Ann's Places

An Overview of Asylums in England to 1850 and the Connection with Ann Walker

Contents


    Preface

    To better understand Ann Walker’s mental health journey in the first half of the 19th
    Century, it is helpful to consider the era and societal attitudes to see what asylums and
    related systems were not and to avoid framing her experience by modern standards.
    This piece will provide an overview of the growth of asylums from the early 18th Century
    English history until she died in 1854. It will also examine the role of the Lunacy
    Commission in managing the care and property of mentally ill people. Because Ann
    Walker was a part of society’s upper class, and that will be the primary focus.
    Colloquially, the terms ‘mad’, ‘madhouse’, and ‘mad doctor’ were used interchangeably
    with lunatic and did not carry the negative connotation of modern usage.

    Care of the Lunatic 1700-1800s

    The first known asylum in the UK was at Bethlem Royal Hospital in London. It had
    begun in 1247 as a Priory and was a place of refuge (asylum) for the poor and ill.
    Around 1407 it began admitting patients with mental illness. Shortened to “Bedlam”, it
    was infamous for its methods of “curing” lunatics; such as water treatments, whipping,
    isolation, and chains. At one time it allowed the public to pay to watch the mentally ill
    patients for entertainment. This “display of madness” was a means of raising hospital
    income.1 Overcrowding and differing views of care led to most of these abuses.

    Image of Scene at Bedlam from The Rake’s Progress by William Hogarth. Wellcome Collection Gallery (2018-03-30);

    Scene at Bedlam from The Rake’s Progress by William Hogarth. Wellcome Collection Gallery (2018-03-30); https://wellcomecollection.org/works/hfrudd44 CC-BY-4.0

    This led to a common misconception that all asylums in the 1800s were evil places where sane people could be incarcerated illegally for corrupt motives, such as a family ridding themselves of an inconvenient relative or appropriating someone’s wealth or inheritance. There were instances of these abuses; however, many of these abuses were curbed after outrage led to reform and a series of Lunacy Acts beginning in 1803. (See Appendix) 

    The care of lunatics still mainly fell to families. The wealthy could afford private care and individual treatment, usually at home. In cases where the families could not feasibly keep a lunatic at home, placement for their care fell under the jurisdiction of the local civil authorities and the parish. The lunatic dependent on charity was known as a ‘pauper lunatic’ whose care was funded by several sources: a landowners’ ‘Poor Tax’2, church charity, or by subscription.  

    There were two main characterizations, or categories, of lunacy at that time. One label was ‘imbecile’ or ‘idiot’ meaning their mental state was congenital and nothing could be done for them. They were usually sent to workhouses, houses of correction, or prisons whose function was to simply keep them in custody. 

    The second characterization was ‘lunatic’ or being of ‘unsound mind’ meaning their mental problems were due to outside forces such as stress or melancholy. “This person [of unsound mind] is temporarily unable to care for themself or conduct business, but had the expectation of full recovery”.3

    Lunatics were sent to county asylums, for-profit private dwellings, or to small farms – known as ‘pauper farms’ – and the fees for their care were paid by the family or negotiated with the Poor Law Guardians of the parish. Room and board and light work to help pay for their care was provided by the pauper farm and known as ‘farming out’. With scattered regulations, the quality of the county asylums, private dwellings, and poor farms varied greatly.

    By the beginning of the 19th Century, the number of pauper farms had grown into for-profit institutions and were an important part of public welfare provision. On admission, the lunatics were categorised into different groups: men and women were kept separately, as well as members of different social classes. Additionally, patients were classified according to their mental and physical condition. The groups each had their own day room, dormitory, and activities. As the need for housing grew, the Asylum Act of 1808 permitted and encouraged counties to build asylums, however, only a small number were built. A series of other Parliamentary Acts in 1845 regulated standardized care and treatment, such as requiring oversight by a physician and regular visits by authorities. These laws resulted in the decline of pauper farms and many lunatics were sent to county or private asylums although with often greatly inferior care.

