Colonial Asylum Research Articles

Beyond the Asylum: Mental Illness in French Colonial Vietnam by Claire E. Edington (review)

Reviewed by: Beyond the Asylum: Mental Illness in French Colonial Vietnam by Claire E. Edington C. Michele Thompson Edington, Claire E.–Beyond the Asylum: Mental Illness in French Colonial Vietnam. Ithaca, NY: Cornell University Press, 2019. 291 p. Claire E. Edington’s Beyond the Asylum: Mental Illness in French Colonial Vietnam truly does go “beyond the asylum” in its examination of the complex interplay between culture, both French and Vietnamese, medicine, and patterns of colonization and resistance to it in French Indochina, primarily Vietnam. This solidly researched and gracefully written volume is thought-provoking in many ways, and pertinent to the study of many topics in Vietnamese history from the late nineteenth century to about 1950, that it really should be read by anyone who studies or teaches about Vietnam during that period. Beyond the Asylum is based on Edington’s extensive archival research in Vietnam, France, and Cambodia and on a solid selection of secondary sources in English, French, and Vietnamese. She uses her numerous archivally sourced illustrations, which range from blueprints to reproductions of artwork from popular literature of the period, to maps and photographs, to draw attention to important points in the text in a way that a mere written description never could. For example, the very first figure, a 1934 photograph of the entrance to the Biên Hòa Asylum, [End Page 213] shows a road through a gate that is clearly decorative, rather than truly confining, and grounds with large trees and grassy lawns. The photograph illuminates and supports Edington’s statement that this asylum was based on a “more humanitarian conception of care than earlier methods of confinement—one that proved useful in improving the poor public image of the asylum” and that “the appearance of freedom itself was seen as curative” (p. 56). This, in turn, sets the scene for much of the discussion which follows on the everyday lives of patients and staff in Chapter 2 and even the author’s arguments regarding therapeutic labour in an increasingly exploitative colonial agricultural system in Chapter 3. Edington’s discussion of these subjects builds her case that while the French tried “to fashion the asylum as a world unto itself,” the paradigms in the outer world constantly impinged on French colonial asylums (p. 85). The author’s depiction of the history of the French colonial adoption of the labour-as-therapy pattern of treatment primarily from Dutch colonial mental health practices in the Dutch East Indies (today’s Indonesia) is especially interesting. It is rare for works on the history of colonial era medicine in Southeast Asia to go beyond the boundaries of any one colonial power or to discuss in any detail collaborative efforts between and among medical professionals from them. Clearly, there is more work to be done on the subject and Edington is leading the way. No work of scholarship is perfect and, despite its many strengths, this one is not either. It appears that most, if not all, of the small problems that I feel compelled to note appeared during the process of cutting this volume down in terms of length and, probably, in terms of notes. For example, on page 23 Edington discusses the Vietnamese concept of mental health and mental illness. She mentions both fourteenth-century documents and the physician Lȇ Hữu Trác in a sentence structure that suggests he himself lived in the fourteenth century when he lived in the eighteenth. There are also places (for example, page 25) where the source cited does not match the source from which the quote derives. On page 25, Edington is citing one of my own publications, but the wrong one. There are other small problems of this sort that are not worth going over in detail. Almost all of them concern the pre-modern period and Vietnamese Traditional Medicine and they do not materially affect Edington’s argument or the many great strengths of this book. One of those strengths is Edington’s commitment to discussing the effects of French colonization on ordinary everyday Vietnamese people and the resulting deterioration in what the French, and sometimes the Vietnamese, defined as mental health. This can be...

Escape from the Colonial Asylum

David Taylor was a white Barbadian, a member of my immediate family, who died in 1963 at age 46 in the Barbados Mental Hospital, as the island’s psychiatric hospital was then known. Although making...

Papering over madness: accountability and resistance in colonial asylum files: a New Zealand case study

ABSTRACTThrough an examination of New Zealand legislation governing lunacy and the files from the Seacliff Asylum, this article argues how paperwork served to uphold an elusive ideal of a compassionate society. Paper, in the form of letters, reports and forms, was sent up and down the country in order to prevent wrongful confinement and to monitor costs and cure rates. Paper provided for patients allowed them to challenge their incarceration, sometimes successfully. That maze of paperwork, generated for both statutory and institutional administrative ends, mirrored the disorder of those confined within the institution. The curating of digital exhibitions of such materials flattens out their complexity and smooths over what were often disjointed narratives.

