Then, 130 years later on, one historian described them as "museums for the collection of the unwanted". Ground Floor Plan, 1853, St John's Hospital, Bucks. Bars on the windows. Laws allowed families to commit their relatives with little supporting evidence. During the day they also made use of rooms for relaxation and ate in large communal dining halls. Those who supported the creation of the first early-eighteenth-century public and private hospitals recognized that one important mission would be the care and treatment of those with severe symptoms of mental illnesses. Conditions at asylums in the 1900s were terrible, even before doctors began using treatments like the lobotomy and electric shock therapy. Straitjackets. And patients might stay in psychiatric institutions for extended periods. The strange parallel world of the asylum always stirred up strong emotions, as it continues to do so today. The 'mentally unsound' were moved in ever greater numbers from their communities to these institutions. Officials at psychiatric hospitals in the 1900s, known at the time as lunatic asylums or insane asylums, locked patients up against their will, with few ideas on how to properly treat their problems. By the early 20th century, many mental hospitals tested patients for syphilis. In 1866 the physician Sir George Paget (1809-1892) hailed the asylum as "the most blessed manifestation of true civilization the world can present". Find out about listed buildings and other protected sites, and search the National Heritage List for England (NHLE). Male and female attendants were as strictly segregated as their patients and they worked and lived out their lives on the site, often for generations. This is when asylums themselves became notorious warehouses for the mentally ill. “The purpose of the earliest mental institutions was neither treatment nor cure, but rather the enforced segregation of inmates from society,” writes Jeffrey A. Lieberman in Shrinks: The Untold Story of Psychi… Each ward housed up to 100 people. "You do just what the doctor says if you want to get out of here," one patient said. And there was always a cemetery. We use cookies to give you the best possible experience online. Now reformers claimed that an asylum would be a safe place where 'lunatics' could be cured and 'idiots' taught. She reported horrific treatment from doctors, including hair pulling and solitary confinement. There would often be an asylum fire brigade with its own fire engine. Grade II listed Sandford Parks Lido, Cheltenham. Some people with mental health issues tried to hide their condition to avoid being sent to an asylum. Families could even "purchase" confinement for relatives they didn't want to deal with. © Historic England XA00152. Philadelphia Hospital for the Insane, Philadelphia, PA c. 1900 The history of psychiatric hospitals was once tied tightly to that of all American hospitals. Other treatments, still used at the end of the 19th century, included harnessing patients and swinging them, or branding a patient with hot irons in an attempt to "bring him to his senses.". Interior of 'K block', a first floor padded cell from west, Hanwell Lunatic Asylum (St Bernard's Hospital, Uxbridge Road, Southall) © Historic England BB98/23864. The asylum age arrived suddenly in the 19th century. By 1904, only 27.8% of asylum patients in the US had been institutionalized for a year or less, with the vast majority being long-term cases. In their rural settings and surrounded by high walls to prevent escapes, asylums were a self-contained world. Like most American asylums, all three closed permanently in the late 1990s and 2000s. But when the first large asylums were built in the early 1800s, they were part of a new, more humane attitude towards mental healthcare. The Middlesex County Lunatic Asylum at Hanwell, on the outskirts of London, was one of the first of the new state asylums, and it set many of the standards for mental healthcare in the Victorian age. Until then it had been accepted in English society that people with disabilities or illness who needed care and support got it from family, friends and community. By contrast, about 71% of people in psychiatric institutions today are voluntary patients. By the early 1900s the treatment of those with mental illness has improved by a landslide. Sedatives. More and more people arrived, and fewer and fewer ever left. Patients quickly learned to simply parrot back what doctors wanted to hear in the hopes of leaving the facility. In the early 19th century, asylums in England used a wheel to spin patients at a high speed. In 1900, patients at mental hospitals in the United States faced inhumane treatment, often because doctors could not identify the cause of their melancholy or mania. Claybury Asylum, London. Sedatives. Bars on the windows. On either side were the wards, with the sexes rigorously separated. From 1808, parliament authorised publicly funded asylums for 'pauper lunatics', and 20 were built. Leading off the wards were 'airing courts', walled gardens with shelters where patients could safely exercise. A firsthand account from a patient at the Oregon State Hospital warned that peculiar behavior could land people in the hospital against their will: They'll put you out at the end of Center street if you don't watch out. The history of people with disabilities since 1050. As Nellie Bly witnessed when she went undercover at Bellevue Hospital in New York, patients were beaten and choked, and their living quarters often looked more like prison cells than hospital rooms. At the Oregon State Hospital, doctors used "malarial treatment" for people newly infected with the disease, which was incurable before antibiotics. In 1900, patients at mental hospitals in the United States faced inhumane treatment, often because doctors could not identify the cause of their melancholy or mania. In 1887, journalist Nellie Bly agreed to go undercover in a mental asylum to record the conditions inside. Straitjackets. Bly also decried the way patients were treated like prisoners: I could not sleep, so I lay in bed picturing to myself the horrors in case a fire should break out in the asylum. The truth about what life was like at a historic mental institution will appall you. This section describes the rapid development of the asylum movement in the 19th century, and the strange parallel world that the asylum offered its inmates and attendants. New wings and storeys were constantly added until eventually a second, or even third county asylum had to be built in many areas. More and more people arrived, and fewer and fewer ever left. The same patient later died by suicide. See our extensive range of expert advice to help you care for and protect historic places. © Historic England Archive. Early optimism that people could be cured had vanished. © Historic England BB98/23875. In the early days of mental hospitals, not everyone chose to enter one. Please click on the gallery images to enlarge. In an account that came out of Boston in 1883, a witness testified that women and children were dying of starvation. Using an old browser means that some parts of our website might not work correctly. Shortly after the asylum population explosion in the mid 1900s, when mental health treatment was arguably at its worst, an apparent salvation emerged. Conserving the Fog Battery Station on Lundy Island. Some asylums even had their own railway stations with a branch line into the grounds. One patient in Oregon reported, "Right now, four or five patients on the ward are in bed with malaria. They'll put you out in the bughouse with the rest of the nuts. In 1883, Henry Frazier was sent to an asylum in New Orleans because his mother called him uncontrollable, saying that "he masturbates himself to complete exhaustion.". Historic England holds an extensive range of publications and historic collections in its public archive covering the historic environment. The grounds were designed by some of the finest landscape gardeners; they contained farms, orchards, workshops, bowling greens, croquet lawns and cricket pitches. As the asylums multiplied, the number of people certified as 'insane' soared. Doctors who used the treatment, first advocated by Dr. Julius Wagner-Jauregg, intentionally injected malaria germs into a patient's bloodstream based on the theory that malarial fever could kill syphilis. There were three main types of asylum built: the 'conglomerate', a hodgepodge of miscellaneous structures (Suffolk County Asylum); the 'corridor' type, with wards connected by corridors up to a quarter of a mile long (Colney Hatch Lunatic Asylum in Middlesex), and later the 'pavilion' type, where rows of female and male blocks each housed 150-200 patients (Leavesden Hospital, Abbots Langley, Hertfordshire).