departmental Committee on Mental Deficiency (the Wood Committee) set up. It reported in 1929. Members included: A.H. Wood - Cyril Burt - A.F. Tredgold - Douglas Turner - Evelyn Fox - Mrs Hume Pinsent. Initially concerned with children. Adults added early in 1925. From 1925 to 1927 Edmund Oliver Lewis, from the Board of Control, carried out an investigation into the incidence of mental deficiency in six areas, which became part of the 1929 Report.
Tuesday 24.6.1924 composition and the terms of reference of the Royal Commission on Lunacy and Mental Disorder published. Reported 1926
Evidence from ex-patients
Thursday 26.6.1924 Valentine McEntee asked for "adequate facilities be given to the inmates of asylums to bring to the notice of the Royal Commission circumstances and conditions which, owing to the secrecy prevailing in lunacy institutions, do not usually come under the cognisance of the medical officers in charge thereof". (Hansard)
7.10.1924 First hearing of evidence by the Royal Commission [20 days of hearing to 10.2.1925] [22 days of hearing 24.2.1925 to 11.12.1925]
Review of Nervous and Mental Diseases
29.11.1924 Editorial in British Medical Journal suspected there were too many semi-popular books on psychoanalysis even though public interest was great. Reading them suggests psychoanalysis is fraught with danger because of the transference mechanism which could induce signs of violent love in the patient towards the analyst.
December 1924 Charlotte Mew met Siegfried Sassoon and the Untermeyers. Louis Untermeyer later described her as an exceedingly reticent and hermit-like poet.
17.1.1925 Public hearing of evidence by the Royal Commission from Mr H. W. Holman (former patient). Hearing continued 26.1.1925. (Reported British Medical Journal 31.1.1925 offline). Then on 27.1.1925. On 25.2.1925 the commission announced that further hearings from ex-patients would be in private.
21.4.1925: Board of Control Conference on what to do about the nursing service in mental hospitals
Board of Control Conference to consider ways for increasing mental hospital accommodation in England and Wales
21.5.1925 Question in the House of Commons about grant for councils running hospitals for early uncertifiable mental cases.
November 1925 schedules of forms and causes of insanity
Nurse Jessie Millar dismissed from "Garlands Mental Hospital" for striking Elizabeth Foster (aged 70), a feeble patient who was "constantly getting in and out of bed", on the head with a stick of firewood. At Carisle, on 14.11.1925, Jessie Millar was fined £2 and 10/- costs. "For the defence, it was stated that the nurse lost her patience through nervous exhaustion. She had to attend during the day to a mother who had since died, and during the night she had the care of 31 patients" (Asylum Workers Magazine December 1925)
11.12.1925 Concluding hearing of evidence by the Royal Commission
Child guidance in Scotland In 1925 James Drever set up, within the Psychology department at Edinburgh University, "the nucleus of a clinic for the study of delinquent children. This soon developed into a Child Guidance Clinic, staffed on a voluntary basis by the members of the Psychology Department working in collaboration with psychiatrists and social workers. This pioneer voluntary clinic led to the establishment of child guidance clinics in Edinburgh and other parts of Scotland." (source)
1926 General Strike
Report of the Royal Commission on Lunacy and Mental Disorder Summary from Michael Warren:
[argued] that there is no clear distinction between mental and physical illness, defining mental illness as "the inability of the patient to maintain his social equilibrium"; recommended a community service based on the treatment of patients in their own homes wherever possible with a strong preventive element; certification should be a last resort, not a preliminary to treatment; there should be no distinction in the methods of certification used for private and pauper patients; local authorities should established outpatient clinics, provide observation beds in general hospitals and fund after-care services provided by voluntary agencies; mental hospitals should not exceed 1000 beds [See also voluntary boarders] "The keynote of the past has been detention. The keynote of the future should be prevention and treatment".
1926 Mental After Care Association providing for 400 people in "cottage homes" and 150 people with work placements. Another 1,450 received home visits.
Hydrotherapy: At Warley, "Hydrotherapy became a vogue in 1926 that lasted until the war" - In the management of "turbulent patients" the main resources mentioned by MacPhail in 1928 are seeking the cause, separation and/or seclusion, continuous baths and sedation. A "continuous bath, with the use of a cover to the open bath, with an aperture therein for the patient's head" was one of the five means of "mechanical restraint" permitted by the Board of Control.
American philanthropy - child guidance - psychiatric social work
1926 An appeal to The Commonwealth Fund (New York) by Cyril Burt and Amy Strachey, (born Amy Simpson 1866) "Mrs St Loe Strachey" for funds to start training psychiatric social workers at the London School of Economics (see below) and support for Child Guidance.
AIM25 contains "material relating to the Mental Health Course, 1926-1957, including papers of the Child Guidance Council, the Commonwealth Fund and the Mental Health Training Committee; material on the teaching of Statistics and Computing Methods, Insurance, Social Studies, Latin American Studies, Management and Management Studies." - A grant is recorded to "London, University of, 1926- 1968" in the Commonwealth Fund archives.
Child Guidance in England "developed from an American model. Child Guidance services were originally staffed by specially trained social workers.... Bowlby (1987) records the first introduction of psychiatrists and educational psychologists into a London (Canonbury) Child Guidance clinic in 1936." (Baldwin, L. 2008 p.22). As an indication of the importance of child guidance in the 1930s, see the address of the President of the The Royal Medico-Psychological Association on 6.7.1938.
The East London Child Guidance Clinic, funded by the Jewish Health Organisation, opened in 1927 (evening consultations). The London Child Guidance Clinic or Canonbury Child Guidance Clinic, funded by The Commonwealth Fund, was founded in Islington in 1929 and the Notre Dame Child Guidance Clinic opened in Glasgow in 1931. See Child Guidance Council. The Association for the Scientific Treatment of Criminals (1931) appears to have focused on work with children and young people.
25.3.1927 "Report of the sub-committee appointed to consider the details of the proposed Demonstration Clinic, and to report to the" [Child Guidance] "council.." The clinic's chief objects would be:
to demonstrate the need and the possibility of specialised scientific training for those who have to handle delinquent and difficult children.
to demonstrate to parents, officials, social workers and the public generally the importance and value of making an individual study of such cases by scientific means.
to demonstrate the importance and value of scientific research upon the general problem involved
25.3.1927 Report quoted (Stewart, J. 9.2009, p.410
1927 A Text-Book of Psychiatry for Students and Practitioners by D.K. Henderson and R.D. Gillespie first published - (extracts)
1.1.1927 74 County Mental Hospitals and 24 County Borough Mental Hospitals in England and Wales = 98 Mental Hospitals. The total number of patients was 110,701. 101,031 were "rate-aided". 9,670 were "Private (including all Criminal patients)". The majority of the private patents were ex-service men. There were 2,888 females in the private patient column and 6,782 men. 5,376 of the men were ex-service men. 4,898 were "paid for by the Ministry of Pensions, and classed as 'Service' patients". 478 were "paid for by the Board of Control, and classed as 'ex-service' patients. (1.1.1927 List)
October 1927 Announcement that Julius Wagner- Jauregg was awarded the Nobel prize in medicine was for his "discovery of the therapeutic value of malaria inoculation in the treatment of dementia paralytica" (weblink). The next psychiatric Nobel was Moniz in 1949
ALL MEMBERS OF THE NATIONAL ASYLUM-WORKERS' UNION ARE URGED TO WORK AND
Vote for the Labour Candidates
1928 The Child Guidance Council [An explanatory leaflet] published by the Child Guidance Council (London). See 1935 - 1937 - Provisional National Council for Mental Health. See also Child Guidance
Model Answers to Questions for Mental Nurses by Hector MacPhail
1928 - 1932 - 1940 - 1944
25.2.1928 Joan Hughes born
24.3.1928 Charlotte Mew drank half a bottle of disinfectant, from which she died.
Meagher's Report on treating General Paralysis of the Insane by inducing malaria, published by the Board of Control
1929 With money from The Commonwealth Fund, a Diploma in Mental Health started at the London School of Economics to train Psychiatric Social Workers. The fund's Director, Barry Smith, had written in 1928 that "the training of psychiatric social workers is an essential and fundamental part of [a] child guidance program." (source)
January 1929: Our Baby - For Mothers and Nurses page 126 lists Idiocy under Congenital Defects:
"This is a term for mental weakness which dates from birth. It varies in degree from a mere feebleness of intellect, to a state in which the mind seems wholly absent. Should a child fail to answer to most of the tests of normal progress given on page 88, it must be considered backward, and the child should be taken to a doctor, as systematic training should be begun very early, considerable improvement being then almost always possible. (See list of recommended books page 177)"
The relevant recommended books are MacDowall and Thomson. As far as I can tell from library lists, there was not much more available.
The National Society for Lunacy Law Reform: ... justice for the helpless by Lord Henry Cavendish Bentinck, Eight page pamphlet. London, 1929. Wellcome catalogue lists a file on the society "1923- 1932". Reference SA/EUG/D.142 [See The National Society for Lunacy Reform
The Wood Committee report was presented on 24.1.1929. The section dealing with adults had not been published on 26.3.1929 (Hansard)
Wood Report on Mental Deficiency published by the Board of Control
"the majority of the feeble-minded are to be found within a relatively small social group, a group which may be described as the subnormal or social problem group, representing approximately 10 per cent of the whole population. Most of the parents in this subnormal group are themselves of poor mental endowment, and would no doubt have been classed, when children, among the dull or retarded. Similarly the dull children of the present generation, who form a large majority amongst children in this subnormal group, are the potential parents of many feeble-minded in the next generation. Therefore, from the standpoint of the prevention of many social evils it is of the utmost importance that the problems of the education and social care of the borderline retarded child should be effectively tackled....
Let us assume that we could segregate as a separate community all the families in this country containing mental defectives of the primary amentia type. We should find that we had collected among them a most interesting social group. It would include, as everyone who has extensive practical experience of social service would readily admit, a much larger proportion of insane persons, epileptics, paupers, criminals (especially recidivists), unemployables, habitual slum dwellers, prostitutes, inebriates and other social inefficients than would a group of families not containing mental defectives. The overwhelming majority of the families thus collected will belong to that section of the community which we propose to term the " social problem " or " subnormal " group. This group comprises approximately the lowest 10 per cent in the social scale of most communities"
20.4.1929 Letter in the Journal of the American Medical Association about the establishment of the London Child Guidance Clinic
See Robina Addis - Bowlby 1936 - Tavistock 1967
30.10.1929 to 2.11.1929 Conference on Mental Health convened by the Joint Committee of the National Council for Mental Hygiene and the Tavistock Square Clinic. Held in Westminster. [See Lord, J.R. 1929/1930
Minutes of the Home and School Council of Great Britain, 1929-1950s held by Institute of Education, University of London.
Science Time Line 1930
1.4.1930 Under the 1929 Local Government Act, councils took over functions from the poor law guardians. This brought to an end (by incorporation into local councils) the separate structure of government established under the 1834 Poor Law and subsequent Acts
5.5.1930 to 10.5.1930 First International Congress of Mental Hygiene held in Washington. An estimated 4000 people (psychiatrists, psychologists, health planners and others) attended. It was organised by the "International Committee for Mental Hygiene"
The 1930 Mental Treatment Act
Royal Assent 10.7.1930
The 1930 Mental Treatment Act modernised, without replacing, the Lunacy Laws. It reorganised the Board of Control, made provision for voluntary treatment and psychiatric outpatient clinics and modernised the terms used. The intention appears to have been to make voluntary treatment available for all classes, not just those who could afford fees:
"I think it is a great charter for the poor of this country, and for the first time it gives the poor as great a chance as the rich. I think the Bill gets away from the spirit of detention to that of prevention and treatment." (Dr. J. H. Morris-Jones, M.C. Labour - Denbigh, the last speaker in the Debate on the third reading in the House of Commons)
British Journal of Nursing, Volume 78, June 1930 Editorial "A Message of Hope"
However, a 1939 Guide to Middlesex County says of voluntary patients under the Act: "these private fee-paying patients in the majority of cases pay a higher maintenance rate than that received for the rate-aided patients". (Radcliffe, C.W. 1939 pages 153-154)
22.7.1930 and 23.7.1930 The Board of Control held a Conference on bringing into effective operation the powers conferred by the Mental Treatment Act. The report was called Mental Treatment
New Mental Hospitals
In 1930 the average number of patients in the 98 "County, County Borough and City Asylums" was 1,221 (Jones, K. 1972, p.357).
The last of the (large) mental hospitals to be built in England or Wales were the new Bethlem in south London (Kent), Shenley, in Hertfordshire, and Runwell, in Essex. No new ones were built after the second world war. Mental deficiency colonies (then hospitals) continued to be built. The last to open was Bryn-y-Neuadd in 1971.
The new Bethlem Royal at Beckenham in Kent was completed in 1930. The old Bethlem at St George's Fields became the Imperial War Museum. 9.7.1930 Formal opening of the new hospital by Queen Mary.
Moss Side, Maghull, Liverpool, was opened in the 1930s as England's second State Institution for mentally defective people considered dangerous. (See Rampton). It had been serving as a hospital for soldiers.
Hedley Report on colonies for mental defectives published by the Board of Control
1931: Admission Units for "recent cases, wholly separate from the main building in which are housed patients of confirmed mental disorder"
Carlos Paton Blacker (1895-1975) was General Secretary of the Eugenics Society from 1931 to 1952. See 1942 - 1944 - Historical background to community care - 1946 - 1952
July 1931 Association for the Scientific Treatment of Criminals - renamed the Institute for the Scientific Treatment of Delinquency in July 1932
Friday 16.10.1931 South London Press LETTERS TO THE EDITOR - ILL-TREATING MENTAL PATIENTS - "Their Complaints Are Only Regarded as Delusions" - Sir.-Many workers in the field of Lunacy Reform will rejoice over the smart fine inflicted on the dismissed mental home attendant who gave a patient a black eye. The Board of Control by bringing the case show that they are just beginning to realise that their normal function is not to serve only the sectional interests of the doctors and nurses. Cases of ill-treatment are seldom brought to notice as patients' complaints are regarded by the authorities as "delusions." It is not unusual for an attendant to provoke a man to violence, so as to get the opportunity of paying off old scores, but the stomach is generally the target and not the face, where marks are so conspicuous. Violence is all too frequent. Only just recently an old man died in a London asylum suffering from eleven broken ribs after being crushed in a straight-jacket! The National Society for Lunacy Law Reform has been exposing these abuses for some ten years or so, and sympathisers would be doing good work by supporting them. VINDEX - Herne-hill.
1932 The Mental After-Care Association provided a part time social worker for Brentwood Mental Hospital from 1932 to 1944.
1932-1933 Robina Scott Addis (1900-1986) took LSE course in Mental Health, qualifying as a psychiatric social worker. Followed by a Commonwealth Fund Fellowship for research into enuresis - which possibly meant a year in he USA. From 1934 to 1939 she worked in London Child Guidance Clinics. During the war she was a Welfare Officer for the Mental Health Emergency Committee. - From 1951 she worked at the National Association for Mental health's HQ in London. papers - (Wellcome biography)
Science Time Line 1933
On 5.5.1933 the first residents of Borocourt Certified Institution for Mental Defectives moved into a converted Victorian mansion
Borocourt: See 1966, 1981
Germany The case for eugenics (breading healthy people) and euthanasia (humane killing) reached an extreme under the National Socialist (Nazi) regime in Germany. The Nazi party came to power in 1933, committed to the construction of a racially pure "Aryan" Germany. In addition to the attempted elimination of Jewish people, attempts were made to eliminate mentally and physically degenerate Aryans. In 1933, less than six months after their election, they passed the Law for the Prevention of Genetically Diseased Offspring (see external link). In September 1935 the Law for the Protection of German Blood and German Honour forbade marriage or sex between Jews and "citizens of German or cognate blood".
1959 comment: "It is obviously useless to sterilise idiots and imbeciles, as was widely done in Germany... from 1933 to 1940, because they do not in any case have offspring except in the rarest cases" (Penrose 1959, p. 102) - But not so "obvious" at the time (see below)
1934 Laurence George Brock, chair of the Board of Control, published his committee's report on the voluntary sterilisation of mental defectives, with memoranda on what was happening elsewhere in the world.
May 1934 King George 5th opened Shenley Mental Hospital in Hertfordshire. Middlesex County planned this in the neighbouring county as a small town in the countryside, composed as a network of villas of 20 to 45 beds, with 2,000 patients and 500 staff. The Middlesex Colony at Shenley, on land to the north of the main Shenley Hospital estate, had been opened by the Minister of Health in 1933. Its reception hall was opened during Jubilee Week in 1935. (Radcliffe, C.W. 1939 pages 153-154) On this 1980s Ordnance Survey map, I believe the hospital to the west of London Colney is Napsbury, opened in 1905. This was the first of the Middlesex in Hertfordshire mental hospitals and colonies. That to the south of the map is Shenley, and north of that Shenley Colony. Please tell me if I am wrong. Leavesden was north of Abbotts Langley, further west. Hill End, Hertfordshire's own Mental Hospital, was near St Albans to the north. The MP for this area in the 1970s and 1980s was Cecil Parkinson. A report of the Parkinson Committee, published in part in 1981, triggered the closure of the mental hospitals.
The first antibiotic was sulfanilamide, which Time magazine dated from February 1935. penicillin followed and then streptomycin.
Child Guidance Council Executive Committee minutes November 1935 to June 1937 held by Warwick University, Modern Records Centre - See Child Guidance [?] - Feversham 1936 - new constitution
Metropolitan observation units In 1936 there were six observation wards in general hospitals run by the London Council Council. These were at Fulham - St Pancras - St Clements - St Alfege's (Greenwich) - St Francis (SE22?) - St John's (Wandsworth?). In 1936, 6,233 patients were admitted to the London observation wards of whom 3,117 were transferred to mental hospitals (only 10 per cent of these went as voluntary patients) and 1,054 discharged to the care of relatives. (source)
Wilson Report on hypoglycaemic shock treatment in schizophrenia published by the Board of Control, followed in 1938 by a report that also dealt with cardiazol shock treatment
External Link: Renato Sabbatini's article on The History of Shock Therapy in Psychiatry (archive) explains the relationships
1936 "The London Child Guidance Clinic" (Islington - Canonbury) "trained educational psychologists, social workers and child psychiatrists. Each year three fellowships in child psychiatry were advertised - they were half-time fellowships for one year". John Bowlby was appointed to one in 1936. (Bowlby, J. 19.10.1977) - See 1951 - A Two Year-old Goes to Hospital
8.4.1936 Lord Feversham chaired a preliminary meeting of a committee of representatives (two from each?) from the National Council for Mental Hygiene - the Central Association for Mental Welfare - the Child Guidance Council and the Home and School Council of Great Britain. Committee formed to inquire into the extent of mental disorder in England and Wales and the measures taken to deal with it by statutory and voluntary agencies. The inquiry was conducted with the sympathy and assistance of the Board of Control and other parts of central and local government. It reported in 1939
24.9.1936 Lennox Castle Certified Institution for Mental Defectives (external link) opened in Dumbartonshire, Scotland. See also Glasgow archives: "It had 1,200 beds when it opened... and was the largest mental deficiency hospital in Britain"
March 1937 circular letter about a new Child Guidance Council Constitution and membership (Warwick University, Modern Records Centre) - Also Child Guidance Council "Memorandum re Amalgamation prepared for the Feversham Committee" (dated March 1937)
Monday 19.7.1937 to 24.7.1937 (Second) International Congress on Mental Hygiene held in Paris. On the Monday morning, Clifford Beers, "secretary-general of the International Committee for Mental Hygiene reported on the activities of the committee since the first congress in 1930 and Dr George Genil Perrin, secretary-general of the congress, made a brief report. The themes of the afternoon session were Eugenics and Sterilization in Relation to Mental Hygiene, and Mental Hygiene in Relation to Sex. Ernst Rudin spoke first on the "Condition and Role of Eugenics in the Prevention of Mental Diseases". He argued that "the only method of extirpating hereditary mental disorders was by preventing the propagation of tainted sex-cells". Bernard Sachs complained to to Beers that Rudin was "the most outspoken and rabid Nazi protagonist... who heads a whole group of men who are now openly making eugenic doctrines conform with the race purity doctrines of the present German regime". The choice of speakers, however, was not something that Beers had any control over. ( Psychiatric Quarterly Volume 12, Number 1. March 1938 and Dain, 1980)
1937 Official opening of Runwell Hospital, Wickford, Essex. (Jones, K. 1960 p.357) says that this already had a "patient-population of 1,010". Administrative records in Newham Public Libraries start in 1934. General records start in 1937. Kathleen Jones (who does not mention Shenley) says
"Runwell was a completely new hospital - the first to be planned since the First World War, designed to embody new ideas in mental treatment. Larger than Bethlem, it had at the time of opening in 1937 a patient-population of 1,010; but this total was broken down into small units, each largely self-contained. Runwell is the only English mental hospital to be built entirely on the villa system - Small one - or two - storey blocks with flat roofs were scattered over a wide are of garden and parkland. Parole patients, who required relatively little supervision, were housed in units for twenty to twenty-five persons... Separate blocks were constructed for patients' clubs, where resocialisation through group methods could be tried out; and a research wing was built and equipped for the examination of the biochemical and neurological bases of mental disorder" (Jones, K. 1960 pages 130-131)
April 1938 Rome: "S.E.", a thirty nine year old man diagnosed schizophrenic, was chosen by Ugo Cerletti as the first human to have convulsions artificially induced by an electric shock through the brain. The origin of Electro-Convulsive Therapy. See Europe below.
6.7.1938 The President of the The Royal Medico-Psychological Association spoke of the change in psychiatry from pessimism to opimism since Maudsley published The Pathology of Mind in 1879:
" The great work of Sigmund Freud has cast a brilliant, if necessarily unequal light upon the dark places of psycho-pathology. General paralysis would now appear to be largely under our control. Schizophrenia is being attacked with renewed hope since recent therapeutic knowledge and research have brought insulin and cardiazol and other agents to our aid. Wider fields spread before the psychiatrist than ever before. In out- patient dispensaries, in child guidance clinics, in juvenile courts he finds an increasing welcome. Psychological factors in industry, in unemployment, in the aetiology of war invite his co-operation."
