Bedlam, shell-shock and ‘care in the community’

Published: 8 October, 2010
by PETER GRUNER

FROM asylums where the “mad” were stared at like animals at the zoo, to “care in the community”, Islington has been at the forefront of changes in attitudes to mental health.

Now a brilliant new exhibition at Finsbury Library – to be launched by Islington Mayor Cllr Mouna Hamitouche tomorrow (Saturday) – charts those changes over more than 600 years.

Alex Smith, heritage assistant at Islington Museum, has produced some first-rate research, starting with the notorious St Mary Bethlem Hospital at Moorfields.

Founded in the 13th century, “Bedlam”, as it became known, was one of the first institutions to deal with mental illness in England. People could visit the zoo animals at the Tower of London and then stroll up to Moorfields to see the mentally ill on display. Visitors gawped at the chained patients in their cells.

In 1672, James Newton established the “Madd House” on the site of the old Northampton Manor House in Clerkenwell, now the location of City University.

During the 18th cen­tury, attitudes towards the care of those with mental illness started to change and in 1759 a new hospital was built in Old Street. St Luke’s Lunatic Asylum had 57 patients when it opened, increasing to 298 by 1815.

The second half of the 18th century witnessed the growth of private madhouses. “Mad doctors” could gain wealth through the management of these institutions.

Families were known to abandon relatives in madhouses and in some cases those abandoned were sane.

Islington’s mentally ill poor were sent to Colney Hatch Asylum (later renamed Friern Barnet Hospital), which opened in 1851. It was one of a new generation of Victorian asylums built on a massive scale and located in picturesque, countryside settings.

However, the Victorian asylums did not deliver what they had promised. In 1865, a report by The Lancet highlighted that workhouses were still housing the mentally ill.

In 1862, Colney Hatch Asylum controversially revived the practice of restraint. Some super­intendents used methods such as locking naked patients in side rooms for weeks at a time. They slept on the floor without either bed or pillow, being supplied only with strong quilted rugs.

Doctors at Colney Hatch used techniques such as packing violent patients in wet sheets or restraining them with belts, wrist straps and locked gloves.

The First World War fundamentally changed attitudes to mental health and its treatment. Large numbers of soldiers who managed to survive the horrors of the trenches came home with a new condition – shell-shock.

Doctors originally thought that the illness was a physical reaction to the shock of shell explosions in the trenches but it gradually became apparent that this was a psychological problem.

Some groundbreaking doctors developed treatments that directly link to practices used today.

In 1948, the Victorian asylums became the responsibility of the National Health Service.

From the 1950s to the 1970s these asylums were known as “long-stay hospitals” but the intention remained the same – to lock people away from the rest of society.

But new developments in the field of drug therapy changed the way mental illnesses were treated. 

This led to the closure of the large institutions and the introduction of care in the community.

• Bedlam and Beyond is at Finsbury Library, St John Street, EC1, until November 22, after which it will tour the borough. For details phone 020 7527 7970.