Lunatic Asylum Research Articles

Death, Burial, and Commemoration in 19th- and Early–20th Century British ‘Lunatic Asylum’ and ‘Mental Hospital’ Cemeteries

Abstract Throughout the nineteenth and early twentieth century, ‘lunatic asylums’ and ‘mental hospitals’ in Britain were legally obliged to provide for the burial of deceased patients whose remains were not reclaimed by relatives or guardians. While burial in local churchyards and cemeteries was idealised in administrative guidance, burial frequently took place in onsite asylum cemeteries instead. Due to their poor historic documentation, these spaces and practices have not been readily foregrounded within existing literature and have received only limited scholarly address. In the present paper, a broad range of documentary and material evidence will be presented, correlated, and thematically arranged, facilitating for the first time a sustained review and interrogation of these spaces and practices. This will contextualise further enquiry into the historic emotional significance of these sites and practices, employing theoretical lenses of ‘remembering’ and ‘forgetting’ in relation to the navigation of grief, memory, and complicated loss. This paper will thereby demonstrate how novel multidisciplinary research methodologies – further to facilitating the reconstruction of understudied spaces and practices in the history of psychiatry – can also be used to gain insight into the emotional histories of marginalised populations of the past, many of whom are under-represented in fragmentary and authoritatively authored historic documentary records.

Lunatic Asylums: Their Organisation and Management, by Charles Arthur Mercier

SUMMARY Lunatic Asylums, published 130 years ago, is a fascinating insight into how these institutions were managed in the late Victorian era. This brief article considers what it reveals about the zeitgeist of the time and the book's author, the remarkable Charles Mercier.

Bly in Blackwell’s: A Turning Point for Mental Health and Journalism

ABSTRACT “Bly in Blackwell’s: A Turning Point for Mental Health and Journalism” tells the story of Nellie Bly, a Pennsylvania-born investigative journalist. In 1887, Bly was set with the task of writing and reporting on an infamous insane asylum in New York—The Lodge on Blackwell’s Island. To do this, Bly acted “insane” and was sent to the institution as a patient so she could report on its inhumane conditions and expose it firsthand. After over a week of work in a terrifying environment, Bly was able to leave and wrote a two-part article for The New York World that was later published as Ten Days in a Mad-House. By making this brave effort, Nellie Bly changed the course of journalism and mental health, especially for women. This historical article shares the steps of Bly’s journey and shows just how much of an effect this plucky young writer had on our world.

A forgotten pioneer in Australian psychiatry: Dr Edward Waldegrave Wardley (1813-1872).

British-born Dr Edward Waldegrave Wardley (MRCSL, 1842) is an unacknowledged pioneer in the history of mental health care in Australia. Between 1857 and 1872, he assisted in the development of a policy of non-restraint across lunatic asylums in New South Wales (NSW). He then went on to extend this approach to the treatment of NSW's criminally insane patients. In addition, he trialled experiments to intellectually engage educated psychiatric patients across the colony. A prolific writer, and sufferer of chronic depression, Dr Wardley serves as a unique example of a nineteenth-century alienist with lived experience of mental illness.

Delivering Exercise Services to Refugees and Asylum Seekers in High-Income Countries

ABSTRACT Given the recent unprecedented number of refugees resettled in the United States of America yearly, exercise professionals in high-income countries are increasingly likely to engage with refugees and asylum seekers in their practice. Resettled refugees and asylum seekers often experience an array of stressors, including traumatic experiences associated with forced displacement, postdisplacement challenges, and cultural adjustment. These stressors place refugees and asylum seekers at greater risk of both mental and physical health disparities than people who have not experienced forced displacement. While exercise is associated with improved physical and mental health outcomes, refugees and asylum seekers are at a high risk of inactivity, and they face barriers at interpersonal, structural, and sociocultural levels. This expert commentary outlines strategies to address considerations in working with refugees and asylum seekers, including the impact of the refugee experience, the need to harness the client’s strengths and resources to foster exercise self-efficacy, and the cultural capability of the exercise workforce. The aims are to draw attention to the refugee experience and to equip exercise professionals with guidance to provide quality, person-centered, and strength-based services to refugees and asylum seekers within a safe and culturally sensitive environment.

Do Universities Improve Local Economic Resilience?

