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
9. That the occasional use of slight coercion, particularly in
protracted cases, possesses this additional advantage: that it gives the
patient the opportunity of taking exercise in the open air at times
when, but for the use of it, he would necessarily be in a state of
seclusion.
10. The system of non-restraint cannot be safely carried into execution
without considerable additional expense; a matter which will necessarily
enter into the consideration of those who are desirous of forming a
correct opinion as to the precise benefits likely to arise from the
adoption or rejection of such a system.
11. That the benefit to the patient himself, if indeed it exist at all,
is not the only question; but that it ought to be considered, whether
the doubtful advantage to himself ought to be purchased by the danger to
which both he and his attendants and other patients are exposed, when
restraint is altogether abolished.
And 12thly. That, when a patient is forced into and secluded in a small
room or cell, it is essentially coercion in another form, and under
another name; and that it is attended with quite as bad a moral effect,
as any that can arise from mechanical restraint.[183]
Passing on to 1847, we find the Commissioners in Lunacy, having acted
under the new powers conferred upon them by the two Acts passed since
the date of the Report of 1844 (8 and 9 Vict., cc. 100 and 126), able to
give a satisfactory sketch of the progress of reform in the condition of
asylums. "In several of the county asylums and hospitals," they observe,
"the adoption of a more gentle mode of management was originally
designed in the direction of these establishments, and was the result of
public opinion and of the example set by the managers of the Retreat
near York. A strong impression was made on the feelings and opinion of
the public in reference to the treatment of lunatics by the publication
of Mr. Tuke's account of the Retreat at York. The able writings of Dr.
Conolly have of late years contributed greatly to strengthen that
impression, and to bring about a much more humane treatment of lunatics
in many provincial asylums, than that which formerly prevailed."
Referring, then, to the Report of the Metropolitan Commissioners (1844)
it is observed that "proof is afforded therein that this amendment had
not extended itself to old establishments for the insane, and that much
severe and needless restraint continued to be practised in numerous
private, and in some public asylums. In many of the private asylums, and
more especially in those which received great numbers of pauper
patients, much mechanical coercion was practised, until it came to be in
great measure laid aside in consequence of the repeated advice and
interference of the Commissioners.... In private licensed asylums it
has been thought impracticable to avoid the occasional use of
mechanical coercion without incurring the risk of serious accidents.
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