    References: Preface

    1. Victorian Era Lunatic Asylums: The Rise of the Lunatic Asylum (The Victorian Era) https://www.valmcbeath.com/victorian-era-england-1837-1901/victorian-era-lunatic-asylums/
    2. Reference to Anne Lister and Ann Walker paying this tax is in her diaries:

    24 February 1835: “Moore wants his brewhouse draining – said it was to be done but told Riley they must all pay their poor rates – I paid taxes for none of my tenants –” WYAS: SH:7/ML/E/17/0170 Kerstin Holzgraebe

    4 October 1836: “. . . A- paid him the last years poor rate £7.17.6 tho’ the lease settles that the tenant is to pay all taxes but Mr. SW- had paid them! A- will pay no more – this well understood by Bairstow now –“ WYAS: SH:7/ML/E/19/0118 Francesca Raia

    3. Shelford, Leonard, Esq.: A Practical Treatise of the Law Concerning Lunatics, Idiots, and Persons of Unsound Mind, Law Booksellers and Publishers, London, 1847; p.40.

    19th Century Lunacy Reform: the Moral Treatment Method

    In the late 1700s, William Tuke from York and his fellow Quakers revolutionized mental health care with the establishment of the Retreat at York (not to be confused with the notorious York Insane Asylum which had a history of abuse and neglect). You can read about the two York Asylums here: http://borthwickinstitute.blogspot.com/2014/10/the-york-lunatic-asylum-scandal.html]

    At the Retreat, “30 patients lived as part of a small community in a quiet country house, engaging in a combination of resting, talking, and light manual work. Rejecting any medical theories or techniques at the time, this centered around minimising restraints.”1 This method of restoring mental health focussed on allowing patients to live in a community, partake in daily activities, and not be subjected to the brutality of the commonplace asylum, all of which were very rare in the treatment of lunatics at that time.2 

    A new era of social enlightenment and medical advances in the study of lunacy placed emphasis on compassion for the lunatic. Lunacy was no longer considered a character defect, but a treatable disorder of the mind. Instead of custody, emphasis was placed on cure. The aim of this method, called ‘moral treatment’, was to restore mental health through gentle discipline, order and well-intentioned manipulation.3

    Private Asylums or Madhouses

    ‘Private madhouses’ were establishments for the care of insane persons, conducted as a business proposition for the personal profit of the proprietor or proprietors. In the course of their lifespan these institutions were referred to by a variety of terms: ‘houses for lunatics’, ‘madhouses’, ‘private madhouses’, ‘private licensed houses’ or ‘private asylums’.4 

    Types of Private Asylums

    Home care

    The lunatic was confined in his or her own home, with or without the assistance of a paid attendant or attendants. Ann Walker’s last years were spent with a paid attendant. 

    Lodgings and/or single houses

    The lunatic was confined in a house (not his or her original home), under the care of a paid attendant or attendants. Some of these lodgings or single houses were a family home where two or three lunatics lived with a family who was paid for their care. Heworth Grange where Ann Walker stayed under the care of Dr Stephen Belcombe was a private lodging. 

    Mad houses or mad asylums

    More than one lunatic was confined under the care of a paid attendant or attendants. The houses with more than one lunatic needed to be licensed, but the kind of care might not differ from that in a single house. 

    Some doctors provided services relating to this whole range of provisions. For example, he might have visited a home where a person was confined by relatives. The same physician might have recommended a paid attendant (keeper/male, nurse/female) who would keep guard over the patient. Alternatively, the physician might have recommended someone who would arrange single care in lodgings, or he might recommend a madhouse. In the case of attendants, in single houses, and madhouses, there would be a variation of financial arrangements between the physician, the attendants, and the house. Often, the physician would receive a regular retainer for making recommendations.5  

    Some doctors who practiced the moral treatment method admitted a select number of lunatics into their own private homes and treated them as an extension of their own family. Ann Walker resided with Dr Forbes Winslow and his family in Sussex House in 1845. 

    Find out more about Ann Walker and Sussex House.

    References: 19th Century Lunacy Reform: the Moral Treatment Method

    1. Mander, Joe: The History of Mental Asylums, Beyond the Point, 26 July 2020. https://beyondthepoint.co.uk/a-history-of-mental-asylums/Houston_2019_Asylums_Lancet_Psychiatry_AAM.pdf
    2. Kibria AA, Metcalfe NH. A biography of William Tuke (1732-1822): Founder of the modern mental asylum. J Med Biogr. 2016 Aug;24(3):384-8. doi: 10.1177/0967772014533059. Epub 2014 Jun 18. PMID: 24944052.
    3. Hamlett, Jane: At Home in the Institution: Material Life in Asylums, Lodging Houses and Schools in Victorian and Edwardian England, ISBN: 978-1-137-32239-5; p.38. https://link.springer.com/book/10.1057/9781137322395
    4. Ibid p.39.
    5. Roberts, Andrew: 1981/MadHouses. http://studymore.org.uk/mhhglo.htm#MadHouses

