Seeking Refuge: Why Asylum Facilities Might Still Be Relevant for Mental Health Care Services Today

Abstract

This article reassesses the history of mental asylums in New South Wales, arguing that far from being 'cemeteries for the still breathing,' Victorian and Edwardian asylums served multiple purposes, providing genuinely therapeutic conditions for many patients, while warehousing chronic incurables and those without networks of support. Mental asylums in nineteenth century New South Wales rarely resorted to measures of restraint and seclusion and had a notable record of high rates of recovery and low rates of readmission. The marked institutional decline of the twentieth century that eventually prompted critics from many quarters to demand the closure of large asylums represented more a loss of faith in institutionalisation and the desire of psychiatrists to achieve higher status and more lucrative remuneration treating new middle class populations of neurotics than inherent flaws in the asylum ideal itself. Thus deinstitutionalisation policies were built on a fundamentally revisionist history that failed to consider the reality of care in these institutions, an insight that opens up opportunities to rethink the role and function of refuge in contemporary mental health policy.