Abstract We use a novel identification strategy to investigate whether regional universities make their local economies more resilient. Our strategy is based on state governments using similar site-selection criteria to assign normal schools (to train teachers) and insane asylums between 1830 and 1930. Normal schools became larger regional universities while asylum properties mostly continue as small state-owned psychiatric health facilities. We find that a regional university roughly offsets the negative effects of manufacturing exposure. We show the resilience of regional public university spending is an important mechanism, and we show correlations consistent with bachelor’s degree share also playing a mediating role.

Developing partnership with patients and carers: A need of the time for mental health service delivery.

Contemporary practice of psychiatry is witnessing a radicle shift in the care of mentally ill. As compared to the 20th century, we are now moving towards community psychiatry and large mental hospitals and asylums are closing with a shift to manage these patients closer to their homes. Following these changes in mental health care, current literature provides growing evidence for developing partnership with patients, carers and family members in the delivery of mental health services. While this approach is appreciated for improving the quality of life of patients, there has also been some concerns about increasing burden of carers and families when they have limited resources and support to face the challenges in dealing with the management of their patients.1 Treatment and management of mental health problems are complex and needs a wider recognition for having patients and care-givers involvement in the treatment processes. Patients with mental health problems unfortunately suffer from a wide range of psychosocial adversities and require engagement leading to more empowerment in decision making processes. Furthermore, quality of health services can be measured by the experiences of patients and their families. Their viewpoints can reflect their happiness as well as the effectiveness of the services that could be based on their knowledge and understanding of their role in the treatment processes. However, in many societies, the nature and role of families are either undermined or not fully understood.2 Families may be considered as a cause for the onset of mental health issues and can be blamed for causing or triggering the illnesses. Similarly, the clinicians are given the full authority to decide about the treatment choices and preferred possibilities. Their role may be acknowledged as “the ultimate expert” who can decide in a final way and patients or families may have limited opinions in such decisions. Professionals may also consider confidentiality issues as a primary reason for not sharing information and taking relatives or family members on board, so they are frequently excluded from the decision-making processes. Apart from confidentiality reasons, clinicians may not have sufficient training and skills to deal with families and patients in terms of supporting and dealing with their concerns.3 Continued...

Nellie Bly’s life and journalism in comics and the adaptations of Ten Days in a Mad-House

ABSTRACT One hundred years have passed since Nellie Bly’s death and yet she continues to be celebrated for her journalism and for being a feminist icon. This is in part thanks to her reports on women’s poor working conditions and her trip around the world when it was unthinkable for a woman to take the journey alone. Bly also stands out for her undercover investigations, chiefly among them is when she feigned insanity to be committed to an insane asylum to reveal its cold-hearted conditions. Because of all of this, Bly has been the subject of many adaptations throughout the years, including in comics. However, Bly’s exploits in the asylum have been mostly absent from this medium. That is, until recently with the publication of four graphic novels. To explore this matter further, this study will start by approaching Bly’s career, followed by an analysis of her many comic features. Afterwards, this study will then consider the recent adaptations of Bly’s asylum report, while comparing it with her original work. Finally, we will seek to understand why it took so long to adapt it into the comic book medium.

MALE PATIENTS COMMUNICATING RESTORED MENTAL HEALTH BY THEIR FACIAL EXPRESSIONS AND GENTLEMANLY PERSONA AT THE GRAHAMSTOWN LUNATIC ASYLUM, 1890–1907

During the medical superintendence of Dr Thomas Duncan Greenlees at the Grahamstown Lunatic Asylum, from 1890 to 1907, he was watchful of his patients’ appearances, facial expressions and conduct. Of particular interest, Greenlees would closely monitor the patients’ faces to identify if there were any involuntary expressions that were indicators of underlying emotional unease or mental distress. Greenlees thus regarded involuntary facial expressions as a litmus test of a patient’s recovery, but it was the patient’s conscious facial expressions, as well as their presentation of upstanding behaviour and conduct, that signalled to the staff that they were self-composed, and hence on the path towards convalescence. In this article, I explore how three white male patients of the Asylum communicated their convalescence and/or restored mental health to the staff by posing for their casebook photographs and by presenting a gentlemanly persona. To this end, I interpret the photographs of the three men alongside entries from their casebooks as an interface to explore dimensions of time that lie outside the split second that was captured by the camera lens. In doing so, the glimpses of a patient’s agency and appearance in a photograph can be understood and compared with their performance of a gentlemanly persona that was recorded in the casebooks.