29.7.1938 to 2.8.1938 10th International Medical Congress for Psychotherapy held at Baliol College, Oxford - Its first meeting in an English speaking country. Sargant and Slater 1963 (page 165) say that reports were presented of the trial of insulin coma treatment in several countries. Manfred Sakel had carried out the experiments putting schizophrenic patients into an insulin coma since 1927. See 1947 - 1948 - 1950 - 1952 - St David's 1956 - Croydon 1956 - 1963 - 1968 - 2009
The following is a typed copy of the medical register entry for a patient who died at Saxondale Hospital, Nottinghamshire in 1939. This, like other medical registers, uses a code for the type of illness and the cause of the illness. To work out what the codes mean, see 1925 forms
Form of Mental Illness: L16
Jubilee book for Middlesex divides care of mental defectives into community care and institutional care
"In 1939, Kalinowski began a tour to advertise ECT" [Electro- Convulsive-Therapy] "around the globe, visiting the Netherlands, France, Switzerland, England, and the United States." (Sabbatini) - It was introduced at Warley in 1941. In 1957 it was described on television as an exciting new advance in medicine, and this created a consumer demand for it.
Germany In Spring 1939, a Reich Committee for Scientific Research of Hereditary and Severe Constitutional Diseases was established that oversaw the killing of an estimated 5,000 'deformed' children in a 'euthanasia' programme that finished in November 1944. In July 1939 planning of the 'T4' programme of 'mercy killings' of the insane began. Experimental gas chambers were tried out at Brandenburg euthanasia centre in late 1939. An estimated 80,000 to 100,000 people were killed before the T4 programme was 'stalled' in August 1941 after public protest. Experiments in humane extermination continued in occupied Poland. In September 1941, 250 mental patients and 600 Russian prisoners of war were gassed at Auschwitz. During the war, about six million Jews from all over Europe were exterminated in the Polish death camps, notably Auschwitz 2 (Birkenau), Belzec, Chelmno, Majdanek, Sobibor, and Treblinka. See entry into Belsen (concentration camp) 1945
humane killing of 80,000 in Britain recommended
External link - another - See also above
January 1939 Mental Welfare Price 10d - Annual Subscription Post Free 3/6 - January 1939 - Vol. 20, No.1 - Published by the Central Association for Mental Welfare Incorporated - 24 Buckingham Palace Road, London, S.W.1
Early 1939? A Mental Health Emergency Committee established by voluntary organisations to address the "problems of mental health, mental deficiency, and community care in time of war". Address 24, Buckingham Palace Road. [Address of the Central Association for Mental Welfare] (Hansard 29.2.1940)
July? 1939 The Voluntary Mental Health Services: The Report of the Feversham Committee published by the committee. 16 introductory pages. 268 main pages. - "Mental Health Council - Feversham Committee's Proposal" Yorkshire Weekly Herald 28.10.1939 headline to article on the report of the committee, which it said was published "yesterday"
Second World War 1939-1945
Sunday 3.9.1939 Britain declared war on Germany
"The Emergency Medical Service was introduced as soon as war broke out, and gave central government a right of direction over both voluntary and municipal hospitals which it had never before possessed. Patients were discharged or evacuated from the hospitals in central London in preparation for a wave of air-raid casualties which did not materialise" (Geoffrey Rivett)
Hospitals during world war two: - Belmont - Sutton - Netherne - Surrey - Hellesdon - Norfolk - Rooksdown House - Hampshire
Having been sent to Northampton as a Mental Health Emergency Committee Welfare Officer to care for child evacuees, after Dunkirk, Robina Addis cared for adults billeted in the Northampton area who were psychiatric casualties
The Blitz, sustained bombing of London and other British cities 7.9.1940 to 10.5.1941.
The mass-production of Penicillin was developed in the United States from 1941. A recent medical website (archive) describes General Paralysis of the Insane as "a syndrome of madness and weakness occurring in tertiary syphilis, which is now very rare because of treatment with penicillin". Penicillin's use in connection with general paralysis is after 1945.
The annual death rate (England and Wales) fell steadily from 2.272 in 1901 to 68 in 1957. (Hare, E.H. 1959). Although treatments by malaria or penicillin do not show any marked influence of the curve of the decline, I would think the statement that it has become rare because of treatment with penicillin is correct.
In one industrial concern more than three times as many work- days per man were lost in 1941-1942 owing to neurosis than had been lost in a pre-war year. (Aubrey Lewis 4.3.1942)"
Long-term hospital patients were moved to residential homes to make room for injured soldiers. By 1942 the Mental After Care Association (MACA) was running fifty homes. The war established the residential care-home model and, by the 1950s, MACA had several of its own properties, where up to 50 people lived as many as five to a room.
4.3.1942 Memo from Aubrey Lewis to the Director General of the Emergency Medical Services - Surprisingly few cases of overt neurosis had resulted from the air attacks, but psychiatric stresses appeared to be increasingly felt, especially in industry. Called for an investigation of the extent of neurosis and allied states, and the facilities for consultation and rehabilitation.
April 1942 Term Lack of moral fibre (LMF) adopted by the Royal Air Force to stigmatize aircrew who refused to fly without a medical reason.
21.10.1942: Carlos Paton Blacker was seconded to the Ministry of Health as adviser on population and medico-social problems to undertake. with the Medical Research Council, a survey to obtain information on the adequacy of psychiatric out-patient facilities to deal with the psychiatric troubles of a civilian population subjected to more than three years of war. The publication of the Beveridge report in December 1942, however, suggested that the survey might also consider "how the psychiatric services of this country might be improved after the war." (Bolby)
The Mental Health Emergency Committee lent their Regional Representatives to the survey: Mrs D. Hardcastle (two regions from Derbyshire to Essex) - Miss E.M. Findlay (Oxfordshire to Dorset) - Miss H.E. Howarth (Wiltshire to Cornwall) - Miss L. Shaw and Miss E.C. Selley (Warwickshire to Herefordshire) and Miss Robina Addis (Kent, Sussex and Surrey). [Robina Addis became Regional Representative in October 1942]
1942? Mental Health Emergency Committee became the Provisional National Council for Mental Health, divided into 13 areas, based on Civil Defence Regions [??] - Provisional National Association for Mental Health Annual Report 1943/1944 and Provisional National Council for Mental Health (incorporating... Child Guidance Council...): Ad hoc Committee on the extension of clinical training (Play Therapy) ['Inter-clinic Comm'] minutes February 1944 to May 1944, held by Warwick University, Modern Records Centre.
"They Called It Shell-Shock: Approximately one-third of the men invalided from the army have been discharged on psychiatric grounds. In the last war they called it shell-shock. The term was used to cover almost all types of psychological illness arising in association with, or as a result of, enemy action. The true significance of psychological factors was not appreciated. It was assumed that these disorders were the results of actual damage to the brain or nervous system caused by the effects of high explosives, and comparable in their origin and effects to actual head injury and concussion. It was a confusing and unfortunate term and is not now accepted as a diagnosis. For psychiatry has come a long way since then, and its influence in the Army is very considerable. There are ten special Army mental hospitals with, so far as possible, one Army Psychiatrist to fifty patients, and up to about four hundred patients. These beds have never been completely filled, though some hospitals have had a big and quick turnover. The average stay in hospital is about six weeks.... " (Major) Anthony Cotterell R.A.M.C. [Royal Army Medical Corp] Hutchinson, no date, but probably about 1943
Our Towns: A close-up - A study made in 1939-1942 - with recommendations by the Hygiene Committee of the Women's Group on Public Welfare, chair Amy Sayle, (in association with National Council of Social Service). Preface by Margaret Bondfield.
"The effect of evacuation was to flood the dark places with light and bring home to the national consciousness that the 'submerged tenth' described by Charles Booth still exists in our towns like a hidden sore, poor, dirty, crude in its habits, and an intolerable and degrading burden to decent people forced by poverty to neighbour with it.
With this group are the 'problem families' always on the edge of pauperism and crime, riddled with mental and physical defect, in and out of the courts for child neglect, a menace to the community, of which the gravity is out of all proportion to their numbers"
3.2.1943 Neurosis Questionnaire distributed to Regional investigators.
15.11.1943 Final report on neurosis questionnaires received back from regional investigators.
December 1944 Carlos Paton Blacker signed his preface to Neurosis and the Mental Health Services
Preventive Psychiatry a Mainly Sociological Question.
Historical Background to Community Care
National Health Service
Breakdown of taboo of silence. 1950s 1958 1960s 1972
Royal Commission on the Mental Health Laws 1954 to 1957
The Hurt Mind
1959 Mental Health Act
Enoch Powell's Water Tower Speech
1962 Hospital Plan
Better Services White Papers, 1971 and 1975
1981 Care in the Community Green Paper
Glenside Hospital Museum: Dr Donal Felix Mary Early, a consultant psychiatrist, worked at Glenside Hospital, Bristol, from 1944 to 1979. With Dennis Griffiths and volunteers he began collecting artifacts during this time, and placing them into storage. After some time, the hospital granted the use of the balcony overlooking the dining hall at Glenside. The collection gradually built up, as people donated artifacts to the museum.
But see below Bristol Exhibition 1961
When the Hospital closed in 1994, the use of the derelict chapel was given to the Museum. The chapel was repaired by volunteers. The museum gradually developed with Dr Early as the guiding light, forming the exhibits, and telling the story of the Hospital.
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)
26.7.1945: Election results: Labour Government (to 1951)
9.8.1945 Nagasaki destroyed by the second atomic bomb.
15.8.1945 End of second world war.
September 1945 International conference in Zurich of S. E. P. E. G.; Semaines internationales d'eïtude pour l'enfance victime de la guerre. International Study Weeks for Child Victims of the War. Robina Addis was [the?] British representative.
Hospitals are for Healing:
The origin and context of community-care policies
1940s and 1950s: Historical Background to Community Care
The therapeutic asylums planned in the 1840s failed monumentally, the monuments being a network of large asylums full of long-stay patients with little or no hope of rehabilitation. In post war Britain the National Health Service inherited these asylum which still stood in open countryside outside the towns, or had been engrossed by the expanding suburbs.
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).
See Geoffrey Rivett for the history of the National Health Service
March 1946 National Health Service Bill introduced
April (or earlier) 1946 Neurosis and the Mental Health Services by C. P. Blacker, 218 pages, published by Oxford University Press, 1946. Price, 21/- "The influence of the report of the Feversham Committee will be apparent to all readers" (Author's Preface, p.vii)
November 1946 The 1946 National Health Service Act passed. This stripped the Board of Control of nearly all its functions except those of providing an inspectorate of mental hospitals, especially with respect to compulsory detention, and managing Rampton and Moss Side. The Act came into force on 1.7.1948
Mind History website - archive
[Date of foundation (below) is the date the three constituent bodies formerly merged. - Confirmed by Rachael Twomey at the Mind Information Office]
25.11.1946 Foundation of the National Association for Mental Health (now Mind). This was a combination of existing organisations, partly merged in 1939 as the Mental Health Emergency Committee for war-time coordination. This had become the Provisional National Council for Mental Health. Its components were the Central Association for Mental Welfare (formed in 1896 as the National Association for the Care of the Feeble Minded), the National Council for Mental Hygiene (founded 1922) and the Child Guidance Council (foundation date uncertain). Only the National Council for Mental Hygiene "had any real interest in the mentally ill" (Mary Applebey 1976). The Association worked closely with the Ministry of Health and the Board of Control. - See Mind and the Users Voice -
"The grandmother of it all was Dame Evelyn Fox" (Mary Applebey 1976) - In 1971 there was a pastel portrait, made after her death, in the council room of the National Association for Mental Health at 39 Queen Anne Street (DNB) - Mind moved to 22 Harley Street in the early 1970s. It moved to 15-19 Broadway, Stratford, London E15 4BQ in 1993/1994
Conferences (and AGMs): 1961 - 1973 move and AGM - 1974 - 1975 - 1975 - rights - 1976 - 1976 AGM - 1977 - 1978 - 1980 - 1981 - 1982 - 1983 - description of target audience - October 1984 - 1984 - [World Mental... July 1985] - 28.11.1985 - 1985 - NW Mind at Crawshawbooth - 1986 Conference - 1986 AGM - planning for 1987 - 1987 - [International 26.9.1988] - 1988 - (See also 1988) - 1989 - 1990 - 1991 - 1994 - 1994 AGM - 1998 - 14.11.2002 - 16.3.2006 - 6.9.2006 - 6.11.2007 - [Mind blog - 2009] -
Archives: See National Association for Mental Health (later Mind) collection in the papers of Robina Addis
1946 Social Psychotherapy Centre established in Hampstead by Joseph Bierer with day places and night places (closed weekend). It was known as the Marlbourough from 1954 and adopted the title "Day Hospital" shortly after the term was used in 1958 by Cameron in the United States. The centre used community and group therapies. Historians have sometimes confused the Marlborough with Paddington Day Hospital.
Photograph is enlarged from the back cover of the 1952 edition of Psychiatry Today 1946? David Stafford-Clark (17.3.1916-9.9.1999) began studying at the Maudsley Hospital. At some time, Allen Lane of Penguin Books enquired about a writer for a popular book on psychiatry. Aubrey Lewis recommended David Stafford-Clark, who finished writing Psychiatry Today in July 1951.
An anonymous obituary in The Times (10.9.1999) said "Stafford-Clark did more than almost anyone to dispel long-held prejudices about "lunacy" and "mental deficiency" and to remove the stigma from being mentally ill".
See 1952 - 1957 - 1963
Out of sight - Out of mind - Stigma and taboo
The stigma of disability was intense. In the early 1940s, for example, a mother who attempted to meet other parents of handicapped children to form a playgroup had her advertisement refused by her local paper because of the "shame and disgrace" of having a handicapped child.
In 1946 The Association of Parents of Backward Children (now Mencap) was formed by parents concerned about the lack of support to help them maintain a child at home, and the isolation and poor facilities of the deficiency hospitals that were the main alternative. [For changing names, see below) Mencap History website archive 2001-2006 - current link
The 1946 Report of the Care of Children Committee complained about the "motley collection" of people it found in workhouses. In one room, with children of workhouse inmates, there was "a Mongol idiot, aged four, of gross appearance, for whom there was apparently no accommodation elsewhere. A family of five normal children, aged about six to fifteen... were sleeping in the same room as a three year old hydrocephalic idiot, of very unsightly type, whose bed was screened of in the corner... We found a number of institutions in which normal children were sleeping with low grade mentally defective children..." (Cmnd 6922 paragraphs 140 and 142).
Compare the revulsion expressed with 1847, 1894 and 1916. Some of the same may have been involved in the refusal to show patients faces in The Hurt Mind in 1957. However, The Hurt Mind and the previous 1954 Archers programme, were deliberate efforts to break through the taboo of silence on mental health issues.
pre-frontal leucotomy and insulin coma - See Warley 1946
1947 Pre-frontal Leucotomy in a thousand cases by Isabel Wilson and E.H. Warland published by the Board of Control.
about 1947 to 1953 A period during which "practically every mental hospital in the country" (England and Wales) used insulin coma treatment. (Sargant and Slater 1963 p.170 commenting on 44 deaths from the treatment reported to the Board of Control in that period (W. Maclay, 1953 "Deaths due to treatment" Proceedings of the Royal Society of Medicine 46, 13)
National Association for Mental Health "Film Visiting Committee" formed in 1947 to "help in relation to producing, and also in avoiding inaccurate presentations which would tend to vulgarise psychology and give the public a false idea of its possibilities" (Mental Health, 1967, 7 (2), 47, quoted Crossley, N. 2005 p.78. This joined forces with members of the British Film Council in 1948. Eventually gave rise to the Mental Health Film Council (Crossley, N. 2005 p.78)
"Euthanasia:... with regard to the 80,000 or more idiots and imbeciles in the country... These are... incapable of being employed... their care and support absorbs a large amount of the time, energy, and money of the normal population... many... are utterly helpless, repulsive in appearance, and revolting in manners... In my opinion it would be an economical and humane procedure were their existence to be painlessly terminated... It is doubtful if public opinion is yet ripe for this to be done compulsorily; but I am of the opinion that the time has come when euthanasia should be permitted at the request of a parent or guardian" A Text-Book of Mental Deficiency (Amentia) by A. F. Tredgold, Consulting Physician to University College Hospital, London. Seventh edition 1947. Page 491. [My copy ex "Bangour Village Medical Library"] - See 1933 and Historical background to community care
See Valuing People
The 1947 Annual Report of the National Council for Civil Liberties refers to a woman released from a mental ward after the NCCL proposed applying for a writ of Habeas Corpus as she appeared to have never been certified. Another woman was made a voluntary patient after NCCL began enquiries, and released herself. Both women had had illegitimate children.
"Not until after the Second World War did the Council concern itself with the most important liberty of all - the loss of total liberty when a person is wrongfully imprisoned in a gaol or institution. The first mental deficiency case which came to the Council's notice was brought to them in 1947 by a retired solicitor's clerk who, enraged by the circumstances of a young girl unrelated to himself, waged such an excellent one man war that the girl was freed before the Council needed to list a finger. The second was brought to the Council's notice by a clergyman, the third by a London legal advice centre... [in 1958 there were] 860 mental deficiency cases on the Council's files, of which more than eighty concern patients... in Rampton.." (Roxan 1958, p.224)
See 1951 - Peter Whitehead 1.11.1954 - Royal Commission 1954 - Peter Whitehead 1955 - 1956 - Roxan 1958 -
Science Time Line 1948
See 1930 and 1966.
July 1948 National Health Service Act came into operation
The National Health Service (NHS) took over from county councils and boroughs the major responsibility for mental health. The reforms of the 1920s and 1930s had only touched the edge of the mental health system. The main inheritance of the National Health Service was a system of over 100 asylums, or "mental hospitals", with an average population of over 1,000 patients in each.
The integration of the mental hospitals into the National Health Service was possibly the most decisive factor leading to a general move away from institutional policies in the 1950s. See 1959. Andrew Scull (1977, chapter 5) refers to studies of individual English mental hospitals, including Mapperley Hospital, Nottingham where inpatient numbers fell from 1948 due to changes in administrative policy, including avoiding admission altogether and early discharge of those who were admitted. In-patient numbers at Mapperley fell from 1,310 in 1948 to 1,060 in 1956. They were down to 870 (with annexes) in 1960.
External link to Community Care history about Mapperley
[See archive - international archive]
(On the Mental Illness Concerns All (mica) web site)
1948 World Health Organization published the Sixth Revision of the International Classification of Diseases. For the first time this included sections on mental disorders The first international classification of diseases, the Bertillon Classification of Causes of Death was brought in in 1898. Revisions came into effect in 1918 (ICD2), 1922 (ICD3), 1931 (ICD4), and 1940 (ICD5). In 1948 the International Classification of Diseases in its sixth revision was extended to include non-fatal diseases. The ninth revision was adopted in 1975, the tenth revision in 1989. The tenth revision included a supplementary classification of impairments, disabilities and handicaps. external link to decoder
Previous international conferences: 1930 - 1937. See also 1909
11.8.1948 to 21.8.1948 "Der Monster Kongress" (Anna Freud's description) in which 2.500 representatives of 42 countries met in London during ten days to evaluate what had been learnt about mental health during the war and to plan for peace. This is counted as the founding congress of the World Federation for Mental Health - External link to website - The founding meeting was held in London. See 1951 - 1954 - 1961 - 1968 - 1973 - 1977 - 1979 - 1981 - 1983 - Brighton 1985 - 1987 - 1989 - Mexico 1991 - [First World Mental Health Day] - 1993 - 1995 - 1997 - 1998 - 1999 - 2001 - 2003 - 2005 - 2007 - 2009 -
Universal Declaration of Human Rights
1.10.1949 Full implementation of post-war open door policy at Dingleton Hospital. Melrose, Scotland. "It appears to be the first mental hospital with open doors in the world" (Ted Hayes). The medical superintendent, Macdonald Bell (G.M. Bell) published a paper "A mental hospital with open doors" describing it in an early issue of the International Journal of Social Psychiatry, 1955, 1 pages 42 to 48). The open door system was also adpted in England at Mapperley, Warlingham Park and other hospitals
1949 Foundation of the Mental Health Trust and the Mental Health Research Fund. These merged in 1972 to form the Mental Health Foundation (website) - information on charity - Database of Archives of Non-Governmental Organisations. The Research Fund was started by Dr Derek Richter (1907-1995) because there was so little research in the field. Dr Richter was at the Neuropsychiatric Research Centre, Cardiff from 1950 to 1983. - Published histories 1984 and 2009 - website archive from 1.6.1997
1949 Publication of E. Jacobsen and O. Marten-Larsen's "Treatment of alcoholism with tetraethylthiuram disulphide (Antabuse)" published in the Journal of the American Medical Association, 139, 918. Jacobsen and Marten-Larsen reported on trials in Denmark in 1948
See Wagner Jauregg in 1927 October 1949 Announcement that the Nobel Prize for physiology or medicine for 1949 would be shared by Walter Rudolf Hess of Switzerland for "for his discovery of the functional organization of the interbrain as a coordinator of the activities of the internal organs" and Egas Moniz of Portugal "for his discovery of the therapeutic value of leucotomy in certain psychoses". See Controversial Psychosurgery Resulted in a Nobel Prize by Bengt Jansson on the Nobel website.
BBC web's The Origin of Community Care begins in the 1950s
By the 1950s, the Mental After Care Association (MACA) had several of its own properties, where up to 50 people lived as many as five to a room.
"residential homes in the 1950s and 1960s were more homely than the old hospitals, but seem institutional by today's standards." (Together History Leaflet)
MACA's first hostel offering short-term care opened in Ipswich in 1961.
Mind's Key Dates: "1950s Day hospitals began to be established, increasing flexibility in psychiatric services and reducing the use of hospital beds. Hostels and therapeutic social clubs were set up to provide support for discharged patients. The introduction of neuroleptic drugs helped to shorten the length of new admissions to hospitals and encouraged the discharge of many into the community. Some new district psychiatric services were developed in general hospitals, ceasing to use beds in the regional mental hospitals, providing a model for future changes."
Henry Rollin (born 1912) became medical superintendent at Horton Hospital
Le Premier Congrès International de Psychiatrie
The picture (from the collection of the Henry Ey Foundation) shows the opening ceremony the First World Congress of Psychiatry in the Grand Amphitheatre of the Sorbonne, Paris (external source) [The World Psychiatric Association began as an association for organising these congresses]
Sargant and Slater 1963 (page 165) say that the value of insulin coma treatment was "generally accepted" at the Congress "as the best available treatment of early schizophrenia". They say this "began to alter radically" in 1953 "with the use of the new tranquilising drugs, such as chlorpromazine"
Second World Federation for Mental Health congress held in Mexico
25.10.1951 Conservative government in United Kingdom
1951 John Bowlby's Maternal Care and Mental Health published in Geneva by the World Health Organisation, in London by Her Majesty's Stationery Office and in New York by Columbia University Press. An abridged version: Child Care and The Growth of Love (2nd edition, 1965) was published by Penguin.
