Restraints in a Victorian Insane Asylum

Life in a psychiatric facility is not without its challenges. With the stigma that stills surrounds mental health, being admitted to one of these facilities comes with shame and humiliation. Basic freedoms that we take for granted every day become a privilege to these patients. However, the psychiatric hospitals of the Victorian age are unrecognizable to what they are today.

A ward for non-violent women
West Riding Asylum, Wakefield, England (1)

Psychiatry is a fairly new branch of medicine compared to other branches. There is still a lot to discover about the human brain and mental illness, and there are some mental illness that does not ever get cured, but merely managed.

Before asylums, people suffering with mental illnesses were left solely to the care of their families, and faced things such as starvation and homelessness. It wasn't until the early 15th century that facilities to house the mentally ill were constructed. These were built and maintained by Christian institutions, (4) so treatment was more religious than scientific. Treatment did not become more scientific until the late 18th early 19th century. The Madhouse Act of 1774 was a step in the right direction for reform, but terrible conditions still persisted. In the year of 1814, thirteen women were crammed into one cell in York Asylum. Later that same year in Bethlem hospital in separate side rooms, patients were found chained to the wall. One case of a patient named James Norris was especially bad. Kept in a place typically saved for "troublesome and dirty" patients, he was locked in an iron bar device and chained to a pipe. He died only a few days later. It was not until 1828 that a more established law and group of commissioners was created to inspect asylums. Five of the commissioners had to be doctors. (3)

Patient in a restraint chair.
West Riding Asylum, Wakefield, England (5)

The number of asylums tripled in the 19th century due to the Lunacy Act, which made it a requirement for every county to have an insane asylum. By the end of the century, there was more than 120 asylums across England and Wales, housing about 100,000 patients. (6) From 1853 to 1880, things seemed to look up when people believed more and more in going restraint free. Without the mechanical restraints, other terrible practices rose up to replace it like more locked seclusion, cold baths, and chemical restraints. Although these do not seem as terrible as the mechanical restraints, it did not take long for facilities to abuse these practices, that led to trauma and death to some patients. Finally, after much talk about whether mechanical restraints should be used or not, they started using them more. In some cases, the mechanical restraints were a better solution than other methods they employed. This method would take us out of the Victorian age. (3)

Now, we have a more progressive mindset toward the mentally ill. There are still hospitals that have restraints to this day, but more are going restraint free. The restraints that are used now are more ethical, and there are better practices to ensure they are not abused. Though the hardships the patients in the Victorian age had to endure were not right, it moved us forward into more ethical standards when treating the mentally ill. Though the stigma still persists, we continue to understand more, which leads to more effective treatment. 

Late 1840s "Utica Crib" carved from wood. (2)

Work Cited

1. Burns, Stanley B. "An 1860s Mental Hospital." CBS News, www.cbsnews.com/19th-and-20th-century-psychiatry-22-photos/12/, Accessed 17 October 2018.

2. Burns, Stanley B. "Utica Crib." CBS News, www.cbsnews.com/pictures/19th-and-20th-century-psychiatry-22-photos/12/, Accessed 17 October 2018.

3. Fennel, Phil. Treatment Without Consent: Law, Psychiatry, and the Treatment of the Mentally Disordered People Since 1845. Routledge, 1995.

4. "Mental Institutions." Brought to Life Science Museum, broughttolife.sciencemuseum.org.uk/broughttolife/themes/mentalhealthandillness/mentalinstitutions.

5. News Dog Media. "Haunting Photos of Insane Asylums from Decades Past." Wellcome Library, London. All That Is Interesting, www.allthatisinteresting.com/mental-asylums#2, Accessed 17 October 2018

6. "The Growth of the Asylum - a Parallel World." Historic England, 2018, www.historicengland.org.uk/research/inclusive-heritage/disability-history/1832-1914/the-growth-of-the-asylum/.