Rare finding of a porcelain gallbladder in an early 20th‐century asylum cemetery: Radiologic, clinical, and bioarchaeological perspectives

AbstractPorcelain, or calcified, gallbladder is a finding rarely identified in archaeologically excavated remains. This study reports on an ovoid calcification found in the torso of adult skeleton from an early 20th‐century mental asylum cemetery in Mississippi. The calcified object was imaged using conventional x‐ray and computerized tomographic (CT) scanning (standard and micro), which produced images consistent with those of a clinically diagnosed porcelain gallbladder containing a single large gallstone. The aim of this paper is to raise awareness of this medical condition, which may not be familiar to most anthropologists, and of the efficacy of CT scanning for the identification of calcified gallbladders, which may increase the number of cases reported in archaeological literature and provide more information about the prevalence of this condition, and gallbladder disease in general, in past populations.

Mortality in an Italian factory producing tetraethyl lead

The Società Lavorazioni Organiche Inorganiche (SLOI) in Trento (North-Eastern Italy) produced tetraethyl lead from 1941 to 1978, when it was closed following an explosion, luckily with no fatalities. Working conditions were very bad. During the 1960s, 325 acute lead intoxications were reported and over 100 workers were hospitalized for neurological conditions attributable to tetraethyl lead. At least 12 SLOI workers were hospitalized in the mental asylum (psychiatric wards).The present work describes the first formal epidemiological study ever carried out on SLOI workers. In the absence of any original SLOI employee registers, a list of 1,742 workers hired since factory startup was assembled using the files of the Italian National Social Security Agency (digitalized in 1974 and perused manually by one of the Authors for the previous period). To date, follow-up for mortality has been completed for the 580 male employees at work in 1961 or hired subsequently and who worked at SLOI for at least 12 months. Twenty-two (3.8%) were lost to follow-up. Mortality in this sub-cohort was compared with that of the population of the province of Trento, gathered since 1986 by the Institute of Statistics of the Trento Province. Excluding deaths occurring at age 90+ years, during the 1986-2016 period, deaths in the SLOI sub-cohort were 295 vs 229.0 deaths expected from age- and period-specific rates in the reference population (standardazied mortality ratio 1.29; 95%CI 1.15-1.44). In the absence of individual data, the possible contribution to the mortality excess by non-occupational risk factors cannot be estimated. Identification of causes of death is underway.

The Construction and Government of Lunatic Asylums and Hospitals for the Insane, by John Conolly

SUMMARYThis article offers a review of John Conolly's book of 1847 concerning the construction and administration of asylums for the mentally ill, which gives detailed advice on the selection and management of staff and remarks on the role of the medical superintendent.

A Geocritical Reading of the Playwright Ramu Ramanathan’s Play The Boy Who Stopped Smiling

Today’s education system is more focused on the development of the infrastructure of the institution than the mental and insightful development of the students. Rabindranath Tagore in his short story titled Tota kahinee or The Bird’s Tale said that “the cage is improving, but what news of the bird?” (Tagore, 4). The playwright Ramu Ramanathan is an excellent vocal or throaty of these issues. Most of the writers in general and the playwright in particular associate children’s stories with fairy tales. They don’t often even write any sort of drama or any piece of writing from a small child’s perspective. Their questions and queries are sidelined. The writers are least bothered about the mental space of the characters. We the people force the children to memorize our school syllabi, courses, formative and summative exams, and class work. According to Nehal Hardik Thakkar, “The children aren’t given a proper individual space, and their issues have remained socially invisible”. We don’t often push them to enjoy and learn something. We never ask them to forget about marks and all. We don’t also encourage them not to chase success. We insist and compel them to pursue success. If we critically think about it, we will come to know that we push them to get traumatized and assist them to stop their smiling. The epoch-making playwright Ramu Ramanathan in his play called The Boy Who Stopped Smiling talked about all these exact things. He breaks the traditional way of drama writing and here in this play, he uses the concept or the style of Grips theatre. The study of this paper will attempt to discuss this play from a geocritical perspective. Here the researcher will try to spend a maximum amount of time to discuss about the space, place, and several other things. Through the central character named Malhar, the playwright endeavored to provide a lifelong lesson to all the parents' community. Here in this play, other characters make fun of the protagonist named Malhar. They called him mad and also wanted him to be sent to a mental asylum. Nobody in this play thinks from Malhar's perspective; even the mother of Malhar avoids visiting the space and place of Malhar’s mental faculty. All of the other characters stigmatized him as mental and crazy and also considered him as poorly weak.