1951: 50,000 Outside the Law: an examination of the treatment of those certified as mentally defective published by the National Council for Civil Liberties (NCCL). 40 pages. Second impression in 1952.
National Council for Civil Liberties history website - an Open University website
The pamphlet dealt with 200 cases of alleged wrongful certification and detention. It said the law was being administered "in a far from humane manner" and that patient labour in institutions, and release on licence to employers, created an economic motive to continue certification.
Many patients were humiliated, required to work without wages, dressed in institutional clothing and left without education and training. Young women were often dressed in children's clothing, which "assisted in the appearance of backwardness. Those released on licence were forbidden to associate with a person of the opposite sex. 'Victoria', one of NCCL's clients, had to stay another four years in an institution after she went to the cinema with a young man.
1951 Mary Applebey became Director of the National Association for Mental Health in place of the original General Secretary: Miss M C Owen and the Medical director since 1947: Dr Alfred Torrie
1951 Robina Addis moved from Northampton to London to became Head of the National Association for Mental Health's Social Services Department. From 1954 to 1965 she was Deputy General Secretary.
1952 "In 1951, the great majority of hospitals either forbade visiting by parents altogether or restricted it to, say, once a week. James Robertson played a very very big part in changing that". (John Bowlby).
July/August 1952 James Robertson (who had never made a film before) shot A Two Year-old Goes to Hospital in order to demonstrate to professional audiences the truth of what he said happened to children separated from their parents in hospital. - See Robertson Films website
Social Psychiatry: A Study of Therapeutic Communities by Maxwell Jones and others, foreword by Aubrey Lewis, published London: Tavistock Publications, 1952. Republised in the USA in 1953 as The Therapeutic Community - A New Treatment Method in Psychiatry
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
The major changes in the 1963 edition were the introduction of the drugs chlorpromazine (and derivatives) - meprobamate (and derivatives) - and the antidepressants
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: 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"
it happened to Jack: In September 1954, Jack Archer, a leading character in the popular wireless soap The Archers, was admitted to a mental hospital after becoming more and more depressed. He came home to his family in time for Christmas. He was a much happier person. [See only hands or feet]
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 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
The last burial in the Horton Hospitals' cemetery was in 1955. Unlike farms, the use of hospital cemeteries appears to have been a matter for local rather than national policy.
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)
Goffman in St Elizabeths
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)
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.
8.7.1957 House of Commons debate on the Report of the Royal Commission on the Law relating to Mental Illness and Mental Deficiency. (Hansard). "The second general mental health debate that there has been in this House in the last twenty-seven years" (Christopher Mayhew)
Go forward to the 1959 Act
Who first talked about Community Care?
15.10.1957 Lifeline, with David Stafford-Clark, first televised by the BBC (source). This series of programmes continued to 1963. See 1959 - 1961 - 1962 -
Antidepressants Both Iproniazid (Marsalid), the first Monoamine Oxidise Inhibitor, and Imipramine (Tofranil), the first tricyclic antidepressant, were introduced into psychiatry in 1957 (Sargant and Slater 1963). The oldest Monoamine Oxidise Inhibitor still in general use is Phenelzine (Nardil). William Sargant (1960 onwards) suggested Nardil as the treatment of choice for reactive depression. My memory suggests that these antidepressants were coming into general use from about 1963.
"after taking [Nardil] for a week, I felt so well ... that I said that I would like to leave hospital and start applying for new work." (Joan Hughes 1965)
looking you straight in the eye David Roxan's Sentenced Without Cause told the story of Peter Whitehead's successful struggle for freedom and the letter writing campaign it fuelled amongst patients in Rampton. Peter Whitehead's photograph, taken from a newspaper, was the frontispiece.
This is my much battered copy. Bought second hand from Allan Saville's bookshop in Billericay - It was read and marked by fellow patients at Ingrebourne in 1963 and later.
1.3.1958 Freda Kendall Mew died, aged 78 at Whitecroft Hospital, Newport. She had lived there for almost sixty years. She had received no communications for very many years.
By 1959 only 12% of admissions to mental illness hospitals were compulsory, and the trend was towards shorter periods of in-patient treatment and towards outpatient treatment. Whilst in 1930 there had been practically no outpatients, by 1959 there were 144,000 attendances at outpatient clinics. ( Maclay, W.S. 1961, p.98)
It is the above change that people are generally referring to when they speak of the therapeutic revolution of the 1950s.
The 1959 Mental Health Act
Two years after the Percy Report, the 1959 Mental Health Act sought to create a legal framework within which the hospital treatment of mental disorder could approximate as closely as possible to that of physical illness. Its two main objectives were:
To allow admissions for psychiatric reasons to be, wherever possible, as informal as those for physical reasons.
To make councils responsible for the social care of people who did not need in-patient medical treatment.
The 1959 Mental Health Act abolished the Board of Control.
The 1959 Mental Health Act excluded promiscuity or other immoral conduct (alone) as grounds for detention.
Section 4 (5) of the 1959 Act says:
"Nothing in this section shall be construed as implying that a person may be dealt with under this Act as suffering from mental disorder ... by reason only of promiscuity or other immoral conduct"
The 1890 Lunacy Act's grounds for confinement were that the person is a "lunatic, idiot or person of unsound mind". The 1959 Act uses a similar catch-all phrase: "any other disorder or disability of mind" - but the exclusion clause restricts it.
Between the 1890 Act and the 1959 Act there was a great expansion in the power to confine people on moral grounds. This was under the 1913 Mental Deficiency Act which brought in the concept of moral defect and feeble minded. The 1957 Percy Report explained that, in practice, these concepts had been applied to people of normal intelligence who behaved unconventionally.
1959 Dr Russell Barton's Institutional Neurosis outlined the symptoms of a disease that often (but not always) developed as a result of being in an institution. (See dictionary)
In 1959 BBC Lifeline included programmes on Leucotomy "Surgery of the brain" - "Fear" - "Hypnosis" as a means of examining the unconscious - a discussion with L. S. Penrose about the "Mongoloid child" - and "Battle for the mind" about the techniques used by "orators as diverse as Hitler and John Wesley".
1959 Richmond Fellowship founded by Elly Jansen, a young theology student from Holland, who invited patients from Long Grove Hospital to leave and live with her in the community in Richmond, Surrey. Many Richmond Fellowship houses developed as therapeutic communites.
October 1959 Patricia Hornsby Smith spoke about the 1959 Mental Health Act in an election broadcast on behalf of the Conservative Party.
In 1960s there was a breakdown in the taboo of silence about mental health in the press and TV. Radio had sowed seeds in 1954. On television, the seeds were sown by The Hurt Mind, in January 1957 and the Lifeline series from October 1957 to 1963. Man Alive (1965? on) showed people with conditions usually regarded as taboo talking about their own experiences. A famous example in the press was an Observer reporter, John Gale, who had a mental breakdown, re-covered and was re-instated to his position as a feature and news reporter. He described his subjective experiences in an Observer feature in 1966.
Along with the new openness about mental illness came the possibility of open debate. In America, The Myth of Mental Illness (1961), by Thomas Szasz was published. It contained a theoretical basis for arguing that the states of mind described as "mental illness" are not "illness" but actions for which the mentally distressed person must be held responsible. [See Mental Health and Civil Liberties].
In France Michel Foucault's Histoire de la Folie told the history of unreason in an age of reason in a way that the English speaking world was not yet ready for. (extracts)
- In Italy Franco Basaglia (1924-1980) was in charge of the Gorizia psychiatric hospital, near Trieste from 1961. He moved to Trieste in 1970. "Psichiatria Democratica" was founded in 1974. The law that has been called "Basaglia's law" was passed in 1978, the same year that a press conference caused a media sensation by announcing the closure of Trieste's old asylum. Franco Basaglia spoke at a Europe wide "Alternatives to Mental Hospitals" conference, shortly before his death. Members of Psichiatria Democratica visited London, Sheffield and Manchester in April 1984, stimulating the creation of "Asylum - a magazine for democratic psychiatry" in 1986.
Kathleen Jones Mental Health and Social Policy 1845-1959. See 1955 and 1972
R. D. Laing's The Divided Self: An Existential Study in Sanity and Madness.
Alfred Hitchcock's black and white film Psycho ... in a lonely hotel, vicious murders take place... "This young man... being dominated by an almost maniacal woman was enough.."
In 1960 BBC Lifeline included programmes on "Hallucinations and delusions" (were Joan of Arc and Francis of Assisi suitable cases for psychiatric treatment?) - and "Obsessive compulsions" in which David Stafford-Clark spoke to former patients.
February 1960 Chlordiazepoxide (Librium), the first benzodiazepine, marketed in the United States. Diazepam (Valium) was marketed in 1963. I think their heyday of the benzodiazepine tranquillisers was the early 1970s.
January 1961 Long term planning of hospital services begun
Thursday 9.3.1961: Enoch Powell's Water Tower Speech:
The full scope of the community care policy for the mentally ill adopted in the 1960s was revealed in 1961 when the Minister of Health, Enoch Powell, opened the annual conference of the National Association for Mental Health with a speech on how his forthcoming Hospital Plan would affect psychiatric services.
The Percy Report contrasted community care with hospital care. Phrases like in the community have generally been used to mean outside hospital. However, from the Water Tower speech until the 1980s, community care policy was to have as its central feature, the transfer of hospital treatment from isolated mental hospitals to local hospitals. (See diagram). The two main features of the policy were:
That hospital treatment should be in Psychiatric Units in District General Hospitals.
That as much care and treatment as possible should be provided outside hospital.
Kathleen Jones says that newspaper placards in London said Mental Hospitals to Go - Powell (Jones in Mind October 1980, p.17). Compare the speech, which expresses his inclination that most (not all) old style hospitals should eventually disappear, with the provision of the Hospital Plan (below), which he was discussing.
April 1961: Official opening of Balderton Subnormality Hospital by Enoch Powell. [See policy]
4.5.1961 to 24.5.1961 An exhibition "Bristol in the evolution of mental health. 1696-1961" at the Royal West of England Academy - "the first of its kind and scope to be held in Great Britain".
Sharples Gallery: A general survey of the history of mental health
Winterstoke Gallery: The Bristol Hospitals and Institutions and their associations. Mental nursing.
Gallery 3: Art and the Psychiatric Patient. Creative Activity in the Aged.
Gallery 4: Techniques of investigation and treatment. Architecture.
Gallery 5: Mental subnormality. Bristol Local Authority Services.
See asylums index - Bristol index - The exhibition introduction is signed "R.E. Hemphill", who was the Medical Superintendent of the (new) Barrow Hospital. The catalogued exhibits for the "Glenside/Barrow Hospital Group" (pages 36 to 43) show some relation to the Glenside Hospital Museum exhibits.
1961 Fourth World Federation for Mental Health congress held Paris.
In 1961 BBC Lifeline included programmes on Epilepsy "The sacred disease" (an electrical storm in the brain which still carries stigma and fears) - the problems of an autistic child, called "Schizophrenia in children" - and several programmes on the unconscious, especially as uncovered by hypnosis, including a woman who "meets and talks in the studio to people who exist only in her own mind" -
January 1962: The Hospital Plan
cutting mental illness beds from 151,899 (in 1960) to 99,090 by 1975
increasing mental handicap beds from 59,840 (in 1960) to 63,620 by 1975
a "considerable" increase in psychiatric units in general hospitals - for short stay (three months or less) patients (outlined in circular HM(61)25)
even greater reductions in the number of mental illness beds with alternative community provision.
closure of thirteen of the existing 109 mental illness hospitals with 400 or more beds by 1975
possible closure of another nine of the large hospitals after 1975
leaving 87 to continue indefinitely. Most long term care would be in these old hospitals. The size of most would be reduced, but 25 would still have 1,000 or more beds by 1975.
Oxford region planned wards for medium or long stay patients near District General Hospitals
Sheffield Region planned to build Crookhill Hall, a "new psychiatric hospital at Conisbrough" (in the countryside outside Doncaster) for 420 patients and, later, "a long-stay psychiatric hospital at Sheffield", as well as (eventually) closing three of its nine large hospitals. [It changed its mind on Crookhill Hall (Hansard 1.3.1965)]
1962 Paddington Clinic and Day Hospital established in Harrow Road. Its initial parts were 1) A child guidance clinic with an established history - 2) A newly founded day hospital (Paddington Day Hospital) involved in rehabilitating patients from Horton. A department for adult out-patients joined in 1965. In the early 1960s, Basil Gregory introduced a therapeutic community approach. In 1965 he brought in staff from Henderson. - See 1972. In 1974 the building was renamed the Paddington Centre for Psychotherapy. See Baron 1987 and Spandler 2006
26.9.1962 to 28.9.1962 Third British Congress on the History of Medicine and Pharmacy. The papers for this were published as The Evolution of Hospitals in Britain, edited by F. N. L. Poynter, Librarian, The Wellcome Historical Medical Library, in 1964. The paper on "Mental Hospitals", by Alexander Walk, M.D., D.P.M., "late Physician Superintendent, Cane Hill Hospital, Coulsden" has been made available by Jeremy Jones at
In 1962 BBC Lifeline included three programmes on "Children under stress"
1963 Richard Hunter and Ida Macalpine's Three Hundred Years of Psychiatry 1535-1860 "This book is...an endeavour to present original sources and through them trace clinical and pathological observations, nosologies, theories and therapies, and the care of the insane as well as social and legal attitudes to mental illness" (pp ix-x). Over 1,000 pages of documents, scrupulously indexed, each with a detailed historical introduction. Richard Hunter and his mother provided foundations for every other historian to build on. History subsequent to 1860 was covered, in a different way, by Psychiatry for the Poor in 1974
1963 UNAFAM (Union des Amis et Familles de Malades Psychiques) formed in France
1963 Second edition of David Stafford-Clark's Psychiatry Today published by Penguin, taking into account "important new techniques" developed in the "ten years" since first publication (1952).
The main change in the treatments section since 1952 is the new prominence for drug treatment. The drugs discussed (not indexed) are
meprobamate and derivatives (the "most successful" tranquillisers) - new
chlorpromazine and derivatives, which, used with electrical treatment, "have virtually replaced deep insulin treatment" in the treatment of schizophrenia - new
amphetamine and derivatives (the "symptomatic anti-depressant preparations" - also in the 1952 edition.
monoamine oxidise inhibitors and imipramine and derivatives (the "basic anti-depressant medicines") - new
antabuse - also in the 1952 edition.
April 1963: Health and Welfare [The community care equivalent to the Hospital Plan.
June 1963 Mental Health Film Council founded (see above) "following a meeting called by the National Association of Mental Health to bring together "representatives of organisations involved in the use or distribution of mental health films". The First Chairman was Kenneth Robinson MP. Became Mental Health Media in the 1990s - website history
"Because general paresis is now so easily treatable by neurologists, it is a pleasure to omit the whole chapter relating to it from the present edition. We look forward to seeing how an efficient physical treatment such as penicillin can put an end to a disease which caused so much mental illness and so much misery for generation after generation. We are sure that this pattern will be repeated again and again, as more and more mental disorders become simply and easily treated by medical methods" (Sargant and Slater 1963), page ix
15.10.1964 Labour Government
4.11.1965? First Man Alive on BBC Televison. People sometimes allowed to speak openly about taboo subjects such as agoraphobia - phobias - suicide
In 1966 there were 107 mental illness and 66 mental handicap "hospitals and units with 200 or more beds". (Hospital Statistics 1975, pp 5+7).
In 1966 Borocourt Subnormality Hospital was a well equipped one. Few subnormality hospitals had anything but Victorian type institutional wards, but the largest Borocourt one had only 30 beds. In the late 1960s Oxford Regional Health Authority spent 1.25 million pounds at Borocourt on nine completely new wards, upgrading old wards and building a school, a gymnasium and a workshop.
The Mental Health Association of Ireland began in 1966, with this logo. It kept the logo when it became Mental Health Ireland. But, in 2008, it decided the logo must change. The World Federation for Mental Health held is congress in Dublin in 1995.
12.1.1966 BBC Man Alive programme "The Frightened Ones" about agrophobia, in "which victims talk about their illness and a doctor and a psychiatrist discuss what can be done for them".
5.6.1966 Mental Health Week
The Observer Colour Supplement began a three part coverage on changing attitudes to madness down the centuries. The third part was John Gale's personal account. As it became acceptable for professional writers who had been mental patients to describe the experience in print, so some people's minds turned to the possibilities of listening to patients in mental hospitals.
1967 Declaration of a summer of love
Stanley Solomon Segal, Headmaster, Franklin Delano Roosevelt School, London. No child is ineducable - Special Education - Provision and Trends Commonwealth and International Library. Pergamon Educational Guides. 332 pages.
3.5.1967 Man Alive programme "Living with Fear" talked to "some of the half million people in Britain who suffer from apparently illogical phobias - including fear of birds, dogs, visitors and leaves."
24.5.1967 Man Alive programme "A case of suicide" looked at "how people who commit suicide might have been helped to stay alive by those near them and those who have had to live with the suicide of someone near to them."
1967-1969 HOSPITAL SCANDALS:
The 1960s concentrated attention and resources on the treatment of short term mental illness. There was a corresponding neglect of long-stay patients, along with a failure to implement the community care side of the new policies. The scandals of the late 1960s and 1970s shone a light on the consequences.
1967 Sans-Everything - A Case to Answer
1968 Report of Government Inquiry into the Sans Everything allegations
Sans-Everything was a collection of articles edited by Mrs Barbara Robb that dealt with the condition of elderly residents in institutions. It included accounts of individual cases of ill-treatment in psychiatric and geriatric care. The official report into its allegations substantiated many of them.
The establishment in 1972 of a Health Service Commissioner ("Ombudsman") to investigate complaints of individual ill-treatment, followed suggestion made by Professor Abel-Smith in Sans-Everything
July 1967: Allegations of misconduct at Ely
26.2.1968 Shelton Hospital Fire
December 1968 Police investigate Farleigh Hospital
March 1969 Ely Hospital Inquiry Report
June 1970 Farleigh Hospital Inquiry appointed
November 1970 Farleigh Hospital Inquiry Report signed
February 1971 Whittingham Hospital Inquiry appointed
April 1971 Farleigh Hospital Inquiry Report presented
October 1971 Whittingham Hospital Inquiry Report signed
February 1972 Whittingham Hospital Inquiry Report published
5.7.1972 Fire at Coldharbour
The light shone into mental subnormality (handicap) hospitals with the publication of official reports into Ely Hospital, Cardiff, in 1969; Farleigh Hospital, Somerset and Coldharbour Hospital, Sherbourne, Dorset, in 1971.
Richard Crossman, Secretary of State at the time, responded to Ely as a personal challenge. He launched a programme of additional resources to the mental handicap hospitals, established (November 1969) a Hospital Advisory Service to visit hospitals - especially long-stay ones - and advise him on their condition, and started a re-appraisal of plans that eventually surfaced as the white paper Better Services for the Mentally Handicapped
The National Association for Mental Health (1969/1970 Annual Report) had a "perverse" regret that there had not been a scandal on the same scale as Ely in a hospital for the mentally ill whilst Crossman was Minister, to stimulate an "accelerated re-appraisal of their needs and progress". It was coming, but by the time the Whittingham Inquiry reported the government had already announced its intention to scrap the old asylums and replace them by "comprehensive psychiatric services" in each district.
This way to the next scandal
1968 Fifth World Federation for Mental Health congress held in London
1968 Questions and Answers on Mental Nursing for Pupil Nurses by John Michael Andrews, Principle Tutor, Claybury Hospital. Edward Arnold:
"Question: Name some physical methods of treatment for mental disorder".
"Answer: Drugs - electroplexy (electro-convulsive therapy, ECT) - pre-frontal leucotomy and other cerebral surgery - prolonged narcosis - modified insulin therapy - deep insulin coma therapy (rare now) - hydrotherapy - occupational and industrial therapy".
Insulin treatment is not even mentioned in Insight - A Guide to Psychiatry and the Psychiatric Services in 1973.
Bring back the Lunacy Commissioners
23.8.1969 Miss Janet F. Henderson of Craigiemichael, Innellan, Argyll, argued in a letter in TheTimes that
"There is no mystery about the cause of any deteriioration of conditions in any British mental hospital. In 1948 the progress toward better attitudes and circumstances was suddenly brought to a stop by the loss of the work of His Majesty's Commissioners in Lunacy. Their wide and intimate knowledge of each of these institutions throughout the country was available everywhere as expert advice, their criticism a powerful stimuls to improvement.
Their visits were always unannounced so that any attempt to cover up deficiencies was forestalled. (notices of patients' rights to complain viva voce or by writing to these Commissioners were posted up permanently in every ward.) All this wise protection was lost to patients when they were given over to the care of committees Management and Regional who, however well-intentioned, had all to often no practical experience of this pecuiarly difficult and complex hospitalisation, especially that involving realationships betwen patients and staff.
I cannot see any hope for improvement unless Mr Crossman restores promptly a similar peripatetic expert body"
The quality control functions of the Board of Control (previously Lunacy Commission) had been assumed by the Management Committees of the National Health Service. Its civil liberties functions had continued to 1959. The Hospital Advisory Service (1969) could be seen as reinstating independence for quality control advice and the Mental Health Act Commission (1983) as reinstating central civil liberties functions.
November 1969 Establishment of the Hospital Advisory Service, an independent arm of the Department of Health that advised the Secretary of State on the quality of care in hospitals - especially those for long-stay patients. In its first report (external link) it said its visits concentrated on hospitals for the mentally handicapped and the mentally ill, for geriatric and chronically ill patients. The main problem was a lack of co-ordination between hospital and community social service departments. In 1976 it became the Health Advisory Service, so that its reviews would cover community as well as hospital services.
Local hospitals for everyone -
Out with the distant asylum
Sir Keith Joseph's 1971-1972 Memorandum proposals for the replacement of mental illness hospitals by comprehensive local services.
In the late 1960s Hospital Boards were informed of a change in government thinking. Instead of just acute, short stay, psychiatric units, they were asked to provide a comprehensive service for all patients at District General Hospitals (Ham, C. 1981 p. 129). This changed thinking was incorporated into Hospital Services for the Mentally Ill in December 1971.
Fluphenazine (Modecate). The first long-acting anti-psychotic phenothazine was tested at All Saints Hospital, Birmingham in 1969. By one injection every few weeks it was now possible to ensure people were medicated even whilst living outside hospital. Patients needed to be readmitted only if they refused their injection. If a patient did not keep an appointment at the "Modecate clinic", a psychiatric community nurse would visit to see what was happening.
