The first asylums often included people that were seen as a nuisance to society along with those that were mentally unwell. This included criminals, prostitutes, beggars and those that were unemployed (Conrad & Schneider, 1992). That created a chaotic environment where it was difficult to determine who was fit for work and who was not which later resulted in an institutional diversification where prisons, workhouses, almshouses and madhouses were created. Before the madhouse act of 1774, asylums were often run by non-licenced practitioners for profit – they often had little regard for the patients.

Separation and confinement of the ‘mad’ came with its own issues. A particular issue was the lack of a proper treatment. A scale of wellness was not established so those with severe difficulties were alongside those with milder symptoms. The treatments that were given were often cruel and ineffective. They included blood-letting, forced vomiting and the spinning chair. Before effective drugs were administered, practitioners would often restrain unruly patients. William Tuke set up the first establishment to treat patients fairly and offer therapy. Restraint was no longer used, and focus was on work and recreation. The recreational activities included sports, arts and music. Farms were the main employers for the male patients and laundry ward was the main employer for the female patients.

Due to the work of John Conolly and Lord Shaftsbury, the lunacy act of 1845 was put in to order. This built upon this foundation of moral treatment pioneered by Tuke and allowed ‘lunatics’ to live as patients instead of prisoners. Every county was legally obliged to open an asylum and treat their mentally unwell patients.

In the 1900s treatment evolved to include ECT and lobotomy. However, the evidence of its effectiveness was questionable. Years after the second world war, there was a development in psychiatry. There was an introduction of antihistamines to treat schizophrenia. From that moment onwards, there have been even greater advancements in medicine for the mentally ill. This development resulted in less of a need for mental hospitals so many mental hospitals were closed in the 1970s and 1980s. Public attitudes were also changing – people had more hope for their loved ones with mental disorders being able to live a productive life in the community.

The journey for treatments of mental illness has been a long one but today we have better treatment than ever. We have learnt that there are more effective methods than shock therapy and confinement. The use of talk therapy with medication has been proven to provide benefits for many mental health issues.

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6 thoughts on “The History of Asylums

  1. An instance of fire and subsequent deaths of mental patients (who were chained to bed) in a mental hospital in South India in the year 2001 is a case in point for scant respect for their rights, as also that treatment for such disorders is still sub-par in the under-developed world. The prisonlike condition of asylums and their staffers and officials being apathetic and scornful, has to change. Mental health care must draw from advanced techniques, with a humane approach.

    Liked by 3 people

  2. There were other medical areas back then where they practiced such things as bloodletting, or other treatments that we would consider horrible today. But I definitely think that talk therapy is the best. That started with Freud, didn’t it? And there were also people like Carl Jung. The side effects of the medications can often be worse than the illness itself. I’m going to fight for the right to get off them. And for other people’s right to make that choice. As it stands now, we can’t get much treatment unless we agree to take the medications. I believe individuals, perhaps those who have had an illness, should be able to practice talk therapy, with or without a degree. It’s like holistic medicine. People are allowed to practice that without a degree. They just shouldn’t be able to misrepresent themselves.

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  3. Realize however that ect is still used. I work inpatient psychiatric and for the first few years of my employment 2006-2009 it was my job to assist with the procedure. It is different now as ect is now performed with the patient under anesthesia and muscle relaxers are given prior to relieve the seizure activity. Many patients come in requesting the procedure. Not saying I’m a full believer as I believe in the placebo effect but I can only report what patients have told me regarding its efficacy

    Liked by 1 person

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