From small acorns...

Once the Garlands Hospital was opened in 1862, it quickly became apparent that cases of insanity were more widespread than originally thought. 

The lunatic asylums began to defeat their own purposes as they grew larger, for staff could not give individual attention to the inmates, but even in these overcrowded institutions the standards of comfort were higher than in the homes of the poor. (M. A. Crowther The Workhouse System London 1981, p. 66) In 1827 9 county asylums held an average of 116 patients each, but by 1910 91 county asylums held an average of 1072 patients each. (K. Jones Mental Health & Social Policy 1845-1959 London, 1960, p. 210)

I should probably note that the Garlands hospital did not just receive pauper patients at the cost of each parish they belonged to, when the space permitted, private patients were also admitted, at a higher rate, from 1869.

Due to overcrowding, subsequent extensions to the Garlands Hospital had to be made in 1866, 1868, 1882, 1883 and 1906. Much of the extension work was carried out by the male patients, with the females making the interior furnishings and textiles. (Garlands Hospital Carlisle in a pamphlet written for the opening of the new Garlands clinic on the same site, 21 June 1862, B/CAR/362.11, Carlisle Library)

Several explanations were offered as to the reason for the unexpected rapid increase of patients. One such explanation was made in the 1876 annual report by Dr Campbell - the medical superintendent of the asylum at the time. Campbell stated that: 

"I firmly believe that if the patients were as comfortably kept in the Irish district asylums...the asylums on the west coast of England would not require such frequent enlargements."

Here, he is referring to the large number of Irish migrant workers that came to cumbria in the post-famine era and ended up depending on the English Poor Law system. This was a nationwide problem, particularly in those areas nearest the ports in which the Irish workers arrived. Throughout the records of the Garlands Hospital, the 'problem' of Irish patients is a recurring one, and one which I shall visit in more detail in a following post.

In the face of rising alarm at the increase of inmates in the Garlands Hospital Dr Campbell attempted to reassure the Board of Guardians - a body of overseers in charge of inspecting English asylums to ensure they were being run effectively & looking after their patients correctly - as to why this was the case. In the 1875 annual report, Dr Campbell stated that:

"there has not been a marked increase of admission of the three most incurable types of insanity, but that the admission of patients whose age prevents recovery, or probably is the cause of their disease, has markedly increased during the last three years."

As mentioned above, the problem of overcrowding and the rapid increase of cases of insanity was a nationwide one. Several commentators of the time attributed this to the industrialisation of Victorian Britain, which had brought about increased mechanisation, displacing labourers - particularly among the agricultural classes - thus placing greater stress on them as they attempted to survive in this rapidly changing society.

On the other hand, other contemporaries argued that there was no marked increase in insanity, it was just that now the lunatic population of England was being properly accounted for. In other words, before the creation of the county asylums network, there was no central system which was registering/recording the number of mentally ill accordingly, so the statistics from that time were serious miscalculations and should be treated with caution. They also believed that with the change in attitudes towards the asylum as an institution, whereby people now viewed it as a place that offered the correct care for the mentally ill, rather than maltreating them, families were much more willing to admit their relatives when they became particularly difficult to deal with.

However, by 1902 the problem of overcrowding had still not been solved and pressure on the Garlands Hospital was growing.  The medical superintendent, Dr Farquharson, wrote a ten page pamphlet to the lunacy committee outlining the current problems he was facing. He began by stating that no extension of the asylum had been made since 1883, despite the patient numbers increasing from 495 at the end of 1884, to 604 on 31 March 1902. He also included the daily average number of patients, which had risen as high as 688, due to the growing number of private patients being admitted to the asylum. He argues his case for a new extension by admitting that due to the high volume of patients, separating the curable and chronic patients is impossible, which is affecting the rate of recovery and the level of care which the attendants are able to deliver. (W. F. Farquharson, 'A Memorandum on the Increasing Pressure on the Accommodation at Garlands Asylum' Carlisle, 28 April 1902, DHOD/11/102) Despite his plea, the extension was not completed until 1906.

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylums history as it is one currently unwritten.

Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.

A Late Starter...

The Cumberland and Westmorland Joint Lunatic Asylum - from here on in will be referred to it's more commonly used name, the Garlands Hospital - opened on 2 January 1862 with accommodation for 200 patients. Although Garlands was built in the height of the Victorian lunatic asylum era, it was one of the last County institutions to be constructed. 

Original legislation stipulating that every county in England should construct a lunatic asylum was passed in 1808. The 1808 County Asylums Act was passed specifically 'for the better care and maintenance of lunatics, being paupers or criminals in England'.  Although the Act laid the basis for the English county asylum network, it had a very limited impact, with only 8 counties building an asylum by 1825. (L. D. Smith, 'Cure, Comfort and Safe Custody': Public Lunatic Asylums in Early Nineteenth Century England London, 1999, p. 24)

It was not until 1845 that further legislation was introduced to make it a necessity for every county in England and Wales to build a lunatic asylum for their pauper population. More counties now complied, as the pressure from above increased, and as the pressure upon their existing institutions also increased. As mentioned above, Cumberland and Westmorland's institution - it should be noted that the two counties received assent that they could open a joint institution, for which each county would be charged separately for its patients, but housed in the same asylum - did not open it's doors until 1862, thus making it one of the last areas to do so. The delay in creating such an institution was down to finance. The local government board was responsible for finding the funds necessary for purchasing a suitable site and building the new asylum. In total, the building of the Garlands Hospital cost £32 043 7s 4d, around £1.4 million in today's money.

In the decades before the creation of the Garlands Hospital, the insane of Cumberland and Westmorland were either housed in the workhouses of the two counties, or sent to Dunston Lodge private asylum which was just outside of Gateshead. Of the initial 186 patients sent to Garlands upon its opening, 146 were sent directly from Dunston Lodge. One of the reasons why the building of a county asylum in Cumberland and Westmorland could no longer be delayed was that the agreement with Dunston Lodge was coming to an end, and the problem of where to treat their pauper lunatics had to be solved.

Before the 1845 County asylums act, the English lunatic asylum was regarded as a place of horror, degradation and destitution. It was only used as a last resort, to lock away the insane population to protect them from harming the public, regardless of the threat they posed to themselves. However, the expansion of the county asylum network, together with the advances in psychiatric medicine led to an approach of moral treatment in the latter half of the nineteenth century. No longer were patients shackled to beds, violently treated and regarded as animals, now a healthy diet, exercise, employment in work and therapy became the normal practice.

Therefore, the Garlands Asylum, as many others of its era, was not a place of incarceration to be regarded with horror. It was one of many in the country built specifically for a programme of moral treatment, by pioneering doctors of the age. It was a place the mentally unstable came for serenity, a proper routine and a degree of care they could not get elsewhere. The change in attitude towards the asylum was no more apparent than by the admission records. Originally built to accommodate 200 patients, by 1909 the hospital had expanded to the extent that it now housed 846 patients.  Some historians have viewed this as a great increase in the number of insane persons, I, however view this as an altered view of the asylum by the public. Thus, because the asylum now treated it's patients humanely and had an excellent recovery rate of non-chronic cases, families were more willing to admit their relatives than they would've done when the asylum held the horrific reputation of the past century.

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylums history as it is one currently unwritten.

Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.