    Daily Life in the Private Asylums

    Middle and Lower Classes

    Image of Female workroom, Bethlem Hospital. Wood engraving probably by F. Vizetelly after F. Palmer, 1860. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0

    Female workroom, Bethlem Hospital. Wood engraving probably by F. Vizetelly after F. Palmer, 1860. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0

    On admission, patients were identified as either ‘pauper patients’ or ‘private patients’ and were housed in wards appropriate to their status. Whereas private patients had fewer beds to the ward and some degree of privacy, pauper wards contained as many beds as the hospital could accommodate, meaning there was barely space between the beds and no privacy. Men and women were separated and then separated further by diagnosis and class.

    The moral treatment method emphasized keeping the lunatic busy in order to distract them from their problems, thereby leading them to better mental health. 

    “All patients were expected to follow a regular, predictable routine, avoiding stress and no visitors. The routine included work and exercise […].  Patients were expected to dine at the table, make polite conversation over tea, and do regular chores. These asylums tried to be self-sufficient so the men performed menial labor or were expected to work on the farm.1  Women’s activities were limited to a gentle walk around the gardens [and] they could expect to spend their time indoors doing needlework, knitting and general housework. Sports and games were encouraged […]. Overall, a quiet and orderly regime was maintained, in which socially acceptable behaviour was constantly encouraged without physical coercion.”2

    Treatment fell into several basic methods: sedatives, isolation, hot and cold shower baths, and blistering. The use of restraints varied from one asylum to another, but they were accepted as a necessary part of mental healthcare. A ‘generous diet’ was the most commonly prescribed treatment and was considered necessary for recovery. Alcohol was seen as being a medicine in its own right and pints of ale, sometimes multiple times a day, were prescribed.3 

    The men, women, and families who ran small private houses, asylums, and working farms took their charge seriously and compassionately. Within the societal norm of class, they provided good meals, entertainment such as dances and musical entertainment and religious services.

    Wealthy and Aristocratic Classes

    Madness in upper-class culture was still viewed with shame and fear and many believed that it was hereditary. Licensed private houses and asylums that wished to cater to the upper class and wealthy needed to differentiate themselves from a private house that catered to working class or paupers. These houses often resembled country houses or hotels and were run by socially acceptable lay proprietors and families, doctors, or clergymen. They had access to much better quality and standard of care. The accommodations depended on the fees charged. Bedrooms and sitting rooms were modeled after a boarding school and some houses allowed live-in personal servants.4 

    As with the middle- and lower- classes, asylums were strictly segregated between men and women and families and friends were not permitted to visit: “. . . it was felt to be important ‘to remove the Insane from their own houses and friends’, to avoid the inherent ‘distress and confusion’”.5     

    All were expected to follow a daily routine and leisure activities were encouraged. The diversion of thought and looking outside themselves was a primary function of a private asylum.  Doctors allowed patients to engage in pursuits they enjoyed. Upper-and wealthy-class women knitted and sewed, painted, played piano, walked in the gardens, and played cards. The men were encouraged to play sports, billiards, and gardening. Many private asylums had gardens, a conservatory, a music room, private chapel, and evening entertainments. Some had a carriage for personal use and were permitted to attend church alone. 

    The splendour was meant to distract patients, in addition to emphasizing their status and reassuring relatives and family. It was in this form that madhouses served what was perhaps their most fitting role, by making comfortable provision for the wealthier patients in relatively small, well-staffed houses, where privacy and much personal liberty could be enjoyed.6  

    Spring Vale, Staffordshire and Hook Norton, Oxfordshire are two asylums in the early 1800s that catered to the wealthy upper class.

    Spring Vale, Staffordshire

    Thomas Bakewell (1761-1835) was a non-medical asylum keeper who published a family guide for the management of the insane in 1805, based on his family’s long history of observing and caring for the mentally ill. He consolidated his humane approach at Spring Vale and ran it mainly as a centre of moral therapy and occupational recuperation. 

    Bakewell’s son, Samuel, followed in his father’s footsteps in the care of lunatics and wrote:

    “Lunatics are often weighed down by the most grievous melancholy. Loss of character, of property, of the affection of their friends, is impressed upon
    their minds with all the hideousness of reality, and indeed produce, I believe, more distress of mind than these misfortunes would, were they actually to occur to them in a state of health . . . The torments of hell itself seem to beset some unfortunates. —They conceive that the phials of God’s wrath are about to be poured forth upon them for some imaginary unpardonable crime—that they are damned forever. Hope never comes to them that comes to all.'” They abandon themselves to unmitigated despair, and refuse to be comforted.”7

    View of Spring Vale c. 1834,  Calvert, F. 

