In
line with Time to Change’s ‘Time to Talk’ day on 1 February, I would like to
reflect on the stigma of mental illness in the nineteenth century, as a way of
highlighting how far we have come, and how important it is that we conduct open
and honest conversations about the topic, in order to end mental health
discrimination.
It
is clear from previous posts that the way in which those suffering from mental
illness in the nineteenth century were considered, was a far cry from how we
consider sufferers now. For a start, incarcerating individuals in an asylum
that was built on the outskirts of Carlisle, far from the main population (it
was described in an article in the Carlisle
Journal in 1898 as a ‘little segregated colony’), is an indication that it
was something to be treated in a sealed environment. The terms used to classify
those in an asylum seem somewhat insensitive and discriminative to the modern
eye - ‘lunatic’, ‘imbecile’, ‘idiot’, ‘feeble-minded’ – and the way in which
patients were described in the case notes was in a much less than sensitive
manner. In addition, friends and relatives on the outside could also be
affected by the stigma of being associated with sufferers of mental illness.
After
the 1845 County Asylums Act, every county and borough in England and Wales had
to provide an asylum to accommodate pauper patients. Increasingly after this
date, families became more willing to admit their relatives to these
institutions that offered specialist care, and an increased risk of recovery.
Despite this, a stigma remained attached to those suffering from mental
illness, and the medical superintendents of Garlands in the later nineteenth
century continued to state the need for relatives to admit their loved ones at
as early a stage as possible in order for a greater chance of recovery. This
was reinforced in the 1885 annual report by Dr Campbell:
A mistaken
kindness on the part of their relatives allows them to exhaust all the questionable
benefits of home treatment often without recourse to special knowledge of the
disease, and only when home treatment is found worse than unavailing is the
patient sent to an asylum.
However,
not all families could be so ‘kind’. Dr Clouston recalled one case that came to
Garlands in 1871:
One young woman
was sent here in a deplorable state of filth and neglect, who had been for
years allowed to remain in a state of nudity in her father’s house, occupying
the same sitting apartment as the rest of the family, scorching herself at the
fire, looked after chiefly by a brother, nearly grown up; and all this in the
middle of a town of considerable size.
Therefore,
despite the availability of specialist care in the Garlands Asylum, families
were held back by the stigma attached to admitting that a relative was
suffering with a mental condition.
One
particular example I have come across in my PhD research of the Garlands
nineteenth century patients, highlights this stigma. Isabella Y, aged 33 from Carlisle,
was admitted in November 1896 suffering from mania. The event that led to her
committal was the death of her husband, William. Her case notes stated: ‘Her husband is said to have locked her up
in a room and not to have let her outside for years; he was found dead at his
home yesterday, he was an old man about 70 years of age.’ Her physical
state on admission indicated that she had been kept indoors for some years, as
she was described as pale, emaciated, filthy, and in a generally poor
condition.
The
fact that Garlands had been open since 1862, less than 5 miles from where they
lived, meant that specialist care was readily available within a short
distance. This then leads us to believe that the stigma of having a wife
suffering from a severe mental illness was so prominent, as he saw it necessary
to conceal her from the outside world for such a long period. The additional
consideration of the large age gap between the two can also be quite telling.
Looking back at census material and marriage certificates, I cannot find much
about the pair. The only document I can find is the 1891 census which lists
them both living in Botcherby, Carlisle, as man and wife. Isabella is not
listed as having any mental condition, so no indication of her illness has given
to the outside world (on her Garlands admission she was stated as being
mentally unwell since 1886). Consultations with family historians have led me
to understand that such large age gaps in this period were not very common.
Mostly they would occur when an older man would agree to marry his friend’s
daughter, in the event of his death, in order to look after her, and guarantee
her financial security. On Isabella’s case notes her next of kin is listed as a
second cousin, indicating that she had no nearby close relatives. This may have
been because her family was originally from overseas. Her entry on the 1891
census gives her place of birth as Brooklyn, USA. Whether this was true or not,
I have not been able to verify through other documents. William’s will listed
him as a gentleman, and his effects were left to Isabella’s second cousin in
Carlisle. Any records stretching further back I have been
unable to trace.
Whatever
the explanation for Isabella’s incarceration at home, it is apparent that William
was so concerned about the stigma of her mental illness, that he took drastic
measures to conceal it.
This
case, along with many others I have come across, indicates the stigma attached
to the association with those suffering from mental illness that was so
dominant in the Victorian period. Although this progressively eased throughout
the twentieth century, people still feel unable and uncomfortable with speaking
about mental health to the present day. I hope that by looking back at such
cases we can see how far we have come, and use this as a platform to encourage
the discussion around mental health, to see what still needs to be done. For
further information about ‘Time to Talk’ follow the links below, and start the
conversation.
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