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Views from an asylum: a retrospective case note analysis of a nineteenth century asylum

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Abstract

Purpose

To investigate whether lifelong admission to psychiatric asylum care was usual practice before community psychiatric care was introduced.

Methods

Historical archives (1838–1938) for 50 patients at the Northampton General Lunatic Asylum in England were studied. Regression analyses were performed to investigate associations between predictor variables (age, gender, marital status, social class) and outcomes (diagnoses, length of stay and admission outcomes).

Results

30 patients (70%) were discharged into the community. 15 (31%) patients were admitted longer than 1 year. Diagnosis of mania was significantly higher in patients who were married. Trend associations were observed for melancholia being diagnosed in higher social class patients and monomania being diagnosed in unmarried patients. No associations were found between predictor variables and length of stay or admission outcomes.

Conclusions

These findings challenge the myth that asylum incarceration was a usual practice before the advent of community care. Most patients were discharged from psychiatric asylum hospital within a year of admission even before the advent of psychotropic medication.

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Acknowledgements

We thank Roberta Judd, archivist at St Andrew’s Healthcare in Northampton, England and Dr Vaughan Bell, senior lecturer in the Division of Psychiatry at University College London, England for his suggestions in preparing the manuscript. This study was unfunded.

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Authors and Affiliations

  1. St Andrew’s Healthcare, Northampton, UK

    Elvina May-Yin Chu

  2. Department of Neurosurgery 6th floor (room 690), Montreal Neurological Institute, 1280 Rue Université, Montreal, QC, Canada

    Elvina May-Yin Chu

  3. University College London, London, UK

    Elvina May-Yin Chu

  4. Department of Psychiatry, VU University Medical Center, GGZ inGeest Dienst Onderzoek en Innovatie, Oldenaller 1 (room H1.09), 1081 HJ, Amsterdam, The Netherlands

    Joeke van Santen

  5. Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and NeuroSciences (NIMHANS), Hosur Road, Bengaluru, 560029, India

    Vijay Harbishettar

  6. South Essex Partnership NHS Foundation Trust, Grays, UK

    Vijay Harbishettar

Authors
  1. Elvina May-Yin Chu
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  2. Joeke van Santen
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  3. Vijay Harbishettar
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Corresponding author

Correspondence to Elvina May-Yin Chu.

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Conflict of interest

The first author EC was employed by St Andrew’s Healthcare while this study was carried out. The co-authors (JM and VH) declare there is no conflict of interest.

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Chu, E.MY., van Santen, J. & Harbishettar, V. Views from an asylum: a retrospective case note analysis of a nineteenth century asylum. Soc Psychiatry Psychiatr Epidemiol 53, 1141–1147 (2018). https://doi.org/10.1007/s00127-018-1575-1

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  • DOI: https://doi.org/10.1007/s00127-018-1575-1

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