Re-contextualising Criticisms of Colonial Asylum Building in the Mid to Late Nineteenth Century: The Case of Lawson’s Seacliff Asylum

Designed in 1878 and opened in 1884, Dunedin’s Seacliff Asylum was criticised by New Zealand’s Inspector-General of Asylums as being “badly designed and out of date” in 1882, two years prior to its completion. Similar accusations echo through other New Zealand and Australian examples including the Whau (Auckland, 1863), Yarra Bend (Melbourne, 1846–1848), Ararat (Victoria, 1865), Beechworth (Victoria, 1867) and Kew Asylum (Melbourne 1872). But how often were these statements qualified? For the claim of “out dated” to be upheld, there must be a corresponding development within either the architectural or treatment theories that underpinned asylum construction between the mid- and late nineteenth century. Examining Seacliff Asylum, relative to nineteenth-century documentation around best practice in asylum design and lunacy treatment, this paper will illustrate that substantial development did not occur in either sphere; it will interrogate how often criticisms of colonial asylums were qualified, challenged or warranted. While existing studies in the field examine asylums against best practice as documented within leading nineteenth-century texts, this paper proposes that asylum designs should be evaluated against a broader understanding of their therapeutic potential – the ability of a particular architectural response to support the delivery of moral treatment.

Neurasthenia at Mengo Hospital, Uganda: A Case Study in Psychiatry and a Diagnosis, 1906–50

ABSTRACTThis article uses a case-study approach to examine the complex and contradictory nature of diagnoses like neurasthenia in colonial Africa. Drawing on the case notes of European and African patients diagnosed with neurasthenia at the Church Missionary Society's Mengo Hospital, Uganda, it argues that in practice, and outside the colonial asylum in particular, ideas about race and mental illness were more nuanced than histories of psychiatry and empire might imply. At Mengo, the tales of pain and suffering recorded by the doctors remind us that there is more to the history of neurasthenia than colonial anxieties and socio-political control. This was a diagnosis that was negotiated in hospital examination rooms as much as in medical journals. Significantly, it was also a diagnosis that was not always reserved exclusively for white colonisers—at Mengo Hospital from the early 1900s neurasthenia was diagnosed in African patients too. It became part of a wider discussion about detribalisation, in which a person's social environment was as important as race.

Insanity, Identity and Empire: Immigrants and Institutional Confinement in Australia and New Zealand. 1873–1910

132 BOOK REVIEWS practice of yi, while acknowledging that it would require retraining of doctors and that it is not scientific in the western sense. Her book is argued in great detail, is provocative, and deserves to take its place in current academic debates about Chinese medicine, its transformation, and the socio-political developments in China that led to this change. ANDREW MURRAY RYDE, NSW Catharine Coleborne. Insanity, Identity and Empire: Immigrants and Institutional Confinement in Australia and New Zealand. 1873–1910, Studies in Imperialism (Manchester: Manchester University Press, 2015). ISBN: 978-0-7190-8724-0 (HB). B&W illustrations and tables. xiv + 224pp. Consider the challenges of logging the 1897 admission of Jenny Ah Yen who arrives from the Chinese camp on the Castlemaine goldfields at the Yarra Bend Asylum, Melbourne, on one apparently unremarkable day. Jenny’s reputation as a prostitute accompanies her, as does her opium-smoking habit. She is run-down and heavily scarred, both physically and mentally. Her mental history includes a prolonged narcotic addiction and delusional thinking throughout the preceding two months. The official note-taker needs considerable skill in separating the facts about Jenny from the uncertainties that cloud her story, but there are few tools that allow him (or less likely her) to convey any disparities. In the end he writes her age as ‘36’, her religion as ‘Church of England’ and her inconclusive marital status as ‘single?’ Working with the words, punctuation marks, and gaps in Admission Warrants and Case Books is stock in trade for social historian, Catharine Coleborne, and central to Insanity, Identity and Empire. In it, she teases out the content and context of copious records made by colonial police, gaol warders, asylum note-takers, and welfare staff, to derive woven-together identities that are sufficiently elastic as to allow for some interpretation. In the case of Jenny Ah Yen, Coleborne speculates about whether she is a Chinese woman, or a European woman who has taken a Chinese name, and whether she is married or has resumed her single status. Official records about Jenny, together with those of nearly four thousand other patients admitted between 1873 and 1910 to the Yarra Bend Asylum, and to the Auckland Provincial Lunatic Health & History ● 18/2 ● 2016 133 Asylum in New Zealand, provide Coleborne with her chief primary source materials. She has contextualised these patient histories with contemporaneous records of welfare organisations including the Immigrants’Aid Society in Melbourne, the Melbourne City Mission, and the Auckland Ladies’ Benevolent Society. Drawing together these official records, she skilfully derives patterns of patients’ experience in order to explore ideas about how their identities pressed the boundaries of race, class, ethnicity, and gender, as well as testing the limits of conformity to social norms and resistance to authority. This record-centred approach features in the last five of the book’s six chapters, having set the scene in the first with an examination of insanity and its institutions in the context of migration to Australasia from the 1850s to the 1880s. It was this period, this ‘age of mobility’, that has given rise to much scholarship about identity formation. In Chapters 2 and 3 she unravels the often travail-ridden histories of immigrants to the Victorian colony and the Auckland province, while Chapters 4 and 5 deal with the construction of gendered identities for the insane. Chapter 6 focuses on the identity formation of ‘others’, the non-white patients in colonial asylums, including Indigenous, Chinese, and so-called ‘half-castes’. While gender was a category that led to strict spatial segregation within institutions, Coleborne finds that the distinctions of class and race floundered to some extent in the face of official conceptions of mental illness. She comments that ‘Public asylums were places where “everyone” admitted was deemed “mad”, so there is also a sense in which these institutions collapsed differences between people, herding them into state care and confinement’(p. 86). Though non-white patients were sometimes identified according to physical characteristics like hair length (such as pigtails) and language, she found little in their records to suggest that European doctors used racial markers to distinguish their mental states from those of other patients. Coleborne also highlights...