    Hook Norton, Oxfordshire

    Between 1775 and 1825 the family of Joanna Harris ran a private asylum of no more than 20 patients at Hook Norton, Oxfordshire. She advertised that her concern was to use “the utmost tenderness” with her charges.  
    All patients were expected to follow a regular, predictable orderly routine, avoiding stress. Patients had private rooms and leisure activities were encouraged. Some were allowed to go on country walks by themselves, and even went to church unaccompanied. No visitors were allowed, especially family members, until release. She reveals that most patients over the last three years have stayed with her for only a short time: 62% stayed less than a year and 68% less than 6 months.8

    Bridge House in Hook Norton
    Copyright:
    Hook Norton Village Museum Photographic Archive and must not be reproduced without permission.


    References: Daily Life in the Private Asylums

    1. The Age of the Madhouse – Home of the Well-Attired-Ploughman | Historic England 
    https://historicengland.org.uk/research/inclusive-heritage/disability-history/1660-1832/the-age-of-the-madhouse/
    2. Hook Norton Local History Group. https://hook-norton.org.uk/wp-content/uploads/2015/03/Mad-Houses.pdf
    3. 1818 – Casebook for Stafford Asylum. https://staffordshireasylumrecords.wordpress.com/tag/1818/
    4. Smith, Leonard D: Private Madhouses in England, 1640–1815: Commercialised Care for the Insane (Gewerbestrasse, Switzerland: Palgrave Macmillan, 2020, p 209.
    5. Staffordshire’s Asylums: https://staffordshireasylumrecords.wordpress.com/tag/1818/
    6. Parry-Jones MD MRcPsych, William L: English Private Madhouses in the Eighteenth and Nineteenth Centuries; Proc. roy. Soc. Med. Volume 66, July 1973, p 26. https://journals.sagepub.com/doi/pdf/10.1177/003591577306600730
    7. Bakewell,MD, Samuel Glover: “An Essay on Insanity”; Edinburgh; printed by Neil & Company, 1833, p 2.
    8. Ratcliffe, Donald: Hook Norton Local History Group: The Madhouses of Hook Norton; p 10. https://hook-norton.org.uk/wp-content/uploads/2015/03/Mad-Houses.pdf

    Ann Walker and the Private Asylums

    Ann Walker’s great wealth provided options for a high level of individual care at the moral treatment facilities available to the upper class and aristocracy such as those listed previously. She was also fortunate to live during the first fifty years of the 19th Century, an era of great social health reform; a time of unprecedented growth in health and science that led to the compassionate care method of treatment.

    After 1834 she received professional care from practitioners of the moral treatment method; and despite tensions and her illness, after Anne Lister died, she had family and those who cared about her and hoped she could be restored to mental health.

    Letters, diaries, and official documents reveal that she resided in private licenced houses that catered to the upper class of society. During her time with Anne Lister, she took lodging at Heworth Grange and, after Anne Lister’s death, at Terrace House under the care of Dr Stephen Belcombe. In 1845 she lived with Dr Forbes Winslow and his family at Sussex House. In 1848 she returned to her childhood home of Cliffe Hill and remained there until she died in 1854. 

    Heworth Grange

    Image from Martin Walker (2023) “A Short History of Heworth Grange”: In Search of Ann Walker [9 August 2023]

    Martin Walker (2023) “A Short History of Heworth Grange”: In Search of Ann Walker [9 August 2023]

    Prior to her marriage to Anne Lister and before moving into Shibden Hall, Ann resided in the Lodging House, Heworth Grange.

