Revolting to humanity: histories of mental health

On 10 November 1859, three men broke into a house in Hanover, Jamaica, where Ann Pratt, aged 29, lived alone. She was subjected to acts of violence from all three of the men, but one of them, John Davies, assaulted her personally, committing what she described as ‘a felonious act’. A child followed, for which only one of the men was present, notably not the man she alleged had raped her, and the court ruled against her, imposing a fine of £1.

Returning home, Ann had what we would describe today as a nervous breakdown. She describes how she became very ill, and fell into convulsions, and for a time was deprived of her senses. As a result of her condition, she was initially confined in prison, and then transferred to Kingston Lunatic Asylum for seven months. However her treatment in the asylum was so appalling that Ann put together a pamphlet containing allegations of the abuses she both saw and experienced.

One of the most shocking accounts of her experience in the asylum comes in her account of ‘tanking’. In Christie Warren’s paper on mental health and colonial power, Warren describes the tanking procedure as ‘a cold water immersion’, going on to explain that it was used as a punishment for inmates in Kingston Asylum. This indeed appears to be the case, but it’s worth noting when you listen to Ann’s account, that this same kind of procedure was also being used for those suffering mental health problems in this country, not as a punishment, but rather as a treatment.

For a woman whose body has been controlled and violated at the hands of the rapist, the response of the asylum appears to be to control and violate the body further, in an effort to treat or punish the mind. Ann reports that:

‘I was stripped and seized, my arms being held back from me, my legs extended and separated. I was thus plunged face down into the water. The asylum staff now got into the tank to hold me down. I struggled hard. I fought for my life. Mulgrave sat upon my chest, and when I threw her off, she sat on my shoulders. Antonette stood outside the tank with her hand twisted in my hair, and she struck my head violently against the sides of the tank.’

The National Archives is full of these kinds of snapshots, each one allowing possible insights into those suffering from mental illness, those treating it, and – perhaps most significantly, through the way central government interacts with issues of mental health – pieces in the wider story of how the mind has been perceived and responded to throughout history.

The reason I chose Ann’s story, however, is not just because it reveals such a dramatic snapshot, but because it so well characterises the problematic nature of archival records relating to mental health held here.

Until recent work carried out on cataloguing colonial office correspondence from the Caribbean in this period, this story was, to all intents and purposes, utterly hidden. If you tried to look under any of the words connected to the case – her name, the asylum, her condition – you would have drawn a blank. The description as it stood was simply ‘dispatches’.

The only way you could have found it, would be if you knew enough about this correspondence to know it might be something there. Yet if you did know enough about this correspondence, then you would also know that the diverse subject matter, combined with its significant size, would mean that you would need considerable time and patience. In essence, without prior knowledge that she existed, finding Ann would be down to serendipity.

[Shows image] So, if you can bear with the picture that I’ve got here, if we think of Ann Pratt’s story as the kind of archival treasure you’re looking for, then what I want to focus on this afternoon is how you can go about getting it. There’s some stuff, like you can see the mouse demonstrating, that’s quite easy to get at, but the vast majority is not, unless you have a grasp of the three barriers, or challenges, which stand between a researcher and the object of their research. These, I will be arguing, are language, document description and an awareness of the administrative history behind government departments. Working out how to get across these is critical to revealing the full picture of mental health records held at the National Archives.

Let’s start with the first barrier, language. And I should point out that we’ll be concentrating on the 19th and early 20th century here. Language can pose a major problem, both from the point of view of the researcher trying to find the material they want, but also from the point of view of the archivist, working to make things searchable. And if we have time at the end, it might be interesting for us to touch on this in more detail.

But to stay focused on the researcher’s perspective, the main problem is the anachronistic and sometimes unfamiliar nature of the words used in catalogue descriptions. Words to describe a person suffering from mental illness include those such as ‘idiot’, ‘lunatic’, ‘feeble-minded’, ‘imbecile’, ‘insane’ [and] ‘weak-minded’; and those used to describe illnesses themselves, such as ‘melancholia’, ‘mania’, ‘hysteria’ and ‘dementia’. It is also worth bearing in mind that because of the way the catalogue works, it is well worth searching for some words by using the root and an asterisk, to ensure you pick up all the related words. Here I’ve got the example of ‘idio*’ which would pick up both ‘idiot’ and ‘idiocy’.