"Die Moderne macht sie geisteskrank!"

Abstract This article opens with a discussion of the British anthropologist and psychiatrist Margaret Field’s famous study of Ghana, “Search for Security” (1960), before going on to investigate the long history of discourses and practices hinged upon the idea that traumatic everyday experiences of modernity such as industrialization and agricultural mechanization induced insanity in so-called primitive peoples in tropical Africa. The article focuses especially on the way in which British, French, German, and North American psychiatric knowledge travelled to Africa from the late nineteenth century onwards before returning back to the Global North. Finally, the article presents two case studies from a mental hospital run by German missionaries in Tanganyika and a British colonial asylum in Kenya that underscore the manner in which tropical Africa served as a “living laboratory” (Helen Tilley) for frequently violent and abusive psychiatric research.

‘At variance with the most elementary principles’: the state of British colonial lunatic asylums in 1863

In 1863 the Colonial Office reviewed colonial hospitals and lunatic asylums in those parts of the British Empire it administered - probably the first and widest international comparative study up to that date. This article outlines the background, process and scope of the review of asylums, and considers its significance. The resulting 'digest' is an important source to explain how, why, when and by whom metropolitan ideas acquired official endorsement and spread throughout the British world. Using the review's general findings and suggestions, a tool is provided for comparing inter-colonial achievements. With New Zealand as a case study, the article concludes that, relative to other influences, the digest played a limited and largely indirect part in shaping New Zealand's mental health policy before 1876.

Black Skin, White Coats: Nigerian Psychiatrists, Decolonization, and the Globalization of Psychiatry by Matthew M. Heaton (review)

Reviewed by: Black Skin, White Coats: Nigerian Psychiatrists, Decolonization, and the Globalization of Psychiatry by Matthew M. Heaton Jock McCulloch Matthew M. Heaton. Black Skin, White Coats: Nigerian Psychiatrists, Decolonization, and the Globalization of Psychiatry. New African Histories Series. Athens: Ohio University Press, 2013. x + 249 pp. $32.95 (978-0-8214-2070-6). The past two decades has seen a rich literature on colonial asylums in Kenya, Malawi, Nigeria, South Africa, Zimbabwe, and Algeria.1 Historians have used [End Page 764] those institutions and their supporting science to gain insight into the construction and gendering of colonial states, and to identify the similarities and differences between governance in imperial centers and peripheries. In contrast, Matthew Heaton’s innovative Black Skin, White Coats is the first full-length history of a national mental health system focusing on the transition between the colonial and postcolonial periods. Heaton has conducted archival work in Nigeria, London, and Geneva, interviewed specialists in the field, and read the secondary literature. The only obvious omission is the standard psychiatric texts, and in particular Henderson and Gillespie and Martin Roth, to which Nigerian psychiatrists such as T. A. Lambo and his generation were exposed. Those texts present both the disease categories and the racially based assumptions about personality and character on which colonial psychiatry was based. Black Skin, White Coats is built around three governing arguments. First, the transformation of psychiatric practice and theory in Nigeria was part of the decolonization project. That transformation fed into a postcolonial modernity that was global rather than national in character. In this process, Western science was adapted to local settings. Finally, in adopting a cross cultural focus, Western psychiatry was changed fundamentally—and part of that change originated in Nigeria. If Heaton’s thesis is correct, such profound changes must be reflected in the established disease categories. The book begins with the colonial asylums and their place within the science of ethno-psychiatry, and then traces the decolonization of medical servicing and the establishment of global networks. An innovative chapter then looks at mental illness among Nigerian immigrants in the United Kingdom. Chapter 4 examines schizophrenia, depression, and the culture-bound syndrome of brain fag. Heaton then turns to the story of traditional healers and biomedicine, an important and hitherto neglected subject. Chapter 6 examines the introduction of psychoactive drugs and the impact of illicit drug use. The text ends with an essay on Nigerian psychiatry and globalization. Much of the concluding argument revolves around T. A. Lambo and the Aro village experiment in community care. In summary, Black Skin, White Coats explores the shift from colonial subjects to citizens. The major change in the period under review (1950s–1970s) was the revolution in psychotropic drugs that saw the shutting down of asylums in the OECD states and their replacement by outreach programs. In the 1970s, Nigeria’s health infrastructure developed rapidly. However, it was not until the 1980s, when the health sector was seriously underfunded and understaffed, that some Nigerian specialists begun to question Western disease models and to reassess the value of traditional healers. [End Page 765] While Heaton’s study makes a number of interesting and valuable contributions to the literature, his main thesis remains unconvincing. There were, as he acknowledges, ample precedents for the Aro Village scheme founded by T. A. Lambo. More broadly, to sustain the claim that Nigerian psychiatry made a major contribution to a global science, there would need to be evidence that it influenced the North Atlantic psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders. There should also be—but are not—references to the influence of Nigerian psychiatry on the massive public health systems in India, China, and Russia. For all its virtues, Black Skin, White Coats also provides little detailed insight into the social dynamics of Nigeria itself. For example, passing references to the social and economic history of Nigeria make it difficult to identify what led men and women through the asylum gates. We know from Blida (Algeria), Mathari (Kenya), and Ingutsheni (Zimbabwe) that violence, poverty, drink, or an organic brain disorder were the most common reasons for admission. We also know that elsewhere in Africa admissions...

