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The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904

Rehling, J; Moncrieff, J; (2020) The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904. Psychological Medicine 10.1017/S0033291719004021. (In press). Green open access

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Abstract

BACKGROUND: Contrasting historical views represent the asylum as a manifestation of humanitarian and therapeutic progress or as an institution of social control designed to bolster the capitalist economic order. More extreme critics suggest it was used to incarcerate people exhibiting only political or social deviance. METHODS: Case notes of 200 consecutive male and female admissions to the Essex County Asylum in 1904 were inspected. The nature of presentations was classified in contemporary terms into broad categories of disorder. Outcomes were identified and differences between men and women were explored. RESULTS: We found no evidence that patients were admitted without signs of significant mental and behavioural disturbance. In total, 44% of admissions had signs of an organic condition, and these were more frequent among men. Women were admitted at a faster rate and were 1.6 times more likely to have mania or a psychotic disorder. Overall, 45.5% of patients were discharged, with 62% of patients with non-organic disorders discharged recovered or improved. CONCLUSIONS: Evidence partially supports both views of the asylum. In line with other studies, there is no evidence that the asylum was used to incarcerate people who did not show significant signs of disorder, but it did provide care and containment for those who could not be accommodated elsewhere, including many with organic conditions. The asylum also had a therapeutic orientation, however, and encouraged discharge where possible. In contrast to some other studies, women were more likely to be institutionalised than men, possibly reflecting their greater economic dependency.

Type: Article
Title: The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0033291719004021
Publisher version: https://doi.org/10.1017/S0033291719004021
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Edwardian psychiatry, Michel Foucault, history of psychiatry, history of the asylum, patient outcomes
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10093191
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