The history of the British Lunatic Asylum
Entering the Asylum
Each patient that was admitted to an asylum underwent and examination before they were certified; people were admitted for a number of reasons. Such cases were Stress, Trauma and child bearing (Post-natal Depression); other cases were less obvious, such as eccentricity. Finally, some cases were for disorders that we know do not consider to be a Mental Health problem, such as Epilepsy. Under the laws of certification that were present in the Mental Health laws from 1890 until 1959, the process was an irretrievable one and was not easy to get out of. If a patient did become released from an Asylum, the image attached to them was very difficult to remove and a normal life was hard to live. To become admitted into an Asylum often meant that the patient would be incarcerated for years to come; even if they had become certified for a minor psychological reason. However, If a patient was to escape and hide for a total of fourteen days they were considered, by law, to be free.
Once there, each patient was assessed upon their admittance through administration and housed in an admissions ward; they were then assigned to a ward bed (male or female blocks depending). Liable patients were assigned to a confinement cell. Padded cells were only used in extreme cases of violence or suicide attempts. The male and female wards differed vastly; in general, the male and females led very separate lives. The longer a patient stayed in an asylum, the less chance they had of release; there are a number of reports of patients being admitted in their twenties and staying there until their death many years later.
The Females
According to case notes, most women came in for short periods only simply to recover from the stress and exhaustion of their domestic lives - once rested and relaxed they were sent on their way. Women were also admitted from problematic marriages or as a result of giving birth to illegitimate children - even if a result of rape. Post natal depression was also a common reason for a women admittance.
The females wards differed vastly from the male wards; they were based around Victorian ideals of femininity with little opportunity for them to go outside and even fewer opportunities to play games. It was only later that this changed. As with the tradition at the time the women's activities were confined to the indoors, which led to a strong bond being formed between both female patients and staff. The women were put to work throughout the asylum, mainly undertaking jobs in the needle room, the laundry and general housekeeping duties around the ward - the latter was kept for problematic patients.
The daily routine of the ward remained unchanged for many many years,
patients would rise at 7am for breakfast which would consist of coffee, tea or
cocoa with porridge and bread as the main. After breakfast the 'good'
patients would have been taken to there respective jobs in the laundry or needle
room - the others would have waited around until the airing courts were opened
later in the morning. Lunch would have been served at around 12:30 and
would have consisted of food produced on the local farm; this was the main meal
of the day. The airing courts were then opened up again in the middle of
the afternoon for just over an hour. Tea was served in the early evening
and was known to consist of bread and cake. Due to staff shortages on the
female side of the hospitals, nurses were known to have dosed the patients with paradehyde in the evenings to ease the load.
The Males
The majority of male patients within the asylum system before the second world war were often poor and without spouses to look after them. After WWI 'Shell Shock' was a prevalent condition among men admitted to the Asylums; at the time of this condition being introduced it cause controversy due to the condition being similar to the female psychosis. Alcoholism and the delusion insanity related with it were also common reasons for certification. Unlike the female sides of the asylums, the male sides were smaller in numbers. Escape was more common with male patients than females; but due to the smaller numbers of males in some hospitals it was noted that they had a more stable time within the ward.
The males wards had the same daily schedule as the female wards and instead of being involved with the laundry and needle rooms, they worked the kitchen and the bakehouse. They were also involved in the daily housekeeping of the wards. Other than the difference in activities the male wards were normally run with a stricter discipline; which most of the patients would have been used to given their backgrounds within the military. The male population of the Asylums received a wider range of activities for their recovery; they were allowed to join sports teams and the hospital band (if there was one); there were also inter-hospital leagues fort hem to compete in. Rational patients were also employed on working the farms and the upkeep of the grounds and gardens; they were also employed in various workshops and engineering practices. One such example is an account from Severalls that states that the male patients were used to lay 2-inch piping to the cricket ground and build a band stand.
The other difference between the male population and the female population was that there tended to be more violence between the male patients; this was due to the size of the patients and their close proximity. Violent patients were controlled in a number of ways, they were either restrained by a mechanical aid, placed in an isolation cell and when the drugs became available they were put under sedation.
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