Reconstructing Harry: a genealogical study of a colonial family 'inside' and 'outside' the Grahamstown Asylum, 1888-1918.

Recent scholarship has explored the dynamics between families and colonial lunatic asylums in the late nineteenth century, where families actively participated in the processes of custodial care, committal, treatment and release of their relatives. This paper works in this historical field, but with some methodological and theoretical differences. The Foucauldian study is anchored to a single case and family as an illness narrative that moves cross-referentially between bureaucratic state archival material, psychiatric case records, and intergenerational family-storytelling and family photographs. Following headaches and seizures, Harry Walter Wilbraham was medically boarded from his position as Postmaster in the Cape of Good Hope Colony of South Africa with a ‘permanent disease of the brain’, and was committed to the Grahamstown Asylum in 1910, where he died the following year, aged 40 years. In contrast to writings about colonial asylums that usually describe several patient cases and thematic patterns in archival material over time and place, this study’s genealogical lens examines one white settler male patient’s experiences within mental health care in South Africa between 1908 and 1911. The construction of Harry’s ‘case’ interweaves archival sources and reminiscences inside and outside the asylum, and places it within psychiatric discourse of the time, and family dynamics in the years that followed. Thus, this case study maps the constitution of ‘patient’ and ‘family’ in colonial life, c.1888–1918, and considers the calamity, uncertainty, stigma and silences of mental illness.

Going in and Getting out of the Colonial Asylum: Families and Psychiatric Care in French Indochina

AbstractThis paper explores the movements of asylum patients in and out of psychiatric care in French Indochina as the product of everyday interactions between psychiatrists, colonial authorities, and the public, especially patients' families. Throughout the interwar years, families and communities actively participated in psychiatric decision-making in ways that disrupt our notions of the colonial asylum as a closed setting that patients rarely left, run by experts who enjoyed broad, unquestioned authority. Vietnamese families, by debating individuals' suitability for social life, engaged with professional psychiatrists to find common ground for thinking about and discussing mental illness. At the same time, they pursued their own strategies in ways that significantly limited the power of experts. Debates revolved around the mental health of patients, but also around the capacity of families to assume their care upon release, and whether the asylum itself was the most appropriate site for treatment and rehabilitation. By considering how lay people and experts came together to negotiate the confinement and release of asylum patients, this paper offers a novel perspective on the development of psychiatric knowledge and power in colonial settings. I argue that by situating the history of psychiatry within the local dynamics of colonial rule as opposed to expert discourse, the asylum emerges here less as a blunt instrument for the social control and medicalization of colonial society than as a valuable historical site for reframing narratives of colonial repression and resistance.

<em>Madness in the Family: Insanity and Institutions in the Australasian Colonial World, 1860–1914</em>, by Catharine Coleborne