9.5.1970 Times article "A Case of Schizophrenia, by a Correspondent", written by journalist John Pringle about his son. - History on Politics website - Led to formation of National Schizophrenia Fellowship - See The Early Years
The Schizophrenia Association of Great Britain (SAGB) was started by Bill and Gwynneth Hemmings in 1970 (Archive of home page). It closed on 15.6.2007 (Archive of closure notice)
- 1970 In Italy, Franco Basaglia moved to Trieste
June 1970 Conservative Government
From being a Labour Minister, David Ennals became Mind's first Campaign Director.
July 1970 Meeting at the Henderson that initiated the Therapeutic Community Round Table. It met at Ingrebourne in October 1970. It also met at Halliwick. This was followed by the Association of Therapeutic Communites. Principle founders of the Association were Drs Whiteley, Robert Hinshelwood (Marlborough Day Hospital) and Nick P. Manning. ATC Newsletter Nunmer 2 (the first distributed) was published in June 1972. An ATC Research Group first reported in the Newsletter in 1974. (Millard, D.W. Summer 2008). The Association met at Paddington Day Hospital in 1975.
1971 Science Time Line
In 1971 St Lawrences had 1,850 patients from all over London - mostly mentally handicapped - from young children to men and women who had grown old in the institution. (See 1870 and 1981)
Royal College of Psychiatrists the new name for the Medico-Psychological Association
In the 1960s the British Consumers Association broke taboos with its Consumers Guide to Contraceptives. In 1971 it broke another taboo by making mental health a consumer issue, publishing Treatment and Care in Mental Illness
In April 1971 Local Education Authorities became responsible for the education of all mentally handicapped children, however severe their handicap, under the 1970 Education (Handicapped Children) Act. As a result of the Act some level of education had to be provided for every child from five to fifteen years old. As well as providing education for the children, this meant that parents of severely handicapped children were relieved of their care during the day. The Jay Report in 1979 thought this had had such an impact on the lives of families with severely handicapped children as to partly explain why far fewer children went into residential care in the 1970s.
See 1955 form with law excluding children from school
Better Services White Papers
There were two Better Services White Papers. The one on Mental Handicap in 1971, and one on mental illness in 1975.
June 1971: Better Services for the Mentally Handicapped
This White Paper proposed a U-turn in public policy - a pronounced shift in the balance of provision away from hospitals towards non-medical services in the community. Better Services for the Mentally Handicapped took the unprecedented step of setting targets for the number of places in hostels, schools and training centres that local councils would need to supply if the new policy was to be successful.
Bryn-y-Neuadd was the last National Health Service Hospital for people with a mental handicap to open
Campaign for Mentally Handicapped People
The White Paper fell short of what members of Crossman's working group desired. One of them, Peter Townsend, published his disagreements in the Sunday Times on 27.6.1971, the week after the paper was published. He believed the hospitals should have been phased out altogether and that the proposed 25 bed hostels for those who left hospital were:
"a system of minor isolated barracks put up by local authorities in pale imitation of the larger Victorian barracks which are at present run by the hospital authorities"
Townsend wanted mentally handicapped people to live in small houses resembling private housing. A similar position was taken by the Campaign for Mentally Handicapped People (CMH), a group started in 1971 in the belief that people with a mental handicap:
had a right to live lives as close as possible to those of other people
should participate as much as possible in the decisions that affect their lives
should use the same services as everyone else
This policy of normalising the lives of disadvantaged and stigmatised groups has since been called normalisation. It is the converse of the Social Darwinist policy of segregation. Social theory, though not social reality, had turned full circle
Scottish mental patients unite See London
26.7.1971 "Petition for the Redress of Grievances put forward by the patients in Hartwood Hospital, Shotts Lanarkshire". The signatories to which are counted as the founding members of SUMP (Scottish Union of Mental Patients) formed by Tommy Ritchie and others. This was the first "union" of psychiatric patients in the United Kingdom that I know of.
Associations of psychiatric patients under other names are older. See 1845 - 28.5.1963
filmed demented: 19.10.1971 Mary Applebey, NAMH Director, told me about the problems getting Hurt Mind broadcast in 1957. She commented that "last week a patient was filmed who was frankly demented".
December 1971: Hospital Services for the Mentally Ill
This stated that the development of psychiatric methods, and increase in psychiatric units, had brought things to a point where it was thought possible:
to accelerate developments...towards the eventual replacement of the large separate mental hospitals by a service based on general hospitals"
People go into hospital ... and they are cured
"Psychiatry is to join the rest of medicine... the treatment of psychosis, neurosis and schizophrenia have been entirely changed by the drug revolution. People go into hospital with mental disorders and they are cured, and that is why we want to bring this branch of medicine into the scope of the 230 district general hospitals that are planned for England and Wales"
This statement is credited to Keith Joseph by Kathleen Jones. It is not in Hansard for 7.12.1971, as referenced, and (in the 1980s) Keith Joseph could not recall saying it (which is not surprising). It may have been taken from a newspaper report.
Friday 24.12.1971 "Christmas Day in the Nuthouse" edition of Time Out (guide to London events) gave a detailed preview of Family Life, along with other material, in a nine page feature by Neil Lyndon. Included photograph of a wall with the slogan "PSYCHIATRY KILLS".
Kathleen Jones' A History of the Mental Health Services. See 1955 and 1960
William Ll. Parry Jones: The Trade in Lunacy. A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries. Good reading for anyone who wants to know about the range of private houses: good and bad, rich and poor etc. I use this regularly for the asylums index
possibilities of listening In 1969 Patients and their hospitals: a survey of patients' views of life in general hospitals by Winifred Raphael had been published. It had used confidential questionnaires distributed to patients by participating hospitals. "Many people doubted whether psychiatric patients could in a similar way comment on their care and surroundings" (A.C.Dale, 1977 Foreword). Nevertheless, questionnaires were designed and patients in nine mental hospitals were polled, leading to the publication of Psychiatric hospitals viewed by their patients in 1973. Eleven more hospitals sent in survey results which were incorporated into the second edition in 1977. [See 1954, 1957, 1960s, 1966] In the meantime, some mental patients felt sufficiently confident to join and form protests
13.1.1972 The film Family Life told a story of Janice who, as a consequence of family conflict, received two types of psychiatric treatment. Group therapy helped her, but drugs and electroconvulsive therapy broke her spirit. The film (and the television play that preceded it) dramatised the theories of Ronald Laing and David Cooper. The Paddington Day Hospital Protest involved Family Life in its campaigning.
This way to the previous scandal
THE WHITTINGHAM HOSPITAL REPORT.
February 1972: Whittingham Hospital, just outside Preston in Lancashire, had 3,200 beds in 1953 and 2,045 in 1971. It was one of England's largest mental hospitals, though shrinking as active psychiatry was moved to District General Hospitals in Preston. Allegations of ill-treatment and the conviction of a male nurse for the manslaughter of a patient, led to an inquiry, which reported that for many of Whittingham's patients "the therapeutic revolution of the 1950s" never happened. Almost half had no occupation during the day, but sat around "becoming cabbages". On one ward, 126 patients were cared for by just six nurses. Doctors did not visit long stay wards, but concentrated on acute work and their work outside the hospital. The inquiry conclude that the English mental health system was dividing into "well staffed 'acute' units and 'long stay dumps'".
This way to the next scandal
Patients join protest
The establishment of Psychiatric Units in General Hospitals was also squeezing out community therapy. Community therapy aimed to develop patient self-determination. It was perhaps, not surprising, that squeezing led to patients taking part in the protest. See 30.11.1971 - 10.12.1971
3.3.1972: "800 people crowded into a meeting at Sidney Webb college on 3rd March to discuss the threatened closure of the Paddington Day Clinic, a therapeutic community. The opening of a psychiatric unit in a nearby general hospital has been given by the Regional Hospital Board as the reason for making the hospital redundant. The patients and staff of the P.D.H. have formed a protest group to oppose this proposal because they feel the work done in this hospital is concerned with increasing the individuals awareness of the problem rather than blotting out the symptoms it may produce". First paragraph of an article signed by Nicky Road, Anna Chadwick and Keith Venables in Politics of Psychology Newsletter 12.3.1972
July 1972: National Schizophrenia Society founded by (amongst others) relatives of people with schizophrenia. It became the National Schizophrenia Fellowship in January 1974. - See 1975 - October 1979 - February 1980 - March 1982 - 9.4.1982 - Judy Weleminsky - National Voices Forum - opinions 1988/1989 - The fellowship's web archive dates from 11.11.1998 - See 23.2.2000 - In July 2002 the fellowship changed its name to Rethink - Present website - archive
Schizophrenia Ireland was founded in 1975. National Schizophrenia Fellowship (Scotland) was founded in 1984.
October 1972: Services for Mental Illness Related to Old Age
Mental patients unite in London See Scotland - Manchester
December 1972: A group of people in the London area produced a pamphlet on The Need for a Mental Patients' Union arguing that "psychiatry is one of the most subtle methods of repression in advanced Capitalist society". This was circulated to psychiatric hospitals and various places where ex-patients were likely to congregate, together with notices of a meeting to be held during March 1973 to discuss the formation of a union.
"The National Health Service is only 25 years old and the Mental Health Act that gives a legal basis to our services was only passed in 1959... pressure from voluntary association like the National Association for Mental Health and the National Society for Mentally Handicapped Children has brought about promises for further reforms... Once successful treatments are proven, the stigma of mental disorder will wither away. Like tuberculosis, mental disorder will cease to be surrounded by an aura of mystery and dread... we need public interest in our work. Public attitudes are at the root of all the difficulties of psychiatric practice... Only patients and relatives can tell us what they need at particular times during the progress of an illness... it is patients themselves who are the most likely people to influence future developments. Who better to advise how to make the struggle for sanity easier than the people who have been through the experience of modern madness and survived it?"
Bill Kenny (Psychiatric Social Worker) and Tony Whitehead (Consultant Psychiatrist) in the final chapter (The Future) of Insight - A Guide to Psychiatry and the Psychiatric Services (1973). Library of Eric Irwin.
About 100 people attended a meeting at Paddington Day Hospital to discuss forming a mental patient's union (MPU). The majority were patients or ex-patients. Most lived in London, including people who had previously formed the Scottish Union of Mental Patients. People were present who had tried to form a Union in Oxford and a message was received from another group in Leeds. The MPU was formed with full membership reserved for patients and ex-patients.
The large attendance was substantially due to an item on the Today programme in which Michael Sheils interviewed Andrew Roberts, one of the ex-patients involved. Today originally asked a social worker to speak. They were told that the speaker for the group would have to be a mental patient. We waited a few hours whilst they decided if they could risk this.
A working party of some two dozen full members was formed and not long after set up office in a London squat. This nucleus was given the task of producing a statement of the union's intent and drafting a proposed organisational framework for MPU.
"We proclaim the dignity of society's so-called mental patients"
"I have done many things in my life which I would not have been allowed to do if the people concerned had suspected I had mental symptoms. (Until recently, I kept them to myself). I think that many people could do a lot more if society let them, and that the more you can achieve, the healthier you will be."
Villa 18B Shenley "My family do not visit me. The last time... was 1963. An ex-patient who lives locally visits another friend and me most Sundays."
Andrew Roberts began work on his thesis on the Victorian Lunacy Commission
Trip round Pastures Hospital, Derby
21.11.1973 Mind AGM at the Royal Institute of British Architects. At the beginning of November, Mind had moved from 39 Queen Anne , W1M OAJ to (cheaper) accommodation at 22 Harley Street, W1N 2ED
1973 World Federation for Mental Health 25th Anniversary Congress held Sydney, Australia with the theme "Cultures in Collision"
Better Services in Harder Times:
The end of sustained economic growth and Labour's shift in emphasis to positive community care in Better Services for the Mentally Ill (1975)
Economic crisis and cuts: Community care policies from 1961 to 1972 assumed continuous economic growth, from which they would be financed. The Arab- Israeli war of October 1973, and the Arab oil embargo, signalled a long period of economic problems. The (Conservative) government responded with drastic cuts in health and welfare capital expenditure, and the cuts were continued and later increased by the subsequent Labour government.
We are people first
1974 to 1976 Short lived "New Psychiatry" magazine in UK
- 1974 Franco Basaglia and his colleagues founded "Psichiatria Democratica" as a loose association of professionals fighting for radical change in Italian psychiatry.
Sometime in 1974, Community Health Councils came into being. These were in place of the representative function of management committees as new health authorities were to be managerial. (Intentionally or otherwise) considerable flexibility was given to local people in the way that the CHCs operated. Many became well informed community forums and were more accessible to patients, carers, relatives and the community in general than any other "official" body before or since. (See empowerment and mental health index). The Conservative Government gave serious consideration to abolishing them in the early 1980s and the Labour Government succeded in getting rid if them at the end of 2003. See new millenium
February 1974 Labour Government
28.2.1974 to 1.3.1974 Mind's Annual Conference , on the theme ""New Knowledge in Mental Health" held at Church House, Westminster.
1974: Mind Report: Co-ordination or Chaos?
April 1974: Interim report of the Butler Committee. As a result of this, a network of Regional Psychiatric Secure Units was planned for England and Wales. (external link)
By the 1970s, Broadmoor was seriously overcrowded. On a visit, I looked through a window and saw a sea of short haircuts so close that one could have walked across the room from one head to another. Partly to relieve this pressure, a new "Special Hospital", called Park Lane, was built on land next to Moss Side. The first 35 patients moved in in 1974.
1974 Richard Hunter and Ida Macalpine's Psychiatry for the Poor. 1851 Colney Hatch Asylum-Friern Hospital 1973. A medical and social history. continued their history of psychiatry in a completely different form. "in the story of this one hospital, Drs Hunter and MacAlpine have managed to encapsulate the whole history of psychiatric care for the masses between 1851 and 1973" (David Delvin, General Practitioner 7.11.1975). To my mind, the best book if you want to know "what asylums were like". To look at the asylum from the patient's point of view, you could read Tongue Tied by Joseph Deacon and A Mad People's History of Madness. For patients views on this site see Joan Hughes on Rubery Hill and Valerie Argent on Essex Hall and her friends in Hackney Hospital. There is also an outsider's view of Broadmoor.
1975 Schizophrenia Association of Ireland launched. Later changed its name to Schizophrenia Ireland - old website - Changed its name to Shine-Supporting People Affected by Mental Ill Health on 20.1.2009 - new website - Phrenz groups are mutual support and social groups for people with mental ill health. May have begun in the early 2000s.
February 1975: Barbara Castle's Mencap speech
A Directory of the Side Effects of Psychiatric Drugs (October 1975)
9.5.1975 to 10.5.1975 Mind's Annual Conference , originally advertised as "Can We Afford Mental Health?", altered (same content) to "Psychiatry and Alternative Support Systems" held at YMCA Central Club, WC1. Organiser John Barter (Mind Out 12.1975 p.16 - 2.1975 p.15 - 4.1975 p.12
October 1975: Butler Committee Report and
Better Services for the Mentally Ill
Castles in the Air
The ninety one page White Paper Better Services for the Mentally Ill was nicknamed Castles in the Air by COPE when it was presented by Barbara Castle, the Secretary of State at the Department of Health and Social Security, in October 1975. It was long term strategic document, pointing out the general direction the Government wanted services to take, prefaced with a statement that little progress could be made until the economic situation improved.
Its emphasis was on providing a comprehensive range of local services in place of asylums, before asylums closed:
"... our main aim is not the closure or rundown of the mental illness hospitals as such; but rather to replace them with a local and better range of facilities. It will not normally be possible for a mental hospital to be closed until the full range of facilities described has been provided throughout its catchment area and has shown itself capable of providing for newly arising patients a comprehensive service independent of the mental hospital. Moreover, even then, it will not be possible to close the hospital until it is no longer required for the long stay patients admitted to its care before the local services came into operation" (par.11.5)
31.10.1975 and 1.11.1975 Special Mind Conference on "Rights of patients and staff in the mental health services" held at Church House, Westminster. Organiser Kathy West (Mind Out 10.1975). Corresponding with the launch of A Human Condition
The elements of community care before the 1980s included hospitals. The local psychiatric unit was considered part of the community. Community care was a package of local provision, distinct from the distant asylum care. During the 1980s, care in the community came to mean care outside hospital, as distinct from care in hospital. In the 1990s, support in the community moved towards meaning care outside hospitals, hostels or day centres. Notice, however, the development of secure units which substituted, in part, for the custodial provision in the old asylums.
This diagram, that I drew just before the change took place, shows the facilities provided by the National Health Services and Local Authorities that should be part of the community care packet. Underneath I drew a Bargain Basement which contained the possibility of alternative provision by the voluntary sector. In the 1980s and 1990s, the bargain basement grew and developed a private sector department.
1976 Peak in mental hospital admissions (falling since)
The actual numbers in hospital had been falling since 1954
Between 1970 and 1975 the population of mental illness hospitals was reduced from 107,977 to 87,321. The population of mental handicap hospitals was reduced from 55,434 to 49,683 (In-Patient Statistics 1975, tables A8 and B10).
The statistics were said to reflect the success of care in the community, but some argued that the fall had been achieved by discharging patients to families ill-equipped to cope with them, to private hotels that exploited them or, in some cases, onto the streets.
Better Services for the Mentally Ill acknowledged that such things happened, and said:-
"the public... cannot be expected to tolerate under the name of community care the discharge of chronic patients without... after-care... who perhaps spend their days wandering the streets or become an unbearable burden on the lives of their relatives... Such situations do not occur very frequently; but where they do, the whole concept of community care is placed at risk" (par.2.27)
This way to the previous scandals
THE BIRMINGHAM SCANDAL.
On January 12th 1976, the Daily Mirror sensationally questioned the claim that discharge from hospital without inadequate care was infrequent. It ran a feature by John Pilger sub-headed:
Dumped on the streets and in the slums -
5000 people who need help
Birmingham was headlined as
The city of lost souls
A West Midlands Health Official said the DHSS had "applied the screws" to mental hospitals to "decant" patients. Pilger commented that "to be decanted is to be dumped", if you have not got families or friends to take you. The Midlands organiser of MENCAP told him:
"In a few years... you'll be able to see them dying in the streets"
A practice of discharging patients to hotels had been reported four years earlier as a positive advance in community care. The Sunday Times of 17.10.1971 carried a glowing report of how Denbigh Hospital, North Wales, had cut its size from 1,6000 beds to a mere 600, over seven years, by placing patients in the care of the landladies of seaside boarding houses. The ex-patients paid for their keep from their social security benefit.
Pilger's report showed a seamier side to this policy. In Birmingham, an array of guest houses, hotels and boarding houses flourished on the trade in ex-patients. One landlady told Pilger:
"We pick them off the streets or the hospital rings us up and says 'can you take a few?'"
"a cupboard filled with... prescribed tablets... to keep them quiet".
Although this was one of the better hotels, residents still sat all day
"looking blankly at each other... or at the television" [or went] "to St Agnes's hall to stuff toys - 'occupational therapy'"
In one of the worst establishments patients had been slept
"nine in the attic some of them less than four feet from the ceiling" [and fed on "two slices of bread and dripping and a third of a sausage roll"
A councillor reported seeing guests
"with scabies and lice. They had dirty clothes and ten men had no vests and underpants"
A Birmingham Social Services' spokesman said it was not uncommon to find "disturbed and frightened people" wandering about the railway station:
"having just arrived with a travel warrant from hospitals as far afield as London and Scotland. The word seems to have got out that Birmingham has places that will take them."
Hundreds were said to be "just wandering". The Salvation Army hostel said "up to 30%" of the people it took in "from the streets" were ex-patients. "The overwhelming majority" of those who queued "in the cold every night" outside a Catholic refuge were "psychiatric patients".
Whose fault was it? According to Pilger, Birmingham Social Services blamed the hospitals and the hospitals blamed Social Services.
This way to the next scandal
A debate in the House of Commons on better services for mentally ill people was moved for by the Conservative opposition in January 1976. Shortly before the debate, the shadow health minister, Norman Fowler, asked Cecil Parkinson MP to form a Conservative Party policy group on the progress that had and could be made towards community based services for mentally ill and mentally handicapped people. It was an issue of special interest to Mr Parkinson because his constituency, Hertfordshire South, contained three large hospitals for mental illness and two for mental handicap, only one of which served the constituency - the others received their patients from North London.
Parkinson's group drew on considerable expertise from outside party politics. It met regularly for three years and completed its investigations in spring 1979, just as the Conservative Party moved from opposition into Government.
Priorities for Health and Personal Social Services
A Consultative Circular on Joint Planning and Finance was issued at the end of March.
Priorities was, amongst other things, an effort to advance such causes as Better Services for the Mentally Ill by giving them more money at the expense of other areas.
The 1975 White Paper had said that investment on the scale needed to achieve its ends would not be possible "over the next three or four years" (par. 11.5), but by giving deprived sectors priority of general and acute hospital provision, Priorities proposed a rate of development which, "if maintained", would enable the Better Services aims to be achieved over most of the country within twenty-five years.
Monday 29.3.1976 Five Oscars for the film One Flew Over the Cuckoo's Nest dramatised the 1962 novel by Ken Kesey about the way asylums change the personalities of people who become their in-patients. The novel and film popularised the theories of Erving Goffman, in Asylums (1961)
The Listener (first week of April?) contained an article by Christopher Price (Labour MP, Lewisham West) "It's more than a bit frightening", reviewing Yorkshire TV's Tuesday (30.3.1976 or 6.4.1976?) programme on psychosurgery directed by Chris Goddard "It's A Bit Frightening". Also mentioned during the week - "revelations about St Augustine's" - Horizon (BBC2) on schizophrenia and its possible chemical roots and the five Oscars.
9.7.1976 to 10.7.1976 Mind's Annual Conference with the theme "Prevention in the field of psychiatric disorders" held at Bedford College, London. Organiser Edna Tyrell (Mind Out 3/4.1976 p.24 - 5/6.1976 p.17)
Autumn? 1976 Mind's 30th Annual General Meeting - Mary Applebey gave a talk about her memories which was published in the January/February edition of Mind Out (pages 8-1) as "Thirty years on".
1976 Publication of the first Disability Rights Handbook: A Guide to Income Benefits and Certain Aids and Services for Handicapped People of All Ages. 1977, editor Peter Townsend, by the Disability Alliance (5 Netherhall Gardens, London, NW3 5RJ]) and ATV Network Ltd. 32 pages.
Beech Tree House, Hertfordshire, was established by the Spastics Society in 1977 to demonstrate that even the most severely disturbed children from mental handicap hospitals could be successfully educated given sufficient resources and the right approach.