The temptation is to search under more familiar terminology, and to try only one term. But without approaching the catalogue armed with this vocabulary, you won’t reveal the true picture of what is actually held. [Shows image] You can see here I’ve searched under all the words I’ve just listed for you. You’ll see searching under ‘mental health’ has given me just over 1,000 hits, most of which are from the middle of the 20th century onwards, so not very helpful for our focus on the 19th century. In fact, if you look across to the left, you can see that ‘mental health’ calls up approximately the same number of hits as ‘insane’. The biggest hits are coming from ‘lunatic’ and ‘mad’, and are actually much bigger than they seem.

If you’re not familiar with how the catalogue works [in 2011], it’s worth me explaining that once the catalogue gets to 3,000 hits on a keyword, it comes back with a message that it’s reached its limit and you need to refine your search. So to get all the documents described by those words, you would need to type in specific dates, or perhaps limit the government department you were searching under. [Find help with using our catalogue at http://www.nationalarchives.gov.uk/help/discovery-help.htm]

To make sure you get as much out of keyword searching the catalogue, it is really important that you’ve thought about the words which might be used to describe what you want. And although there is currently work going on to remedy this, to ensure that you search for the derivatives of these words by using the asterisk after the stem.

But once you’ve done some effective catalogue searching using this language, how representative of our holdings are the documents you have found? And here we encounter the second major challenge, because the answer in the area of mental health records is that what you have found is not very representative at all, because even with these language tools, we run into the problems of the descriptions themselves. We saw this with Ann’s story. It is very unlikely that the description ‘dispatches’ would have been in your new vocabulary of mental health related words. And Ann stands as only one example.

This is a letter about Sarah Mousehole [?]. Sarah is an old woman, suffering from what is described as ‘senile imbecility’, and requires considerable care. Up until now, she has been living off the charity of a neighbour, Miss Gastor, who is under no obligation to provide this help. Sarah has £100 in the bank, but cannot withdraw it because of her mental state. But because she has funds, she is technically not eligible for the workhouse. She is not considered dangerous, and so an asylum is not considered appropriate. And if the masses of lunacy were called in to deal with the property she lives in, in order to liberate funds for her case, it would prove too costly. She is essentially caught between the various mechanisms designed to protect the mentally ill.

This letter comes from MH 12, the correspondence from individual Poor Law unions in to central government, the Poor Law Commission, the Poor Law Board, and subsequently the Local Government Board. Using the vocabulary of words relating to mental health we just looked at, I searched MH 12 on the catalogue for relevant documents and this is what I got.

{Shows image] An online search reveals that out of all the folios which are searchable for MH 12, nearly one-tenth of the folios contain references to mental health. But these folios described on the catalogue could only be found because of a remote volunteering project which has been going on across England and Wales.

In its transferred state, MH 12 is made up of millions of individual letters, but because these letters are bound together in big books of 400 or 500 at a time, with one description to cover all of them – for example ‘Axminster union 1850-1853’ – the letters are, to all intents and purposes, hidden. The folios I’ve been able to search are all down to the hard work of this volunteering project.

So let me try and show you the true picture of MH 12. We believe the total number of folios in the MH12 series to be in the region of 11,000,000. So far the volunteers have catalogued 15,000 and those are the ones I’ve searched through for information on mental health. For the remaining 10,985,000, no description exists on the catalogue which would have any use for the kind of research we’re trying to do here.

[Shows image] So if you look at this chart, this tiny, tiny little wedge is the amount of MH 12 folios catalogued in total. These are the 15,000 I was able to search online, but as you can see, this is just the tip of the enormous MH 12 iceberg.

Using the figure of one-tenth of the searchable material in MH 12 relating to mental health, I’ve applied that figure to the whole series. If you think like that, then it’s possible that nearly one million folios of MH 12 are concerned with mental health. One million folios, full of stories just like Sarah Mousehole’s, which are currently not findable using your vocabulary of words. If we add to that the fact that MH 12 is just one series within nearly 200 in just the Ministry of Health department, you start to get the incredible picture of just how much material there might be dealing with mental health which remains hidden.

So if an online search doesn’t reveal the full picture, we move on to the final challenge: the need to understand how and why government departments have been involved with issues surrounding mental health. One of the best places to get an understanding of how the strands of individual departments formed, and how they became responsible for mental health, is the current guide [http://www.nationalarchives.gov.uk/records/research-guides/mental-health.htm]. Through this, you get a picture of the main departments concerned with mental health, and guidance as to which series these records are held in. And in this case, it’s the Home Office and the Ministry of Health.