Reviewed by: Madness in the Family: Insanity and Institutions in the Australasian Colonial World, 1860–1914 Sloan Mahone (bio) Madness in the Family: Insanity and Institutions in the Australasian Colonial World, 1860–1914, by Catharine Coleborne; pp. xv + 220. Basingstoke and New York: Palgrave Macmillan, 2010, £55.00, $89.00. Within the thriving sub-field of colonial histories of psychiatry, Catharine Coleborne’s book represents a welcome change. This is true both for the understudied region with which she is concerned and also for the author’s conceptual interest, not in the nature of “madness” per se, but in the often mundane but extreme stresses and strains of families as glimpsed through the records and correspondence of four key asylums in late-nineteenth-century southeastern Australia and New Zealand. The official records of 215 patients reveal a poignant social history of a struggling population (there would have been many like it the world over) coming to grips with isolation, poverty, and overwhelming responsibilities for one’s kith and kin. Coleborne’s archive includes a wealth of letters tucked away within the clinical case files, and these reveal the extent to which family members interacted with these institutions and negotiated their loved ones’ care. The institutions concerned are revealed to be fluid and dynamic spaces as opposed to monolithic bedlams concerned primarily with confining, punishing, or othering the mad. Instead, the book privileges stories of the dire life circumstances of individuals who moved in and out of the asylum as they struggled with exhaustion, poverty, the weight of extended family obligations, isolation, alcoholism, and illness. Although the book’s subtitle lays claim to a history of “insanity and institutions,” this is neither an intellectual history of psychiatry nor an institutional history of the early asylum. Psychiatry is not altogether absent, however. Many individuals are shown to have exhibited signs of clinical insanity or mental strain, as described vividly by their families’ complaints about delusions, violent outbursts, paranoia, or inconsolable depression. However, the author’s approach is to outline thematically the myriad ways in which the staffs of institutions came into contact with families as a means for uncovering the everyday pressures, fears, and guilt families endured. It is often less about the experience of “madness” than about the very ordinary insecurities of daily life in the Australasian colonial world in the late nineteenth century. Refreshingly, the book foregoes a discussion of anachronistic psychiatric diagnoses of so-called lunatics, presenting instead a more interesting social history of gloom and exhaustion. The innovation of the book is to pay close attention, not just to those individuals (often women) committed to the asylum, but also to the significant impact one’s committal might have on husbands, wives, children, and extended family back home. In such a tenuous setting, one person’s mental breakdown could portend an entire family’s demise. The chapters are thematic, opening with a discussion of the colonial asylum and the general debates about insanity as they existed in the Australasian colonies. The second chapter addresses the nature of these debates as expressed within white settler colonies, which, as in eastern and southern Africa, prompted a preoccupation with ideas about race, heredity, and the tenuous state of future generations amidst very uncertain physical, political, and social landscapes. In the third chapter, Coleborne turns her attention to the “Language of Insanity,” focusing on the reality of mental illness or mental breakdown as experienced and described by individuals. Such accounts might mirror institutional concerns and assertions or might sit in stark contrast with doctors’ [End Page 579] understandings of such stress and despair. The next chapters elaborate on primary source material, such as letters from patients and family members in chapter 4 and detailed records of payment in chapter 5, which is surprisingly revealing of the additional pressures, resistance, and accommodations involved in family and institutional negotiations. This brings to the fore questions about family versus state responsibility for the care of the mentally ill, particularly in the absence of a formal state welfare system or poor law. In some cases, the sources reveal detailed maintenance logs kept by asylums, outlining the harsh circumstances under which people lived and the calamities they faced...

"In the Cheapest Way Possible...": Responsibility and the failure of improvement at the Kingston Lunatic Asylum, 1914-1945

"In the Cheapest Way Possible...":Responsibility and the failure of improvement at the Kingston Lunatic Asylum, 1914-19451 Darcy Hughes Heuring When British psychiatrist Dr. Dale Hewson arrived in Kingston, Jamaica in 1927 to take up the post of head of the colony's only insane asylum, he was shocked by what he found. Open drains with dirty water and sometimes sewage were within easy reach of patients. Some wards had no latrines or washing places, and upstairs latrines leaked into patient wards below. In the years before his death in 1937, Hewson repeatedly tried to improve conditions. And yet his replacement arrived to find that little had changed. How do we explain this lack of progress? This article traces the complex ways in which social perceptions of the insane, a dearth of colonial funds, and the actions of Jamaican politicians on behalf of their middle and upper class constituents stymied attempts to improve conditions at the asylum, and informed conflicts among authorities in Britain, British colonial officials in Jamaica, and Jamaican politicians over who was financially responsible for the island's 'lunatics.' An analysis of the role these factors played in attempts to improve the asylum reveals the ways in which local colonial problems and conflicts shaped British political concerns about the maintenance of empire and its declining position as a global power in the interwar period. This examination departs from current scholarship on colonial asylums in its focus on Jamaica as a site of contestation over responsibility for the insane. This reveals much about the inner workings of colonial rule, rather than the history of institutional psychiatric practice or manifestations of mental illness, the usual historiographical concern.3 Like other colonial institutions for the insane, Jamaica's asylum was a locus of conflicts over economic and moral responsibility between and among British officials and Jamaican politicians, and so it provides a site for studying the intricate dynamics of colonial rule in one context. Furthermore, it helps us better understand the ways in which colony and metropole were "mutually constitutive," as Catherine Hall and other scholars have argued.4 Events in Britain directly impacted Jamaica's affairs. But conversely, Jamaica's problems did not stay "conveniently over there."5 This article demonstrates how the failure of improvement at Jamaica's asylum was in part the fallout of British policies, and helped to shape British imperial policy in a much broader way. An analysis of problems of improvement at Jamaica's asylum demonstrates the complexities and instabilities of governance at the British imperial, colonial, and local Jamaican levels. "The colonizers" were not a unified, homogeneous group who governed a united and uniform group of "colonized" peoples in a consistent and organized manner. Divergent motivations, goals, beliefs, lifestyles, contests over race and class, and even individual pride and selfishness divided the allegiances of British colonizers as well as colonized Jamaicans. As Richard Price argues, while the empire may have appeared unified to those in the metropole, at the local level it was an on-going "untidy" process of negotiation and struggle.6 The Problem of Improvement at the Kingston Lunatic Asylum More than four decades ago, Michel Foucault located the rise of the public insane asylum within a broad narrative of the growing dominance of Enlightenment reason and the rise of scientific surveillance in which a system of penal, medical, and moral regulation was introduced in late eighteenth and early nineteenth century Europe.7 This required expert knowledge to discipline the errant individual. Historians of insanity and psychiatry have since challenged, refined, and qualified Foucault's account of the rise of the asylum, but they have also remained profoundly influenced by the Foucauldian narrative.8 Historians of empire have shared Foucault's understanding of modernization as the introduction of a rational institutional order that marginalized and disciplined the deviant, as well as his view that any institution must be understood in the context of social rules of behavior. However, they have shown that, unlike Europe, Britain's colonies did not experience a "great confinement." Colonial asylums generally confined only a fraction of those considered insane by their families and/or communities, and were underfunded, overcrowded, and neglected by the colonial...