May 1977 HC(77)17 second circular on Joint Care Planning
SEPTEMBER 1977 THE WAY FORWARD
The Good Practices in Mental Health (GPMH) project was started, on a three year experimental basis, by the International Hospital Fund in 1977. "The idea is to describe and publicise local mental health services which have been found to work well". The first report "Good Practices in Mental Health in the City and Hackney Health District (Teaching)" was published in July 1978. From 1980 to 1983 the project was financed jointly by charities and the Department of Health and Social Security. From 1983 it was funded mainly by the DHSS and "has come to be seen as a process in mental health planning and development rather as a time limited project" (SSC 1985 volume 2, page 143). In the mid 1980s, GPMH turned its attention to the development of user-only forums. The final director was Edi O'Farrell, who worked closely with Peter Campbell and Survivors Speak Out. GPMH ran out of money about 1997 and had to close. Edi O'Farrell died in 2008 (email from Thurstine Basset)
1977 World Federation for Mental Health congress held Vancouver, Canada, with the theme "Today's Priorities in Mental Health: Knowing and Doing". This was the regular biennial world congresses.
13.10.1977 to 14.10.1977 Mind's Annual Conference with the theme "Rehabilitation and resettlement of mentally disordered people" held Westminster. Organiser Edna Tyrell (Mind Out 5/6.1977 p.24 - 7/8.1977 p.24)
- "In Italy a new National Health Service (NHS), providing free health care to all Italian citizens, replaced the existing national insurance system. The new NHS also incorporated the public psychiatric system, which had just undergone a radical reform under Law 180. According to this law, all psychiatric hospitals were closed to new admissions (and, after three years, also to readmissions) and were replaced with community-based services and psychiatric units based in general hospitals. The new system was intended to provide care and support to all types of patients, without back-up from public mental hospitals, where only existing long-stay in- patients could remain" (external source)
- "in 1978 we held a press conference, announcing the closure of the mental hospital" [at Trieste] "This created a big sensation in Italy for the situation had not been recognised until then" (Franco Basaglia - March 1980)
April 1978: Maureen Oswin's Children Living in Long Stay Hospitals was the report of a study financed by the Spastics Society. It described the lives of children in eight hospitals chosen to give as representative a sample as possible. These were severely handicapped children who were found, in the main, to be relegated to a tedious, impoverished existence on back wards.
May 1978: The Warnock Report
Although the 1970 Education Act had made local education authorities responsible for educating all children, education for many handicapped children was still in separate "special schools". The Warnock Report on the education of handicapped children recommended that special classes and units should be provided "wherever possible" in ordinary schools (paragraph 7.35) and that "firm links" should be established between ordinary schools and the remaining special schools in their vicinity (paragraph 8.10).
12.10.1978 to 13.10.1978 Mind's Annual Conference with the theme "Positive approaches to mental informity in elderly people" (Mind Information Bulletin June 1978 p.9)
On Our Own. Patient-Controlled Alternatives to the Mental Health System by Judi Chamberlin gave Judi's "patient's view of the mental health system", an account of her own treatment, and an account of communities run by their users. The book drew on the work of colleagues in Mental Patients' Liberation groups in North America, but also used some United Kingdom material.
1979 Science Time Line
The Borocourt Hospital League of Friends donated an outdoor play area for severely handicapped patients to use in good weather. It was a wirenetting fence surrounding a spacious area with a large cedar tree and toys for patients to play on.
March 1979 The Jay Report
The campaign for a normal life won its first major victory with the publication of the Jay report into mental handicap nursing and care. This did much more than examine the training of staff. It made radical proposals for community care however severe a person's handicap.
"Mentally handicapped people" [they wrote] "have a right to enjoy normal patterns of life within the community" [but] "too often... the concept of 'as normal a life as possible' has tended to stop short of those... with severe problems. It is still unfortunately assumed that if a mentally handicapped person has additional physical handicaps or severe behaviour disorder he must live in hospital." (paragraph 86)
In the 1980s and 1990s there were major changes in what community care means. It no longer meant care outside hospital in an overall system where hospital plays a major role. It no longer meant replacing distant asylums by treatment in local psychiatric hospitals. It came to mean providing services for people who continue to live in their own homes, and continually cutting back on any kind of institutional provision, whether in a hospital, a hostel or a day centre. The keynote of the decades was set by the Parkinson Report, made in 1979, but kept secret until 1981.
May 1979 Thatcher Government The New Conservatives and market forces:
Their confusion followed by clarity - followed by my confusion
The Secret Hospital
Spring 1979; The Parkinson Report (see 1976) was produced for the Conservative Party, but it was kept secret until 1981. The report strongly endorsed community care and called for a determined programme of hospital closures, linked to a statutory duty and financial incentives for councils to make community provision.
It said that, although all governments since 1959 were committed to community care policy, there was little real progress in creating services in the community. Amongst hospital staff, they found considerable resistance to the policy and "a strongly held belief that successive governments had not meant what they said."
Cecil Parkinson suggested that the policy had been discredited "because it is not really being implemented". Patients left the hospitals, but the money and skills stayed in them, so patients went into the community without the support they needed.
Confusion The first two years of Conservative rule (May 1979 to July 1981) were years of confusion and uncertainty about the direction mental health policy was to take.
July 1979: Royal Commission on the National Health Service Report
"We are certain that there is a continuing need for most of the mental illness hospitals, and we recommend that the health departments should now state categorically that they no longer expect health authorities to close them unless they are very isolated, in very bad repair or are obviously redundant due to major shifts of population. It should be made clear that they will be required throughout the remainder of this century and for as long as it is possible to plan". (paragraph 10.60)
8.7.1979 to 13.7.1979 World Federation for Mental Health congress held in Salzburg, Austria, with the theme "The Mental Health of Children and Families"
autumn? 1979 Patrick Jenkin to Mind [a letter quoted by Tony Smythe in a speech to the Social Services Conference 19.11.1979)]: This Government is as
"firmly committed to the principles of community care" [but] "we differ from previous governments ... in our overriding determination to secure substantial retrenchment in public expenditure... this retrenchment will have an adverse effect on progress towards the new pattern of services... In some places it may be proved difficult to avoid retreating a little"
October 1979 The National Schizophrenia Fellowship appointed a group development officer was appointed for the North East based in Newcastle.
DECEMBER 1979 PATIENTS FIRST
[December 1979?] National Development Group for Mental Handicap to be axed as a "QUANGO".
About 1980 that Robert James Maxwell became Chief Executive of the King's Fund. "Under the 17-year leadership of Robert J. Maxwell, the Fund also widened the scope of its activities to look at social care and public health." (web history) - See An Ordinary Life 1980 - allies - Preston event - Speaking from Experience 1985 - initial funding of Survivors Speak Out - Minstead Lodge 1986 - Barnet Action for Mental Health 1986 - Collaboration for Change 1988 - Survivors Speak Out funding 1992
1980 The Therapeutic Community: Outside the Hospital edited by Elly Jansen. Published: London : Croom Helm for the Richmond Fellowship. Based on papers presented at the Richmond Fellowship International Conferences, 1973 - 1975 - and 1976. The book is about the therapeutic community in both its narrow sense and as community care outside hospital. It was revied in Mind Out in February 1981.
January 1980: The Nodder Report published: Working Group on Organisational and Management Problems of Mental Illness Hospitals. Set up in March 1977. Held it last meeting in February 1979. The delay in publication was due to the change in government and, for the same reason, there was a "substantial gap... between the agreed committee draft and the report as published".
Although about half the 200 or so Health Districts had a District General Hospital Psychiatric Unit giving "a fairly comprehensive service" to at least part of the district (par.4), many of the others either had no local psychiatric service or a very selective one.
On the other hand, 50 of the 103 mental hospitals with over 200 beds served three or more Health Districts, only 13 served a single district and 21 were actually outside any of the districts they served. The situations some of these hospitals were in was "so complex as to defy any hope of an efficient management structure. So, a "first essential" was to reduce the complexity.
The committee recommended a strategy of first developing comprehensive local services in districts furthest away from a mental hospital and from there moving towards a situation where the mental hospital only served the district in which it was situated. (pars 4.9 to 4.10)
25.1.1980 Patrick Jenkin promises "priority"
DHSS Press Release 80/16: The Secretary of State expressed his determination "even in times of acute economic restraint" to maintain the established "priority" of services for the mentally ill and the mentally handicapped whereby the Department of Health and Social Security attempted to "steer funds" into these "Cinderella" services. He wanted to maintain progress towards the "new pattern" of facilities
February 1980 The National Schizophrenia Fellowship appointed a group development officer (David Lynes?) for the North West based in Warrington - This appointment led to differences of opinion concerning autonomy. Mind had opened a North West regional office in October 1978
March 1980 An Ordinary Life. Comprehensive locally based residential services for mentally handicapped people. Kings Fund Project Paper 24,
31.3.1980 to 3.4.1980 European workshop, in Belgium, on "Alternatives to Mental Hospitals" - Speakers included from Italy, Franco Basaglia - Belgium: Daniel Coens - Sweden: Ebba Neander - France: René Descartes - Holland: C. Trimbos - United Kingdom: David Towell
May 1980: The Future Pattern of Hospital Provision [DHSS Consultation Paper]
"It is now clear that in 70 or so districts which have a well sited mental illness hospital this will have to continue to provide all in- patient care and be the focus for the service in its own district often for many years to come. Only in this way can proper attention be paid to districts at present served by a distant or otherwise unsuitable mental hospital" (page 18)
20.10.1980 to 21.10.1980 Mind's Annual Conference with the theme "The Future of the Mental Hospitals" held at Kensington and Chelsea Town Hall. (Mind Information Bulletin, October 1980, p.1)
Patrick Jenkin invited to open:
"The Royal Commission said that the hospitals should stay unless they are obviously unsuitable; whereas the Government says that some could stay for many years if they are still needed and if they fit in with the desired pattern. This may seem a matter of semantics but it is more than that. It is a recognition first of the primacy of the district services, and secondly of the need, within that, to make the best use of existing services"
DECEMBER 1980: MENTAL HANDICAP: PROGRESS, PROBLEMS AND PRIORITIES (A review of mental handicap services since the 1971 White Paper)
1981 Science Time Line
By 1981, deaths and discharges from St Lawrences had reduced the number of patients to 1,300. It was one of seven English hospitals with the least money to spend on patients. (See 1870 and 1971 and Silent Minority (below))
The International Year for Disabled People
1981 Special Education Act
February 1981: Care in Action
31.3.1981 House of Lords debate "The Earl of Longford rose to ask Her Majesty's Government whether they will take urgent steps to provide a more effective system of mental after-care."
May 1981 European Symposium on Old Age and Mental Health held in Helsinki, Finland, concluding with the "Helsinki Resolution on Mental Health and Old Age" (Mind Out 7.1981 pages 8-9)
This way to the previous scandal
10.6.1981: Silent Minority
This television documentary was shown in peak viewing hours with a warning that some of the scenes might prove disturbing. The scenes were of what happened out of view in two understaffed hospitals for the mentally handicapped, St Lawrences and Borocourt. The hospitals had cooperated with making it "in the hope of conveying...the message that hospitals for the mentally handicapped are seriously understaffed and under-financed", but one of the messages of the documentary was that hospital asylums were the wrong place for mentally handicapped people to live.
Silent Minority concentrated its attention on the most severely disabled patients - those that Government policy still believed would always need "the special facilities of hospital care". It contrasted the understaffed wards at St Lawrences - where children were clean, fed and dressed, but bored and lonely - with Beech Tree House.
It suggested that the intensive education of children in a small unit at Beech Tree House prevented them becoming disturbed, frightened and frightening adults like some who were in a wire compound during daylight hours at Borocourt. Many of the Borocourt patients were sedated with Largactil - but, even so, the hospital had seven seclusion rooms. A man described by the hospital as "one of its most aggressive patients" was said on the television programme to have spent almost six months in almost continuous solitary confinement. A member of staff claimed that, as a result of solitary confinement, the patient seemed "on the edge of almost total madness".
Press headlines gave the impression that Government Ministers reactions to Silent Minority were apoplectic - Film Biased, says Jenkin (The Guardian 11.6.1981) - Fowler raps 'Biased Silent Minority Film' (Nursing Mirror 4.11.1981)
Ministers' reactions contained more positive elements, the most important of which was that the Under Secretary of State, George Young, insisted his civil servants put some urgency into producing the Green Paper Care in the Community.
The effect of Silent Minority that seemed most important to me was its effect on the public, but a friend who lobbies governments disagreed with me when I wrote that "Silent Minority probably did more to create a popular demand for community care than a decade of official policy statements". She was more conscious of what goes on in government. I just experienced what was happening in Hackney.
Relatives and friends of mentally handicapped people from Hackney living miles from home in St Lawrences, and other asylums around London, had simmered with anger and anxiety about them for several years. Silent Minority helped to bring their concern to the boil, and in January 1982 families, professionals, voluntary groups and articulate local people with a mental handicap formed HAMHP (Hackney Action for Mentally Handicapped People) to press for local services that would give all mentally handicapped people from Hackney a chance to live as part of our own community.
Silent Minority can still be seen. It can be bought or rented from Concord Video and Film Council. On their web site, click on education, then learning difficulties, and scroll down.
In the spring of 1981, Andrew Roberts was working on a pencil version of his thesis on The Lunacy Commission. He gave up in the summer for family reasons. The pencil thesis, with some gaps filled in, became his online text. This Mental Health History Timeline is an extension of a feature in the thesis - Which is why it is referenced as "1981-" (1981 onwards)
Care in the Community and the Parkinson Report
July 16th 1981: Care in the Community was the title of a Green Paper that suggested ways of moving money and care from the National Health Service to local councils and voluntary associations. It was a way of implementing the (hitherto secret) Parkinson Report, and seven days later the Conservative Political Centre published The Right Approach to Mental Health, an edited summary of the Parkinson Report.
Care in the Community began by saying:
"Most people who need long-term care can and should be looked after in the community. That is what most of them want for themselves and what those responsible for their care believe to be best".
Care in the Community applied especially to mentally handicapped, mentally ill and elderly patients (in that order).
It suggested that 20,000 long-term patients (15,000 in mental handicap hospitals and 5,000 in mental illness hospitals) could be discharged "immediately" if funds could be switched from the Health Service to local authorities (paragraphs 3.1. and 3.2).
Opinions were sought on seven possible ways of moving money and patients. On July 28th 1982 the Government said it had decided to adopt three main proposals:
The maximum period for which the NHS could pay for schemes under joint finance would be extended from seven to thirteen years for projects to move people out of hospital, and the NHS would be able to pay 100% of the money for up to ten years.
District Health Authorities would be allowed to make guaranteed annual payments to councils and voluntary bodies for ex-patients they provided for in the community.
Fifteen million pounds would be set aside from joint fiance money to develop and assess a series of pilot projects.
1981 World Federation for Mental Health congress held in Manila, Philippines, with the theme "Mental Health, Cultural Values and Social Development: A Look into the '80s".
Autumn 1981 Mind's Annual Conference with the theme "Psychiatric Treatment - Art or Science?" (Reported Mind Out 11.1981 pages 9-11)
Although numbers in the old style hospitals had fallen considerably, by 1982 the only mental illness hospitals to close were St Ebbas, Epsom (converted to a mental subnormality hospital in 1962) and The Holloway Sanatorium, Virginia Water, Surrey (closed December 1980). In November 1982, the only definite closure proposals were a plan to close Banstead and concentrate services at Horton in 1986; and proposals by North East Thames Regional Health Authority to close two of its six large mental hospitals (not then identified, but Claybury and Friern were chosen) by 1992. The only large mental handicap hospital planned to close was Darenth Park. (Information mainly from D. Glassborow, DHSS Mental Health Division, 18.11.1982)
Draft of closures to March 1994
St Ebbas, Epsom (conversion to a mental subnormality hospital)
The Holloway Sanatorium, Virginia Water, Surrey (December 1980)
Exminster, Devon 1985
The Lawn, Lincoln 1985
Banstead October 1986
Coppice Hospital, Nottinghamshire 1986
Saxondale, Nottinghamshire 1987
Horton Road, Gloucester 1988
Naburn, York 1988
Pastures, Derbyshire 1989?
St John's, Lincolnshire 1990
Whitecroft, Isle of Wight 1990
Mendip Hospital, Somerset 1991
Long Grove - April 1992
Cane Hill 1992
St Augustine's, Kent 1992
Herrison, Dorset 1992
Moorhaven, Devon 1993
Friern - 1993
Rubery Hill, Birmingham 1993
Hellingly, Sussex (1994)
Glenside, Bristol (1994)
St Mary's, Burghill, Hereford (1994)
Most the 1994 closures are still on the March 1994 list of ones that are open:
Mapperley Hospital, Notttingham (1994)
Clifton, York 1994
Closure index: See 1994 - 1995 - 1999 - 2002 - 2006 -
Peter Sedgwick's Psychopolitics, published in 1982, criticised the anti-psychiatry movement of the 1960s/1970s theoretically and politically. Sedgwick's political criticism of the Myth of Mental Illness idea was that it undermined efforts to secure community care resources for those who suffer from mental distress.
Mental Health and Civil Liberties
Movements among the mentally ill
We Can Speak for Ourselves. Self-Advocacy by Mentally Handicapped People, by Paul Williams and Bonnie Shoultz. This American book said that mentally handicapped people usually had decisions made for them about every detail of their lives, but that through the Self-Advocacy Movement many were learning to formulate their own needs, to put forward their demands and to campaign to win them.
A Mad People's History of Madness compiled by Dale Peterson. The British authors included are Margery Kempe, George Trosse, Alexander Cruden, Samuel Bruckshaw (1774), William Cowper, Urbane Metcalf, John Thomas Perceval, Marcia Hamilcar (1910), Thomas Hennell (1938), John Cunstance (1952) and Morag Coate (1965)
March 1982 Extraordinary General Meeting of the National Schizophrenia Fellowship, in Friends House, Euston Road, London, attended by 500 people, decided to to close the Regional Offices (Newcastle and Warrington). The Warrington group then (1982) formed the autonomous North West Schizophrenia Fellowship which later changed its name to Making Space weblink
1982 to 1991? Judy Weleminsky director of the National Schizophrenia Fellowship - Bharat Mehta joined NSF as Director of Development in 1989 and became its Chief Executive in 1993
7.6.1982 CHAMH meeting at Homerton Library with Dr Leonard Fagin (Claybury), the author of Unemployment and Health in Families (1981).
25.10.1982 to 26.10.1982 Mind's Annual Conference (Kensington Town Hall) Theme "Working Together? Voluntary and Statutory Mental Health Services" - Norman Fowler, Social Services Secretary, having said, earlier in the year, that the voluntary sector was in a unique position to provide "real community care". [A4 flyer]
1983 1983 Representation of the People Act
"A home, encouragement and a future"
The Mental After Care Association image from the Annual Reports of 1983 and 1984
1983 newspaper cartoon -
Preserved by my father.
9.5.1983 Royal Assent 1983 Mental Health Act. Under the 1959 Mental Health Act it is legally unclear whether a legal order to detain in hospital, against a person's wishes, empowers the hospital to impose medical treatments. If it does (which was generally accepted), there were no controls in the Act of the treatments imposed. The 1983 Act places legal controls on the application of medical treatments, particularly surgery, electro-convulsive therapy and mood- altering drugs.
Section 114 introduced the approved social worker (ASW), specially trained and qualified in mental health. An approved social worker (rather than any social worker) was qualified to make applications for formal admission.
Section 117 imposed a duty on local Social Services Authorities as well as Health Authorities to provide aftercare services for some mentally disturbed patients who have ceased to be detained and who leave hospital.
Section 121 established the Mental Health Act Commission See discussion of need for in 1976 and 1978, 1981; provisons in 1983 and way the commission interpreted these (1985). - Reports - 1985 - 1987 - 1989 - 2003 Strangers - 2004/2005 website - 2009: absorbed by Care Quality Commission - National archive
7.7.1983 Constitution of the Afro-Caribbean Mental Health Association formed to provide services in Wandsworth and the surrounding area. (external link)
22.7.1983 to 27.7.1983 World Federation for Mental Health congress held Washington, DC, USA with the theme "Personal and social responsibility in the search for mental health: Collaboration between volunteers, professionals and governments in the formation of mental health policy and the delivery of services". This congress was announced as a celebration of the work of Clifford Beers and the first International Congress on Mental Hygiene held in Washington in May 1930. However, as the title indicates, ther was little spce for the voices of users.
For a mental health organisation, to be awarded the task of hosting a world congress was something like a country being awarded the Olympic Games. So Chris Heginbotham, the new director of Mind was very pleased to secure the congress for Brighton in 1985.
20.9.1983: Hackney Workers Educational Association introductory lecture on Mental Distress in Old Age given by Dr Tony Whitehead from Brighton. Building on in depth consultation with users, carers and providers the series ran for over a year and published and interim report in June 1984 and a final report in November 1985
Late 1983 Common Concern: MIND's manifesto for a comprehensive mental health service 63 pages. See Simon Hebditch October 1983
29.11.1983 House of Lords debate Mental Health: Richmond Fellowship Inquiry
National Health Service Management Inquiry Report. London: DHSS, 1983 (Not 1984, I think). ISBN: 0946539014. Sometimes referred to as the first Griffiths Report.
Psychiatric Services in Transition From 1983 and 1987, The King's Fund, with support from the DHSS and NHS Training Authority, ran workshops and projects about managing the transition to community care. The main papers produced by the process were published as "Managing Psychiatric Services in Transition" in 1989
1984 Scottish members of the National Schizophrenia Fellowship separated from the main body in London in 1984 and became the National Schizophrenia Fellowship (Scotland). Although it works in collaboration with its sister organisation in England (Rethink), NSF (Scotland) is completely autonomous, being responsible for its own policy, projects and funding. weblink - web archive begins 25.6.1999 - history
John Illman and Malcolm Lader's Pathways to the mind : 25 years of Mental Health Foundation research (112 pages) published by the Mental Health Foundation.
January 1984 Social Services Committee of the House of Commons decided to investigate community care with special reference to adult mentally ill and mentally handicapped people
- 5.3.1984 to 16.3.1984 "From Hospital to the Community: The Italian Experience...A display of photographs, film-shows as well as discussions at the King's Fund Centre...also in Sheffield and Manchester at a later date...Italian mental health professionals who have been involved in implementing the changeover to community care will lead the discussion. Contact Ron Lacey or Teresa Morawiecka at MIND." (Openmind February/March 1984)
- April 1984 four members of Psichiatria Democratica visited London, Sheffield and Manchester at the invitation of Alec Jenner and Shula Ramon. Alec Jener may be the psychiatrist who made a favourable report on the Italian experience to the Social Services Committee. He visited Italy in August 1985.
