Furiously Mad - 300 years of legal insanity.
Hieronymus Bosch paints "The Cure of the Folly"
Partly in response to fears about the number of ex-soldiers roaming the country, the Vagrancy Act allowed 2 magistrates to confine the "Furiously Mad" for as long as "such lunacy or madness shall continue". It used words such as rogues, vagabonds, sturdy beggars, and vagrants. Specifically it referred to those of "little or no estates, who, by lunacy, or otherwise, are furiously mad, and dangerous to be permitted to go abroad" It did not specify where such lunatics were to be detained.
The overseers of the poor in Burscough Lancashire deemed James H of Burscough Lancashire to be furiously mad. There was no place to hold him locally so he was taken to the house of correction in Preston.
The Act made it a crime for a person to claim that any human being had magical powers or was guilty of practising witchcraft. The maximum penalty was set at a year's imprisonment. There was one significant opposition to the Act, by the Scottish Lord James Erskine. He was a fervent believer in witchcraft and that such beliefs were rooted in "Scottish political and religious considerations". His opposition "marked him out as an eccentric verging on the insane"
A lunatic asylum was built alongside Manchester Infirmary in what is now Piccadilly Gardens. In 1849, it was moved to Cheadle Royal. (The Manchester Royal Infirmary relocated to Oxford Road in 1910)
The general public could no longer have a spontaneous day out to look at the Bedlam detainees. They must now get a token from the governor, that would allow up to four people entry. Nowadays, ex-detainees allow you to look at our art.
This was the first legal regulation of the care of lunatics. It set limits on the number of patients who could be admitted into madhouses. The Madhouses were to be licensed, and non-paupers were to be medically examined. There was however no clear definition of qualifications required by the medical practitioner.
The Royal Bethlem Hospital only began to keep records in 1766 and only for administrative purposes. In 1815, it began to keep case books on all patients.
The 1808 County Asylums Act was the first Act that allowed counties to levy a rate to build asylums, but it did not compel them to do this. Its main purpose was to remove lunatics from gaols and workhouses to buildings where they would be easier to manage, with little or no reference to cure.
Perhaps the most notable fact about this act is that it was only repealed in the 1950s. A marriage could be declared null and void if either party was declared to be not sane at the time of marriage, or subsequently. To be a lunatic was not necessarily permanent, and a person could be married after being found sane 'by inquisition'.
Apothecaries were sometimes the chemists of their time, but barely regulated. This act aimed to rectify the situation and introduced compulsory apprenticeship and formal qualifications for apothecaries under the license of the Society of Apothecaries. The act was the beginning of regulation of the medical profession in the UK. The Act required instruction in anatomy, botany, chemistry, materia medica and "physic", in addition to six months' practical hospital experience. However, a few decades later it was noted that: "The training of a practitioner in Britain in 1830 could vary all the way from classical university study at Oxford and Cambridge to a series of courses in a provincial hospital to 'broom-and-apron apprenticeship in an apothecary's shop'". Thomas Bonner, in part quoting M. Jeanne Peterson.
The Court of Chancery was a court whose role and composition changed over time. It was 'a court of equity in England and Wales that followed a set of loose rules to avoid the slow pace of change and possible harshness (or "inequity") of the common law.' (Wikipedia) Amongst other things, it made rules over administration of the estates of lunatics and the guardianship of infants. This law bolstered the court's role... over lunatics with 'estates'.
Madhouse in law meant private houses where small numbers, sometimes only one person were kept. This act tried succeed where the 1774 act had failed. It was to regulate care and treatment of insane persons.