Lee-Ann Monk, Attending madness: at work in the Australian colonial asylum, Clio Medica 84, Wellcome Series in the History of Medicine, Amsterdam and New York, Rodopi, 2008, pp. 266, €55.00 (hardback 978-90-420-2419-9).

Lee-Ann Monk, Attending madness: at work in the Australian colonial asylum, Clio Medica 84, Wellcome Series in the History of Medicine, Amsterdam and New York, Rodopi, 2008, pp. 266, €55.00 (hardback 978-90-420-2419-9). - Volume 54 Issue 4

Attending Madness: At Work in the Australian Colonial Asylum (review)

Reviewed by: Attending Madness: At Work in the Australian Colonial Asylum Gayle Davis Lee-Ann Monk . Attending Madness: At Work in the Australian Colonial Asylum. The Wellcome Series in the History of Medicine. Amsterdam: Rodopi, 2008. 266 pp. €55.00 (978-90-420-2419-9). The history of psychiatry remains an excitingly productive and argumentative field of research, though not one for the claustrophobic. A disproportionate amount of this research, which stems in one way or another from the seminal work of Michel Foucault and Andrew Scull, has focused on the dramatic rise of the asylum as a response to insanity during the nineteenth century and the consequently emerging psychiatric profession that assumed control of inmates. This historiographic preoccupation with the lunatic asylum has produced many interesting and nuanced studies of individual institutions and their doctors, and of the wider relations among patient, doctor, and state. However, one particular group of asylum staff, with only a few notable exceptions, tends to be excluded: the attendants. This fact is regrettable given their numerical importance compared to the "medical" staff and the fact that patients were "for the greater part of the day under their exclusive care" (p. 149). Even a patient's medical care depended to some extent on the attendant's observation and daily management, as the attendant was often the one to acquire detailed knowledge of individual patients and to initiate a doctor's examination, given the high ratio of patients to doctors. Thus, Lee-Ann Monk's Attending Madness, a social and cultural survey of asylum attendants during the second half of the nineteenth century, is a welcome addition to the historiography. She argues rightly that attendants merit more sustained historical analysis than they have received to date, being conceptualized in the main as, at best, the rough-and-ready occupational predecessors of twentieth-century skilled psychiatric nurses (with the emphasis very much on "rough"). Rather, they [End Page 137] deserve to be understood in their own right. Monk locates her work within the colonial context, focusing in particular on asylums within the British settler colony of Victoria, Australia. Given that the subfield of colonial psychiatry has grown particularly rapidly in the last two decades, it is regrettable that the author has chosen in the main to engage with the historiography (or lack thereof) of asylum attendants and has not incorporated the rich colonial historiography to any significant extent. Nonetheless, Monk provides a detailed consideration of attendants—their characteristics, their everyday work, how they constructed their own occupational identity, and how others defined them—within the context of the establishment, institutional ideology, and operation of psychiatry in Victoria. Since asylum officials drew to a considerable extent on British ideas about the nature of insanity and its treatment, and even poached personnel from "home," there are also some useful comparative considerations of British psychiatry and how British ideas on the attendant ideal were articulated within the colonial context. The early-nineteenth-century "mad-doctor" W. A. F. Browne remarked that attendants were "often of the very worst caste," attracted to that career path as a consequence of the low wage and dangerous duties (pp. 8-9), a verdict that many historians have seemed content to accept. However, Monk paints a more nuanced picture, in harmony with David Wright, of a "steady" occupation whose "decent" wages made it "an occupation keenly sought by many ordinary workers for its security and the prospects it offered to fulfil their aspirations" (p. 9). Thus, over time asylum attendants in Victoria remained in employment for longer periods, developing and articulating a specific occupational identity. Attendants were to "keep a watchful eye" over patients at all times and to investigate and report anything suspicious or potentially harmful. Restraint of any kind was to be avoided, and verbal or physical coercion was forbidden. The colonial asylum attendant was to be humane, self-restrained, and temperate. There were, however, impediments to the pursuit of this ideal. The Victorian gold rushes attracted the colony's male population, including those already employed elsewhere as attendants, while the low wages, unpleasant nature of the work, and "unavoidable" risk of violence from patients—"[t]he equation between risk and recompense" (p...