Wednesday 25.5.1984 Robert Loudoun, David Friun, Sidney Crown and Katia Herbst from the Mental Health Foundation questioned by Social Services Committee. The memorandum submitted by the fund argued that community projects for mentally handicapped people were innovative in comparison with those for mentally ill people. (The same criticism was repeated in the evidence).
"community organisations interested in mental handicap schemes are 'on the move' in imaginative and radical ways whilst community groups involved with mental illness schemes remain relatively stuck in the present 'tramlines'" (SSC 1985 volume 2, pages 243)
July 1984 Ten day Social Services Committee visit to the United States - Its first outside Europe. Mostly about investigating the effects of de-institutionalisation.
August? 1984 Valerie Argent's poem Inner Circle was written in a psychiatric ward at Hackney Hospital.
22.10.1984 to 23.10.1984 Mind Annual Conference (Kensington Town Hall). Theme "Life after Mental Illness? Opportunities in an Age of Unemployment" - [A4 flyer]
Dr Hugh Freeman was vice-chair of Mind from November? 1984 to November 1988. He succeeded Dr Douglas Bennett.
Report of Social Services Committee on Community Care
1.3.1985 The National Unit for Psychiatric Research and Development (NUPRD) established. On 12.5.1989 this became RDP Research and Development for Psychiatry. Matt Muijen director 1991. On 22.2.1994 the Sainsbury Centre for Mental Health (Website - Internet Archive from 20.2.2001 - Complete publications list starts 1986.) "Founded in 1985 by the Gatsby Charitable Foundation, one of the Sainsbury Family Charitable Trusts, from which it receives core funding. It is affiliated to the Institute of Psychiatry at King's College, London." See Towards Coordinated Care (1988) - In 2006, Gatsby cut its funding. It shed two-thirds of its staff and concentrated work on employment issues and criminal justice. In 2009 the staff were told that it should not expect to remain in its present form after 2010.
May 1985 The Team for the Assessment of Psychiatric Services (TAPS) set up to evaluate the transfer of care from psychiatric hospitals to district-based services. Its specific remit was (included?) an evaluation with respect to the closure of Friern and Claybury Hospitals. It was also involved at Warley and Tooting Bec - BBC link - 3.7.1999 - 2000 - summary
5.7.1985 UK Secretary of State (Norman Fowler) announced £10,000,000 funding over the next three years for a new programme called 'Helping the Community to Care'. Its chief aim was to improve support for elderly people and for those who are mentally ill and mentally handicapped by helping those who help them, volunteers, friends and family members. (source). About 20 projects were funded, including Womankind in Bristol.
Speaking from Experience 14.7.1985 World Federation for Mental Health congress held in Brighton - hosted by Mind - with the theme Mental Health 2000 - Action Programmes for a World in Crisis. The congress was divided into six themes - each theme was planned with three workshops - each of these was to produce an item for a charter to be presented (printed) to the final session on 19.7.1985. See Charter Mental Health 2000
- August1985 Alec Jenner's visit to Italy.
October? 1985 Mental Health Act Commission First Biennial Report 1983-1985 - Opinion that the 1983 Act could not lawfully be used to produce the effect of a long-term community treatment order. Upheld in subsequent court cases.
Community Treatment Orders: See March 1987 - Edale-September 1987 - Hugs not Drugs-5.12.1987 - July 1990 - Christopher Clunis-17.12.1992 - 23.2.2000 - Mental Health Alliance - 30.3.2009 -
28.11.1985-29.11.1985 Mind's Annual Conference 1985:
From Patients to People [A4 flyer]
4.12.1985 House of Lords debate "Lord Mottistone rose to call attention to the needs of mentally ill and mentally handicapped persons, with special reference to community care".
December 1985 Forgotten Illness Campaign started in The Times. This series of articles preceded the foundation of SANE, a year later.
1985 Comic Relief started in response to the famine in Africa. The first Red Nose Day was in 1988. In 2006/2007 it helped to fund the National Survivor User Network
1986 Disabled Persons Services Consultation and Representation Act. Under this Act, Social Services must assess the needs of disabled people on request for certain welfare services and local authorities must provide to meet those needs if they decide it is necessary. Including provision or help over telephone, television, radio, library facilities, holidays, recreation, access to education, transport to and from services, social rehabilitation and adjustment, occupational, social, cultural and recreational activities. Disabled means "Blind, Deaf or dumb or who suffer from mental disorder of any description or who are substantially and permanently handicapped by their illness, injury or congenital deformity"
Empowerment In 1986 the compilers of the Oxford Dictionary noticed that an old (1690) Quaker word had re-entered the vocabulary with a secular meaning. Individuals and groups were being "empowered" to be stronger and more confident in controlling their life and claiming their rights. The word must have spread quickly: The 1985-1986 Report of City and Hackney Community Health Council, for example, was called Empowering the Users of the Health Service. "Developments in mental health services", it said, will not work well unless they are supported by the people that use them and so the CHC believes they should have a say in planning them and a continuing say in how they are run". A similar theme ran through all issues. - See National Empowerment Center USA 1992.
October 1986 Banstead Hospital closed
SANE (Schizophrenia: A National Emergency) was founded by Marjorie Wallace in 1986. (External link to website). Lord Mottistone was the founding chair. - See SANE Poster - London Alliance march 1983 - SANEline - Reclaim Bedlam March 1999 - SANE Service User Group
13.11.1986-14.11.1986 Mind's Annual Conference held in Hammersmith (London)
1987 Roy Porter A Social History of Madness: Stories of the Insane "The writings of the mad challenge the discourses of the normal... shore up that sense of personhood and identity which they feel is eroded by society and psychiatry".
March 1987 Compulsory treatment of the mentally disordered in the community : the field of choice - a discussion document from the Mental Health Act Commission - See above
27.6.1987 "Sir, I feel I should declare that I have been diagnosed as a 'manic depressive' with schizophrenic tendencies. While this description may have helped the experts in prescribing me numerous 'drug cocktails' over the years, it has not proved a notable success on the dance floors of everyday life. One man's diagnostic tool is another three's insult." Peter Campbell. Letters to the Guardian
October 1987 World Federation for Mental Health congress held Cairo, Egypt, with the theme "The Many Worlds of Mental Health"
October 1987 Mental Health Act Commission Second Biennial Report 1985-1987
October 1987 Publication of Asylum to Anarchy by Claire Baron. The title does not fit he content, which is a sociological analysis of the development of a "tyranny of the therapeutic" within Paddington Day Hospital (not named). It is grounded in participant observation from (roughly) 1975 to 1978 which was developed into a PhD Thesis in 1984. The book is presented as a theoretical development and critique of Goffman's Asylums. It stimulated the research for Helen Spandler's Asylum to Action
November? 1987 Mind's Annual Conference held in Blackpool on the theme "In pursuit of excellence in community care" . ("Mind annual conferences were always in London and then they started going round the country" (Email Thurstine Basset 11.6.2009) - Harrogate? - Bournemouth 1988 - Scarborough 1989 - Brighton 1990 - Blackpool 1991
new-generation antidepressants Fluoxetine (Prozac) was introduced in 1988. It was the fourth selective serotonin reuptake inhibitor (SSRI) on the United States market. The "new-generation antidepressants" are fluoxetine, venlafaxine, nefazodone, paroxetine (Seroxat). source
February 1988 Conference on cordinating commnunity care organised jointly by the Department of Social Security and the National Unit for Psychiatric Research and Development. "Built on the research funded by the department in Salford, Southampton and Hackney to investigate the use of computers in case management systems". Lord Henley Hansard 10.5.1989). Reported as Towards co-ordinated care for people with long-term, severe mental illness by Paul Clifford; Tom Craig; and Liz Sayce (London 1988, 28 pages) National Unit for Psychiatric Research and Development
March 1988 Community Care: Agenda for action report to Secretary of State for Health from Sir Roy Griffiths. London: HMSO, 1988 ISBN: 0113211309. [Sometimes referred to as the second Griffiths report. It was followed by white papers in 1989 and legislation in 1990] External link to review by J.K. Wing
July 1988 Government guidance that by 1991 each health district in England must have developed a care programme to provide for people chronically disabled by mental illness. (See Hansard 1.12,1988)
27.8.1988 Death of William Sargant - His death occasioned controversy Hugh Freeman wrote in the Guardian: "It is deplorable that the death of William Sargant should have been used by David Pilgrim (Letters Sept 7th) for an attack on psychiatry."
Monday 26.9.1988 to Thursday 29.9.1988 Common Concerns: International Conference on User Involvement in Mental Health Services held at The University of Sussex under the auspices of Mind and Brighton Health Authority. Participants included Mike Lawson, a founder member of the Mental Patients Union and of Survivors Speak Out and Judi Chamberlin, author of On Our Own - Patient controlled Alternatives to the Mental Health System. The conference was an important step towards the coming out of mental patients - It was also marked of an early stage in the development of the term "user involvement". The term survivor/user action is used by Pater Campbell (2006) No conference with such a title now would be taken seriously with so few openly declared patients on the platform.
19.11.1988 At Mind's Annual General Meeting, a patient replaced a psychiatrist as the vic-chair
LouisePembroke "first met Judi Chamberlin in 1988 at the start of my own activism at the annual Mind conference when her seminal text On Our Own was published by Mind ... then at a landmark conference in Brighton entitled Common Concerns"
28.11.1988 to 30.11.1988 Mind's Annual Conference held in Bournemouth.
SHE THINKS YOU WANT TO KILL HER
YOU THINK SHE WANTS TO KILL YOU
THEY THINK SHE'LL GO AWAY
In December 1988, SANE launched a multimedia campaign aimed at raising public awareness of schizophrenia. The posters caused the most controversy. Some people thought they communicated the reality of severe mental illness and made people think about the adequacy of public policy. Others thought they communicated a stereotype of mentally distressed people and made it more difficult for those with a label of mental illness to live in the community.
David Ennals was President of Mind from 1989 to 1995
Banstead Hospital demolished
In 1989 the Planned Environment Therapy Trust Archive and Study Centre was established to study and make available materials about therapeutic communities.
January 1989 Department of Health Working for Patients [At foot of cover: The Health Service: Caring for the 1990s]. (Cm.555) London: HMSO. 101 pages. ISBN: 0101055528 Presented to Parliament by the Secretaries of State for Health, Wales, Northern Ireland and Scotland ... January 1989.
July 1989 Street poster showed a young women with spiders crawling through her hair and across her face, with the text "She has all the love in the world. But her life is a nightmare" (Rochdale). May have been North West Schizophrenia Fellowship.
November 1989 Department of Health and Department of Social Security Caring for People: Community Care in the Next Decade and Beyond Cmn.849 London: HMSO. 106 pages. ISN: 0101084927 Presented to Parliament by the Secretaries of State for Health, Social Security, Wales and Scotland by command of Her Majesty, November 1989
November 1989 Mental Health Act Commission Third Biennial Report 1987-1989
30.11.1989 to 1.11.1989 Mind's "Annual Conference and Exhibition" held in Scarborough. Title "Money and Mental Health, Financing the Future". Ros Hepplewhite was welcomed as the new Director.
1989 World Federation for Mental Health congress held in Auckland, New Zealand, with the theme "Mental Health - Everyone's Concern".
29.6.1990 1990 National Health and Community Care Act: The "purchaser/provider" split sprang from this Act. From 1991 health and social services were divided into units that bought services or provided them. Social Services Departments had to set up "arms length" inspection units. establish a complaints procedure and (by April 1991) prepare a Community Care Plan. Users became entitled to a Community Care Assessment of needs.
A kind of market: Within the National Health Service and Local Social Services and along with voluntary and private organisations, the government tried to create a market to achieve the rewards promised by the new followers of Adam Smith, but with the basic services remaining in public ownership and control. The arrangements within the NHS were known as the "internal market".
Health Authorities now "commissioned services" from GPs, NHS "Trusts", voluntary and private providers. Hospitals were rearranged as different Trusts, including some "Mental Health Trusts" or "Mental Health and Learning Disability Trusts". Some GPs became "GP fundholders". A similar division took place in Social Services
For me, the most memorable feature of the period was that I could not work out who was who or who was responsible for what. Unfortunately, government has learnt the advantages of a fog of confusion.
And there was also provision for user involvement in planning
Tuesday 9.10.1990 to Thursday 11.10.1990 Mind's Annual Conference held in at the Royal Albion Hotel, 35 Old Steine, Brighton, Sussex - topic was "Advocacy, in all its varying forms" [Lisa Haywood and Jan Wallcraft took part in the planning]
24.11.1990 Mind's Annual General Meeting at the Cavendish Conference Centre, London. (Mind members only)
April 1991 Mental Illness Specific Grant became available in the United Kingdom. See survey of impact in Scotland
Anika Patrice founded
1991-2004: Matt Muijen director, Sainsbury Centre for Mental Health, London
21.7.1991 "British Prime Minister John Major has launched a citizen's charter to improve public services." BBC
August 1991 World Federation for Mental Health congress held in Mexico, with the theme "People and Science: Together for Mental Health".
August 1991: Death of Kathy Sirockin.
September 1991: Death of Valerie Argent.
October 1991 Madness: A Study Guide by David Herman and Jim Green (32 pages) Produced to accompany a three part BBC2 television series Madness, by Jonathan Miller, shown on 6.10.1991 "To Define True Madness" - 13.10.1991 "Out of Sight" - 20.10.1991 "Brainwaves".
12.11.1991 to 14.11.1991 Mind's Annual Conference held in Blackpool. Theme "The Politics of Mental health" - speakers included Jeffrey Mason and Edna Conlan
November 1991 Survivors' Poetry founded by Frank Bangay and others. From Dark to Night, an anthology edited by Frank Bangay, Hilary Porter and Joe Bidder, was published by the Survivors Press in 1992. In 1999, an illustrated collection of Frank Bangay's poems Naked Songs and Rhythms of Hope (1974 to 1999) was co-published by Spare Change Books, Box 26, 136-138 Kingsland High Street, Hackney, London, E8 2NS and Survivors Poetry, (then at 34 Osnaburgh Street, London, NW1 3ND). In 2001 A True Voice Singing, a CD of Frank Bangay reading fifteen of his poems to musical backgrounds, was published by CORE Arts. Frank Bangay can often be heard performing at the Krazy Kats n Dogs Klub
1992 SANE established SANEline - an out of hours (evenings) telephone helpline for emotional support and information for people affected by mental health problems.
1992 Peter Barham Closing the asylum Penguin. "Discusses NHS spending cuts and the recent drive towards closing mental hospitals and treating patients by means of 'community care'... speculates on the adequacy of community care and support."
end of February 1992 Intention to set up a mental health task force announced.
9.4.1992 to 5.7.1995 Virginia Bottomley UK Secretary of State for Health
September 1992 Mental Health Task Force set up by UK Government "to help unlock resources from the old, long-stay institutions and to help build up a balanced range of local services, based on best practice". (Hansard 17.12.1973. See also Hansard 2.4.1993). The full membership of the group and its support groups was still being finalised in January 1993. The task force was led by David King. The Final Report of the Mental Health Task Force was published in 1995
See Mental Health Task Force Service User Group
10.10.1992 First World Mental Health Day sponsored by the World Federation for Mental Health
17.12.1992 Jonathan Zito murdered by Christopher Clunis (left) on Finsbury Park station. It was an unprovoked murder of a complete stranger. Christopher Clunis was a mental patient. Jonathan's widow is Jayne Zito. The Zito Trust was established in 1994. The 2007 Mental Health Act removed its reason for being and it closed 30.3.2009.
Murders by patients are often blamed on "community care". I have not murdered anyone. Is community care responsible for that?
atypical anti-psychotics Risperidone was launched in the United Kingdom in 1993 - Clozapine (which has a long history) was released in 1990 - Sertindole and Olanzapine were launched in 1996. The claim for the atypicals is that they have less debilitating side-effects than Chlorpromazine.
Homeless mentally ill people not ex-patients of the asylums. Who are they? Publication of a study by J. Leff following 278 patients who were discharged from two long-stay mental hospitals in north London, as part of closure programme. It was argued that as only seven patients (1%) were lost to follow-up, possibly becoming homeless, homeless psychiatric patients were not the result of hospital closure programmes. Paper on East Anglia University website has been removed, but see bibliography
The Independent Wednesday 13.1.1993
Letter: Physical causes of schizophrenia
From Marjorie Wallace, Chief Executive, SANE, London, NW1
David Hill's views on schizophrenia are contradicted by studies from the World Health Organisation and other professional agencies which show that schizophrenia is a problem that affects all races and social classes. There is growing evidence that it involves a biochemical imbalance in the brain and is not simply used as a label to cover those who are socially disadvantaged. The recent case of Ben Silcock - an intelligent young man from an ordinary middle-class background - illustrates this point.
If the existence of schizophrenia is denied, it is no wonder that sufferers such as Mr Silcock are not taken seriously, and denied care and treatment even when they ask for it.
Details on the remaining large mental illness hospitals, with over 100 beds, were published in the mental health task force report, "Survey of English Mental Illness Hospitals, March 1993", copies of which are available in the Library (Hansard 22.2.1995)
28.4.1993 Health Committee of the House of Commons resolved to "examine the implications of any extension of legal powers under the Mental Health Act 1983 for the care of people with mental illness in the community"
29.4.1993 David King of the Mental Health Task Force described his brief to users
"To deliver management objectives on flow of capital and revenue for strategic planning...To look at other options/providers/cost structures in mental health apart from traditional health services ones...To get the concept of consumer satisfaction into the mental health arena which is difficult because of the underlying element of compulsory treatment... To bring in a notion of quality for users ..To inform what is going on - bringing discussion of hospital closure into the public arena, so people understand the issues (as) talk of hospital closures brings strong reactions, and lobbying from MPs."
26.5.1993 Evidence from Ian Bino and Lisa Haywood from Mind and from David Crepaz-Keay and Jan Wallcraft from Survivors Speak Out to the Health Committee Inquiry
11.7.1993 Julie Birchill in The Mail on Sunday
"Last week saw the conviction of a schizophrenic released from the hatch only to rape three women; there have been 40 murders by mental patients in the two blood-drenched years since the grotesquely named Care in the Community con came into being. Not only have the lunatics taken over the asylum; thanks to this government they've now taken over the streets too, making them one big open prison. Open for them, prison for us."
23.8.1993 to 27.8.1993 World Federation for Mental Health congress held Tokyo, Japan, with the theme "Mental Health: Toward the 21st Century"
Friday 17.12.1993 Jayne Zito's account of her experience published in The Independent.
1994 was a "difficult year" for Mind. About here it moved from Harley Street to Stratford, in East London. It faced an annual deficit of £250,000 and had to "re-structure" in a way that meant loosing many members of staff.
February 1994 The report of the Inquiry into the Care and Treatment of Christopher Clunis presented to the chairman of North East Thames and South East Thames Regional Health Authorities
The Zito Trust was set up after the Inquiry report. Registered as a charity in January 1995. The archive of its website does not start until 3.6.2002 - Current website
10.5.1994 HSG(94)27 guidance stated that after any homicide by a person previously in contact with mental health services, the relevant health authority and/or social services should set up an independent inquiry and publish a report on the lessons to be learnt. There were over 120 inquiries by 2002. (Zito Trust website 2002)
May 1994 Mind launched its "Breakthrough - Making Community Care Work" campaign. A petition said "Thousands of people with mental health problems are without proper care in the community. We the undersigned are asking Virginia Bottomley to provide them with rights to 24-hour crisis services, supported accommodation, secure provision, appropriate therapy and opportunities for employment". A Community Care Bill was presented to the UK parliament in January 1995 by Tessa Jowell. The campaign claimed that "the government has failed to provide sufficient funding to implement the Community Care Act" and that "More than a year after its official introduction, Care in the Community is still far from being an effective reality". The "official introduction" may refer to the Mental Health Task Force.
Summer 1994 In Listen To Me - Communicating the Needs of People with Profound Intellectual and Multiple Disabilities Pat Fitton shared what her daughter, Kathy, had taught her.
October 1994: In Finding a Place: A Review of Mental Health Services for Adults, the Audit Commission found that the favoured policy, of individual, locally based care within the community, was "struggling".
1.11.1994 to 3.11.1994 Mind's Annual Conference held in Brighton. Theme "Break through: making community care work".
Saturday 26.11.1994 Mind's Annual General Meeting held in Stratford Town Hall. David Peryer elected chair and Lisa Haywood Vice Chair
December 1994 Launch of Schizophrenia Media Agency
See closure index
Lords Hansard 26.10.1995 : Column WA128 Mental Illness Hospitals: In-Patients
Lord Mottistone asked Her Majesty's Government:
How many patients were, or are, cared for (on closure or now, if not yet closed) in each of the hospitals named in Table 2 of the Survey of English Mental Illness Hospitals March 1994-Monitoring the Closure of the "Water Towers".
Baroness Cumberlege: The information available centrally is given in the table.
NHS Hospitals in Table 2 of the Survey of English Mental Illness Hospitals March 1994-Monitoring the Closure of the "Water Towers":
Numbers of In-patients at 31.3.1994
Hospital In-patients all ages
Barnsley Hall Hospital 57 [Worcestershire - 1903-1996]
Clifton Hospital 100 [Yorkshire 1847-1994]
Coney Hill Hospital 168 [Gloucestershire 1884-mid 1990s]
Hollymoor Hospital 185 [Birmingham 1905?-1995]
Mapperley Hospital 195 [Nottingham 1880-December 1994]
St. Francis Hospital (Nottingham) 38 [???]
St. George's Hospital (Stafford) 147 [1818-???]
St. Crispin Hospital 121 [Northampton 1876-???]