McNaughton Law: It was expedient to consolidate the 1828 Madhouse Act and the 1829 Madhouse Law Amendment Act to more effectually execute their purposes. They were to be repealed with provision for those appointed under them remaining in office until new appointments made, and for acts done under or directed by them remaining good, valid and effectual: "except so far as is specially altered by this Act as to the visitation of single patients"
A padded cell is a cell in a psychiatric hospital with cushions lining the walls. It was introduced in the 1830s as an alternative to mechanical restraint. Padded cells were also used in hospitals for people with epilepsy and/or learning difficulties. They remained in use in some hospitals until the 1980s. (Seclusion rooms still exist into the 21st century, often in combination with an injection of fast-acting medication. Indeed it was such drugs that led to the removal of padded cells) The time spent in a padded cell could vary. Photos of the padded cell in the former psychiatric hospital in Hertfordshire show a room with curved padding, and a mirror. This seems to have enabled a 360 degree view of the patient. Sometimes patients could remain locked in one for several days.
Authorities in local areas were now compelled to provide Asylums for the provision of pauper lunatics. Whilst these were in the process of being built there was an increased demand for places at privately run asylums, paid for by the authorities. This led in some places to exploitation of lunatics and inadequate facilities
Founded by John Thomas Perceval, based upon personal experience. He published an account of his time in asylums. The society managed to influence Parliamentary opposition to the Act of the same year.
Amongst other things appears to have aimed at the movement of chronic patients out of crowded asylums into workhouses to make room for others. It gave the Lunacy Commission power to order the transfer of lunatics from workhouses to asylums at the same time as giving local asylum visitors and poor law guardians the power to provide for a limited number of chronic lunatics in workhouses. (Hodgkinson, R. 1967 p.586)
Though not the first methodology in the practice of individual verbal psychotherapy,[152] Freud's psychoanalytic system came to dominate the field from early in the twentieth century, forming the basis for many later variants. While these systems have adopted different theories and techniques, all have followed Freud by attempting to effect behavioral change through having patients talk about their difficulties.[3] Psychoanalysis itself has, according to psychoanalyst Joel Kovel, declined as a distinct therapeutic practice, despite its pervasive influence on psychotherapy. (wikipedia)
1890 was once again consolidation of laws, and instigated much formal record keeping, including for example, of the use of mechanical restraints in asylums. Orders to detain people were now a judicial matter, and had to be renewed after certain periods. The law was only repealed in 1959.
Bethlem Hospital in London held the first exhibition of art by patients. This was over two decades before the surrealists exhibited 'Outsider Art' in Paris.
Schizophrenia coined by Eugene Bleuler. The roots of the word mean split mind, leading to much popular confusion about the diagnosis. It tends to be applied when a patient reports hallucinations and/or hearing voices - often accompanied by paranoia. It is a contraversial diagnosis not solely because of the stigma, but for the labelling of these experiences as a mental illness.
The first written use of this term was in 1915 in an article by Charles MyersOver. It was published in the medical journal, The Lancet. It assumed a link between the symptoms and the effects of explosions from artillery shells.
This law allowed people to enter hospital voluntarily for the first time. It also permitted outpatient treatment. Asylums were now renamed 'mental hospitals'.
Psychiatry has long used the induction of seizures in patients as a form of therapy. Thus, Ugo Cerletti developed electro-convuslive therapy, first trying to inject electro-shocked pig brains into patients. As with many treatments, psychiatrists are not entirely sure how it works. There is no doubt that there are patients who believe it is a life-changing procedure. There are also survivors of the treatment, for whom memory loss is one symptom amongst many.
The National Health Service took over responsiblity for over 100 mental hospitals.
The use of lithium to treat mania was 'rediscovered' by John Cade, an Australian psychiatrist. The ancient Greeks were the first to use lithium 'medicinally'. Cade was injecting rodents with urine extracts taken from patients who had been diagnosed with schizophrenia. This was an attempt to isolate a metabolic compound which might be causing mental symptoms. Since uric acid in gout was known to be psychoactive (adenosine receptors on neurons are stimulated by it; caffeine blocks them), Cade needed soluble urate for a control. He used lithium urate, already known to be the most soluble urate compound, and observed it caused the rodents to be tranquilized. Cade traced the effect to the lithium ion itself. Cade proposed lithium salts as tranquilizers, and soon succeeded in controlling mania in chronically hospitalized patients with them. However, psychiatrists today still don't know the mechanism by which lithium works. Its efficacy has rarely been properly tested and many patients describe feelings of dullness, memory loss and numerous physical side effects.
