Kathleen Jones - Mental Health and Social Policy, 1845-1959

The International Library of Sociology

MENTAL HEALTH AND SOCIAL POLICY 1845 - 1959

Founded by KARL MANNHEIM

The International Library of Sociology

THE SOCIOLOGY OF MENTAL HEALTH

In 7 Volumes

MENTAL HEALTH AND SOCIAL POLICY 1845 - 1959

by

KATHLEEN JONES

First published in 1960 by

Routledge and Kegan Paul Ltd

Reprinted in 1998 by

Routledge

2 Park Square, Milton Park,

Abingdon, Oxon, OX14 4RN

1960 Kathleen Jones

All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

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British Library Cataloguing in Publication Data

A CIP catalogue record for this book is available from the British Library

Mental Health and Social Policy 1845 - 1959

ISBN 0-415-17803-7

The Sociology of Mental Health: 7 Volumes

ISBN 0-415-17835-5

The International Library of Sociology: 274 Volumes

ISBN 0-415-17838-X

Preface

T HIS book was originally planned to cover a period of a hundred years from 1845, ending perhaps on the eve of the National Health Service Act; but developments which have taken place in the mental health field since it was started have been so striking, and of such lasting importance, that it seemed logical and necessary to extend it to include the Mental Health Act of 1959. The last two chapters, therefore are not historical in character, but represent an interim assessment of events which are still close to the time of writing.

The author owes a debt of gratitude to Professor T. E. Chester, Professor C. Fraser Brockington and Mr. A. B. L. Rodgers of the University of Manchester, and to Professor G. R. Hargreaves of the University of Leeds; all of whom have read the manuscript in whole or in part, and have made helpful suggestions and criticisms. Especial thanks are due to Dr. Alexander Walk, of the Royal Medico-Psychological Association, for his detailed and valuable revision of the text in the final stages. (It is only fair to add that he does not wholly agree with the conclusions drawn in , maintaining that asylum doctors in the 184590 period were more enlightened than the attitude of lawmakers and investigators would suggest.)

Thanks are also due to Lady Adrian, who was kind enough to make available material concerning the life and work of Dame Ellen Pinsent; and to the following, for information on the subjects specified: Dr. Barbara Hammond (sources on the life of Lord Shaftesbury); Mrs. Glyn Owens (early development of occupational therapy); Mr. Kenneth Robinson, M.P. (the parliamentary debate on mental health, February 19th, 1954); Mr. W. A. J. Farndale (material on day hospitals from his own research project); and Dr. A. J. Wilcocks (the passing of the National Health Service Act).

Introduction

I N the first half of the nineteenth century, the tide of industrial change brought new wealth and new opportunities to a few, but squalor and hardship to many. The social problems with which small rural communities had dealt casually, but on the whole effectively, became acute in the towns, where families crowded together in conditions of dirt and disease and despair; but industrialization, if it intensified social distress, also provided the means of dealing with it. The very force of distress produced a new social conscience, a desire to tackle the age-old problems of poverty and sickness and ignorance which had largely been taken for granted by the reasonable man of the eighteenth century; and new, swift communications provided the means of establishing nationalstandardswherepreviouslyonlylocalstandardshadbeenpossible.

In the third and fourth decades of the century, a series of pieces of social legislation were introduced, which embodied a common ethical principle and a common administrative principle. The ethical principle was the belief that the community had a responsibility for those who could not help themselves; the administrative principle was the concept of a national framework with a central inspectorate to enforce its standards. The great Acts of Parliament of this periodthe Poor Law Amendment Act, the Factory Acts, the Public Health Act of 1848are well-known. A lesser-known Act which embodied the same principles was the Lunatics Act of 1845.

This Act marked the end of an era in reform. Behind lay a century of appalling revelations, such as those of the Select Committee on Madhouses of 181516, which brought home to the general public the plight of a group of helpless people. Chained, beaten and half-starved, they lived in cellars and garrets, in prisons and workhouses, out of the public eye and the public memory. A series of reformers had forced this unpalatable story into the open in the Press and in Parliament. In York, William Tuke proved at the Retreat that the insane could respond to kindness and trust, and Godfrey Higgins defied the Archbishop in making public the scandals of the York Asylum. In London, a group of Members of Parliament investigated Bethlem, the oldest hospital for the insane in England, and others forced their way into the private madhouses of the London area. In Gloucester, Sir George Onesiphorus Paul set in train a series of events which led to the passing of the County Asylums Act of 1808, and the first institutions specially designed for criminal and pauper lunatics. A national movement for reform started with the appointment of Lord Ashley, later the 7th Earl of Shaftesbury, to the Metropolitan Commission in Lunacy in 1828.

If any one man can be said to have embodied the social conscience of the mid-nineteenth century, it is unquestionably Ashley. His work for those who laboured in the mines and the factories, for the pathetic climbing boys and for the children of the Ragged Schools was infatigable; but no issue occupied so much of his time and energy as the care of the insane. The appointment to the Metropolitan Commission was his first public appointment, a year after he entered Parliament at the age of twenty-seven. When he died at the age of eighty-four, he was chairman of the Lunacy Commission, and much of the failing energy of his last years was devoted to this same question.