Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

01-10-2018 | Brief report

Views from an asylum: a retrospective case note analysis of a nineteenth century asylum

Authors: Elvina May-Yin Chu, Joeke van Santen, Vijay Harbishettar

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 10/2018

Abstract

Purpose

To investigate whether lifelong admission to psychiatric asylum care was usual practice before community psychiatric care was introduced.

Methods

Historical archives (1838–1938) for 50 patients at the Northampton General Lunatic Asylum in England were studied. Regression analyses were performed to investigate associations between predictor variables (age, gender, marital status, social class) and outcomes (diagnoses, length of stay and admission outcomes).

Results

30 patients (70%) were discharged into the community. 15 (31%) patients were admitted longer than 1 year. Diagnosis of mania was significantly higher in patients who were married. Trend associations were observed for melancholia being diagnosed in higher social class patients and monomania being diagnosed in unmarried patients. No associations were found between predictor variables and length of stay or admission outcomes.

Conclusions

These findings challenge the myth that asylum incarceration was a usual practice before the advent of community care. Most patients were discharged from psychiatric asylum hospital within a year of admission even before the advent of psychotropic medication.

Dickens C (1857) The star of Bethlehem. Househ Words 386(16):145–150

Kosky R (1986) From morality to madness: a reappraisal of the asylum movement in psychiatry 1800–1940. Aust N Z J Psychiatry 20(2):180–187. https://doi.org/10.3109/00048678609161330 CrossRefPubMed

Pow JL, Baumeister AA, Hawkins MF, Cohen AS, Garand JC (2015) Deinstitutionalization of American Public Hospitals for the Mentally Ill Before and After the Introduction of Antipsychotic Medications. Harvard Rev Psychiat 23(3):176–187. https://doi.org/10.1097/Hrp.0000000000000046 CrossRef

Wright D (2001) Mental Disability in Victorian England: The Earlswood Asylum 1847–1901. Oxford University Press, New YorkCrossRef

Killaspy H (2006) From the asylum to community care: learning from experience. Br Med Bull 79–80(1):245–258. https://doi.org/10.1093/bmb/ldl017 CrossRefPubMed

Fakhoury W, Priebe S (2007) Deinstitutionalization and reinstitutionalization: major changes in the provision of mental healthcare. Psychiatry 6(8):313–316. https://doi.org/10.1016/j.mppsy.2007.05.008 CrossRef

Fakhoury W, Priebe S (2002) The process of deinstitutionalization: an international overview. Curr Opin Psychiatr 15(2):187–192. https://doi.org/10.1097/00001504-200203000-00011 CrossRef

Johnson S, Zinkler M, Priebe S (2001) Mental health service provision in England. Acta Psychiatr Scand Suppl 104(410):47–55. https://doi.org/10.1034/j.1600-0447.2001.1040s2047.x CrossRef

Burns T (2006) Psychiatry. A very short introduction. Oxford University Press, OxfordCrossRef

10.

Nasrallah HA (2008) Bring back the asylums? The tragic consequences of deinstitutionalization. Curr Psychiatry 7 (3)

11.

Boffey D (2016) Leaked report reveals scale of crisis in England’s mental health services. The Observer 13

12.

Leff J (2001) Why is care in the community perceived as a failure? Br J Psychiatry J Mental Sci 179:381–383CrossRef

13.

Swartz MS, Swanson JW, Hiday VA, Borum R, Wagner HR, Burns BJ (1998) Violence and severe mental illness: the effects of substance abuse and nonadherence to medication. Am J Psychiatry 155(2):226–231. https://doi.org/10.1176/ajp.155.2.226 CrossRefPubMed

14.

Butcher JN, Mineka S, Hooley JM (2010) Abnormal psychology, 14th edn. Allyn & Bacon, Boston

15.

Mind (2014) Violence and mental health factsheet. http://www.mind.org.uk/media/998781/Violence-and-mental-health-Mind-factsheet-2014.pdf. Accessed 13 August 2016

16.

Torrey EF (2016) Deinstitutionalization and the rise of violence. CNS Spectr 20(3):207–214CrossRef

17.

Shaw J, Hunt IM, Flynn S, Meehan J, Robinson J, Bickley H, Parsons R, McCann K, Burns J, Amos T, Kapur N, Appleby L (2006) Rates of mental disorder in people convicted of homicide. National clinical survey. Br J Psychiatry J Mental Sci 188(2):143–147. https://doi.org/10.1192/bjp.188.2.143 CrossRef

18.