The stalwart – Adolf Meyer

Adolf Meyer (1866–1950), a Swiss-born American psychiatrist, was a prominent figure in the development of Anglo-American psychiatry. He rose to prominence as the president of the American Psychiatric Association. His psychobiological approach emphasized a holistic understanding of mental illness, integrating social, psychological, and biological factors. This laid the foundation for a new approach to psychiatry focusing on individualized care and the importance of social adaptation as a biological function. Meyer’s work challenged traditional biomedical views by advocating for a comprehensive model that considered the mind and body as interconnected entities. He was directly responsible for transforming “insane asylums” into “mental hospitals.”

Words as Medicine: The Therapeutic Art of Storytelling in Michaelides "The Silent Patient"

This study focuses on the way health care providers can connect to and comprehend their patients through narratives. This work sheds light on the area of narrative medicine by presenting a way of improving clinicians' responses to patients' suffering as well as their own experiences. It also explains that narrative medicine is significantly based on three primary factors that are Attention, Affiliation, Representation between clinicians and the patients. In this concept, patients and doctors used to communicate mostly through storytelling, and the ability to deeply pay attention to storytelling. Alex Michaelides The Silent Patient expertly affects what occurs in Alicia's life, whose ideal existence suffers when she killed her husband in a surprising act, then mysteriously goes silent, refusing to speak, and checking her into an insane asylum. In this study the researcher applies the theory of NARRATIVE MEDICINE in literature by Rita Charon and also uses a narrative approach. This study investigates the protagonist past, her traumas and the purposes behind her mysterious quietness to understand when emotions constantly pile up inside of a person, they all suddenly burst into flame and one can frequently get revenge out of mystery.

Suicides of elite Japanese writers: The case of Ryunosuke Akutagawa.

Background . To mark the 130th birth anniversary of Japanese writer Ryunosuke Akutagawa (1892-1927), I revisit his suicide (as recorded by his hand) in comparison to that of his junior contemporaries, who also chose a similar mode of death. Data sources . Two works of Akutagawa, namely Tenkibo (1926: Death Register) and Aru Ahono Issho (1927: The Life of a Stupid Man) in English translation of Jay Rubin were used as the main sources, in addition to published literature about his creativity. Results . In his final work, The Life of a Stupid Man, completed in the penultimate month before suicide, 7 among the 51 brief descriptions, Akutagawa had described his thoughts on illness and death, in addition to visiting his biological mother in a lunatic asylum, and studying a cadaver for his famous short story 'Rashomon'. These descriptions offer a fascinating perspective on Akutagawa's state of mind, before his suicide. Akutagawa's suicide is also compared with the suicides of five other renowned Japanese writers (Osamu Dazai, Yasunari Kawabata, Misuzu Kaneko, Yukio Mishima and Juzo Itami). Conclusion . Before his suicide, doctors offered Akutagawa various diagnoses: 'insomnia, gastric hyperacidity, gastric atony, dry pleurisy, neurasthenia, chronic conjunctivitis, brain fatigue'. Though it is uncertain, what percentage of hereditary factor(s) played a role, why the practitioners of the medical profession in 1920s Japan failed to save the life of this creative individual still remains a question.

"Slum Clearance" in 1890s Wellington

In 1892, a remarkable map of Wellington was completed. Stretching from Thorndon in the north to Berhampore to the south, and taking in the teeming inner-city areas of Te Aro and Newtown, the remnants of Māori kāinga, the town belt, the Basin Reserve, the prison, "lunatic asylum" and hospital, reclamations and every street in between. The map, drawn by engineer and surveyor Thomas Ward, is actually 103 maps, drawn on A1 sheets. On the map, the exact footprint of every single building in Wellington is recorded every commercial building and house, every garden shed and outdoor toilets. Bay windows and verandahs are carefully drawn. Data is recorded for every building, including how many rooms it contains, what the roof and walls are made of and how many storeys it has. Legal titles are exactly mapped, as are the city's streams and even the street lights. Once complete, one full pristine set of the maps was set aside and preserved intact. Another set of the maps was updated regularly, for approximately the next ten years. For that decade, we can follow every change in the city, down to the smallest detail such as the replacement of slate rooves with corrugated iron, but also bigger-scale work such as the reconfiguration of whole streets.
 The Thomas Ward map is a touchstone for the history of our city. It is used every day by Wellington's archaeologists and historians. Wellington City Council provides the map online as an digital overlay over modern satellite images of the city, allowing us to compare the city of 1892 to the city of today. A well-known feature of the history of Wellington in the 1890s was the outbreak of typhoid and other diseases in the inner-city, a result of overcrowding and lack of clean water. To combat this, a number of "slum clearances" were ordered by the city council, resulting in whole streets of working-class houses being demolished. This paper, a part of a much larger project, will examine some of the stories shown in the two sets of maps, with a particular focus of the changed landscape of the inner-city brought about by this "slum clearance" work of the 1890s.

