To
coincide with World Mental Health Day, and as the focus this year is on the
wellbeing of children and young people, this post examines some of those
admitted to Garlands under 14 in the late nineteenth and early twentieth
centuries. What is written here is an extension of the research I have already
undertaken for my PhD, and something I wish to explore further in the future. From
the beginning, the Garlands annual reports stated that it was not an
institution for children. As I did more research, more children kept emerging
from the records, and through this post I want to share some snippets of their
stories. When beginning to look at the case notes of these patients, although intended
to be clinical documents, the emotions acting upon them and their families in
seeking institutional committal, is immediately clear.
‘Insanity’
in this period was the catch-all, legal term that referred to mental health
conditions and disabilities. ‘Lunacy’ was the umbrella term for conditions
regarded as temporary, and curable. These included illnesses such as mania and
melancholia. ‘Idiocy’ and ‘Imbecility’ were the terms used to denote chronic,
life-long conditions. These would be understood today as mental or learning
disabilities, which were present from birth. It is these terms which feature
most prominently in the children who will be explored in this post.
Using
the admission registers for the period 1862-1914, the number of children 14 and
under admitted only stood at 0.5% - 38 children. The mere presence of these
patients is fascinating in itself, as it was constantly reiterated that this
was an adult institution. For instance in 1883, the superintendent noted: ‘An imbecile child of eight years…was sent
here and appeared to me so unsuitable for treatment in this institution…He was
afterwards removed by his parent. Lunatic asylums are not proper places for the
treatment of imbeciles of tender years’.
This
was not uncommon, as the asylums constructed in response to the 1845 Lunacy Act
were given no age restrictions for the patients they were built to treat. As a
result, children can be found in the admission records of institutions which
were only equipped to deal with adult patients. Specialist provision, in the
form of idiot and imbecile asylums, began to be erected after the county
institutions, but often these were not as great in number, and as was the case
for Cumbria, were situated some distance away, and had to cater for a larger
population – leading to a demand on their resources. For instance, the nearest
to Garlands, the Royal Albert Asylum for Idiots was built to provide specialist
provision for children classed as idiots and imbeciles in Lancaster in 1870. It
was also known as the Northern Counties Idiot Asylum, as it was intended to
cater for such patients from Lancashire, Cumberland, Westmorland, Durham and
Northumberland. As such, the cases in the sample should have been sent there to
receive care, and some did, but this was not always true.
In
the first instance, the response was to board the child out to local workhouse
wards, but if patients were displaying violent behaviour, they were reluctant
to receive them. Alternatively, if the case was that the child’s family could
not cope with their illness, and it was clear that they could not be ‘cured’,
then a more suitable place would be sought. For instance, Christopher G, aged
11, was brought to Garlands in October 1890 suffering with ‘epileptic
imbecility’, his father stated in his admission documents that he was
‘difficult to manage’ due to his violent outbursts. When examining Christopher,
the doctors recorded: ‘At present crying
and saying he wants to go home’. These emotions demonstrate the attachment
to his family, and show how difficult it must’ve been for them to make the
decision to admit him to Garlands.
Christopher
was only in Garlands for one week before the superintendent recorded in his
notes: ‘…So far has behaved well, and
from his tender years he appears to me a very unsuitable case to be associated
with adult lunatics. He might have done outside boarded with someone who had no
young children…’ And that is what happened. Three weeks later he was
discharged from the asylum and was boarded out to a child-less couple in
Kendal. However, when he turned 17, in 1897, he was readmitted to Garlands,
where he remained until his death two years later.
For
the children who remained in Garlands, they would stay in adult wards, and
would be placed under the care of fellow patients. Asylums of this era believed
in morally treating patients, and useful employment was a major part of this.
Therefore, caring for children was a form of employment, and was utilised to
keep patients occupied and diverted from their conditions.
One
instance is the youngest patient to be admitted, Richard B, aged 4, who was brought
from Cockermouth Workhouse in 1862. He was noted from the outset as being an
unsuitable case for the asylum. He was noted as causing a ‘great deal of
trouble’ as he ‘takes up the entire time almost of one nurse’ – usually one
nurse would be responsible for up to 14 patients. He was put in the care of
Elizabeth R, a 29 year old female. From her case notes, it doesn’t look as
though she cared for Richard for a prolonged period, and when children got
slightly older, for males, they were removed to the male adult wards.
A
couple more cases have shown that when in adult wards, children could form
bonds, particularly of a parental nature, with other patients. For instance,
Thomas F, aged 10, was noted shortly after admission: ‘Calls one of the other patients Daddy and goes about with him as if he
was his father’. This could also work the other way, as in the case notes
of Robert B, a 9 year old admitted in 1862, it was stated that: ‘James M, another patient, has taken the
delusion that the boy is his and consequently takes great care of him’.
As
mentioned, the Royal Albert Asylum for Idiots was an important consideration
for the asylum doctors when planning on what care was best for children. But,
only 26% of the children who came to Garlands were either sent there, or
arrived having spent time there. It wasn’t a definite that Royal Albert would
accept all cases, as it catered for 5 counties, and in the 1880s could
accommodate around 500 patients. From the outset it was intended to be training
centre. If patients did not show the slightest chance of improvement, or
ability to be trained in a certain area, they would not be sent there.
A
report on ‘How Imbeciles Are Educated’ from 1884, stated that the ‘primary object of the place is to make it a
school for the education of the dormant faculties of imbecile children; they
are admitted between the ages of six and fifteen, for a term of seven years. It
is not a life refuge…the education of these children is, therefore the special
object set before them by the staff of the institution. To discover, to draw
out, and to develop any faculty possessed by their defective intellects is the
great aim of all persons employed’.[i]
There
are instances of children arriving at Garlands having been removed from Royal
Albert due to their behaviour or lack of improvement. For example, Edith P,
aged 14 was admitted in 1903 having spent 2 years and 9 months in Royal Albert.
A letter attached to her admission documents stated that: ‘The poor girl has much deteriorated, and is now most violent. We fear
that she will do serious mischief to other patients, and even to the nurses. We
must therefore ask you to make arrangements for her immediate removal as we
have no proper accommodation for such cases in this institution, such as
provided in lunatic asylums.’ Edith remained in Garlands until her death
aged 19.
Children
sent to Royal Albert often came back once they reached their late teens, and
when their treatment ended. One example, Eleanor B aged 17, was admitted to
Garlands in 1887 following 7 years treatment in Royal Albert. She did stay for
some time at home, but she was ‘beyond the control of her mother’, so she was
sent to Garlands. She remained until her death in 1925.
Family
breakdown was a major factor which triggered an institutional response to
insanity, in patients of any age, but more so for children. For instance, James
D was admitted to Garlands following the suicide of his father, in October
1889. His mother had died some years previous, and he was the oldest at 14 of 3
children. He was described as always being of weak intellect, and it seems that
his father’s death triggered his admission, due to a lack of adult relatives.
Once institutionalised, cases such as James were rarely discharged home, in the
absence of supportive relatives, and he died in an asylum, aged 20.
The
prevalence of hereditary degeneration, and the eugenic school of thought, is
extremely apparent when reading the case notes of these children. A lack of
awareness of how to deal such cases led to a constant farming out, and a focus
on training them in whatever way possible. As stated by the superintendent in
1888: ‘Imbecile children are out of place in a lunatic asylum, and yet if
allowed to grow up without training, as the majority do in these counties, they
in time become the most expensive and troublesome patients met with in lunatic
asylums.’
Going
forward, to echo the sentiments of World Mental Health day, we can use these
snippets of the past to learn from, and to encourage conversation around mental
wellbeing, particularly among children and young adults.