Scalebor Park Hospital 35 [Yorkshire 1902-1995]
Central Hospital 95 [Warwickshire
Claybury Hospital 361 [Essex 1893-1997]
Countess of Chester Hospital 179 [Cheshire 1829- continuing]
Hill End Hospital 153 [Hertfordshire 1899-1997]
Maidstone Hospital 115 [Kent
Netherne Hospital 57 [Surrey 1909-1994]
Princess Royal Hospital 154 [Sussex
Roundway Hospital 99 [Wiltshire
St. George's Hospital (Morpeth) 312 [Northumberland
St. Mary's Hospital (Northumberland) 247 [
St. Matthew's Hospital 157 [Staffordshire 1864-1995
Stanley Royd Hospital 277 [Yorkshire 1818-1995]
Tone Vale Hospital 117 [Somerset 1897-
Tooting Bec Hospital 96 [London 1903-1995]
Whittingham Hospital 153 [Preston, Lancashire 1873-2002 MSU continuing]
St. Nicholas' Hospital (Newcastle) 214 [
Brookwood Hospital 311 [
Carlton Hayes Hospital 249 [
Littlemore Hospital 172 [Berkshire 1846-
Middlewood Hospital 116 [Yorkshire 1872-1999]
Napsbury Hospital 419 [Hertfordshire 1905-1999
Shenley Hospital 424 [Hertfordshire 1934-
The Royal London Hospital (St Clements) 99 [London
Warlingham Park Hospital 143 [Croydon 1903-1999]
All Saints Hospital 261 [Birmingham 1850-2000]
Parkside Hospital 249 [Cheshire 1871-2002]
Knowle Hospital 184 [1852-1996 RSU continuing]
Fair Mile Hospital 212 [
De la Pole Hospital 246 [Hull ]
Fairfield Hospital 415 [
Fulbourn Hospital 301 [Cambridgeshire
Goodmayes Hospital 401 [Still open 2006]
High Royds Hospital 346 [Yorkshire
Horton Hospital 329 [London
Lancaster Moor & Ridge Lea Hospitals 314 [Lancashire
Park Prewett Hospital 245 [Hampshire
Runwell Hospital 320 [1936- Essex - Still open 2006]
Severalls Hospital 218 [
St. Edward's Hospital 254 [Staffordshire
St. Lawrence's Hospital 206 [Cornwall
Warley Hospital 534 [Essex
Winterton Hospital 375 [Durham
Bexley Hospital 241 [Kent
Cherry Knowle Hospital 320 [Sunderland
Garlands Hospital 182 [Carlisle
Rauceby Hospital 173 [Lincolnshire
Towers Hospital 163 [Leicester
Winwick Hospital 398 [Lancashire
Graylingwell Hospital 249 [Sussex
St. Andrew's Hospital (Norwich) 168 [Norfolk
Springfield Hospital 429 [Still open 2006]
St. James' Hospital 204 [Portsmouth - Still open 2006]
St. Luke's Hospital 140 [Middlesbrough - Still open 2006]
St. Clement's Hospital (Ipswich) 190 [Still open 2006]
Stone House Hospital 98 [Kent 1866- Still open 2006]
Wonford House Hospital 116 [Devon 1801-
Highcroft Hospital 132 [Birmingham
West Park Hospital 358 [Epsom 1903-2002/2005?]
Barrow Hospital 212 [Bristol
Bootham Park Hospital 107 [Yorkshire 1777 -
Ealing Hospital 327 [London 1831 - continuing
Hellesdon Hospital 258 [Norfolk - Still open 2006]
Henderson Hospital 24 [Surrey
Kingsway Hospital 285 [Derbyshire 1888 - Still open 2006]
Lynfield Mount Hospital 119 [Yorkshire 1910/1948 -
Maudsley Hospital 217 [1915/1923 - Still open 2006
Old Manor Hospital 145 [Wiltshire 1813? -
Prestwich Hospital 337 [Lancashire 1851 -
Royal Shrewsbury Hospital (Shelton) 197 [Shropshire 1845- Still open 2006]
St. Martin's Hospital 120 [Kent - Still open 2006]
Sundridge Hospital 48 [Kent
The Bethlem Royal Hospital 180 [Kent Still open 2006
Warneford Hospital 70 [Oxfordshire Still open 2006
79 hospitals in this list. 23 previously closed. Total 102. Lists do not include Welsh Hospitals (7?)
1995 Carers (Recognition and Services) Act
1995 Mental Health (Patients in the Community) Act
January 1995 The Zito Trust registered as a charity (No. 1043754)
See closure index
20.2.1995 Government asked in the House of Lords, how it judged the strength of local and family opposition to the proposed closure of the following long-stay hospitals for mentally handicapped people: Cell Barnes Hospital, St Ebbas Hospital, Turner Village Hospital, Llanfrechfa Grange Hospital, Northgate Hospital, Prudhoe Hospital, Meanwood Park Hospital, Ida Darwin Hospital, Calderstones Hospital, Leybourne Grange Hospital, Tilworth Grange Hospital, Clarefield Hospital.
Spring 1995: Home at Last: How two young women with profound intellectual and multiple disabilities achieved their own home.
1995 World Federation for Mental Health congress held Dublin, Ireland, with the theme "Time for Reflection".
In its response to the Scottish Affairs Committee's Report on The Closure of Psychiatric Hospitals in Scotland in 1995, The Scottish Office committed itself to production of "A Statement of Aims and Points which we would expect to be covered in local strategies". The Framework for Mental Health Services in Scotland fulfilled that commitment.
News from 1996
1996 Community Care (Direct Payments) Act
1996 was the 'official' start of user-led or survivor research
April 1996 First meeting of the "Standing Advisory Group on Consumer Involvement in the NHS Research and Development Programme" established by Director of Research and Development in the Department of Health. See first report 1.1.1998. Later known as "Consumers in NHS Research". In 2001 the Group widened its remit to cover public health and social care research commissioned by the Policy Research Programme of the Department of Health. See 2002/2003 Newsletter. Became INVOLVE in July 2003.
News from 1997
Early May 1997 After several months of breaking down, Joe Wick's, a character on BBC EastEnders, is diagnosed as having Schizophrenia - weblink - Adrianne Reveley (medical adviser)
"Schizophrenia is the last great stigma. We have seen cancer, AIDS, and Alzheimer's disease accepted and admitted by a number of celebrities, and this has helped everyone else who suffers. We psychiatrists know there are celebrities who have schizophrenia - we treat them- but few feel able to "come out." That is why a story on a national soap is so important." (Adrianne Reveley)
May 1997 Blair Government New Labour - New Community Care
20 May 1997 After seventeen years, Robert James Maxwell was succeded by Rabbi Julia Neuberger as Chief Executive of the King's Fund - Press report
1.6.1997 New website of the Mental Health Foundation first saved in International Archive.
6.7.1997 to 11.7.1997: World Federation for Mental Health congress held in Lahti and Helsinki, Finland. The theme "Cornerstones for Mental Health" focused on "social, economic, environmental, ethical, physical and psychological issues of mental health". Topics were covered under five cornerstone themes: 1) ethics and values; 2) wellness: healthy body and mind; 3) social structures, culture and environment; 4) interaction, relationships and personal autonomy; 5) services for mental health: purchasing, providing, using. See users
See above - 1995
19.9.1997 A Framework for Mental Health Services in Scotland Scottish Executive (1997) Edinburgh: The Stationery Office.
A framework for England followed in 1999 - for Wales in 2002 - and for Northern Ireland in 2003. In the United States, the Surgeon General made his "first ever" report on mental health in 1999
10.10.1997 World Mental Health Day. - The Alliance for Psychosocial Nursing (APN) launched at Kensington Town Hall, London (England) where the Bethlem Hospital was celebrating its 750th anniversary and the Nursing Times was hosting the 6th International Congress on Mental Health Nursing. More than 400 nurses from 15 countries joined the celebratory launch.
October 1997 Controversial BBC Panorama programme on mental health.
1998 Mind's "Key dates in the history of mental health and community care" was compiled by George Stewart of Mind Information Unit. The first version was 1998. It was updated in January 2003. The first Internet Archive I have traced was 28.12.2005. Current location - The chronology starts in 1601. It has very extensive material about recent mental health history.
News from 1998
Care in the community?: a history of the reprovision programme of Friern Hospital
1.1.1998 Modernising mental health services safe, sound and supportive Department of Health (England). archived outline
Friday 16.1.1998 "Is the media a friend or foe of psychiatry". Panel discussion organised by the Royal College of Psychiatrists at Maudsley Hospital. Chaired by Marjorie Wallace. Panel members: Anthony Clare, Raj Persaud, Rob Kerwin and Martin Deahl.
Care in the community is [not] scrapped
Saturday 17.1.1998 "Care in the community is scrapped". The Daily Telegraph claims that statements made by Frank Dobson, the Secretary of State for Health, amount to the scrapping of the Care in the Community policy
BBC: "The controversial policy of releasing mentally ill people from hospitals is to be scrapped by the Government. The Health Secretary, Frank Dobson, said the care in the community programme launched by the Conservatives in 1990 had failed"
Sunday 18.1.1998 Frank Dobson told a BBC Radio 5 Live phone-in that there was a substantial minority of people who were either dangerous, or made such a nuisance of themselves that they needed 24-hour supervision - but that did not mean, as the Daily Telegraph reported on Saturday, that the entire care in the community scheme was to be abolished.
Monday 19.1.1998 "Dobson denies call to scrap care in community" Anthony Bevins The Independent
March 1998 First Big Alternative Conference
May 1998: Audit Commission published Home Alone: The Housing Aspects of Community Care - archive
May/June 1998 Call for psychiatric patients to reclaim history
Care in the Community has failed - Health Secretary, Frank Dobson repeated this statement several times. It is the misfortune of politicians that their most outrageous statements are remembered for ever. This one must rank alongside Margaret Thatcher's "There is no such thing as society". The statement is prominent in Modernising Mental Health Services. Safe, sound and supportive. As this also says that community care had brought "many beneficial changes", and as it shows no intention of abandoning community care, I would interpret it to mean that care in the community has failed for some, and in some respects and so the government was bringing in a new model of community care which would address the problems.
29.7.1998 Frank Dobson Outline Third Way for Mental Health. (Press release) - First of two press releases alleging that care in the community has failed.
School holidays - Summer 1998 Being bored, Andrew Tierney and friends decided to explore the site of the disused mental hopital at Cane Hill in Surrey, close to their homes. The site had been closed since 1992 and nothing constructive was happening to it. In May 1999 they explored nearby Netherne. This site was being re-developed. Later the same year Andrew started the_one.uk "the UKs only Urban Exploration website. Urban exploration is exploring tunnels, buildings and other "urban" things. It's popular in the US, Canada, and Australia". The first Internet Archive of this was taken on 21.1.2000. The site evolved into UrbeX UK - urban exploration in the UK in January 2002. (Internet Archive)
25.9.1998 "Prime Minister Kjell Magne Bondevik of Norway returned to work this week after a three-and-a-half-week sick leave for depression and insisted that he could handle the stress of the job". (The New York Times)
7.10.1998 Launch of Changing Minds campaign by the Royal College of Pyschiatrists
22.10.1998 to 24.10.1998 World Federation for Mental Health 50th Anniversary Symposium held Church House, Westminster in London, with the theme "Partners for Mental Health: Nations for Mental Health". - Highlights - offline.
October 1998 John Hutton was Parliamentary Under-Secretary of State for Health and Social Care. He became Minister of State with responsibility for Social Care at the Department of Health in 1999. - Minister for Health in 1999 - Minister of State for Health in June 2001. -
3.11/1998 to 5.11.1998 Mind Conference in Brighton with the theme "An Effective Approach to Mental Health". Mind wanted "participants to share knowledge about delivering user-friendly" services, and ran a major consultation on what and who should be in the programme.
The ministerial speaker was John Hutton: "Remember the infamous John Hutton speech "we will not tolerate a culture of non-compliance" [with medication] (Louise Pembroke). "I walked along the seafront and arrived just after Hutton had spoken to find lots of anger in the air. The rumour was that he had just been appointed as a junior health minister and was completely out of his depth just reading his script and apparently expecting most people present to agree with him." (Thurstine Basset) "Well he got a surprise didn't he! The outraged response from the audience was reported in the Argus the following day" (Louise Pembroke). [Email discussion 10.12.2009] See Beehive report relative to Mind Conference.
Modernising Mental Health Services. Safe, sound and supportive
8.12.1998 Strategy Launched To Modernise Mental Health Services (Press release) - Second of two press releases alleging that care in the community has failed.
News from 1999
The Testimonies Project
As the old asylum based hospitals were replaced with different models of treatment, there was concern that the stories of those who had spent time there would be forgotten. Between 1999 and 2004 a group of interviewers from a range of backgrounds went across England and Wales to record first hand accounts from individuals who had experienced life in such institutions. Testimony - Inside Stories of Menta Health Care gives you online access to video clips and transcripts of the interviews.
See Press Release 22.11.2000
Outside the walls of the asylum : the history of care in the community, 1750-2000
Saturday 19.6.1999 I started this webpage
3.7.1999 British Medical Journal Outcome of long stay psychiatric patients resettled in the community: prospective cohort study by Noam Trieman, Julian Leff, and Gyles Glover.
17.7.1999 Richardson Report (to Ministers). Published November 1999 as "Department of Health.Review of the Mental Health Act 1983. Report of the expert committee. London: DoH, 1999") (external link to download)
5.9.1999 to 10.9.1999 World Federation for Mental Health congress held Santiago, Chile, with the theme "Interfaces in Mental Health: Poverty, Quality of Life and Society".
23.9.1999: Audit Commission published Children in Mind: Child and Adolescent Mental Health Services
30.9.1999 National Service Framework for Mental Health: Modern Standards and Service Models Department of Health (1999) London: The Stationery Office.
See earlier framework for Scotland
See closure index
A written answer originally given on 17.7.1997, but updated 16.11.1999 by Secretary of State, Alan Milburn, identified hospitals listed as having recently been, or currently, the subject of consultation which could lead to the full closure. The psychiatric hospitals on this list included: Fulbourn , Goodmayes, Horton, Napsbury, Runwell, Shenley, Warley, Belmont, St. Andrew's, St. Mary's, Winterton Hospitals, All Saints, Ida Darwin, Sundridge Hospital, Highcroft, Monyhull, St. Edward's, Stallington,
November/December 1999 "Current discussion is almost entirely preoccupied with service users as dangerous, murderous and threatening. Mental health service users have to change this." (Peter Beresford)
2000 Representation of the People Act
Henry Rollins' article "Psychiatry at 2000 - a Bird's Eye View
Community Care in the Making: A History of the Mental After Care Association 1879-2000
January 2000: Audit Commission published Forget Me Not: Mental Health Services for Older People
13.1.2000 Convention on the International Protection of Adults signed at the Hague. (external link)
Spring 2000: Rossbret (hosted by Rootsweb) workhouse and hospitals (including asylums) mailing list established. (archives). Supported by people engaged in family history, the list and its website reflect a major change in social attitudes from the days when a relative in an asylum was a closely guarded secret. More social history links
24.5.2000 John Hutton on non-compliance with psychiatric medication.
1.6.2000 Press Release: Mental Health Czar begins the process of Reform for Mental Health Services (archive) National Clinical Directors Louis Appleby
22.11.2000 Press release: "Survivors Add New Voices to Dark Chapter in Medical History" - [Our archive]
Valuing People: A New Strategy for Learning Disability for the 21st Century Department of Health March 2001. The first white paper for people with learning disability since Better Services for the Mentally Handicapped in June 1971.
It says we should all be citizens with legal and civil rights.
It supports independence.
It supports having more choice.
It supports being included.
Archive weblink to orginal -
Current link to read your own copy
Image and reality
The Social Care Institute for Excellence (SCIE) was established by the United Kingdom Government in 2001 to improve social care services for adults and children. - website - See February 2007
The National Schizophrenia Association's Self-Management Project was set up in 2001 - Also called its Recovery Project
About May 2001 New, purpose built and clinically designed, mental health unit, Sevenacres, opened at Newport on the Isle of Wight.
October 2001 Launch of "Well?" The Scottish Executive's National Programme for Improving the Mental Health and Well-Being of Scotland's Population. See Well? on the web
22.7.2001 World Federation for Mental Health congress held Vancouver, Canada, with the theme "Respecting Diversity in Mental Health in a Changing World" - Mad Pride march
Between February 2001 and March 2002 Gary McKinnon is alleged to have hacked into USA miltray (and other) computers. McKinnon has been diagnosed as suffering from an "autism spectrum disorder compounded with clinical depression". (Wikipedia)
Valuing People with Profound and Multiple Learning Disabilites
January 2002 Jeremy Jones of Norwich began his website - See also 1902 Medical Dictionary and 1962 history of mental hospitals
20.2.2002 Sue Lou began her journal
Geraldine Bedell, The Observer Sunday 7.4.2002:
"Today, fewer than 20 of the original 120 Victorian asylums remain"
See closure index
18.6.2002 The Early Years of the National Schizophrenia Fellowship published by Rethink. website - offline - Produced by The History Group: President: Cecil Kavanagh - Chair: Jenny Fisher - Group members: Nicholas Lines - Joy Major - David Morphet - Dorothy Silberston - Philip Wilmot - Editor: John Wing
25.6.2002: House of Commons Mental Health Debate
Liam Fox on Conservative reforms since Lord Ashley
David Hinchliffe: Community Care has not failed
25.6.2002 Draft Mental Healh Bill (England) published.
Link to archive of Parliamentary reports 24.7.2002 to 14.10.2003
Mind archive from 22.6.2003
June 2002 National Institute for Mental Health in England (NIMHE) launched. "To improve the quality of life of anyone with a mental health problem." Part of Care Services Improvement Partnership. - See Experts by Experience April 2002 - Mental Health Research Network 2003 - Making a Real Difference 2005 - A website archive started 10.8.2006. Making a Real Difference 2006 - The National Institute for Mental Health in England was succeded by the The National Mental Health Development Unit in April 2009 - website
October 2002 The 'see me' campaign launched to challenge stigma and discrimination around mental ill-health in Scotland
Victoria Helen Smith's website was online from October 2002 to March 2004
23.10.2002 Mental Health Alliance lobby of UK Parliament - Press Release
27.11.2002 Ceremonial blowing up of the water tower of Bexley Hospital. The plunger on the explosives was pressed by Linda Noyes, who trained as a nurse at Bexley Hospital. Click on the picture for partial archive of news release. Click here for a poem that Debbie Mayes wrote (22.12.1998) about being a patient in Bexley.
"Executives have taken over the asylum: the fate of 71 psychiatric hospitals" by Robert Chaplin and Steve Peters, Psychiatric Bulletin 2003 analyses a sample of pre 1961 hospitals (closed and open) and shows that a large percentage of those preserved have been converted to luxury housing
Adult Mental Health Services: A National Service Framework for Wales Welsh Assembly Government (2002) Cardiff: The Stationery Office.
See earlier framework for Scotland
Fourteen collaborative art projects took place in hospitals across Edinburgh and the Lothians between 2003 and 2005. A creative and colourful report on all of them was published in 2005 as Extraordinary Everyday - Explorations in Collaborative Art in Healthcare
2003: Last year of the Community Health Councils.
Long live the Campaign for Health Concerns!
January 2003: Patient and Public Involvement Forums set up. These include ones for mental health, such as the one for East London and City Mental Health
January 2003 Making Things Happen Better, the first annual report of the Learning Disability Task Force will be available online soon (we hope!). It is available free by phoning 0808 8081111 and you can read a Guardian Review online
January? 2003 Start of Mental Health Research Network set up by the National Institute for Mental Health in England (NIMHE). The earliest international archive of the website is 8.12.2003. There is an archive on this site of the earliest text archived. Service User Research Group England (SURGE) was its service user arm. The UK Mental Health Research Network is said to have been set up in 2004 - building on the above network. Also see October 2005 UK Mental Health Research Network launched (See NHS Archive) - current website
21.2.2003 to 26.2.2003 World Federation for Mental Health congress held in Melbourne, Australia, with the theme "Partnerships in Health" (external link to website
1.3.2003 Launch of the Mental Health in Higher Education website. 10.6.2003 archive - 23.10.2005 archive - Report of activity 2003-2004 - offline -
Spring 2003: First publication of The Naked Bird Watcher by Suzy Johnston. The second and updated edition (ISBN 0954809203) was published in August 2004 by The Cairn.
"The sanity birds glided seamlessly through my dream... Then one bird fell. Screaming it dropped from the clouds... Then another. And another, until the screaming was unbearable and even the clouds hurried to leave."
meanwhile - Jean walks on eggshells
May 2003 Start of three year Royal College of Psychiatrists study investigating the community lives of people who previously lived in a mental hospital. The "Living Project" will explore the social environment which replaced the fixed structures of a closed psychiatric hospital, investigating the problems ex-patients may experience, such as poverty and social exclusion. It hopes to provide a better understanding of the everyday lives of people with serious mental illness who live in the community
On Sunday 4.5.2003 Gordon Tozer took a break from his work on the world of asylums to photograph what is left of Coney Hill Mental Hospital in Gloucestershire
Click on the ruin to see Coney Hill as it was
Gloucestershire Primary Mental Health is part of the structure of community care that has replaced the asylum.
July 2003 Consumers in NHS Research changed its name to "INVOLVE - promoting public involvement in NHS, public health and social care research". Members of the group in January 2009 include - Peter Beresford - Alison Faulkner and Mary Nettle
Annette Crawford elected vice chair of Mencap's national assembly
Commission for Equality and Human Rights to replace Disability Rights Commission, Commission for Racial Equality and Equal Opportunities Commission. (Mind's response)
10.12.2003 Placed Amongst Strangers The Mental Health Act Commission's Tenth Biennial Report. The Guardian report compares the Mental Health Act Commission to the Lunacy Commission. Visit the commission's website. The report takes its name from a passage from John Perceval
"Instead of my understanding being addressed and enlightened, and my path being made as clear and plain as possible, in consideration of my confusion, I was ... placed amongst strangers, without introduction, explanation or exhortation..." John Perceval (1840) A Narrative of the Treatment Experienced by a Gentleman, During a State of Mental Derangement
Promoting Mental Health: Strategy and Action Plan 2003-2008 Department of Health Social Services and Public Safety (DHSSPS) (2003) Belfast: The Stationery Office.
See earlier framework for Scotland
The British Sociological Association's Medical Sociology Group established a Sociology of Mental Health Study Group in 2004
16.1.2004 Draft Comprehensive and Integral International Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities
January 2004 Debate on Attention Deficit Hyperactivity Disorder (ADHD). Is it best considered as a cultural construct or a genetic disease? (Psychiatric Bulletin)
2.2.2004 BBC One Inside Out story alleges psychiatric patients "absconding" in large numbers. Make sure you read the Readers' Comments.
May 2004 Mencap launches Ask Mencap website.
14.6.2004 Results of Mencap's Breaking Point consultation published
22.6.2004 The Guardian corrects itself for saying "the elderly and disabled" and announces that "This week is learning disability week".
Andrew Roberts finished his thirty-one year thesis on the Victorian Lunacy Commission
August 2004 Film Afterlife stars Paula Sage whose "possible film roles" are "limited by her Down's Syndrome". "Paula is also competing in the 2005 Special Olympics in Netball"
14.9.2004 Rethink put Winston Churchill in a straitjacket to protest against the public stigma on severe mental illness. In 1910 Churchill urged sterilisation so that "the sources from which the stream of madness is fed should be cut off". The point of the straitjacket campaign, however, was that Churchill suffered from severe depression and Rethink thought Britain would have suffered if he had been prevented from running the country during the second world war.
