Last year, 54% of all working days lost were attributed to conditions caused by work related stress, and increasingly, pressure due to overwork is inducing bouts of mental ill health among workers.[1] However, the impact of overwork on an individual’s mental health is not a phenomenon consigned to recent decades. This post details three cases that demonstrate how work was found to impact patients in the archives of the Garlands Asylum, in an attempt to link our experiences with those confined in lunatic institutions of the nineteenth century.
It is important to note that patients admitted to a lunatic asylum would be diagnosed according to the symptoms they displayed. As a result, largely due to a lack of understanding of the workings of the brain and how mental illness manifested, conditions were attributed to physical causes. For instance, injuries close to the brain were thought to trigger a breakdown of a person’s mental health. In the casebooks, events such as ‘injury to head from fall on a rock’, were cited as the cause of insanity. In this instance, the patient, Christopher S, had suffered a head injury, which bled profusely at the time, but no one considered it a serious threat to his health. Two years passed before he was admitted to Garlands, which was triggered by the violence towards his wife, to such an extent that she was afraid of him. Less common in the casebooks were explanations of conditions due to ‘moral’ causes, as they were then termed. Anything considered to be caused by a heightened emotional state, for example ‘disappointment in love’, can be found but were much less common. In 1872, in a review of Garlands’ first decade of admissions, Dr Clouston stated that only a quarter of cases were due to emotional trauma.
The first patient, Joseph T, was admitted to Garlands in November 1882. The cause of his insanity was believed to be ‘worry and hardwork’. Given his occupation, a general practitioner, it can easily be deduced as to why his profession would’ve impacted his health. Before the NHS, GPs were their own enterprises. They worked long hours, travelled great distances to visit patients at home, and had to secure their own business. His case notes also tell us that he was resident in the Crichton Asylum in Dumfries five years earlier, and although he had been discharged recovered, it was noted that he had not felt well since. Interestingly, it was work that aided him whilst under treatment in Garlands. Shortly after admission it was noted that he ‘has gone to work with a party in the grounds’. This was part of the work-based therapy offered in Victorian asylums, as useful occupation was seen to divert patients from their disordered thoughts. A little later on, Joseph’s case notes state that: ‘Is very industrious, says he feels he would break windows etc. if he did not work’. However, it was this outdoor work which also led to his exit from Garlands. After being granted more liberty, due to continuous good behavior, he was placed in charge of one of the working parties, and increasingly given more freedom. This gave him the chance to escape, as detailed in the following passage:
‘The patient was allowed a considerable amount of liberty and never showed any tendency to abuse this privilege, nor had there been anything unusual in his mental state of late. He went out for a walk between 7 and 8am and he did not appear at meals. A search was instigated for him...’
Joseph was never found, or brought back to the asylum, and his body was recovered mere miles from Garlands five weeks later near a quarry, which it was presumed he fell into shortly after his escape.
Second, cases can be found in the records of patients who experienced delusions to do with work. One example is that of John W, who was admitted to Garlands in February 1897. He was 37, suffering his first attack of insanity which had lasted about a week. The doctors couldn’t find an apparent cause, but noted that he ‘came home from work saying there was a conspiracy against him and refused to go back’. Under ‘delusions’ it was also recorded: ‘says there was a conspiracy against him by fellow workmen and that part of it is to bring him here’. John remained in Garlands for 6 months, and was discharged as recovered as his delusions abated.
The final case to be presented demonstrates that a lack of work could also be a cause of mental breakdown. Richard A was brought to Garlands on 4 October 1862, and was said to have been driven insane by his ‘anxiety of mind for want of work’. He lacked a hereditary predisposition to the illness, therefore the cause of Richard’s mental instability was attributed to his lack of work and food. Within six weeks Richard was discharged as recovered, restored to full health simply by eating, sleeping well, and being usefully employed in the Asylum workshop. Here we can clearly see that periods of economic decline, specifically in agriculture, effected, not just a person’s income, but also their mental health. Farmers and casual agricultural labourers were at times merely surviving, and, in some cases, the threat of losing work, or being without an occupation, was enough to trigger insanity.
Thank you for taking the time to read this post. If you would like to read more of my research on the Garland Asylum, my thesis is freely available to view online: https://leicester.figshare.com/articles/The_Circulation_of_the_Insane_The_Pauper_Lunatic_Experience_of_the_Garlands_Asylum_1862-1913/10226480
For more information about mental health, talking about mental illness, and support, visit https://www.time-to-change.org.uk/
