A Delicate Matter: The Madhouses of the South West of England, 1770 – 1851

Abstract

This thesis examines the private madhouses of Somerset, Dorset, Devon, and Wiltshire during a period of great transition within the existing lunacy care landscape. Many madhouses pre-dated county asylums in provision for the pauper mentally ill, including in the south west. Madhouses operated as an enterprise, unlike the parish overseen county asylums. This led to a lack of regulations in care. The Lunacy Commission was formed as part of the 1828 Madhouse Act. This led to a series of inspections of all asylums throughout England for the first time. At this time, Devon and Somerset had disproportionally high rates of mentally unwell pauper patients compared to the rest of England. Despite this, no county asylum was built in either of these counties until 1845. Newspaper reports cited magistrates’ claims that they were not needed because of private asylums operating in the region. Private asylums are often associated with wrongful confinement and mistreatment of patients. This reputation was expressed at the time in popular culture and exerts a profound legacy even today. There has been much academic interest in the care of the mentally unwell in this period, yet private establishments remain under-researched. This is especially true of the south west, aside from Leonard Smith’s research on the proprietors of Bristol private asylums (2008 and 2016). This lack of research downplays their importance as providers of care for both private and pauper patients. The south west asylums also hold links to the Quaker-led reforms in mental health care of the 1790s. This thesis begins with an examination of the cultural reputation of madhouses, using examples from England as a whole but relating to the southwest where applicable, and then moves to frame the network of asylums within the south west. This includes examinations of patient care, treatments, staff and proprietors. As many madhouses did not keep or preserve patient records (which would usually be a logical starting point), this thesis uses a novel approach in the combination of different types of source material to create quantitative data for analysis as well as qualitative. Sources include, but are not limited to, extensive archival material, admissions records, family history, and newspapers. Family and local history methods were also used to create a prosopography of asylum proprietors in order to gain a better understanding of their motivations and practice.