    “… & took cabriolet from there to Mr Bewly’s Lodgings – Miss Walker well enough with the 3 rooms & people – terms 2 guineas a week, & kitchen fire & trouble of cooking included 50/. a week – candles and coals to be found by Miss Walker   fair and moderate enough – for the privilege of dining in the room below given into the bargain -“

    14 January 1834: SH:7/ML/E/16/0159; Martin Walker

    Under the care of Dr Stephen Belcombe, and per Anne Lister’s journal, she adhered to a structured day:

    “[…]– laid down a plan for the daily spending of her time in French, drawing, reading working and walking – always to be out from 12 to 3”

    25 January 1834: SH:7/ML/E/16/0162; Martin Walker

    and socialized with sympathetic friends. Visits and outings with the Belcombe family in York were encouraged:

    “- Letter this morning 3 pages & 1st page ¾ crossed from Miss Walker, Heworth Grange, York – 1½ page in French as before – has not quite lost all her fears & doubts but is making the great effort – liked her visit at the Henry Belcombes & likes them all very much […] she has twice spent 2 days with them ‘& all parties are mutually pleased’ – likes the lodgings, the people & her servant & everything – “

    4 February 1834: SH:7/ML/E/16/0165; Martin Walker

    The social success appeared to be mutual as Anne records two letters in her journal in early February 1834.

    [Mrs H.S. Belcombe]: “- they all like Miss Walker, & she seems unreserved & to feel at home with them -” and [Dr Steph Belcombe]: “- thinks her presence here ‘may be the means of disabusing the minds of her friends in regard to her sejour at York – she is a great favourite in the minster yard & I hope was in a fair way of profiting by the plan chalked out’ -“

    9 February 1834: SH:7/ML/E/16/1067; 11 February 1834: SH:7/ML/E/16/0168; Martin Walker

    Ann’s social world also expanded to include Anne’s close friends, the Norcliffes, where Anne writes:

    “- our visit went off very well – all sides sufficiently pleased apparently […] glad we went   the Norcliffes very civil to her her shyness went off and she seemed much pleased with her visit”

    27 February 1834: SH:7/ML/E/16/0174; Martin Walker

    Ann was deliberate in who she trusted on her journey to good health. During a brief visit back to Halifax for a family illness, Ann wrote to Catherine Rawson, inviting her to visit her at Lidgate, to which Catherine replied that she”would be delighted to come.”

    “[…] wrote her the copy of a […] note to Miss [Catherine] Rawson asking her to come tomorrow” which Catherine replied that she “… would be delighted to come.”

    9 February 1834: SH:7/ML/E/16/0167; Martin Walker

    Back in York, Ann also accepted a visit from her long-time friend, Lydia Wilkinson Fenton:

    “… Mr & Mrs George Fenton called on Miss Walker about 11½ and staid about an hour -“

    26 February 1834: SH:7/ML/E/16/0174; Martin Walker

    Terrace House

    Image of Terrace House

    Terrace House, 2021 (Diane Halford)

    Terrace House information 11 March 1837 Yorkshire Gazette ©The British Library Board

     

    11 March 1837 Yorkshire Gazette ©The British Library Board

    Terrace House Advertisement 7 December 1839 Yorkshire Gazette ©The British Library Board

     

    7 December 1839 Yorkshire Gazette ©The British Library Board

    Chancery Visitors to Terrace House in 1843 and 1844 documented (1):

    15 September 1843, Chancery Visitors remarked on the “good health” of the patients and mentioned that nobody was under restraint.

    12 December 1843:  

    “There are now six patients in the House, all Females, who appear healthy and comfortable and none under restraint – Prayers as before – Two or three in general – attend church on Sundays. The House is airy, clean and comfortable – Mr. Currer by particular desire of Miss Walker, whose case is adverted to the Metropolitan Commissioner, had an interview with her for some time but it was by no means satisfactory to his mind that she was in a fit state to be discharged – We understand she has been examined under a Commission of Lunacy from the Lord Chancellor and pronounced Lunatic.” 

    25 April 1844

    “There are six Female Patients in the House all in good health – None under restraint – Prayers are read every day – Such as are able go to Church on Sundays – The House is airy, cleanly, and comfortable – Miss Walker continues much the same – The Patients amuse themselves with reading knitting and sewing, and playing on the Pianoforte; also walking out when the weather is fine.”

    Sussex House 

    Image of Sussex House from London Borough of Hammersmith and Fulham Local Studies/London Metropolitan Archives

    In April 1845, Ann resided in Dr Forbes Winslow’s home/asylum. Like Dr Belcombe, Dr Winslow practiced ‘compassionate care’: treating a patient with kindness and gentle guidance to alleviate stress. Dr Winslow tried to recreate a sense of family for Ann in an effort to restore her health, enabling her participate once again safely in society.  

    Sussex House, Hammersmith advertisement 1 March 1849 Patriot ©The British Library Board

     

    1 March 1849 Patriot ©The British Library Board

    Dr Winslow died in 1874. This excerpt from the 1875 In Memoriam Forbes Benignus Winslow article clearly describes the humane treatment at Sussex House that he had been remembered for.

