Time to Talk Day 2019 – Reflecting on the Victorian treatment of Insanity

In line with Time to Talk Day (7^th Feb. 2019), this post will explore some of the common reasons people were admitted to a lunatic asylum in the late nineteenth century. Using my research of the Garlands Asylum, a number of patient examples will be presented to illustrate how mental illness was regarded, and open up the conversation around mental health to demonstrate how much has changed, and how much further there is still to go.

In 1872, the medical superintendent in charge of the asylum, Dr Thomas Clouston, commented on the statistics for the admissions of the initial decade that Garlands was open. At the head of the causes was a ‘hereditary predisposition’ to mental illness, which had been found in 29% of cases. Asylum doctors at this time had noticed the clustering of insanity in certain family trees, but had no explanation as to why, and were uncertain of the conditions it occurred most frequently in. Clouston noted the difficulty in getting the true family background of a patient on admission from relatives due to the stigma surrounding mental illness: ‘Its existence is often most difficult to get at from relatives…One would not be far wrong to say that one-half of all the cases had this cause predisposing to or directly producing the malady.’

In a patient's records it often details a mother/father or a more distant relative such as brother on father’s side, or maternal grandfather as suffering with some form of insanity also. An example of hereditary insanity is John M, admitted in September 1887, aged 30. He was a single farm labourer from Kirkby Stephen, and although it was his first time in the asylum, this was his second attack of depression. His two sisters had previously been in the asylum, suggesting that this was a hereditary condition. 

Next, Clouston remarked that for the initial decade, 14.8% of admissions had been attributed to intemperance. For almost every patient their state of soberness is stated in the casebooks.  A great number were described as being intemperate, addicted to alcohol, or given as a drunk.

One example was Robert H, admitted in March 1898, aged 29. He was a dock labourer from Maryport, and this was his first case of insanity. He was admitted after being struck down by an attack of insanity which had lasted 6 six days. The cause of his illness was given simply as ‘drink’, and no hereditary predisposition to insanity was found in his family. The excess of alcohol had caused Robert to suffer from delusions. These were detailed in his admission notes: ‘[He] said people were taking his bed from under him’, and  ‘[He] imagines a man is going to put vitriol in his eyes’. Hayton had also shown suicidal tendencies as he ‘tried to cut his throat’.

Those with insanity caused by intemperance often recovered fairly quickly. This was because they were not allowed any alcohol once in the asylum and would have no way of getting any. Therefore, their confinement was a way of them getting sober and returning to a normal state of mind. About two weeks after admission, Robert was noted as laughing ‘at his former delusions, and...[said] they were the effects of drink.’ On remaining sober, he was discharged as recovered six weeks after admission. 

Next, accounting for 8.2% of the admissions, insanity caused by childbirth, whether it be post-natal depression, a traumatic childbirth, the fear of being pregnant, but ultimately a number of different causes of insanity suffered by women only also referred to as

puerperal mania. An example of puerperal mania is found in the case of Sarah F Admitted in Oct 1890, she was diagnosed with ‘pregnancy and domestic troubles’. The problem was that she was afraid to be pregnant, but it seemed she was around 7/8 months pregnant at the time of admission. Only a week later her baby was still born and she remained in the asylum until July 1891.

Also common in the classification of mental illness in the asylum was melancholia. This was characterised by a depressed mood and sometimes accompanied by suicidal thoughts. An example is Ann D, admitted in April 1886, aged 39 from Cockermouth. Her melancholia was her first attack of insanity and had lasted only 14 days. She was recorded as being so down that she ‘begs for a knife to cut her throat’. However, due to quick diagnosis and treatment she recovered and was discharged a few months later on 17 July 1886.

A final reason for admission to the asylum that sometimes occurred was poverty. Lack of success in a persons working life often led to asylum admission. For example, Ellen P was admitted to garlands in February 1893. She was labelled a 'tramp' and her illness was attributed to ‘destitute circumstances’. Her background seems to be a tragic one. Her son had died five years previous to her admission whilst they were in the workhouse, and she would frequently be haunted by her son’s dead spirit. During her illness she had ‘tried to drown her daughter in [the River] Caldew’. However, with effective moral treatment at the asylum, she was discharged as recovered on 7 June 1893.

This blog is a small part of my ongoing research into the Garlands lunatic Asylum. Hopefully these examples demonstrate how far we have come in treating these illnesses outside institutions. What were once stigmatized conditions treated away from public gaze, are now topics we can openly discuss to help each other. Continue the conversation, grab a coffee and chat with friends and colleagues, and encourage openness around mental health.

For more information go to https://www.time-to-change.org.uk/