Thursday, 1 February 2018
Stigma and Mental Illness in Garlands Asylum
In line with Time to Change’s ‘Time to Talk’ day on 1 February, I would like to reflect on the stigma of mental illness in the nineteenth century, as a way of highlighting how far we have come, and how important it is that we conduct open and honest conversations about the topic, in order to end mental health discrimination.
It is clear from previous posts that the way in which those suffering from mental illness in the nineteenth century were considered, was a far cry from how we consider sufferers now. For a start, incarcerating individuals in an asylum that was built on the outskirts of Carlisle, far from the main population (it was described in an article in the Carlisle Journal in 1898 as a ‘little segregated colony’), is an indication that it was something to be treated in a sealed environment. The terms used to classify those in an asylum seem somewhat insensitive and discriminative to the modern eye - ‘lunatic’, ‘imbecile’, ‘idiot’, ‘feeble-minded’ – and the way in which patients were described in the case notes was in a much less than sensitive manner. In addition, friends and relatives on the outside could also be affected by the stigma of being associated with sufferers of mental illness.
After the 1845 County Asylums Act, every county and borough in England and Wales had to provide an asylum to accommodate pauper patients. Increasingly after this date, families became more willing to admit their relatives to these institutions that offered specialist care, and an increased risk of recovery. Despite this, a stigma remained attached to those suffering from mental illness, and the medical superintendents of Garlands in the later nineteenth century continued to state the need for relatives to admit their loved ones at as early a stage as possible in order for a greater chance of recovery. This was reinforced in the 1885 annual report by Dr Campbell:
A mistaken kindness on the part of their relatives allows them to exhaust all the questionable benefits of home treatment often without recourse to special knowledge of the disease, and only when home treatment is found worse than unavailing is the patient sent to an asylum.
However, not all families could be so ‘kind’. Dr Clouston recalled one case that came to Garlands in 1871:
One young woman was sent here in a deplorable state of filth and neglect, who had been for years allowed to remain in a state of nudity in her father’s house, occupying the same sitting apartment as the rest of the family, scorching herself at the fire, looked after chiefly by a brother, nearly grown up; and all this in the middle of a town of considerable size.
Therefore, despite the availability of specialist care in the Garlands Asylum, families were held back by the stigma attached to admitting that a relative was suffering with a mental condition.
One particular example I have come across in my PhD research of the Garlands nineteenth century patients, highlights this stigma. Isabella Y, aged 33 from Carlisle, was admitted in November 1896 suffering from mania. The event that led to her committal was the death of her husband, William. Her case notes stated: ‘Her husband is said to have locked her up in a room and not to have let her outside for years; he was found dead at his home yesterday, he was an old man about 70 years of age.’ Her physical state on admission indicated that she had been kept indoors for some years, as she was described as pale, emaciated, filthy, and in a generally poor condition.
The fact that Garlands had been open since 1862, less than 5 miles from where they lived, meant that specialist care was readily available within a short distance. This then leads us to believe that the stigma of having a wife suffering from a severe mental illness was so prominent, as he saw it necessary to conceal her from the outside world for such a long period. The additional consideration of the large age gap between the two can also be quite telling. Looking back at census material and marriage certificates, I cannot find much about the pair. The only document I can find is the 1891 census which lists them both living in Botcherby, Carlisle, as man and wife. Isabella is not listed as having any mental condition, so no indication of her illness has given to the outside world (on her Garlands admission she was stated as being mentally unwell since 1886). Consultations with family historians have led me to understand that such large age gaps in this period were not very common. Mostly they would occur when an older man would agree to marry his friend’s daughter, in the event of his death, in order to look after her, and guarantee her financial security. On Isabella’s case notes her next of kin is listed as a second cousin, indicating that she had no nearby close relatives. This may have been because her family was originally from overseas. Her entry on the 1891 census gives her place of birth as Brooklyn, USA. Whether this was true or not, I have not been able to verify through other documents. William’s will listed him as a gentleman, and his effects were left to Isabella’s second cousin in Carlisle. Any records stretching further back I have been unable to trace.
Whatever the explanation for Isabella’s incarceration at home, it is apparent that William was so concerned about the stigma of her mental illness, that he took drastic measures to conceal it.
This case, along with many others I have come across, indicates the stigma attached to the association with those suffering from mental illness that was so dominant in the Victorian period. Although this progressively eased throughout the twentieth century, people still feel unable and uncomfortable with speaking about mental health to the present day. I hope that by looking back at such cases we can see how far we have come, and use this as a platform to encourage the discussion around mental health, to see what still needs to be done. For further information about ‘Time to Talk’ follow the links below, and start the conversation.