Attending Madness: At Work in the Australian Colonial Asylum by Lee-Ann Monk

Health & History ● 12/1 ● 2010 133 view than from the patient’s. We have all learned to value looking at psychiatric disturbances from the point of view of the sufferer, but the extraordinarily fragmentary character of the surviving evidence makes it very difficult to move beyond generalities and speculation to any very detailed or substantial discussion of matters of this sort. One group of patients does stand out: aboriginal and Maori patients, for whom admission to an asylum tended to be a one-way process, ending with their death in the asylum. Coleborne has produced a pioneering book that opens many issues up for further discussion. I think she would be the first to admit that this is very much a first foray into a complex and difficult terrain, and her work in many ways raises more questions than it can answer in any definitive fashion. She is rightly aware of the many ways in which insanity could prove a calamity for both the individual and for his or her family. And she is clear-eyed about the limits to our knowledge that result from the way archives have been constructed, and accordingly, what evidence remains from which we can reconstruct our historical accounts. Those are not small virtues, and her book constitutes a valuable addition to on-going debates. ANDREW SCULL UNIVERSITY OF CALIFORNIA, SAN DIEGO Lee-Ann Monk, Attending Madness: At Work in the Australian Colonial Asylum, Clio Medica 84, Wellcome Series in the History of Medicine (Amsterdam/New York: Rodopi, 2008). ISBN 978-90-420 -2419-9 (HC). 4 B&W illustrations, 270 pp. This study, which focuses on asylum workers in asylums in colonial Victoria, has much to recommend it. Monk’s initial point—and it is a significant one—is that historians of asylum workers need to move away from considering attendants as proto-nurses. Instead, she identifies the role of ‘attendant’ as a valid form of employment in its own right, removing it from the ‘pre-nursing’ position which it has unfortunately occupied for too long. The role of attendant provides a different lens through which to view the colonial lunatic patient: attendants were closer to the patients on a daily basis, and their impressions of and attitudes to madness are painfully apparent. Attending Madness is full of useful information 134 BOOK REVIEWS about the development of the Yarra Bend Asylum, the Kew Asylum and their subsequent government inquiries. Monk’s attendants are vivid characters; they have a strongly three-dimensional sense, which is helped by her use of original sources which speak for themselves. Monk provides a thorough analysis of the role of the attendant: what qualities were and were not desirable; whether this translated into actual practice; the place of violence and cruelty in the asylum, and official responses to this. The gendered implications of asylum work are immediately obvious: the patient population was largely male and from the labouring classes, but the men who cared for them were drawn almost entirely from the same class, and largely uneducated. Once this is understood, the institutional importance of drawing a very sharp line between patient and attendant is clear. Monk’s book helps us to understand how these issues of gender and class translated into the day-to-day practice of working in Yarra Bend and Kew, including the perceived male role as breadwinner which dominated the debate over wages for asylum workers. Importantly, Monk also examines the beginnings of formalised training for asylum attendants. The debate between the ideas of ‘general’training and ‘mental’training in nursing, as well as between ‘training’and ‘experience’, are perennial ones, and dominated nursing education in Australia for decades. The idea of ‘on the job training’as preferable (and indeed desirable) is one of the cultural aspects which marks out the nineteenth century so clearly from the twenty-first, but the furore over the transfer of nursing training to universities is a more recent reminder. Given the fascinating subject material, the book’s style is a little disappointing. There is a tendency to reproduce a marvelous quote, but then to undo its impact by spending the next paragraph repeating the contents of the quote, and telling the reader...

