Jonathan Andrews and Anne Digby (eds), Sex and seclusion, class and custody: perspectives on gender and class in the history of British and Irish psychiatry, Wellcome Series in the History of Medicine, Clio Medica 73, Amsterdam and New York, Rodopi, 2004, pp. vi, 338, €80.00, US$104.00 (hardback 90-420-1186-6); € 39.00, $51.00 (paperback 90-420-1176-9).

Abstract

This addition to the Wellcome Series in the History of Medicine continues its excellent tradition of making important debates in the history of medicine available to the widest possible audience. Jonathan Andrews and Anne Digby have brought together well-known contributors to recent discussions about the identification and management of mental illness and mental deficiency as social and medical problems, and have posed an important new question about the significance of the interplay between class and gender. The introduction provides an unusually thought-provoking overview of what had seemed exhausted territory. While other recent volumes have extended their coverage of time and space to trace the global development of care in search of new sources and debates, this collection revisits familiar historical and geographical landscapes in a genuinely novel way. The sophisticated case studies produced, which link detailed archival work to broader methodological questions, show the value of this approach. Students should find these very readable accounts a useful way into the complex literature on the history of asylums and psychiatry, and even scholars familiar with the wider research projects the papers are drawn from will want to take note of the individual contributions and the collection as a whole. The invitation to authors to put the interplay of class and gender at the heart of their analysis has produced nuances of argument missed by other studies. This revives and reinvigorates debate about professionalization and lay as well as medical conceptualizations of insanity. The consideration of masculinity as well as femininity and the relationship of both, mediated through class, to work and notions of respectable behaviour, is a theme that draws many of the papers together. It also merits further attention in the light of recent debates emerging from both labour history and ongoing work on the Poor Law. While some papers give more attention to class or gender issues, the key question remains in focus and there is evidence of tight editorship and a real commitment to the project by all the contributors. The introduction stresses the importance the editors attached to getting the geographical coverage right, and the resulting balance of papers reflects this. Contrasts between different parts of England and the Celtic fringe underline the importance of social, economic, political and legal factors in the construction and management of insanity. The book also contextualizes different patterns of kinship relations and the importance of religion, helping to explain how community notions of appropriate class and gender roles were not simply imposed from above. Thematically the volume also works well, but the chronology is more problematic. While coverage does extend from the mid-eighteenth to the late-twentieth centuries, the editors acknowledge the majority of papers concentrate on the Victorian and Edwardian periods. Robert Houston does an effective job of setting the scene at the outset but the two final chapters cannot possibly capture all the complexities of twentieth-century developments in psychiatric practice or institutional and community care, so ably summarized in the comprehensive introduction. In fact Mark Jackson's paper deliberately concentrates on the campaign for, rather than implementation of, the Mental Deficiency Act and this leaves Joan Busfield with the impossible task of covering every major development in the field of mental disorder since 1913. Her explanation for her rather arbitrary decision to consider four main periods 1890–1929, 1930–53, 1954–73, and 1973 to present, then has the unfortunate effect of crowding out the much anticipated case studies of shell-shock and psychopathic disorder that are given excellent but necessarily brief treatment at the end. It might have been better to expand the case studies and simply anticipate developments to come. However, this is a minor point that does not detract from the overall quality of the book.