Women in the nineteenth century Asylum – Balanced Treatment?

To coincide with mental health awareness week (13-19 May 2019), this post will look at the treatment of women in the nineteenth century lunatic asylum. Taking into consideration the notion of balance, the focus will be on the inequality of attitudes within asylum environment, which reflected the moral conventions that governed the Victorian era.

Lunatic Asylums themselves were patriarchal institutions. Modelled on a familial framework, the male medical superintendent formed the head of the ‘family’, and the patients were the ‘children’ who had to adhere to the regime. The patients were segregated by gender, and interaction with the opposite sex was limited to mealtimes and during certain events such as the weekly dance. The day-to-day tasks of the asylum were completed by the patients, and were implemented by gender. For instance, men would work on the land, tend to the gardens and the livestock on the institution’s farm. Women would be required to carry out household chores, work in the laundry and tend to any clothing repairs.

Treatments implemented in asylums were also decided upon by men. All doctors in county institutions were male. There were female nurses employed to work on female wards, but they had no say in what treatments should be administered, even though they – along with male attendants employed on male wards - were the ones who had the most day-to-day contact with the patients.

Upholding moral standards was an important aspect of the regime and the asylum environment, which reflected wider societal attitudes. The female staff could not socialise with the male attendants, relationships were prohibited and could result in dismissal. Similarly, immorality was a key factor commented on in asylum patient casebooks, and was used to indicate symptoms of insanity. For instance, in the case of females admitted that had given birth to an illegitimate child, it would be clearly outlined in the admission documents.

An example is Barbee L (Barbra on birth record, but spelling fluctuates), who was admitted in November 1902, aged 18 from Ambleside. The supposed cause for her condition was given as: ‘through giving birth to illegitimate child’, which occurred 25 days prior to asylum committal. The form of her illness was given as ‘puerperal mania’, which we know today as post-natal depression. Her occupation was given as a domestic servant, and she had given birth in Milnthorpe workhouse, where she had begun accusing the nurses of mistreating her baby, which was stated as a delusion. After some months in the asylum, Barbee was discharged as recovered, and did not return to Garlands. It is unclear whether or not she was reunited with her child.  However, on the records of males who had fathered illegitimate children, there was no mention of this, and certainly not as a factor in their illnesses.

The stigma of illegitimacy was also passed down to the illegitimate children. For both male and female offspring, if later in life they were admitted to the asylum, it would be remarked in their case record that they were illegitimate. Thus, indicating that it could have been a contributory factor in their mental illness which caused them to be admitted to the asylum.

The display of unfeminine behaviour attracted attention in the asylum casebooks, and was also used an indication of insanity. This is evident in the next two cases. The first is Elizabeth S, admitted in July 1887, aged 21, single, a domestic servant from Kendal, said to be suffering from mania caused by a 'love affair'. On her case notes recorded on admission, it was stated that: ‘Behaving foolishly and in a silly way, swore a great deal, and began to go with loose company’. It was also stated that she talked in a ‘lewd way’ and ‘said she was pregnant’. Six days after admission the superintendent recorded the following observations of Elizabeth: ‘She labours under mania. She told me today that she had been pregnant for long; that she felt the child moving in her, that its father was a William Woodburn. She is menstruating at present. She also says that Woodburn several times induced abortion for her, but can owe no account of how it was done or the result: talks about little else than sexual subjects.’ The supposed love affair that caused her illness is not mentioned in any detail, rather, the doctors focus on her ‘coarse and vulgar’ language that she used, and referred constantly to the sexual nature of her conversation. Also stated in her notes, four months after admission, was that she: ‘Is very lazy and untidy, foolish and erotic looking’. The reference to laziness and willingness to work is common throughout the case books, but the ‘erotic looking’ reference is quite unclear and is not something which I have come across in other patients, particularly never for males. Thus, the descriptions of her demonstration of insanity were based on appearance and her sexuality, and in turn her immorality. Elizabeth remained in Garlands until October 1888 when she was discharged as recovered.

The second case, that of Phoebe D, demonstrates that the societal notions of femininity presided over the diagnosis of mental illness in the late nineteenth century. Admitted in April 1871, Phoebe was transferred to Garlands from Carlisle Gaol, where she had been imprisoned for throwing vitriol over a man who accused her of having sex with him. Whilst in gaol she began showing signs of insanity, and was admitted to Garlands. In her casebook record, the two causes given for her illness were: ‘lactation’ and ‘being accused by a man of having had sexual intercourse with him’. Throughout her notes the feminine stereotypes are prevalent in signalling recovery. For instance, two weeks after admission it was noted that: ‘A few days ago got much excited when she saw her husband. She even asked about her children.’ However, the following month, any signs of her returning back to normality, in which she would be interested in the welfare of her family, had abated: ‘taking no interest in anything. Shows no signs of caring for children.’ Therefore the stereotypical role of women as primary caregivers was used as an indicator of recovery. If she showed an interest in her family, she must be getting better. Phoebe remained in Garlands until December 1873 when she was transferred unimproved to Staffordshire Asylum. This case demonstrates that female norms were predicated upon women in the asylum as diagnostic tools that could signal both their insanity and recovery. It would be interesting to examine the extent to which male patients were judged by notions of masculinity, and whether or not this was used in their diagnosis and recovery.

The final case to be discussed in this post, is one that I found reported in the local Carlisle press. Titled ‘Shamming Insanity’, a small news item detailed how Mary G from Dumfries had been arrested in Carlisle as she has broken a grocer’s shop window, and was in a state of intoxication. Whilst on trial for her crime, she behaved in an ‘excited manner’ and struck the chief constable in the face whilst in the dock. The constable noted that she had only just come out of gaol, and was behaving this way ‘in the hope of being sent to an asylum’. However, she was noted as not being insane, and was sentenced to two months hard labour. This case demonstrates that, as much as the asylum was believed to be a place of perceived horror that carried a great stigma, for some it was a viable option, as the alternative was much worse.

Through this post, some of the preconceived notions of femininity of the nineteenth century, are evidenced through the statements recorded by doctors on the patient case records. Attitudes towards illegitimacy, female sexuality and women’s roles as mothers have been demonstrated using a handful of cases. Male patients could also be noted to have symptoms of a sexual nature – i.e. through masturbation which was regarded as a sinful act signalling insanity – but these were predominantly through physical acts, rather than through using sexual language, or through illegitimacy or other symptoms discussed here that were attributed to women.

This is part of my ongoing research into the Garlands Asylum, through which I aim to encourage the conversation around mental health by reflecting on the history of treatment, the patients who suffered, and the institutions in which they were resident. For more information on mental health awareness and support: https://www.mentalhealth.org.uk/  http://www.cemind.org/