Attending Madness: At Work in the Australian Colonial Asylum

Attending Madness: At Work in the Australian Colonial Asylum

Freedom in the Imperial Imagination: Mental Asylums, Ideology, and Political Economy in Colonial India

Mental hospitals in India, mostly established by the colonial state, remain the backbone of the state's response to mental distress. However, the quantum and quality of care in these hospitals are in urgent need of improvement. In attempting to answer why this is so, this paper responds to the thesis that the popularity of the colonial asylums was in large part due to the social control functions which they performed. It is argued that asylums exist because they are embedded in a discourse of care, improvement, and freedom of the mentally distressed which originated in imperial Britain and Europe. In a nuanced and complex manner the combination of 'care and cure' and 'control and emancipation' was introduced in India through lunatic asylums. This ideology of freedom, however, gained widespread legitimacy because it was nestled within a larger discourse on freedom which was articulated keenly by the emerging political economy. Listening thus to the ideology of freedom in mental asylums and in political economy helps us in understanding the continued reliance on mental hospitals as the frontline in the battle against mental distress in India.

Reading 'Madness': Gender and Difference in the Colonial Asylum in Victoria, Australia, 1848-1888

Reading 'Madness': Gender and Difference in the Colonial Asylum in Victoria, Australia, 1848-1888

Reading 'Madness': Gender and Difference in the Colonial Asylum in Victoria, Australia, 1848-1888 by Catharine Coleborne

Catharine Colebome, Reading * Madness': Gender and Difference in the Colonial Asylum in Victoria, Australia, 1848-1888 (Perth:API Network, 2007). ISBN: 9781920845346. 219 pp. Book Reviews EssayReview Reading Madness is an intriguing and innovative history of the lunatic asylum in Victoria,Australia,between the establishment of the colony's first such institution, at Yarra Bend in 1848, and the report of the Zox Royal Commission into Asylums for the Insane and Inebriate, nearly forty years later. Coleborne's chief concern is with the ways that our colonial forebears sought to make sense of madness by containing it within a system of differences- that is, by putting it into a language. The 'language of the asylum,9 as Coleborne analyses it, was structuredby the rigorous distinctions drawn between patient populations, enforced in the segregated spaces and iron routines of the institutionand disseminated in medical, legal, journalistic andbureaucratictexts. These texts, she contends, did not merely reflect, but actively constituted social relations by reconfiguring understandings of pathology and normality- both within the institution and beyond its walls. As its title suggests, this is a work written from a vantagepointbeyond history's ' linguistic turn.' By emphasising thefictive and generic dimensions of asylum documents, the way thatthey 'made up' the people they purportedto describe, Coleborne aims to deconstruct or problematise the key sociological categories of patienthood which earliermedical and social historians often took for granted. Class, race and gender appear in Reading Madness, not as natural 'givens,' but as cultural constructions embodied in institutional writing and circulated throughout the wider culture. The representations generated by the asylum, she insists, cannot be accepted as transparentdescriptions of an empirical reality,but must be interrogatedas rhetoricalvehicles for the 'production' or 'invention' of the proper patient, the authoritativedoctor or the ideal asylum. 170 Health&History, 2007.9/2 Health& History • 9/2 • 2007 171 The earlierchaptersof the book aredevoted to the asylum's "invention,9exploring the imagination and legitimation of a reformedandtherapeuticspacetoreplacethebedlamandthegaol. Inventing the asylum was not only an affair of state. Coleborne quotes from several colonial newspapers which agitated for separate institutional provision for Victoria's lunatics from the 1850s onwards just as vociferously as their contemporary equivalents decry the failures of deinstitutionalisation. Then, as now, community responses to the scandal of public madness were complex and ambivalent, as humanitarianconsiderations competed with an overriding fearof the Other.On the one hand, the mentally ill deserved protection and kindness- on the other, they requiredconfinement and control. Coleborne implies that this equivocal public discourse had specifically colonial overtones in a society seeking to harness economic dynamism and social mobility to the conservative values of gentility and public order. In the context of late nineteenth century Victoria, the asylum could be idealised as emblematic of a triumphant civilisation, emerging from the excesses and disorders of the past. As psychiatric statistics began to be gatheredand intercolonial comparisons were made, Victorians came to see themselves as living in 'the maddest colony' of the Empire, where, as the Ballarat Star put it in 1858, uniquely "violent and rapid changes in industry,wealth, social relations and civil status' had brought many to 'despair' and rendered them 'dangerous to society.' Against this background, the imagined curative institution would not only reform its inmates, but would palliate the ailments of an overheated and under-governedsociety. The tension between theidealised image of the asylum as a place of moral rectitude, caring medicine and peace and quiet, and a reality which appears to have been crowded, neglectful and routinely violent soon led- in Victoria as elsewhere- to a cycle of scandals and official inquiries, which Coleborne considers further 'wrote the mad' into the popular consciousness. Gender is a key theme of Coleborne's history. Her argument throughout is distinguished by its attentiveness to ways that the discourse of alienism was also a discourse on the 'natural'differences between the sexes. The legitimation of the asylum keeper as an expert capable of pronouncing on legal and social issues, she argues, was crucially contingent upon 172 BOOK REVIEWS his ability to naturalise the patriarchalorder and to camouflage its abuses. Exploring evidence given in criminal trials and case studies presented in medical journals, she notes that all forms of conducting unbecoming a Victorian woman...