Improvement of Attitudes towards the Mentally in the 19th Century UK - Essay Example

Critical Discussion of the Extent to Which Attitudes towards the Mentally Ill Improved in the Nineteenth Century United Kingdom Term Paper 2518 Words Name Institution Critical Discussion of the Extent to Which Attitudes towards the Mentally Ill Improved in the Nineteenth Century United Kingdom INTRODUCTION The United Kingdom has an interestingly unique history of handling psychologically unstable patients. This uniqueness arises from the United Kingdom’s rise in the number of mentally ill patients admitted to hospitals during the late eighteenth century. As a result, the United Kingdom’s department of public health divided its physician workforce into a special group of experts called ‘mad doctors’. In addition, the United Kingdom was undergoing an industrial revolution during the late 1700s and early 1800s. A developed industrial community demanded the government take complete responsibility for institutionalising the mentally ill. This responsibility slowly occurred during the early and mid-1800s. This new treatment of psychologically unstable patients marked the beginning of a new recognition that irregular psychological states and behaviour patterns were the outcomes of possibly treatable illnesses. The following paper critically discusses the degree to which attitudes towards the mentally ill improved in the nineteenth century UK. To understand this degree, the paper will begin by briefly discussing the attitude of the UK health industry and society towards the mentally ill several decades before 1800. The 1800s saw the slow emergence of a humane attitude towards the mentally unstable, but geographic and institutional separation would persist in the treatment of mental disorders. BRIEF HISTORY Before the nineteenth century, the United Kingdom health department, together with society, did not take psychological illnesses seriously. Before the deployment of ‘mad doctors,’ there were no medical facilities for the mentally ill. As a result, doctors often isolated a psychologically unstable patient from the rest by ensuring the patient was homebound.1 Another indication of the unserious treatment of mentally unstable patients was their relatives’ denial of the illness. Physicians who recommended mentally ill patients to remain at home often fuelled this denial by family members. In spite of a more compassionate attitude called ‘moral treatment’ having arisen between 1790 and 1800, the entire UK health department was far from treating the mentally ill morally.2 The construction of asylums did not assist in improving this attitude either. Instead, asylums simply showed society that the government had recognised mental problems as treatable issues, but not through conventional methods. The main purpose of moral treatment was to diminish external, bodily coercion, which was not evident until the onset of the nineteenth century.3 CRITICAL DISCUSSION The 1800s marked the onset of institutionalisation to show that the UK health sector accepted abnormal mental states as treatable illnesses.4 Instead of superstition and religion, the UK health department recognised the treatment of the mentally ill through medicine in around 1805. Researcher Franz Gall developed phrenology as a medical model for diagnosing symptoms of mental illness, which became popular amongst ‘mad doctors’.5 According to Gall’s phrenology, one can determine a patient’s psychological faculties through the examination of lumps, ridges, and shape of the skull.6 This meant that physicians had to view consciousness as a role of the brain. Even though extremely false by modern medical standards of psychological assessment, Gall’s doctrine was a pioneer for brain science between 1820 and 1840.7 As a result, ‘mad doctors’ often used Gall’s model to lead and determine courses of action while caring for and treating the psychologically unstable. Institutionalization through asylums was a measure borrowed from French doctors and installed in the UK to show the government’s change in attitude towards the mentally ill.8 The lead doctor of asylums in France, Philippe Pinel, supported the great reform of prohibiting the maltreatment of ‘the insane’ irrespective of how hard the therapy was.9 The adoption of Pinel’s model of asylum therapies in the UK in 1810 led to the rise of the number of doctors who frequently went to these institutes irregularly. Pinel caused physicians in UK asylums to stop using punishment as a form of therapy because it is a nonstandard method of treating a sick human being. Instead, Pinel showed UK physicians to understand mental illnesses as a combination of the effect of historical events, shifting social surroundings, and extreme changes in the human brain.10 Asylums prevented the English society from seeing mental illness as the effect of demon possession or personal choice of irrational behaviour because of Pinel’s efforts.11 Instead, the community began understanding that people with psychological instabilities were victims of external or internal circumstances beyond their control. This was a crucial development for the UK’s health departments considering they always branded nonconformity to social norms as insanity before Pinel’s influences.12 Asylums were the foundation for the treatment of the mentally ill on medical bases. For example, asylums allowed the UK state to cater to women who society believed were not showing stereotypical feminine behaviour and masturbation amongst men.13 Industrialism did not contribute much towards changing society’s attitude toward the mentally ill.14 English health departments began administrating asylums using models based on logical scientific findings that did not essentially add to the advancement of mentally ill patients. For instance, Richard Napier, a doctor and astrologer, applied medical truths alongside spiritual factors because of his belief in their correlation.15 Napier practised these beliefs in the sixteenth and seventeenth centuries, which was well before the expansion of industrialism into England. Napier’s application of science and superstition was very compassionate to the psychologically unstable in comparison to how physicians separated the mentally ill from the rest of the patients and