Understanding how this came about, and why records would have been created by these departments and their predecessors, is the final key you need to be able to find this material. As I mentioned earlier, we’re concentrating today on the 19th and early 20th centuries. And one of the main reasons for this is because prior to the 19th century, there had been no clear definition of what mental illness was, and more significantly, no distinction existed for the category of mental illness in society as a whole.

Those who were suffering from severe mental disorder were frequently treated as if they were fully responsible for their actions. If their condition led them into poverty, they fell under the jurisdiction of the Poor Law. If they broke the law, they would be dealt with under the Penal Code. If they wandered away from their place of settlement, they became subject to the complications of vagrancy laws. As Andrew Scull in Museums of Madness writes: ‘Mad people were assimilated into the much larger, more amorphous class of the morally disreputable’.

As you can see here, the start of the 19th century ushered in central government’s involvement with the subject of mental illness for the first time. This makes it a very good focus for us today. Just like so many other contemporaneous areas of government, it is characterised by the notion of inspection and the creation of the institution, and from the movement of legislation from voluntary to permissive to mandatory. Understanding this process can give important keys into areas of research.

The first Select Committee report which looked into this area in 1807 kick-started a process that took until 1845 to fully take effect. The essence of this first report was to highlight how there was no sense of the total number of people being held in institutions and private homes due to mental health problems. Attempts were made to ascertain the actual number of criminal and pauper lunatics, but it was impossible to obtain an accurate picture.

One of the main reasons why it was so difficult was that control lay with individual parishes at a local level and was conducted in a very eclectic manner, where few parishes kept good records, and few had officials who wished to get involved visiting institutions under their jurisdiction.

The main outcome of the committee’s report was to conclude, perhaps unsurprisingly, that many pauper lunatics were kept in a state ‘revolting to humanity’. And the act which followed the next year in 1808 was created to provide better care and maintenance of lunatics, being paupers or criminals, by erecting institutions where lunatics could be held that were specifically designed for that purpose, rather than housing them in jails, bridewells and workhouses.

The act itself, however, had no real teeth, and so most counties just didn’t get involved, mainly because the cost was so prohibitive. But the real significance of the act itself was the way in which it aided the development of further investigation and legislation.

The Select Committee report of 1815 covered the main types of institutions which confined the insane, uncovering terrible conditions, the case of York Asylum being particularly notorious. Godfrey Higgins, a man of independent means, and part of the reform movement associated with the Society of Friends, virtually forced his way into the York Asylum following several attempts by asylum officials to create smokescreens. He reports that he forced a locked door to be opened and was presented with:

‘a very horrid and filthy condition. The walls were daubed with excrement, the air holes of which there was one in each cell were partly filled with it. I then went upstairs and the keeper showed me into a room, 12 feet by 7 feet 10 inches, in which there were 13 women, who, he told me, had all come out of those cells that morning. I became very sick and could not remain longer in the room.’ He reports that then he vomited.

As shocking as these conditions were, to a large degree they actually cemented a rising public belief in the abuses going on behind closed doors in the asylum system. The committee itself had come about partly as a result of the scandalous case of William Norris, which was reported extensively in the press. The sad tale of this man had captured the attention of the public in 1814, when he was discovered in Bethlem Royal Hospital, mechanically restrained, not able to move more than 12 inches, and in poor health, having been confined in isolation for more than ten years.

Norris, a seaman from America, was originally incarcerated in Bethlem for an unnamed lunacy, and was, after a number of violent incidents, restrained in this extraordinary device designed specifically for him. No less than six Members of Parliament visited Norris during 1814, each maintaining that he was rational, quiet and capable of coherent and topical conversation. As a result of the publication of this image, and the interest it generated in asylum reform, Norris was released from his restraints in 1814 yet remained confined in Bethlem. However the conditions he had endured for more than ten years had so weakened his constitution that he died within a few weeks of his release, of either pneumonia or tuberculosis.

The Select Committee report and the case of James Norris, with the public interest they created, were instrumental in the creation of the Madhouse Act and County Asylum Act of 1828. These Acts sought to license and regulate asylums for those who they describe as ‘the insane’, and to improve the treatment of the insane by bringing in legislation pertaining to regular inspection, more detailed certification, and regulations about how records should be kept. And for the first time, a movement towards management from central government, as 15 Metropolitan Commissioners in Lunacy were appointed by the Home Secretary, and reported to him annually.

Here is an example of the commission’s report from 1829, following a visit to an asylum in Twickenham which was overseen by Dr Probin. They report that:

‘There were three patients in this house, one of whom we found in a state of high irritation. There was only one keeper in the house, and Dr Probin being absent, the keeper was unable to restrain him properly.’

