Above all a patient should never be terrified

: an examination of mental health care and treatment in Hampshire 1845-1914

Abstract

Challenging significant historiography this study argues that the period 1845-1914 was a time in which to have been in receipt of the care of county lunatic asylums was substantially preferable to the alternatives for the local poor and mad, suggesting wider studies might show the same for other parts of England. Case examples are provided from the close research of two pauper lunatic asylums built in Hampshire during the period. Underpinning these is a methodology which synthesises an ‘alltagsgeschichte’ deriving from the Annales School with medical and local history. The research follows a metaphorical patient-journey beginning with the pre-patient stage when policy enforced the building of county lunatic asylums, examining the concept of architecture for sanity as well as local reaction to the building programme. It has identified a novel perspective for our understanding of the loci of control responsible for translating ideology into the physical structure of the asylum. Patient assessment and the asylum admission process are critically reviewed, and the identification of the symptoms of insanity as well as contemporary beliefs about aetiology are interrogated. Medicalization of aberrant behaviour and the early attempts at classification and diagnosis are subsequently analyzed. Significant differences in causes for and forms of disorder were revealed between rural and urban populations, contributing new knowledge. An important question, which hitherto has been incompletely addressed, is the extent to which insanity had risen to epidemic proportions. This study comprehensively evaluates local evidence to conclude that it had not. The medical and physical treatments prescribed are scrutinized and eliminated as contributing to the recovery rate whereas the dominant method of intervention, the dual approach of moral treatment and management was found to be significantly successful as curative or palliative. The roles of the staff in contributing to the comfort and welfare of patients are examined within the spirit of policy, legislation and developing scientific knowledge.

Date of Award	Sept 2010
Original language	English
Awarding Institution	University of Portsmouth
Supervisor	James Thomas (Supervisor) & Karl Bell (Supervisor)