Chlorpromazine was first synthesized on December 11, 1950. It was the first drug to be developed with specific "antipsychotic" action, and became the prototype for the phenothiazine class of drugs. The introduction of this drug is often seen as enabling an improved prognosis for patients, and the end of the indefinite hospital stay for some. It is also known as thorazine, and largactyl (hence the largactyl shuffle). These side-effects have meant it is now less widely prescribed since the arrival of newer anti-psychotics.
The Percy Commision was set up in 1954 by Churchill's Conservative government. Its report was published in 1957 and set the course for the move of mental health services into the community. Notably, it called for mental illness to be regarded in the same way as a physical illness or disability and that psychiatric hospitals should be run as nearly as possible on the lines of “normal” hospitals. It also described how the 1913 Mental Deficiency Act ( which brought in the concept of moral defect and feeble minded) had been applied to people of normal intelligence who behaved unconventionally.
The two main aims of this act were to allow psychiatric admissions to be as informal as admission for physical reasons; and to make councils responsible for the social care of people not needing in-patient treatment. It also clearly excluded promiscuity 'or other immoral conduct' as sole grounds for hospital admission.
Widely quoted, but possibly less read as a whole, Michel Foucault's work "Madness and Civilization" was published in 1960. The book discusses how West European society had dealt with madness, arguing that it was a social construct distinct from mental illness. Foucault traces the evolution of the concept of madness through three phases: the Renaissance, the later 17th and 18th centuries, and the modern experience. It is a history of ideas more than events. An abridged version was first published in English in 1964.
RD Laing was a Scottish psychiatrist whose first book The Divided Self questioned the medical model of his profession. He wrote of schizophrenia as a rational response to intolerable experiences. Later, this book Sanity, Madness and the Family was seen as blaming the family rather than the individual patient for their distress. However, to say that the methods he tried to develop from this understanding were not necessarily helpful, is probably an understatement.
Inbetween visits to the Carribean to recruit NHS staff, as Minister of Health, Enoch Powell's Water Towers speech outlined the Conservative governments determination to close the asylums.
One Flew Over the Cuckoo's Nest is known mostly for the film. It began life as a novel, by Ken Kesey, growing from his experience as a hospital orderley. It was adapted first into a play, and then a Hollywood movie. However, Kesey withdrew his support during the making of the film. Its portrayal of the psychiatric hospital arguably continues to influence the public's perceptions of both staff, patients and such institutions today.
Diazepam was released to the market by Roche. It was an improved version of Librium. Diazepam is a benzodiazapine. It has sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), euphoric, anticonvulsant, and muscle relaxant properties. This is achieved by enhancing hte GABA neuro-transmitter. Diazepam was widely prescribed and helped Roche to become a pharmaceutical industry giant. Sales peaked in the US in 1978. It is now realised that drugs in this group are particularly addictive, both psychologocially and physically. The fact that they are also used as a recreational drug makes many GPs more reluctant to prescribe them.
March 21 saw a meeting of about 100 patients and ex-patients at Paddlington Day Hospital. Most were from London, but it turned out there were other groups. They formed a national organisation with full membership reserved for patients and ex patients.
In 1952, when the American Psychiatric Association published its first Diagnostic and Statistical Manual of Mental Disorders, homosexuality was included as a disorder. Almost immediately, however, that classification began to be subjected to critical scrutiny in research funded by the National Institute of Mental Health. .....In recognition of the scientific evidence,[136] the American Psychiatric Association removed homosexuality from the DSM in 1974, stating that "homosexuality per se implies no impairment in judgment, stability, reliability, or general social or vocational capabilities."
This was the nickname for a booklet 'The Case for a Mental Patients Union.' It was written by one of the patients at Paddington Day Hospital,Eric Irwin. He and three professionals, Liz Durkin, Lesley Mitchell and Brian Douieb, thought there was a need for an organisation of patients. Later they were joined by two other patients, Andrew and Valerie Roberts. It is a pilot group for the MPU. The booklet is often called "The Fish Pamphlet" because it has a picture of a fish on a hook on the cover. This is to illustrate that the behaviour of someone who is suffering from mental illness may appear mad, but may really be a way of getting over his or her problems.