    “Here, perhaps, he went further than all his compeers, in the completeness with which he carried out his benevolent views. Kindness and gentleness were the two universal factors in his treatment. The surveillance to which his patients were submitted, while unremitting in the care of dangerous cases, was most unobtrusive; concerts, dinner parties, balls, games of all kinds and varieties, were called in to play their part in his scheme. The life of the asylums was essentially a home life, the good doctor and his family living in the midst of his patients, who became for the time being members of his family circle. Those who manifested signs of improvement were allowed to go out of the gates on parole, and this parole was most honourably observed. This treatment, combined with skilful therapeutic remedies, produced in many cases very marked results, and during the latter part of his life Dr. Winslow was continually receiving most pleasing tributes of affection from grateful patients, to whom he had restored the light of reason.”

    “In Memoriam” Forbes Benignus Winslow, M.D., D.C.L. Hon. Oxon 1875 / semanticsholar.org

    Read more about Ann Walker and Sussex House.

    Cliffe Hill

    Image of Cliffe Hill, Parker, James; Illustrated Rambles from Hipperholme to Tong; 1904

     

    Cliffe HIll
    Parker, James; Illustrated Rambles from Hipperholme to Tong; 1904

    After living at Shibden Hall from 1845 until the just after death of Aunt Ann Walker, Ann returned to the home of her birth and early years, Cliffe Hill, in early 1848. Per the 1851 census, Lydia Wilkinson Fenton, her childhood friend and now a widow, was also living there with Ann as she had done in her last few months at Shibden Hall. A paid attendant for Ann, Johanna O’Brien,1 also resided at the home. Her aunt, Mrs Harriet Dyson was her Committee of Person.

    Shortly before her death, Robert Parker wrote to a friend that “[…] tho’ very feeble, her mind has been restored to reason!”2 Ann, however, remained a Chancery Lunatic until she died, 25 February 1854.  Her outstanding legal issues continued after her death with her nephew and heir, Evan Charles Sutherland Walker, her trustees and her committee of Estate

    From Custody to Cure: Summary

    The shift in emphasis from the ‘custody to cure’ of mentally ill people in the early 1800s led to patients benefitting from being treated as ordinary people. The reformers believed that a scientific approach to improved surroundings, and a humane approach to care could lead to rehabilitation and recovery. With the emphasis on treatment and cure, reintroducing patients to domestic regimes was thought to be important to the restoration of mental health.  

    A reputation for treating insanity promptly and successfully was the most effective advertisement for a madhouse and cure rates were used for this purpose. Fairly short periods of stay were the general rule, and the successful restoration and rehabilitation of the lunatic was the primary objective. 

    Most published accounts of the outcome of treatment in madhouses suggest that one-third to one-half of admissions were discharged cured. Cured was considered the disappearance of the signs and symptoms of mental disturbance and a degree of social remission.3

    References: Ann Walker and the Private Asylums

    1. Johanna O’Brien was also a paid member of staff at Shibden Hall from 1845-1847.
    2. West Yorkshire Archive Service, Bradford 68D82/5/241)
    3. Parry-Jones MD MRcPsych, William L: English Private Madhouses in the Eighteenth and Nineteenth Centuries (Warneford Hospital, Oxford) Volume 66 July 1973, p 26.

    The Decline of the Moral Treatment Method

    The economic success and recovery rate of patients led to heightened demand and the need for increased regulation and oversight. Parliamentary acts between 1828 and 1845 led to the formation of the Lunacy Commission in 1845, which passed a series of laws that dramatically changed the scope and responsibility of asylums. [See Appendix 1]. 

    A significant change occurred when they realized that keeping idiot and imbecile patients in prisons with criminals was cruel and that overcrowding of smaller county asylums and hospitals was unacceptable. Additional facilities were needed to provide for the subsequent increase in patients. Parishes and counties were required to build more asylums and workhouses in 1845, and the workhouses were to include separate lunatic wards. Closer regulation and inspection were also required to enforce these mandates.

    As a result, the number of asylums went from 20 in 1808 to up to 120; and beds rose from 12,000 in 1850 to 100,000 in 1900. (See the Figures and Tables below.)1

    Number of asylums went from 20 in 1808 to up to 120; and beds rose from 12,000 in 1850 to 100,000 in 1900. (See the Figures and Tables below.) (1)

     

    Parry-Jones MD MRcPsych, William L: English Private Madhouses in the Eighteenth and Nineteenth Centuries; 1973 pp. 660-661

    Correspondingly, the small, private madhouses of the type that Ann Walker benefited from were in significant decline. Small, private madhouses and lodges were unable to afford or maintain the staff required for the detailed regulatory paperwork and personalized curative care like the moral treatment method. 

