Bethlem Hospital

Bethlem Hospital

This article relates to Revelation

The Bedlam Hospital that appears in Revelation is no figment of the author’s imagination. It is fashioned after what is perhaps the oldest hospital for the mentally ill in the Western world, Bethlem Hospital in London. Bethlem has also gone by the name Bedlam, the root of the modern English word bedlam, meaning "uproarious confusion." Open at first to small groups of patients in the 1300s, Bethlem hospital was long the only hospital in Britain for the mentally ill. The wealthy families who could afford to have patients confined and "treated" unwittingly (or wittingly) subjected their loved ones to cruel and inhumane conditions.

In the 17th century, the need for more room and the dire conditions of the existing building (today the site of the Liverpool Street Station) caused Bethlem to move to a grand, new space with wide hallways and elegant ironwork. During this time, the only alternative to Bethlem for British in need of psychiatric care was a private madhouse, a place populated mainly by the insane poor. Presumably, better treatment could be had in Bethlem, but only for the 12-month periods patients were allowed to stay. Former Bethlem residents may have been granted special rights to beg on London streets, and just such a “Bedlam Beggar” appears in Shakespeare’s King Lear.

By the 19th century, the hospital had moved again, this time to the site of the current day Imperial War Museum. This new building had a library that was available to the patients, and dancing was allowed in the evenings, but these small comforts did little to assuage the abuse patients faced. The 96,000 members of the viewing public who came to the hospital in 1814 to see the "Show of Bethlem" were even allowed to bring sticks to poke at the unfortunate inmates.

As modern interest and research provided more insight into the experience of the mentally ill, treatment improved and the conditions at Bedlam also evolved, though the hospital has not completely escaped its historical reputation. As recently as 1997, with the launching of the "Reclaim Bedlam" campaign, patients and ex-patients have spoken out against the experience of receiving treatment in Bethlem. In 2008, a £33.5 million, 89-room addition to Bethlem Hospital, now Bethlem Royal Hospital, represented a major improvement in the quality of care for mentally ill patients living in the vicinity of the hospital, which is now located in the south-eastern suburbs of London.

Bethlem Royal Hospital Archives & Museum Service

Filed under Places, Cultures & Identities

This "beyond the book article" relates to Revelation. It originally ran in February 2009 and has been updated for the February 2010 paperback edition. Go to magazine.