The Wall began as a double album, then performed live with elaborate theatrical effects, and adapted into a feature film. The imdb (internet movie database) describes it as "A troubled rock star descends into madness in the midst of his physical and social isolation from everyone."
was the name given to a report by Cecil Parkinson MP. Publication had been delayed by two years, work on the report had begun in 1976. There was already a realisation that closing asylums was leading to an increase in the prison population. He also was keen to ensure unmarried mothers weren't automatically detained in mental hospitals and thus distracted, but most of this report did find its way into the 1983 Mental Health Act.
1982 saw the publication of Peter Sedgwick's PsychoPolitics. His book was critical of anti-psychiatry, but from the left. ‘It is in the battle on the wrong side; the side of those who want to close down intensive psychiatric units and throw the victims of mental illness onto the streets.’
This act required a social worker to be one of the three people required to assess and if necessary 'section' a person. It also allowed a patient to appeal this decision. The law covers the reception, care and treatment of 'mentally disordered' persons, and such things as the management of their property. In particular, it provides the legislation by which people diagnosed with a mental disorder can be detained in hospital or police custody and have their disorder assessed or treated against their wishes, unofficially known as "sectioning". Its use is reviewed and regulated by the Care Quality Commission.
This was an Audit Commission report. Managers know best, don't you know.
Founded by a group of mental health service users and workers. The term survivor was chosen to portray a positive image of people in distress and people whose experience differs from, or who dissent from, society's norms. The main aim is to promote self advocacy." [studymore.org.uk]
Fluoxetine (branded as Prozac) is an antidepressant. It was one of the first SSRIs (selective serotonin reuptake inhibitor) and marketed by Elli Lilly from 1987. Fluoxetine went off-patent in August 2001. It began as a treatment for depression but is now able to multi-task and treat a range of conditions. The nhs.uk website warns that it has been linked to suicidal thoughts in early treatment.
'Community Care: Agenda for Action', also known as The Griffiths Report. Sir Roy Griffiths, onetime director of Monsanto, then deputy chair of Sainbury's told Thatcher that Community Care was "everybody's distant cousin but nobody's baby".
The first UK Hearing Voices group was formed in Manchester. Hearing voices has been regarded by psychiatry as ‘auditory hallucinations’, and in many cases a symptom of schizophrenia. However not everyone who hears voices has a diagnosis of schizophrenia. Traditionally, the usual treatment for voice hearing has been major tranquillisers, administered to reduce the delusions and hallucinations. However not everyone responds to this treatment. There are some psychiatrists and psychologists who now work with people who hear voices using talking therapies and exploring the meaning of the voices.
Recovery began as a user movement in the US. "The person credited with starting the 'recovery' movement was Patricia Deegan, a mental health system survivor in the USA. Her article ... does not cite any previous work on recovery. She is arguing that existing models of rehabilitation do not allow for the complexity of the recovery process" (Jan Wallcraft email 2009) sudymore.org.uk It is the current (2014) buzzword in UK mental health services, but is rarely defined by them. In practice, it seems often to be a declaration made by the professionals. It thus denies access to services. The caseload for Community Mental Health Teams is thus reduced. The sometimes devasting effects of this may come to be seen as a repeat of the asylum closures.
This Act defined the NHS as enablers rather than providers. It also required local councils to assess the social care of people with mental or physical problems. It did not make any specifications as to how those needs might be met, by whom and with what money.
Mad Pride takes inspiration from previous movements such as Gay Pride and seeks to reclaim the language of madness, especially that used in the mass media. This UK incarnation was a response to the 750th 'celebrations' of Bedlam which managed to almost completely forget patient/user input. It has both a protest and social side. Some of us have doubts that our madness is always enjoyable and thus a cause for celebration.
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