But even with these new tighter controls, monitoring was fraught with complication, as there were still five ways in which those suffering from mental health problems could be housed: the county asylum, as we’ve seen, coming under the ultimate control of central government; in Bethlem, which was still exempt from external supervision; in private madhouses; as single lunatics; and in workhouses. Let’s turn to the last one of those for a moment.

The problematic nature of taking those with mental health problems under a system created to deal with poverty was clearly evident. The harshness of the deterrent workhouse system created under the new Poor Law in 1834 was focused on the able-bodied, not on those who could not work. The way the workhouse system dealt with mental illness, certainly in its early years, was directly impacted by the 14-day rule, section 45 of the Act, which stated that:

‘Nothing in this Act contained shall authorise the detention in any workhouse of any dangerous lunatic, insane person or idiot for any longer period than 14 days. And every person, wilfully detaining in any workhouse, any such lunatic, insane person or idiot for more than 14 days, shall be deemed guilty of a misdemeanour’.

Kathleen Jones in her book, A History of the Mental Health Services, argues that the operative word was ‘dangerous’. It became the practice for the boards of guardians to pass on to the county asylum the violent patient, whose condition might be incurable, while retaining in the workhouse the milder or quieter ones who were perhaps in the early stages of the disease, and more readily susceptible to treatment.

County asylums had no choice in the matter. They did not have the choice to select specific patients suitable for treatment. For the workhouse guardians, the cost of sending a patient to the county asylum was much higher than keeping them in the workhouse, and so those who perhaps most needed it, were not attended to.

It was the 1845 Lunacy Act that finally started to pull things together, by making it mandatory for justices of counties and boroughs to provide adequate asylums. Unlike the earlier permissive legislation, each institution was now bound to keep records of admission, discharge, diagnosis, as well as treatments and restraints used. A full system of inspection was initiated, together with a tighter system of certification.

And there’s a huge amount of documentation to show this in action. MH 83 contains the correspondence and surviving plans relating to the original erection and additions to county asylums. [Shows image] Here we can see a new epileptic block being added to the Parkside Asylum in 1889. This is an interesting example as it reveals how even later in the century, there were many conditions such as epilepsy, blindness and deafness being considered as problems of the mind.

MH 85 contains representative case papers, giving an insight into the tightening up over the certification of the insane. Here two doctors provide thorough notes on the single care patient Bernard Rickman. Dr Smyth writes:

‘He is restless and excited in manner. He considers the letter S should be expunged from the alphabet as it is full of abominations and the shape of the serpent. He lighted a piece of newspaper, and having blown out the flames, asked me to smell it, for, as he alleged, it smelled of blood from the murders which are published in the papers.’

MH 51 holds examples of Rule Books. [Shows image] Here we have examples of books from Liverpool, Buckinghamshire and Manchester. The cut-outs here related to the keeping of the admission and discharge registers, and the need to obtain proper certificates. There are also hints of the treatment, or at least the proposed treatment, of those kept there. One rule reads that:

‘The feet of all the patients confined to their beds be carefully examined and gently rubbed every night and morning, and that during the winter season they be covered in flannel.’

Another reads that:

‘All the duties of the attendants be done quietly and regularly, that they open and shut the doors without noise and violence and do not shout in the wards, or talk to the patients in a loud or scolding manner.’

MH 51 also contains special reports. Here’s one I particularly like for Colville House Idiot Institution. There were three children in this institution aged 16, 8 and 7. The inspector reports that:

‘They spend much of the time out of doors, in riding about on a donkey, in strolling about the grounds, and in the common sports and amusements of children’.

[Shows image] So let’s just come back to the timeline once more, to briefly consider what happens after the 1845 Act. There was another Select Committee report in 1859, and amongst other things, it is pointed out there is still no full list of single patients. This is one of the categories I mentioned before and one that because it stood outside the system for so long was ripe for abuse. As Kathleen Jones points out:

‘The single lunatics are the hidden mad. Just like the mad woman in the attic in Jane Eyre, no Commissioner in Lunacy would stop by and see how they were being cared for, for they were at the mercy of the family in their own homes, leading to extremes of care and neglect.’

The 1890 Lunacy Act finally swept this loophole under the umbrella of government control, providing proper notification and inspection, finally covering single patients in their own homes. And so things moved forward to just before the First World War, when with the passing of the Mental Deficiency Act, where the Commissioners of Lunacy are absorbed into the Board of Control, we see the first effective separation of the treatment of those certified as mental defectives from those certified as lunatics. And differences are drawn between those born with a condition which affects their mind, and those of seemingly good mental health, who become afflicted with a condition later in life.

