The Victorian Mental Asylum

The original meaning of the word Asylum is “retreat” or “sanctuary” and they were built to protect mentally ill patients. We may have heard very real horror stories about how patients were treated in these past asylums but what really happened?

Before asylums were built, people with mental problems were cared for by their family, who may not have ‘known’ how to deal with or cure their loved ones but at least they understood and loved them. By the 1700’s, a few private institutions existed but were open only to the very wealthy, where their ‘mad’ relatives could be ‘put away’ discreetly. The poor relied on the local parish and some of these ‘ill’ creatures ended up in prison, or worse, the Workhouse. Harriet Martineau, who was a social campaigner, is quoted as saying: “In pauper asylums we see chains and strait-waistcoats, three or four half-naked creatures thrust into a chamber filled with straw, to exasperate each other with their clamour and attempts at violence; or else gibbering in idleness or moping in solitude.”

Those who were in charge of these ‘institutions’ had little or no medical knowledge and were really like guards using restraints on some very ‘ill’ patients. The emphasis seemed to be on stopping the person from hurting themselves or others, and not on trying to understand the person and helping them to overcome their ‘illness’. Many were strapped to their beds at night so that they couldn't hurt anyone, including themselves. In fact, some patients actually asked to be restrained, afraid of where their minds may have been leading them. Another problem was the violent way these inmates were restrained. A patient was left unsupervised overnight in a straightjacket and strapped to a bed. He was found the next morning dead from strangulation and the authorities knew that it was time to look into and to change the “System”. Thankfully. All physical restraints were abolished and a “Non-Restraint System” was set up. Attitudes towards mental illness was changing.

At the beginning of the 1800’s, local authorities now had a legal responsibility to care for the mentally ill, especially in a purpose-built institution. The emphasis was now on trying to cure the patient and it was no longer acceptable to keep a mentally ill person in a Workhouse or a prison, they had to be put into a proper asylum which was now based on the ‘latest scientific and medical knowledge about mental illness’.

Hanwell Asylum was one of the first such buildings. It opened its doors in 1832, and from the very start took on a progressive approach in caring for its patients. Dr. William Charles Ellis was the first Superintendent, and along with his wife, Mildred as the Matron, ran the asylum. Ellis believed in the principle of therapeutic employment, that work was essential to the patient’s recovery and rehabilitation (along with Christianity). Within the first four years of Ellis taking charge of the asylum, 320 out of 560 patients became regularly employed.

The building had decorated, multi-coloured brickwork of sturdy and reliable construction which formed the outer walls. There were large multi-paned windows and high ceilings which allowed better circulation of air. The latest in gas lighting provided relief from the dark. Warm air came up from the floors through the use of patented boilers. The grounds were extensive and used not only for recreation, but also for farming with a bakery, brewery and other ‘cottage industries’ so that the asylum could be as self-sufficient as possible.

In 1834, Harriet Martineau visited Hanwell Asylum and found an industrious environment, saying: “In the bakehouse --- are a company of patients, kneading their dough; and in the wash-house and laundry many more, equally busy, who would be tearing their clothes to pieces if there were not the mangle to be turned.” The patients were gaining the therapeutic benefits of hard work, as well as earning their own keep.

John Conolly, who was the third Superintendent at Hanwell Asylum, established the removal of the physical restraints system, which actually meant that the attendants and nurses had to be specially trained “to provide manual restraint without injury”. If a patient was particularly unruly or violent, they were put into seclusion (as a last resort), being put into a padded cell so that they would not harm themselves or others. Before this, the asylum keeper was little more than a jailer, whereas now they were specially trained nurses and attendants. The Metropolitan Commissioners found Conolly’s use of seclusion in a padded cell “to have a very powerful effect in tranquillising and subduing those who are under temporary excitement or paroxysms of violent insanity.” This new “Regime” relied on strict operational systems and monitoring, for both staff and patients.

It is interesting how some of the patients viewed these asylums. George Longmore re-admitted himself into Broadmoor Asylum. The reason for this was that his family could no longer ‘cope’ in caring and supporting George, but also, George enjoyed the ‘social community’, He could talk with, work and enjoy leisure pursuits with the other male patients.

Before this much more ‘Modern System’, the treatment of the mentally ill showed up just how much mankind needed to learn and understand mental health. The ‘insane’ were hidden away and many were chained. The mentally ill were thought to have been moral misfits, being punished by God, and were separated from normal society with no emphasis on curing the patient.

Nellie Bly, who was a journalist, went ‘undercover’ at the Blackwell Island Insane Asylum in 1887 in New York. Her findings were disturbing. Nellie was committed without much of an examination and she found herself in conditions which were cruel, harsh and inhumane. “For crying the nurses beat me with a broom handle and jumped on me. Then they tied my hands and feet, and throwing a sheet over my head, twisted it tightly around my throat, so I could not scream, and thus put me in a bathtub filled with cold water. They held me under until I gave up every hope and became senseless” wrote Nellie. Psychiatry was in its fledgling stages and, unfortunately for these poor patients, asylums were the perfect ‘lab’ for psychiatric experiments.

Electroconvulsive shock treatment was one of the most infamous treatments. Drugs were experimented with and ‘Lobotomies’ were performed. As mankind learned more about the human mind, he stopped ‘drilling’ holes in the heads of restrained patients and instead started to listen to them. Today, drugs can play its part in helping a mentally ill person but the emphasis is on listening and allowing the person to talk, giving much more hope in the cure or control of mental health issues.

Thankfully today there is more understanding when it comes to mental health. We do have psychiatric hospitals with specially trained doctors and nurses, however, most ‘mental illnesses’ are dealt with at home or in the community, these patients not needing to be hospitalized. One of the main ‘treatments’ is to allow the patient to talk with the doctor listening, and therefore learning how to help the patient. It is taking its time but mental health issues are being accepted within society, with more and more people becoming open and asking for help.

Please, please please --- if you are struggling mentally --- ask for help! We live in a much more advanced and understanding world than our Victorian cousins and their asylums.

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