Much
is documented about the chronic underfunding of the NHS in the modern era, and,
in particular, mental health services. The growing number of people diagnosed
with mental illness, and a lack of provision to effectively treat them, is not
a problem confined to recent times. The optimism of the 1845 Lunacy Act in
making compulsory the construction of a lunatic asylum in every county and
borough throughout England and Wales, soon proved to be a victim of its own
success.
Soon
after Cumberland and Westmorland opened its own asylum – Garlands – in 1862, there
were calls for an extension to its accommodation. Originally intended to house
200 pauper patients, by 1863 this had been exceeded, as on 31 December of that
year, 225 were resident.
This
angered many among in the local Poor Law Unions who funded the institution, as
they regarded the building of the asylum an extravagant ‘blunder’. The
following passage documents a meeting of the Whitehaven Board of Guardians, and
focuses on the strain on accommodation so soon after opening. It was published
in the Whitehaven News in October
1863.
It was built at a great
expense; and yet, in less than two years, we are obliged to go and seek shelter
elsewhere for any lunatic patients we may henceforth have…It is with the
greatest difficulty that information can be obtained with reference to this
costly building…I am told that the asylum cost the two counties £50000, which
seems an enormous and startling sum…I cannot reconcile such wholesale expenditure
of public money upon an asylum like that, with the fact that before the
termination of two years, it is full…
Again
in April 1864, the Whitehaven Guardians debated the cost of the asylum when it
was built, and the necessity of an extension. They alluded to the fact that
they could not see a direct cause for the increase in calls for provision:
From some cause or
other lunacy was greatly on the increase. The average number from this union
[Whitehaven] used to be 25 to 27: now they had 37…
Garlands
underwent several extensions throughout the remainder of the
nineteenth-century, taking the capacity to 660 patients. Many cases had to be
refused entry. Some were sent to other asylums at a higher cost to the ratepayers.
Most were housed in nearby workhouse wards, but the substandard level of care
was widely known, and frequently commented on in the annual reports of the Lunacy
Commissioners. For instance, they stated in 1860 of the Kendal Workhouse:
The larger of the
day-rooms is gloomy and cheerless, dirty, wretchedly furnished, and destitute
of every comfort…Two men are, in several instances, placed to sleep in the same
bed…There is no paid nurse in any part of the Workhouse, and the porter,
assisted by pauper inmates.
An
article published in the West Cumberland
Times in June 1894 reflected the despair of ratepayers at the unrelenting
pressure on mental health provision at Garlands.
The strain on
accommodation at Garlands is hardly less than is the case at similar
institutions in Northumberland and Durham. The total number of inmates under
the charge of Dr Campbell at the end of 1893 was 579…however, as the Committee
of Visitors inform us, the number of patients at Garlands has frequently
exceeded 600. Thus the County Council are brought face to face with the
question of making further provision for the insane…it is clear that the insane
at Garlands grow more numerous with each decade.
However,
although the tone of the article begins with the Whitehaven Board of Guardians
complaining about the increase, they do state the benefit it brings to those
who are treated in Garlands, as those in need of provision are more likely to
receive it after the asylum is enlarged:
There is a greater
desire to have the benefit of skilled treatment such as is afforded at Garlands
Asylum to those whose lives have been darkened by mental afflictions. Patients
who were formerly dealt with in workhouses are now sent to asylums.
Into
the twentieth century, the issue did not abate. After further extensions, the
number resident in 1919 had grown to 913. In an article in the Penrith Observer in July 1919, again the
pressure on expenditure was being debated in the public arena. However, this
time the tone had become much more sympathetic to the work done at Garlands.
The Asylum had just, after 58 years, changed its name to the Cumberland and
Westmorland Mental Hospital. Rather than
stating its unjust expense, the Penrith
Observer was much more understanding of the need for mental health
provision, and regarded Garlands as a ‘costly
necessity’. They also praised the hard work of the staff, and stated how
underfunded they were:
The staff –
already insufficient – must become larger, work shorter hours, and yet be
better paid, while the cost of living will very likely fail to drop for a
considerable time.
These
sentiments echo those of the national media today. Underfunded and
understaffed, in this respect, not much has changed in the 100 years since this
was penned. What is apparent is that mental health has become much less stigmatised
since the Victorian institutions have closed. Reflecting on the provision of
mental health in the past helps create a lasting conversation. This is to
encourage the increased openness and understanding of the invisible conditions
suffered by so many of us.
This
post is part of my ongoing research into the Garlands Lunatic Asylum, and the
history of mental illness. If you want to contact me about this post, or my
work, please do so at caradobbing@gmail.com
or on Twitter @caradobbing
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