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The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904

Published online by Cambridge University Press:  15 January 2020

Joseph Rehling  and
Joanna Moncrieff
Joseph Rehling
Affiliation:
School of Health and Social Care, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK
Joanna Moncrieff*
Affiliation:
Division of Psychiatry, University College London, Gower Street, London WC1E 6BT, UK
*
Author for correspondence: Joanna Moncrieff, E-mail: j.moncrieff@ucl.ac.uk
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Abstract

Background

Contrasting historical views represent the asylum as a manifestation of humanitarian and therapeutic progress or as an institution of social control designed to bolster the capitalist economic order. More extreme critics suggest it was used to incarcerate people exhibiting only political or social deviance.

Methods

Case notes of 200 consecutive male and female admissions to the Essex County Asylum in 1904 were inspected. The nature of presentations was classified in contemporary terms into broad categories of disorder. Outcomes were identified and differences between men and women were explored.

Results

We found no evidence that patients were admitted without signs of significant mental and behavioural disturbance. In total, 44% of admissions had signs of an organic condition, and these were more frequent among men. Women were admitted at a faster rate and were 1.6 times more likely to have mania or a psychotic disorder. Overall, 45.5% of patients were discharged, with 62% of patients with non-organic disorders discharged recovered or improved.

Conclusions

Evidence partially supports both views of the asylum. In line with other studies, there is no evidence that the asylum was used to incarcerate people who did not show significant signs of disorder, but it did provide care and containment for those who could not be accommodated elsewhere, including many with organic conditions. The asylum also had a therapeutic orientation, however, and encouraged discharge where possible. In contrast to some other studies, women were more likely to be institutionalised than men, possibly reflecting their greater economic dependency.

Keywords

Edwardian psychiatryMichel Foucaulthistory of psychiatryhistory of the asylumpatient outcomes
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 7 , May 2021 , pp. 1140 - 1146
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Copyright
Copyright © Cambridge University Press 2020

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