London and Its Asylums, 1888-1914: Politics and Madness, by Robert Ellis

Abstract

Reviewed by: London and Its Asylums, 1888-1914: Politics and Madness by Robert Ellis Leslie Topp (bio) London and Its Asylums, 1888-1914: Politics and Madness, by Robert Ellis; pp. viii + 296. Cham, Switzerland: Palgrave Macmillan, 2020, $119.99, $89.00 ebook. Scholars of Victorian asylums are often faced with archival and primary sources that are if anything too rich and interesting: case notes, daily logs, photographs, and inspectors' reports that bring these immense institutions to life in all their problematic human complexity. Robert Ellis, by contrast, has been brave enough to tackle a very different set of sources, much drier and more impenetrable. London and Its Asylums, 1888-1914: Politics and Madness is not, despite its title, directly concerned with the British capital's psychiatric institutions, but rather with the bureaucratic structures that oversaw them (and poor people's mental healthcare more generally) at the end of the nineteenth century and the beginning of the twentieth. The sources that Ellis digests and deploys [End Page 512] are the products of administrative bureaucracy, above all the carefully compiled minutes of twenty-six-years' worth of committee meetings. The result of this herculean task is an account that, while requiring some effort and persistence to read, offers an original and compelling angle on the history of mental healthcare, particularly as it was affected by electoral politics. The Local Government Act of 1888 created the London County Council (LCC), setting up for the first time a municipal government for all of London. In one stroke, this new body became responsible for the institutional care and treatment of residents who were deemed to need confinement due to mental disturbance and who could not pay for their maintenance, a group of people who were still referred to throughout this period as "pauper lunatics" (10). The LCC took on responsibility for the management and funding of four existing asylums, completed one which had been in the planning stages, and built six further asylums. Altogether, by 1914, this group of institutions housed thousands of patients. The Local Government Act meant that for the first time in England, institutional mental healthcare was the responsibility of a democratically elected body. Ellis's decision to focus on London and the LCC results in an in-depth study of how this combination of democratic local politics and the provision for (and control of) this large, growing, and very vulnerable group worked in practice. London's exceptional status as a world city and capital of empire, and its vast scale, give his findings wide relevance. Central to Ellis's argument is his insistence that the sources show that mental healthcare in the period was not the "non-contentious" science-led area of public policy it was often presented to be later in the twentieth century (49). (Indeed, Ellis points out that the neglect of mental healthcare under the Conservative austerity politics of the 2010s in the UK shows that this area still cannot be separated from political positions.) The years covered by the book witnessed two distinct party-political regimes within the LCC: the Progressives, who were aligned with the Liberals at the national level, had a majority until they lost the 1907 election to the Municipal Reformers, who were aligned with the Conservatives. The contrasting approaches of the two parties allow Ellis to open up new key insights into why asylums and asylum-based practices developed in the ways they did. And, often, this had nothing to do with internal psychiatric debates. For instance, the Municipal Reformers had as a central plank of their platform control over spending and keeping taxes down. The very large asylums they built represented not an impressive commitment to a marginalized group, but, in the context of laws that compelled local councils to build asylums, an attempt at savings through economies of scale and a deprioritization of patients' and their families' needs to have institutions closer to their homes and accessible for visiting. Ellis also shows that the Council made itself aware (through impressive transnational networks) of international tendencies in asylum design toward the so-called villa asylum, but instead chose to persist with outmoded corridor-system designs in order to control budgets. Under the...