Mental Health in the 19th and 20th Centuries

This article relates to The Vanishing Act of Esme Lennox

• The events in The Vanishing Act of Esme Lennox are based on a real British policy which deinstitutionalized thousands of psychiatric patients beginning in 1990. Margaret Thatcher's Care in the Community program sought to end outmoded, Victorian-era mental institutions by releasing such patients back into their homes, their illnesses controlled by medication and individualized treatment rather than confinement. The program ended in 1998 after a series of highly-publicized crimes by former inmates. The British health secretary recalled many patients who were living without supervision and placed them back into residential treatment centers.
  
• Mental institutions were a humane advance in the early 19^th century, when the treatment of mentally ill people evolved from brutal imprisonment and restraint to the creation of a homelike environment within a health-care setting. Yet the 19^th century also took a step backward in its treatment of mental health; patients were involuntarily committed not just for illnesses but for behavior which simply didn't fit within mainstream society. For instance, in Great Britain and Ireland, prostitutes were locked up in Magdalene Asylums, which were Roman Catholic institutions established to reform women's immoral behavior. Patients were forced to undergo hard labor, periods of silence, and corporeal punishment. Gradually Magdalene Asylums were extended to unwed mothers, developmentally challenged women, and abused girls, all of whom could be committed at the request of a family member and held against their will. The last Magdalene Asylum closed in 1996, but most mental hospitals had begun to change their admissions policies as early as the 1910s and 1920s, when the treatment of mental illness by custodial care gave way to the scientific exploration of the biological basis for mental illness.
  
• The word "Bedlam" became a popular name for the Bethlem Royal Hospital in South London, the world's first psychiatric hospital, which has admitted mentally ill patients since the early fifteenth century. The term has since come to mean, according to Webster's, "a state of uproar and confusion."
  
• In the USA, the criticism of insane asylums began during the Progressive Era, when muckraking journalist Nellie Bly faked lunacy in order to be committed to the notorious Women's Lunatic Asylum on Blackwell's Island. Her exposé of the inhuman conditions at Blackwell's was published in Joseph Pulitzer's New York World and later made into a book, Ten Days in a Mad-House.
  

Filed under People, Eras & Events

This "beyond the book article" relates to The Vanishing Act of Esme Lennox. It originally ran in October 2007 and has been updated for the June 2008 paperback edition. Go to magazine.

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