Sanity at the mercy of language: Interpreting the “nonsense” of a Chinese miner in Australia

ABSTRACT Written in an interlanguage of English and Chinese, Jong Ah Siug’s autobiography “The Case” (1872) is rich in ambiguity; this makes it urgently in need of interpretation. Tried unfairly and detained in a lunatic asylum, Jong wrote “The Case” to narrate the cause, process, and aftermath of a fight to prove his innocence, yet unknowingly he introduced another case with the use of highly individualized language: does his “nonsense” imply that he was of unsound mind? This article will analyze “The Case”, first to deduce what Jong’s case really is, what it tells us about Australian colonial culture, and how medical knowledge was powerfully channeled in the colony. Secondly it will examine the case of “The Case”: how the text is accepted by contemporary critics, translators, and psychiatrists, why they are prone to regard the narrator as mad, and what part language plays in the construction of Jong’s insanity.

'Catastrophic Experience' of Structural Violence in Sadat Hasan Manto’s “Toba Tek Singh”

This paper aims to analyze, interpret, and examine the impact of structural violence in Sadat Hasan Manto’s story “Toba Tek Singh”. It particularly stresses the form of violence in which social structure or social institution harms the major character Bishan Singh by preventing him from meeting his basic needs of life, liberty, and pursuit of happiness. The political decisions forced him to leave the nation where he lived before. He was deprived of his rights to preserve his nationality and pursuit of happiness. This paper also explores how Bishan gets inflicted by the decisions imposed by the rules in the name of democracy and people’s aspiration; and traumatizes the people of his strata. Further, it exposes the patriotic feeling of the homeland and brotherhood relationship within the same territory. For this, the concept of trauma theory was employed to explore how the people suffered from the decisions of the nations and felt pain when the intense desire of the common people was suppressed and forced to abide by the unwise decisions. This article argues that Manto uses the setting of the mental asylum to show the structural violence that is inherent in the social, political, and economic systems of the newly formed nations of India and Pakistan. The study, thus, contributes to the readers to understand multidimensional impacts of structural violence and enforces the rulers to rethink their prudent decisions in the law-making process.

The evolution of mental health facilities and treatment in Sri Lanka

The historical events reveal that therapeutic measures for mental illness were practised in Sri Lanka since the 6th century BC. The Indian Prince Vijaya suffered with mental illness. He got married to local princess named Kuweni and was treated with native medicine according to her tribal relatives. This was the most prominent incident in Sri Lankan history. The Western treatment was introduced in the early 19th century AD with arrival of European colonists. Further, to develop the treatment under law, the Lunatic Ordinance of 1873 Act was amended in 1956 as Mental Diseases Act No. 27 by the independent government of Sri Lanka. The mental disorder was not much familiar among Sri Lankans till then. The first mental asylum was established in Hendala, Gampaha District for patients who suffered from mental disorder due to leprosy. There are no records of diseases in Sri Lanka till Europeans landed in. During the British ruling period, two other asylums for mentally ill were established in Borella and Jawatte, Colombo District when the in-patient count went up. This proves that ill treatment and harsh policies of colonists have made locals to suffer from mental disorders in the past (before Sri Lanka gained independence in 1948). The most recognised non-profitable organisation Sumithrayo situated at Horton Place, Colombo, was introduced in 1974 to provide an emotional support to those who are at risk of suicide in Sri Lanka. There are ten Sumithrayo centres across the island with some special volunteer officers. These services are free of charge and function as independent organisations without any barriers. Workshops, awareness programmes, webinars provide emotional support for people who are stressed and strained of life everyday under the motto “There is a help – there is a hope”. Sumithrayo also focuses on supporting those who are going through difficult times in life, assuring confidentiality as well as acceptance with respect and care through their consultations to reduce mental illness. Another goal is to provide emotional support for school children to develop skills and how to deal with everyday stress before they face the society as adults. Due to psychological, social, biological and cultural factors without racial or class distinction, persons can be depressed and feel isolated with own problems. Sumithrayao takes care of them with non-judgemental approaches. Also, they are accepted by listening and befriending.