Chapters in the History of the Insane in the British IslesTuke, Daniel Hack
History
Chapters in the History of the Insane in the British Isles
Tuke, Daniel Hack
Mental health laws -- Great Britain; Mental illness -- Great Britain; Mentally ill -- Care; Psychiatric hospitals -- Great Britain
As to public asylums, the evidence brought forward convinced the
Committee that little alteration was required in the law, they being
"well looked after and carefully attended to." It was suggested that
they might be in some instances too large, and the staff of attendants
too small and not sufficiently paid. Also that it might be desirable to
erect, in connection with them, detached buildings of a simple and
inexpensive character for the reception of imbecile and chronic
patients.
It was considered that the chief evil for which a remedy was required
lay in the detention of a large number of pauper lunatics in workhouses,
amounting to 68,000 January 1st, 1857, and 7632 on January 1st, 1859.
"It cannot be denied that, with regard to those who are really lunatics,
there is a great absence of proper supervision, attendance, and medical
treatment. In some workhouses there are not even separate wards;
mechanical restraint is frequently applied, because the imperfect state
of the accommodation will not admit of a better mode of treatment; in
many cases, the medical officers of a union cannot have the special
knowledge requisite for the management of the insane; and it may
generally be concluded that the special appliances of a union workhouse
are not by any means equivalent, as to this class of inmates, to those
of a lunatic asylum." The Committee did not recommend the removal of
all cases, but that no person should be detained in a workhouse
respecting whose sanity a doubt existed, without a medical certificate,
renewable quarterly; that there should be distinct wards for such
patients, with distinct attendance; that the guardians should visit such
patients once a quarter, and make a special entry of their condition;
that the Commissioners should visit them at least once a year; and that
the same power of removing any patient to an asylum should be given to
the Commissioners as that possessed by the justices.
Lord Shaftesbury on this occasion recommended that magistrates should be
empowered to provide asylums by money raised on the security of the
rates, for all the non-pauper classes. "When I look into the whole
matter," he said, "I see that the principle of profit vitiates the whole
thing; it is at the bottom of all these movements that we are obliged to
counteract by complicated legislation, and if we could but remove that
principle of making a profit, we should confer an inestimable blessing
upon the middle classes, getting rid of half the legislation, and
securing an admirable, sound, and efficient system of treatment of
lunacy." The Committee, however, while encouraging such asylums founded
on private contributions, could not recommend that a burden should be
imposed on the ratepayers, or that their establishment should be
compulsory.
The Committee suggested as safeguards against the improper detention of
lunatics in private asylums (after dismissing the proposal to require
the sanction of a magistrate) various important precautions.
Public-domain text, read in full here on John Shaqi.
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