Priebe S, Badesconyi A, Fioritti A, Hansson L, Kilian R, Torres-Gonzales F, Turner T, Wiersma D (2005) Reinstitutionalisation in mental health care: comparison of data on service provision from six european countries. BMJ 330(7483):123–126. https://doi.org/10.1136/bmj.38296.611215.AE CrossRefPubMedPubMedCentral

19.

Taylor PJ, Gunn J (1999) Homicides by people with mental illness: myth and reality. Br J Psychiatry J Mental Sci 174:9–14CrossRef

20.

Levin A (2014) Experts refute myths linking mental illness, violence. APA Psychiatric News. https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2014.4a14

21.

Angermeyer MC, Schulze B (2001) Reinforcing stereotypes: How the focus on forensic cases in news reporting may influence public attitudes towards the mentally ill. Int J Law Psychiat 24(4–5):469–486. doi:https://doi.org/10.1016/S0160-2527(01)00079-6 CrossRef

22.

Klin A, Lemish D (2008) Mental disorders stigma in the media: review of studies on production, content, and influences. J Health Commun 13(5):434–449. https://doi.org/10.1080/10810730802198813 CrossRefPubMed

23.

Haw C, Yorston G (2004) Thomas prichard and the non-restraint movement at the Northampton Asylum. Psychiatr Bull 28(4):140–142. https://doi.org/10.1192/pb.28.4.140 CrossRef

24.

Foss A, Trick K (1989) St Andrew’s Hospital, Northampton. The first one hundred and fifty years (1838–1988). Granta Editions, Cambridge

25.

St Andrews Healthcare (2014) Who we are: Our heritage. http://www.stah.org/our-heritage. Accessed 12 July 2016

26.

Corporation I (2013) SPSS statistics for windows. vol version 22. IBM Corp, Armonk

27.

Rutherford S (2008) The Victorian Asylum. Shire, Oxford

28.

Stevens M (2014) Life in the Victorian Asylum: the world of nineteenth century mental health care. Pen & Sword, Barnsley

29.

Renvoize EB, Beveridge AW (1989) Mental illness and the late Victorians: a study of patients admitted to three asylums in York, 1880–1884. Psychol Med 19(01):19–28CrossRef

30.

Wright D (1997) Getting out of the asylum: understanding the confinement of the insane in the nineteenth century. Soc Hist Med 10(1):137–155CrossRef

31.

MacKenzie C (1985) Social factors in the admission, discharge and continuing stay of patients at Ticehurst Asylum, 1845–1917. Anat Madness 2:147–174

32.

Doody GA, Beveridge A, Johnstone EC (1996) Poor and mad: a study of patients admitted to the Fife and Kinross District Asylum between 1874 and 1899. Psychol Med 26(05):887–897. doi:https://doi.org/10.1017/S0033291700035236 CrossRefPubMed

33.

Showalter E (1980) Victorian women and insanity. Vic Stud 23(2):157–181PubMed

34.

Wright D (2004) Delusions of gender? Lay identification and clinical diagnosis of insanity in Victorian England. Clio Medica (Amsterdam, Netherlands) 73:149–176

35.

Eid Laeticia L (2013) Bipolar disorder and socioeconomic status: what is the nature of this relationship? Int J Bipolar Disord 1:9CrossRef

36.

Ellison Nell N (2013) Bipolar disorder and stigma: a systematic review of the literature. J Affect Disord 151(3):805–820CrossRef

37.

Beveridge A (1995) Madness in Victorian Edinburgh: a study of patients admitted to the Royal Edinburgh asylum under Thomas Clouston, 1873–1908: I. Hist Psychiatry 6(21, Pt 1):21–54. https://doi.org/10.1177/0957154X9500602102 CrossRef

Title: Views from an asylum: a retrospective case note analysis of a nineteenth century asylum
Authors: Elvina May-Yin Chu
Joeke van Santen
Vijay Harbishettar
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 10/2018
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-018-1575-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Views from an asylum: a retrospective case note analysis of a nineteenth century asylum

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 10/2018

Intersections of discrimination due to unemployment and mental health problems: the role of double stigma for job- and help-seeking behaviors

Perceived neighbourhood social cohesion and depressive symptom trajectories in older adults: a 12-year prospective cohort study

Patterns and predictors of depressive symptoms among Jamaican fathers of newborns

‘Between a rock and a hard place’: family members’ experiences of supporting a relative with bipolar disorder

Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study

Interpersonal and institutional ethnic discrimination, and mental health in a random sample of Palestinian minority men smokers in Israel