Late 2004 Scottish Recovery Network formally launched as an initiative within The National Programme for Improving Mental Health and Wellbeing - website - See April May 2005 - See recovery movement
January 2005 Mad Mary Lamb: Lunacy and Murder in Literary London by Susan Tyler Hitchcock will be published. This is a biographical companion to the writings of a madhouse patient who, having murdered her mother, was released to the community and became story teller and poet to generations of children.
January 2005 When Jean Johnson's daughter, Suzy, had a mental breakdown at university she insisted on carrying on and succeeded in graduating. Then came another breakdown, even more devastating, and Jean had the fight of her life to understand what was happening to the daughter she loved. In To Walk on Eggshells, Jean shares what she discovered. Suzy has already told her story.
January 2005 National Institute for Mental Health in England issued its Guiding Statement on Recovery - (See recovery movement)
25.1.2005 First internet archive of Mental Health Act Commission website.
February 2005 Edward Shorter A Historical Dictionary of Psychiatry published by Oxford University Press.
April 2005 Centre of Excellence in Interdisciplinary Mental Health at Birmingham University began to recruit staff. The official launch was after a purpose designed building was completed.
7.4.2005 Royal Assent to the English Mental Capacity Act 2005
21.4.2005: Survivors' history People met in London to create a history and archive of mental health users/survivors
19.7.2005: Together - the relaunch of MACA
July 2005 Hackney Action on Learning Difficulty, founded 1982 held its last monthly meeting - We ran out of money - Click here to see if we survive
26.8.2005: Person-centred planning leads to improved life experiences for people with learning disabilities, though not all, says new report - archive
On 1.9.2005 it was the Manic Depressive Fellowship. On 3.9.2005 it was MDF The Bipolar Organisation. (Internet archive)
28.9.2005: first ever national survey about the lives of people with learning difficulties - partial archive
4.9.2005 to 8.9.2005 World Federation for Mental Health 28th congress held in Cairo, Egypt,with the theme "Equity and Mental Health".
The Equalities Bill, going through the UK Parliament, would establish a "Commission for Equality and Human Rights" in place of the Equal Opportunities Commission, The Commission for Racial Equality and the Disability Rights Commission
"Our society is based on the belief that everyone has a contribution to make and has the right to control their own lives. This value drives our society and will also drive the way in which we provide social care. This is a vision for all adults. It includes older people and younger adults who need care and support, people who are frail, people with a disability or mental health problems..."
"Services should ... support independence, not dependence and allow everyone to enjoy a good quality of life, including the ability to contribute fully to our communities. They should treat people with respect and dignity and support them in overcoming barriers to inclusion. They should be tailored to the religious, cultural and ethnic needs of individuals. They should focus on positive outcomes and well-being, and work proactively to include the most disadvantaged groups."
Our health, our care, our say: a new direction for community services Presented to Parliament by the Secretary of State for Health... January 2006
Spring 2006 Asylum to Action Paddington Day Hospital , Therapeutic Communities and Beyond by Helen Spandler. See also the MPU website.
23.3.2006 UK Government Press Release: New shorter Bill to amend existing Mental Health Act (Press Release DH_4132068) -
Thursday 13.4.2006 Survivor's Poetry launched the full volume of David Kessel's Collected Poems (1970-2006 "O the Windows of the Bookshop Must be Broken" with emotional readings, by David himself, at the Poetry Cafe. Also launched: Lee Wilson: You've got an eyelash and readings from Dino Campana - Selected Works by the translator Christina Viti.
Thursday 29.6.2006: Irish Mental Health Coalition (IMHC) launched its manifesto in Buswell's Hotel, Dublin. The coalition aims to campaign for the improvement and prioritisation of mental health services in Ireland. The organisers of the campaign are Amnesty International, Bodywhys - The Eating Disorders Association of Ireland, GROW in Ireland, The Irish Advocacy Network and Schizophrenia Ireland. "For the first time, Irish organisations are formally uniting with the aim of harnessing the support of all stakeholders to campaign for improvement in mental health services".
4.10.2006 Official launch of the Centre of Excellence in Interdisciplinary Mental Health at Birmingham University. launch video - A to Z of resources - See Suresearch - Glynn Rooms - International seminar - 2010 seminars.
October 2006 Survivor Arts Project established at Birmingham University. Exhibitions from January to July in 2007 - 2008 (see video) - and 2009 (see video). - online
It is not an asylum water-tower - It is the clock-tower at the University of Birmingham.
See closure index
8.11.2006 Email from Peter Cracknell of http://www.countyasylums.com listing the county and borough asylums and public and subscription hospitals stiil open as psychiatric hospitals:
Eleven English and four Welsh that were county or borough hospitals before the inception of the National Health Service. Seven other surviving hospitals were voluntary hospitals, or otherwise not county or borough asylums, before the inception of the National Health Service. Each of these currently has in-patient facilities still using the main asylum buildings. Excluded from the list are any where the site remains only in partial use such as villas in grounds or a fraction of main complex. Two, marked red, are due to close within one year. Others, marked brown, are proposed for closure.
Goodmayes Hospital, Essex
Hellesdon Hospital, Norwich
Kingsway Hospital, Derbyshire
Runwell Hospital, Essex
St Clement's Hospital, Ipswich
St James' Hospital, Portsmouth
St Luke's Hospital, Middlesbrough
St Martin's Hospital, Canterbury
Royal Shrewsbury Hospital (Shelton)
Springfield Hospital, London
Stone House Hospital
Cefn Coed Hospital, Swansea
Glanrhyd hospital, Glamorgan
St Cadoc's hospital, Newport
Whitchurch hospital, Cardiff
Seven other English hospitals
The Bethlem Royal Hospital
The Retreat, York [Not NHS]
Bootham Park Hospital, York
Wonford House Hospital, Exeter
St Andrew's Hospital Northampton [Not NHS]
Two hospitals use approximately half or more of the asylum property to include inpatient services:
St Nicholas' Hospital (Newcastle)
St Bernard's Hospital, London
21.11.2006 Innovative Approaches in Mental Health Research Seminar at the Royal College of Psychiatrists. By clicking on the title link you can download all the soundtrack and slides. Participants included the Service User Research Enterprise (SURE) - Hester Parr on a film by LUNA - Lisa Blackman on research she was enabled to do by the Hearing Voices Network - John Curran on SPEKTRA, the Cultural Consultancy Service (See pdf factsheet on Mental Health and Ethnicity) - Peter Barham on his book Forgotten Lunatics of the Great War - Tom Craig from the Institute of Psychiatry - and Sue Estroff from the University of North Carolina. -
The Department of Health's "What's New" webpage includes details of the new Mental Health Bill.
13.12.2006 General Assembly of the United Nations adopted the Convention on the Rights of Persons with Disabilities. This came into effect on 3.5.2008, when sufficient countries had ratified it. The Convention relates back to the Charter of the United Nations and the Universal Declaration of Human Rights (1948) and subsequent conventions. - Wikipedia article
January 2007 The Fundamental Facts - The latest facts and figures on mental health produced by the Mental Health Foundation. Most of the data relates to "Britain" (England, Wales and Scotland) or to "England and Wales". It is arranged in sections: "Extent..." on how many people with different type of mental health problems - "Differences" on gender, age, ethnic group etc - "Factors related" on deprivation, family etc - "Treatment" on number of people treated and type of treatment - "Cost" including economic, health and violence.
Tuesday 20.3.2007 Social exclusion, social inequality and mental health A one-day seminar funded by the Economic and Social Research Council at The University of Manchester. By clicking on the title link you can download all the presentations.
1.4.2007 Stand to Reason launched - website - Disability Now article - 10.6.2009
Friday 30.3.2007 3rd Annual UWE Bristol, History of Health and Social Care Conference Health and Welfare in the Spaces of Confinement
22.6.2007 "Mental Health and Human Rights: Sociological Perspectives" BSA Sociology of Mental Health Study Group symposium. University of Warwick. External link to report by Lydia Lewis - Mike Carpenter's presentation on human rights
19.7.2007 Royal Assent to the 2007 Mental Health Act
"After the legislation, things went pretty quiet at the trust" Michael Howlett of the Zito Trust
19.8.2007 to 23.8.2007 World Federation for Mental Health congress held in Hong Kong, China, with the theme "East Meets West: Impact of Culture on Mental Health". website
Friday 28.9.2007 The life world and emotional wellbeing A one-day seminar funded by the Economic and Social Research Council at The University of Nottingham
1.11.2007 Interview (Coventry University) with Shelley Jofre about her Panorama investigations on psychiatric drugs, in particular the antidepressent Seroxat - external - offline
20.6.2008 A New Vision for Mental Health - leading to A Future Vision for Mental Health on 7.7.2009
Tuesday 22.7.2008 Last of the summer series of Radio Four's "All in the Mind". "The series will return in November. The presenter, Claudia Hammond is also making a series on the history of mental health care called State of Mind. If you were treated for a mental health problem in the 50s, 60s or 70s or worked in the field at that time she'd love to hear about your experiences - good or bad." (source)
July 2008 The British Journal of Psychiatry announced "Psychiatry's 200th Birthday" - an event that might otherwise have gone unnoticed. External link to issue contents - Link to 1808.
Afghanistan November 2008
State of Mind broadcasting over 5 weeks from 7.1.2009, at 9pm on Radio 4 each Wednesday. - - BBC website -
Synopsis : In any one year in the UK, one in four of us will suffer a mental health problem. Claudia Hammond explores how the treatment and understanding of mental illness has changed over the past 50 years, with the help of Radio 4 listeners who responded to an appeal for testimonies.
See Judith - Daniel and Moyna's stories
All those who were asked conceded that it's better to have a mental health problem now than at any other time in the last half century. Yet there were reservations
7.1.2009 Total institutions episode
Sound clips include Moyna Peters (patient) about Netherne Hospital, Surrey. - Patricia Hornsby Smith election broadcast - Peter Barham - Henry Rollin (Horton 1950) - Carole Thompson nurse about Rainhill in 1957
11.1.2009 - 12.1.2009 - 18.1.2009 - 19.1.2009 Committed: 11th, 12th, 18th, 19th January 2008, 7.30pm, The Finborough Theatre. Poetry by John Clare, Robert Frost, Siegfried Sassoon, Charlotte Mary Mew, Ezra Pound, Rev Charles Smart, William Cowper, Emily Dickinson, Elizabeth Bishop and others who it has been suggested were mentally ill. website
20.1.2009 Launch of Time to Change - "England's most ambitious programme to end discrimination faced by people who experience mental health problems"
February 2009 A brief history of the Mental Health Foundation [Researched (not stated) by Ed Halliwell] - See Mental Health Foundation
30.3.2009 Statement that the Zito Trust would close with effect from 31.3.2009 - offline - "Having achieved our original objectives" - "reforms" having been ... incorporated into legislation, principally the Mental Health Act 2007. extra powers to manage "safely and therapeutically" "those most at risk of harming themselves or other people" - community treatment orders - personality disorders to be included in NHS services - responsibility for individual patients given to psychologists, psychotherapists and senior nurses as well as psychiatrists to broaden the use of the range of treatments now available - improved rights for victims of mentally disordered offenders.
31.3.2009 The Mental Health Act Commission ceased to exist but the Mental Health Act Commissioners continued to function as part of the Care Quality Commission. - Care Quality Commission website
6.4.2009 BBC Radio 4: Revealing the Mind Bender General - A programme about William Sargant's use of insulin coma
5.5.2009 Launch of This is Survivor Research
14.5.2009 EastEnders' Stacey faces bipolar disorder (Press Release) - See Stacey Sectioned
1.6.2009 Launch of what became Collective Voice North West "a regional network to develop service user, carer and public engagement". - website - A conference was held in Liverpool in July 2009 - feedback video - Another in Manchester in October 2009 - feedback video -
23.7.2009 Publication of New Horizons: towards a shared vision for mental health - consultation - external - offline
14.7.2009 Shaping the Future of Care Together Green Paper published by the Department of Works and Pensions and the Department of Health (England and Wales). - external link
Shaping the Future of Care sets out government plans to get rid of Attendance Allowance and, depending on public reaction, also leaves the way clear to end the care component of Disability Living Allowance. It has prompted a campaign to "save Disability Living Allowance and Attendance Allowance". - external link
Time to Change Summer Campaign (August) Two short videos - The Movie appearing as an advertisement on popular websites - and a You Tube (etc) clip in which a "schizophrenic man terrifies kids at party".
6.8.2009 First posting on the new Mind blog - archive
17.9.2009 Westminster Health Forum Mental Health: "New Horizons" - a new strategy for mental health and well-being. "With the ten-year national service framework for mental health drawing to an end, this seminar will look at the New Horizons strategy, what the priorities should be for the next mental health framework and what steps should be taken to improve public mental health" - External link
2.9.2009 to 6.9.2009 World Federation for Mental Health congress to be held in Athens, Greece, with the theme "Working Together for Mental Health"
Thursday 3.9.2009 "Schizophrenic 'cooked victim's brain'" London Informer - "NHS failure over cannibal killer Peter Bryan" Mirror. Report on Peter Bryan's discharge from a secure unit in Newham in February 2004 and murder of his friend Brian Cherry.
Picture: Front page of London Lite - "Unbelievable he was ever thought safe" (Sub-editors precis - page 5 - of comment by Marjorie Wallace of Sane).
10.9.2009 Consultation Pandemic Influenza and the Mental Health Act 1983 - offline A consultation on temporary changes to the English Mental Health Act 1983 that might be required in the event of severe staff shortages during, and in the aftermath of, an influenza pandemic.
14.9.2009 The Sainsbury Trust has called for every NHS mental health trust to employ service users to promote recovery - (external link) - See 2005
8.10.2009 Judy Fryd, a founder of The Association of Parents of Backward Children, was commemorated on a stamp as an eminent Briton
Friday 9.10.2009 "during Eastenders tonight ... they were sectioning Stacey in front of our nation of 10 million soapwatchers" (Jill Goble) - See Stacey Press Release
Saturday 10.10.2009 The Time to Change Dance in Regents Park, London.
Making Recovery Real Roadshows in Thurso on 1.12.2009 - Oban on 24.2.2010 - Stranraer on 24.3.2010 - See brochure - offline
Scottish Recovery Network definition: "Recovery is being able to live a meaningful and satisfying life, as defined by each person, in the presence or absence of symptoms. It is about having control over and input into your own life. Each individual's recovery, like his or her experience of the mental health problems or illness, is a unique and deeply personal process." Journeys of Recovery (2006)
8.1.2010 First Association of Therapeutic Communities Research Workshop discussed quantitative research to assess therapeutic value of community treatment, and the value of qualitative research.
13.1.2010 Mind announces that the March/April issue of Openmind will be the last.
Campaign launched to save Openmind.
11.2.2010 Disability Now article "Openmind Closure fear" by Sunil Peck. Paul Farmer, Chief Executive of Mind "refused to rule out retaining Openmind in its current form".
11.2.2010 Dorothy Rowe: The Death of a Great Little Magazine
May 2010 The Chief Executive of Mind wrote to subscribers: "I am pleased to announce that the publication of Openmind will recommence in Autumn 2010. The views of our readers were highly influential in this decision". See below.
9.2.2010 Ajit Singh-Mahal (12 years old) found with fatal injuries inflicted by his mother Satpal Kaur-Singh. "Mother killed her autistic son, 12, by forcing him to drink bleach as she 'feared that social services would take him away'" (Daily Mail 16.11.2010)
Friday 19.2.2010 "Well, just to give you a clue, if someone gets murdered on TV, it often turns out to be the crazy person who dunnit...so who is the crazy person in Eastenders?" Sheila on UKsurvivors
March 2010 Relaunch of Asylum - The magazine for democratic psychiatry
19.3.2010 "A Pageant of Survivor History - Mental patients in poetry, story and song from the 18th to 21st century" - Tower Hamlets' Africans in the 18th century - Voices from the asylums - Mary Barnes and Kingsley Hall - Eric Irwin and Mental Patients Union - Frank Bangay of Campaign Against Psychiatric Oppression - Peter Campbell of Survivors Speak Out - David Kessel of Hackney Union of Mental Patients - Sophie Mirrell from Core Arts - Eamer O'Keeffe: Irish women survivors -
29.3.2010 UK Policy: "Building bridges to work: new approaches to tackling long-term worklessness" - 30.3.2010 Mind: "New benefit test will fail to spot illness and disability"
26.5.2010 UK "Coalition government sets out radical welfare reforms" - 6.6.2010 Clare Allan "Let's assess this government's cynical ruse rather than the mentally ill" (Guardian articles) - 2.7.2010 Mind blog "Welfare reform - What we are doing"
14.6.2010 Equality and Human Rights Commission calls in evidence on disability- related harassment in Britain
30.6.2010 Mike Yeoman's analysis of the advantages and dangers of celebrity culture - (Time Together June 2010). "The real danger is in mental health being trivialised. The experiences of everyday people who experience mental health issues are vastly different from those of a celebrity."
Wednesday 20.10.2010 "Comprehensive Spending Review hits the poor and spares the bankers" (Peter Beresford) - "Predictably it's 'the poor what gets the blame', while the rich are still lined up to get the pleasure".
Street Art, Curtain Road, Tower Hamlets. Art used to advertise Mad Pride Demo Tuesday 26.10.2010
Early October 2011 First issue of a Quarterly Mind Membership News replaced a number of Mind publications including Mind Link Magazine and Diverse Minds. A relaunched OpenMind promised for November. External links to OpenMind - Mind membership - MindLink - Diverse Minds
26.10.2010 Mad Pride protest at speakers corner over the spending cuts
Monday 1.11.2010 8.30 BBC 1 Panorama What Have the Drugs Done to Dad?. Panorama visited Spring Mount - a residential care home in Yorkshire that avoids relying on anti-psychotic drugs for dementia patients. They believe strongly in better staff training and coping techniques for their patients.
Tuesday 16.11.2010 6.30pm "The Death of the Asylum in Late 20th Century Britain" Speakers: Peter Barham, Baroness Elaine Murphy, David Jones and Barbara Taylor. Room G03, UCL, 26 Bedford Way, London WC1H. Admission free.
Thursday 17.2.2011 and Friday 18.2.2011 "Health Rights in Global Historical Perspective" Conference at the London School of Hygiene and Tropical Medicine. Link to call for papers.
Andrew Roberts' web Study Guide
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My referencing suggestion for this page is a bibliography entry:
Roberts, Andrew 1981-/timeline - Mental Health History Timeline <http://studymore.org.uk/mhhtim.htm>
and intext references to
(Roberts, A. 1981/timeline date).
For example: "(Roberts, A. 1981/timeline 1842)"
See ABC Referencing for general advice.
1290: King's prerogative
1436: Margery Kempe
1538 London streets
1601 Poor Law
1621 Anatomy of Melancholy
1636 Hobbes on motion and matter
1654 community care
1670 Private madhouses
1676 Moorfields' Bethlem
1690 Locke on reason and madness
1696 Bristol Poor Act
18th century asylums
1714 Vagrancy Act
1738 Cruden's escape
1746 St Patrick's, Dublin
1749 nervous vibrations
1751 Saint Luke's, London
Pennsylvania's lunatic wards
1755 Rousseau back to primitive
1774 madhouse medical inspection
1788-1789: Royal madness treated and cured
1792: all-seeing eye
1796: Mary Lamb
Gunshot and state asylums
1800 Criminal Lunatics Act
1808 County Asylums Act
1812: Prime Minister shot dead
1812: Philadelphia tranquilliser
1815 St George's Bethlem
1823: Lectures on mental diseases
1828 Home Office controls inspectors
1832 Lord Chancellor controls inspectors
1834 Poor Law
Railway and telegraph
1840s Social unrest and asylum hope
1841 Asylum statistics
1841 Asylum doctors UK
1842 National Inquiry
1843: Daniel McNaughton fails to kill Peel
1844 National Inquiry Report
Census of the insane
1844 Asylum doctors USA
1845 Ashley's Acts and the Lunacy Commission
1846 Haydock Lodge scandal
1847: tainted blood
1863 Broadmoor Criminal Lunatic Asylum
1867 Metropolitan Asylums Board
1870 St Lawrence's and Leavesden
1888 Epileptic Home
1890s Asylum despair
1898: Lebanon: Bible lands asylum
1900 Freud's dreams
1905 Wasserman's test
1910 Rampton State Institution
1913 Mental Deficiency Act and The Board of Control
1918: Chloral Hydrate effects
Between world wars: Psychoanalytic glimmers
1930: Voluntary fee-paying
1930: Bethlem Royal
1930s Moss Side State Institution
1933 Borocourt Certified Institution for Mental Defectives
1939-1945 not Shell Shock now
1940s The asylum inheritance
1946 National Health Service Act
1948 National Health Service inherits asylums
1949 Scotland pioneers open doors
1953 Mental £millions
1954 Percy Inquiry into Mental Health Law
1957 Percy Report favours community care
1959 Mental Health Act
Long acting drugs
1971 Better Services for the Mentally Handicapped
1973 mental patient's union (MPU)
1974 Park Lane Special Hospital
1975 Castles in the air
1976 Birmingham scandal
1979 Thatcher's (secret) Parkinson Report
1981 Silent Minority
1982 Little closed
1983 Mental Health Act
1986 Disabled Persons Services Act
1990 National Health and Community Care Act
1991 Survivors' Poetry
2001 Valuing People
2003 Making Things Happen Better
2005 Survivors' history
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What was life like in an asylum?
What about private asylums?
What were the forms of insanity?
Was there any medical treatment?
Mad Mary Lamb: Lunacy and Murder in Literary London by Susan Tyler Hitchcock
... a positive account of living with mental illness now
Asylum to Action -
Paddington Day Hospital , Therapeutic Communities and Beyond by Helen Spandler
Listen to Me
"a stout ring was rivetted round his neck, from which a short chain passed to a ring made to slide upwards or downwards on an upright massive iron bar... Round his body a strong iron bar about two inches wide was rivetted... which being fashioned to and enclosing each of his arms, pinioned them close to his sides.... bars... passing over his shoulders, were rivetted to the waist bar both before and behind..." (Edward Wakefield to Select Committee in 1815) An expert in insanity????? "Insanity is the scourge brought down on sinful men by the wrath of the Almighty"
(1828) anIts reduced use of restraints and confinement, and therapeutic use of occupational tasks, especially farming chores, were duplicated in scores of later institutions. influential early institution for the intelligent and humane care of the insane," 00