    Often, instead of building new asylums, the county asylums simply added buildings and wings to existing asylums. Soon the demands and pressures on county asylums became overwhelming, and they became too big, were underfunded, and unable to maintain the number of trained staff required. 

    Eventually control of the greatly increased number of patients overrode personalised treatment therapy.  Subsequently, by 1870, with the exception of a few very wealthy large private asylums, the asylums had come full circle and had reverted to the kind of treatment found in the earliest asylums: custody and control in the form of restraints, padded cells, and medication.

    Reference for The Decline of the Moral Treatment Method

    1. Parry-Jones MD MRcPsych, William L: English Private Madhouses in the Eighteenth and Nineteenth Centuries (Warneford Hospital, Oxford) Volume 66 July 1973; p 24-25.

    Ann Walker and the Lunacy Commission

    After Anne Lister died in 1840, Ann returned to Shibden Hall to live. She had life interest in Shibden Hall per Anne Lister’s will and the income from her portion of the Crow Nest Estates. In 1843 after Ann made a series of business decisions that resulted in lawsuits and her increasingly erratic behavior that was affecting her standing in the community, the Sutherlands were notified of the urgency of the legal and financial repercussions of Ann’s situation. Elizabeth and George Sutherland realized the best course was for her to be again under medical care and Dr Belcombe was enlisted to help convince her to voluntarily leave Shibden. She agreed and on 9 September 1843 she left Shibden to be admitted to Terrace House to receive treatment once again from Dr Belcombe.

    Read about Ann’s life after Anne Lister’s death.

    Immediate action was needed to address Ann’s inability to conduct the business of the estates while in treatment. The Sutherlands embarked to Halifax and, on the advice of both estates’ solicitors, reluctantly petitioned the Lunacy Commission to have her declared of ‘unsound mind’. This resulted in the process to have Ann’s finances and estate management (Committee of the Estate) and her health and personal care (Committee of Person) put in the hands of court-appointed third parties. 

    Outline for a petition for Lunacy Elmer, Joseph: An Outline of the Practice in Lunacy; London; 1844; p 64.

     

    Elmer, Joseph: An Outline of the Practice in Lunacy; London; 1844; p 64.

    The Process of Chancery Lunacy

    ‘Chancery Lunacy’ evokes a rather draconian imagery. However, its use was relatively rare and primarily in the upper or aristocratic classes of families where the preservation of income and property was essential. Wealth in the 19th Century was seen as a concern for the entire extended family because so many depended on it for survival. Interfamily connections were solidified through religion, intermarriage, and business. Finances were fluid: members frequently offered mutual help and support. If someone was mishandling or squandering the family wealth, it affected everyone; therefore, petitioning for Chancery Lunacy was not usually a matter of control or censure, but self-preservation.1

    Suzuki, Akihito: Madness at Home: The Psychiatrist, the Patient, & the Family in England, 1820-1860; University of California Press, London; 2006.

     

    Suzuki, Akihito: Madness at Home: The Psychiatrist, the Patient, & the Family in England, 1820-1860; University of California Press, London; 2006. pp. 24-25

    The Lunacy Commission

    The Lunacy Commissioner was comprised of eleven Commissioners: three medical and three legal members were to be employed full time, and five honorary commissioners.  Their principal functions were to advise on the development of lunacy law and policy, monitor asylums and hospitals, regulate treatment, ensure the lunatic’s property be protected in the interests of the lunatic who owned it and not of the heirs of an estate.

    Each asylum or house was to be visited at least once in every six months by two Commissioners, known as Chancery Visits.2 

    Process of Chancery Lunacy

    A Chancery lunatic was one who had been found to be of unsound mind by a trial jury and judge so as to be incapable of governing himself and his affairs.

    The Chancery had nothing to do with committal to an asylum, which was a separate medical procedure (the only requirement for committal to an asylum was for two doctors to issue a certificate). In many cases the alleged lunatic was already in an asylum when the inquisition took place.

    By an expensive process in the court of Chancery it was possible to have someone’s sanity investigated and, if found insane, the Chancellor appointed a committee to administer the lunatic’s property and personal care.