sent them home permanently. Clearly, the onset of industrialism did not contribute to humane therapy for the mentally ill.16 The UK set up asylums before the arrival of Pinel to condemn patients who exhibited abnormal psychological behaviour. The rising numbers of mentally ill patients was a consequence of widespread capitalism in nineteenth century England.17 A capitalist economy led to the rise of centralized governance that facilitated the basis for the advancement of methods for the proficient management of the vast population of mentally ill individuals confined for years. Asylums subjected this population to neglect and mistreatment instead of significant therapy.18 An industrial capitalist England caused the overall population to rise significantly, as well as records of the numbers of mentally ill individuals. Separating these individuals from the rest of the community was common during the second half of the 1700s until around 1810.19 This isolation did not aim at easing the symptoms of the patients but ensuring their regulation socially and preventing their ability to interact with society normally. The 1800s saw the development and usage of actual psychological terms for recognizing symptoms of respective mental illnesses.20 Using names to recognize symptoms for mental problems was a huge step towards accepting medical explanations for abnormal behaviour. Before the 1800s, UK’s health sector did not have a manual for recognizing symptoms of mental illness, which is understandable considering there was not much research work on psychological behaviour. Countless patients with mental conditions were branded as ‘lunatics’ and ‘insane.21‘ Throwing these people into asylums added to society’s fear of such buildings and its inhabitants. This fear was rational to some extent considering the state often admitted even sane individuals to asylums on the account of minor behavioural irregularities.22 In addition, the reigns of Victoria and Georgian discouraged the recognition of medical symptoms for mental conditions and instead encouraged asylum confinement. More specifically, Bethlem Royal Hospital was popular for the inhuman and brutal treatment on the mentally ill. The hospital deprived such patients of human rights through neglect and cruelty.23 The establishment of treatable and untreatable wards in asylums indicated a shift in the way hospitals and asylums in the UK viewed mental patients.24 The construction of these wards was marked by hospitals’ acknowledgement of ‘lunatics’ as actual patients. This change meant that physicians began seeing the ‘insane’ as medical problems with possible medical solutions.25 The mass construction of asylums in London by 1833 meant the state was standardizing and labelling them as medical facilities. This process implied the abolishment of local structures for dealing with mental patients. Legislature passed the 1808 Act to refer to the ‘pauper lunatics,’ the most common asylums in London and other major towns in the UK.26 The act allowed the provision of space in a treatable ward for mentally ill individuals incapable of paying for private asylums. These patients comprised of inmates and house helps. This shift represented the state’s new attitude towards patients who deserved proper care and treatment. The state’s most influential tool towards changing society’s attitude towards the mentally ill was legislation.27 Laws made ‘mad doctors’ treat the mentally ill as patients and not inmates. A major con of the acts passed in nineteenth century England concerning mental illnesses was the right to protest against confinement in court. This meant that admittance to asylums stripped patients of the freedom to file a case against their detention. Indirectly, these acts help patients in asylums against their wills. However, after 1845, the state assembled a Lunacy Commission to manage the treatment of psychologically unstable patients inside asylums.28 The same group of professionals managed the behaviour of physicians or ‘mad doctors’ over patients. The commission then gave a report to the Home Secretary regarding the conditions of newly built asylums and their abilities to accommodate more patients in the future.29 Lord Shaftsbury’s Campaign for Lunacy Reform for the treatment of mental illnesses was the true legal revolution of the handling of psychologically unstable patients in asylums.30 Numerous Justices of the Peace did not support the 1808 Act because its dependency on annual elections. Justices of the Peace did not want to bear the cost of constructing asylums, which defeated the act’s goal.31 As a result, many psychological patients remained in prisons and workhouses that exercised inhumane treatment to assure their complete isolation from society. The rough and cruel handling of the mentally ill in English prisons and workhouses persisted during the nineteenth century.32 Even though this maltreatment was not as extreme as previous generations, the UK was in need of a critical, legislative change to change its attitude towards mental illnesses permanently. A movement for ‘Lunacy Reform’ led by Lord Shaftsbury kicked off in 1845 and Victoria’s administration approved it. The movement became the groundwork for the Mental Health Law that persisted until 1890.33 The 1808 Act assisted in the revolution of how the government granted subsidies to the treatment of the mentally unstable. First, the act stopped referring to the mentally ill as ‘lunatics’ or ‘insane’ and regarded them as patients.34 It became vital for the state to put mental patients in the correct institutes and wards with the proper care and welfare. The act further vested the Justices of the Peace to construct asylums that adhered to human scientific ways like Pinel and different from previous asylums as well.35 Local financing from respective districts provided the financial resources necessary for constructing these wards and asylums. This financing signalled society’s similar acceptance of the state’s consideration of insanity as a curable ailment. Local authorities began making routine inspections of asylums under the 1808 Act and the Mental Health Law.36 These inspections aimed at determining whether the facilities were fit for treating their mentally inhabitants. Lord Shaftsbury’s movement