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.