Chapters in the History of the Insane in the British Isles

by Daniel Hack Tuke

On the 11th of July, 1815, Mr. Rose brought up the Report of this Committee. On moving that it be printed, he said that all who read the Report must feel satisfied of the indispensable necessity of legislative interference. The way in which lunatics were usually confined was that of criminals, and their treatment was in general worse than the ordinary treatment in jails. The number of persons appointed to take care of them was in most cases utterly insufficient, in consequence of which the greatest severity was too frequently resorted to.

The conclusions arrived at in this celebrated Report may be thus summarized: That keepers of houses for the insane received a much greater number of persons than they were calculated for, thus greatly retarding their recovery; that the number of attendants being insufficient, there was unavoidably a larger amount of restraint than would otherwise be necessary; that outrageous patients were mixed with the quiet and inoffensive; that there was an absence of medical attention to the malady for which the patients were confined; that the certificates on which patients were received into asylums were insufficient, and that the visitation of private mad-houses was defective.

The Report concluded that "some new provision of law is indispensably necessary for ensuring better care being taken of insane persons, both in England and Ireland, than they have hitherto experienced; the number of whom appear to be very considerable, as the inquiries of the Committee have convinced them that there are not in the country a set of beings more immediately requiring the protection of the legislature than the persons in this state, a very large proportion of whom are entirely neglected by their relatives and friends. If the treatment of those in the middling or in the lower classes of life shut up in hospitals, private mad-houses, or parish workhouses, is looked at, your Committee are persuaded that a case cannot be found where the necessity for a remedy is more urgent."

The evidence taken before the Committee of 1815 was so full and convincing that it would have seemed wholly unnecessary to have required a further disclosure of the abuses rampant in the asylums of England, but in consequence of the demand for further investigation before the House of Commons committed itself to legislation, a mass of further particulars was obtained in 1816 in regard to the state of various institutions, including Bethlem Hospital and the York Asylum.

In February Mr. Rose had said in the House that, as chairman of the Committee for inquiry into the conduct of mad-houses, he was instructed to move for leave to bring in a Bill for the better regulation of such establishments. But some gentlemen of the Committee being desirous that further investigation should take place, he had acceded to their wish, although the majority concurred with him in thinking that sufficient evidence had already been adduced to justify the proposal of a Bill. Therefore, he should propose, instead of a Bill, that a Committee be appointed to consider of provision being made for the better regulation of mad-houses in England, and report the same, with their observations thereupon, to the House.

On May 28th Mr. Rose brought up the Report of the Committee, and obtained leave to bring in a Bill pursuant thereto. This Bill was for the repeal of the 14th and 55th of the King. He said[149] the Committee had, after the most patient investigation, adopted the provisions of the present Bill, which principally were, that instead of the physicians of the neighbourhood, or those in or near the metropolis, together with a neighbouring magistrate, being the inspectors of such establishments, they should be twice a year examined, etc., by eight Commissioners appointed by the Secretary of State for the Home Department throughout the kingdom; the Commissioners to be assisted by two of the local magistrates in each district, and with equal powers. There was also a provision in the Bill relative to the erection of lunatic asylums in counties, and the ordering the reception therein of pauper lunatics allowed at present to range abroad, to their own and the public injury.

On the 17th of June, Mr. Rose moved that the clauses of this Bill be taken into further consideration. Lord R. Seymour observed that when Parliament in 1774 passed the "Bill for the Regulation of Licensed Mad-houses," it must have meant to do three things: (1) To secure all persons against unnecessary confinement; (2) to better the chance of recovery of all such persons confined as being insane, as well by moral treatment as by the use of medicine; and (3) to insure the restoration of all who might become again of sound mind to society. But the Mad-house Act, he said, does none of these three things, for it does not empower the Commissioners to discharge a patient, however sound in mind; nor does it furnish them with the means of enforcing the observance of any improvement they may recommend. The Commissioners, indeed, may withdraw the licence, but the keeper of such a house must again have it on the next licensing day, if he wishes, upon giving the necessary security. It was not surprising, therefore, that the greatest abuses should have been found to prevail.

Mr. Wynn expressed a wish that magistrates should be empowered to examine houses where only one patient was confined.[150]

This Bill passed the House, but was rejected by the House of Lords.