So what I’ve wanted to show you, through looking at some of the records which now form part of the Ministry of Health and Home Office collections, is how a detailed understanding of how the machinery of government was operating, can give an insight into where to search for documents which are not coming up in an online catalogue search.

But I think that it’s always important to bear in mind that just like all histories, the history of mental health does not just sit neatly in the [government] department codes where you would expect it. The health of the mind affected everyone, and because of this, you can find strands of it throughout many different government records. Understanding why that might be, once again aids discovery.

So the Treasury had to approve government policies which had expenditure implications, such as the construction of Broadmoor and Rampton Criminal Lunatic Asylums. This is another excellent example of the problems of descriptions.

This is the description for the document on the construction of Broadmoor [shows image]. Here it just says ‘1863. Papers 18,544 to 18,561’. It took me two days to track these down, because the only way into the Treasury correspondence in T 1 is through a series of alphabetical and subject registers, which in turn lead to the skeleton registers in T 3. The clerks using these registers bundled papers together across the years, so not only do you have to work your way through each reference after reference in one volume, but you need to order year after year of these registers to see where the correspondence finally stops, in order that you can get a reference that you can convert.

For such a huge and significant department with a finger in every pie of government working, it doesn’t matter what you type into the catalogue, you will not pick up these kinds of documents. We find similar things over in the War Office and the Admiralty, who ran military and naval asylums.

[Shows image] Here is the case of John McKenzie, from an Admiralty medical journal, suffering with symptoms of softening of the brain. His shipmates report that he forgets everything, even the places in the ship and his own lodgings. His wife also gives the same account of his total forgetfulness in every matter. The doctor reports that on examination, he spoke thickly and in a paralysed manner and could hardly comprehend the questions about his health. John McKenzie is sent to Haslar Royal Naval Hospital.

Here we’ve got education. The Specials Services branch of the Board of Education was responsible for implementing special schools and classes for what the Elementary Education Act of 1899 called ‘imbecile and feeble-minded children’. Often those involved in these special schools had strong beliefs in segregation. And with the advent of genetics and the influence of Darwin, lifelong segregation was taken one step further by some, to discuss the issues of sterilisation of the mentally unfit. [Shows image] As you can see in this report by Lord Ridell, who writes:

‘I hear that some of these mental defectives cost as much as 42 and 6 per week. It looks as if we are all going to be eaten out of house and home by lunatics and defectives’.

There are also areas which are very sad but stand as places rich in research material, where the understanding of mental illness is limited or non-existent, and so those with mental health problems fall back under the jurisdiction of other areas of government control. And here is an example from the Prison Commission.

[Shows image] This is a prison licence for Elizabeth Frances Nobel. Elizabeth had a little boy called Harry and he died age seven through starvation and neglect. Essentially, she didn’t feed him. You discover when you read the newspaper report that prior to the child’s death her husband had died. And when neighbours come round to ask and to comment on the state of the child, she says, ‘The child wants to die. It does not want to live. It wants to die and go to its Daddy.’

What is of interest here – you can already see this is a very depressed woman – but the medical sheet at the front of the licence reports that Elizabeth had rheumatic fever, very bad, several times, and what the medical officer does not point out, is that severe rheumatic fever can lead to mania, delusions and acute depression.

Similarly, we find evidence of hidden unrecognised mental health problems in the records of the Metropolitan Police, the only police force in England and Wales accountable directly to the Home Secretary (and thus part of The National Archives’ collection).

[Shows image] These are the books of the habitual drunkards, portraits and descriptions circulated to licensed persons and secretaries of clubs, for those who should not be served. The behaviour of these women is defined through the context of the law and their records exist because they fall under the penal eye but as you look at these, it is a poignant picture of how those at the mercy of addiction and depression slip through the net of care. [Shows images] This is Sarah Scarsbrook. This is Mary Casey. And this is poor Annie Reynolds.

So to conclude. Records relating to mental health in The National Archives are numerous. They provide fascinating insights into those suffering from mental illness, those treating it, and also the way central government interacts with issues of mental health, providing pieces in the wider story of how the mind has been perceived and understood. An informed use of language, and an understanding of the frequent lack of robust document descriptions, should inform the researcher that there is more work to be done. By investing time into understanding the development of the administrative histories, through finding aids such as the current guide, sources are opened up to greater scrutiny and more effective academic evaluation.

Transcribed by Lucy Handscomb as part of a volunteer project, April 2015