fostered the mandatory nature of these inspections. Both acts dictated that county and borough heads must construct and situate every asylum in an airy, remote location to facilitate safe havens for diagnosis and therapy processes.37 The absence of these laws allowed the health department to separate the treatment of physical problems from psychological ones. The discriminative treatment of patients with abnormal mental behaviour in regular hospitals was popular amongst the English community. By the 1800s, this treatment was a national disgrace and citizens demanded local authorities to take action, which was only possible through legislation.38 The humanitarian campaign that began in Europe contributed to the shift in the attitude of the government and society towards the mentally ill in England. Humanitarian movements branched mostly from Pinel’s doctrines and reformist William Tuke. Although Tuke largely adopted Pinel’s theories, he managed to use them to push for legislative reforms that favour the humane treatment of the mentally ill in new asylums.39 After founding the York Retreat in 1792, Tuke, along with other ‘Quakers,’ emphasised compassion and respect for diagnosing and treating psychologically unstable patients.40 These doctrines became priorities in the agenda of the humanitarian movement through ethics management. The humanitarian campaign helped implement ethics management in asylum care in London as a rehabilitation method. The goals of the humanitarian movement encouraged institutionalized, mentally ill individuals to partake in manual work and spiritual discourse as a form of therapy.41 Ethics management was very successful in English asylums during the nineteenth century but did not remain operational through the 1900s.42 The main reason for this discontinuation was ethnic discrimination between employees and patients as immigration rose. In addition, the heads of the ethics management campaign did not teach their doctrines to learning apprentices.43 As a result, the shortage of replacements contributed to the deterioration of ethics management in asylums. A third reason is that advocates of this campaign failed to understand that larger medical facilities vary from smaller ones in terms of scope, services, capital resources, management styles, and operations models.44 This lack of understanding resulted in the overextension of medical facilities without ethics management. A significant change in the attitude of lawmakers, local authorities, and society towards psychological conditions led to the development of methods to improve the lives of the mentally ill.45 The implementation of 1808 Act, ‘Lunacy Reform,’ and Mental Health Law yielded slow but positive results in terms of the number of cured patients. By 1899, local authorities had overseen the construction of schools and special training programs for the mentally ill undergoing treatment in asylums, as well as the cured ones.46 For instance, in 1846, the English state set up a school for the psychologically disabled. In 1886, UK’s legislature approved The Idiots Act to assure the treatment, teaching, and training of disabled individuals. This act aimed at catering to those overcome by the demands of a newly capitalist and industrial England, which included the mentally ill.47 By 1870, the state offered special training to teachable patients to help them after leaving the asylum.48 In 1899, The Elementary Education Act made the construction of schools for the psychologically and physically disabled mandatory in England.49 CONCLUSION Nineteenth century England marked the slow emergence of a compassionate attitude towards the mentally unstable. However, geographic and institutional separation persisted in the treatment of psychological illnesses. The history of attitudes towards mental sicknesses during UK’s Victorian and Georgian eras is an interesting recollection of how the government and society treated the psychologically disabled. Modern methods of treating the mentally ill extremely surpass those of nineteenth century England. However, some factors of modern society’s attitudes toward psychological disabilities have in fact never changed. As a result, this critical discussion begs today’s researchers and psychologists to question how much change is still required to improve the rates of cured patients from mental facilities. Bibliography Brooker, C., and A. Waugh, Foundations of Nursing Practice: Fundamentals of Holistic Care, New York, NY: Elsevier Health Sciences, 2013. Callara, L. E., Nursing Education Challenges in the 21st Century, Los Angeles, CA: Nova Publishers, 2008. Foerschner, A. M., ‘The History of Mental Illness: From ‘Skull Drills’ to ‘Happy Pills’, Clinical Psychology, vol. 2, no. 1, 2010, p. 4. Learmond, W. L., ‘How was Mental Illness Treated in Victorian England,’ http://www.humanities360.com/index.php/how-was-mental-illness-treated-in-victorian- england-11662/, 2011, (accessed 7 December 2014). Littlechild, B., and R. Smith, A Handbook for Interprofessional Practice in the Human Services: Learning to Work Together, New York, NY: Routledge, 2013. Murphy, G., An Historical Introduction To Modern Psychology, New York, NY: Routledge, 2013. Parr, H., Mental Health and Social Space: Towards Inclusionary Geographies, New York, NY: John Wiley & Sons, 2011. Parry-Jones, W., The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries, New York, NY: Routledge, 2013. Shimmon, S. A., ‘Treatment of the Insane in Modern Great Britain: A Ship of Fools,’ NEH Summer Seminar for School Teachers. Oxford, The Dutch Republic and Britain, 2011, pp. 1-10. Wallace, W., ‘Sent to the asylum: The Victorian women locked up because they were suffering from stress, post natal depression and anxiety,’ http://www.dailymail.co.uk/home/you/article-2141741/Sent-asylum-The-Victorian- women-locked-suffering-stress-post-natal-depression-anxiety.html, 2012, (accessed 7 December 2014). Woodend, J. and Minshull, A., ‘The Evolution of the Treatment of the Mentally Ill: How Lancaster County Lunatic Asylum Changed the Face of Treatment,’ http://newhistories.group.shef.ac.uk/wordpress/wordpress/the-evolution-of-the-treatment- of-the-mentally-ill-how-lancaster-county-lunatic-asylum-changed-the-face-of-treatment/, 2013 (accessed 7 December 2014). Read More