    The process began with a petition by a friend or relative of the alleged lunatic, accompanied by medical evidence. 

    The judge would order an inquiry to be held by officers of the Lunacy Court with a jury of financial and societal peers of the alleged lunatic. 

    Proceedings were often held in taverns and coffeehouses and open to the public. Witnesses supporting each the petitioner and the lunatic provided their supporting testimony to the Commissioner and the jury. The Commissioner then examined the alleged lunatic alone and summarized the findings. When all evidence was submitted and the pleas entered, the Commissioner summarized the findings after which the jury rendered a verdict. For more detailed information regarding Ann Walker’s lunacy proceedings, see Ian Philp (2022) “The Inquisition of Ann Walker” In Search of Ann Walker [accessed 22 June 2023].

    If the jurors found the alleged lunatic to be of unsound mind or insane, the court would bring the person and property under the court’s protection.

    The Chancellor committed the custody of the lunatic and his estate to the Committees of the Person and Estate, often relatives, and examined the accounts of the committees to guarantee that the lunatics of wealth lived in the manner to which they were accustomed.

    The legal process was also expensive and time-consuming: the lunatic’s Committees were required to post a bond (Sutherlands: £9500 = £1,500,000 today) and were to live in proximity of the lunatic.

    George Mackay Sutherland bond to be Committee of Estate for Ann Walker National Archives J 103/2. Open Government License.

     

    National Archives J 103/2. Open Government License.

    The Committee of Person was responsible for the lunatic’s personal welfare and day-to-day living.

    The Committee of the Estate received the income of the lunatic’s estate and to saw to the due investment of all moneys of the lunatic. Every payment, sale, lease or repair had to be expressly and formally authorised by the judge following the rigorous consideration of expert evidence to ensure that the transaction was appropriate and beneficial to the lunatic and not to the heirs of the estate.3 

    Petitions for maintenance and upkeep to the estate incurred fees, and detailed statements of time (letter-writing, copying, etc.) had to be meticulously recorded and submitted annually to the Chancery Master.

    Analysis of the Committee's Final Acct for Ann Walker Yorkshire Archive Service, Calderdale CN 100 2

     

    A submission of Capt Sutherland’s report to the Chancery Master
    West Yorkshire Archive Service, Calderdale CN 100/2

    References: Ann Walker and the Lunacy Commission

    1. Suzuki, Akihito: Madness at Home: The Psychiatrist, the Patient, & the Family in England, 1820-1860; University of California Press, London; 2006, p 114.
    2. Roberts, Andrew: 1981: The Lunacy Commission: A Study of Its Origin, Emergence and Character. http://studymore.org.uk/01.htm#4.13.TA
    3. Elmer, Joseph: An Outline of the Practice in Lunacy; London; 1844; pp 58-60.


    Appendix: Chronology Lunacy Commission Acts

    1670s – The earliest consistent records of private mad houses are kept.1

    1713 – One of the first charitable asylums in English towns is opened in Norwich, followed by 7 others, including St. Luke’s, London (1751), Manchester (1766) and York (1777).2 

    1714 – Vagrancy Act is the first piece of legislation to specifically provide for the detention of lunatics.3

    1774 – Concerned that some non-lunatics were being unlawfully detained in workhouses at the whim of spouses or families, the 1774 Regulation of Madhouses Act required a licensing system and inspection by authorities. Patients could only be admitted with a medical certificate (‘certified patient’).4

    1800 – Criminal Lunatics Act leads to long term detention of criminal lunatics in County goals. The pressure of this is a factor which leads to the 1808 County Asylums Act.

    1808 – County Asylums Act (Wynn’s Act), enabled counties to raise funds for asylums. Lunatics in workhouses and gaols were to be removed to these new asylums to more formalize the care for treatment of inmates and provide humane treatment.  Few were built, however, and many paupers with mental illness remained in workhouses, pauper farms or in prisons.5

    1811 – Sneinton Asylum, Nottingham opens. The first asylum which came under the 1808 Act, and the first to be built from the rates. Medical certificates were required for paupers.

    1828 – Madhouse Act.  Establishes Commission model of governance. This included a medical certificate for houses kept for two or more insane persons. Two certificates of lunacy, each signed by a different doctor following a separate interview (the interviews to be undertaken within fourteen days of each other), were required for private patients. No certificate was required if a patient was to be confined in his/her own home.6

    1832 – The Madhouse Act of 1828 was updated requiring written notice from the person sending the patient and their written name, occupation and address. The certificate was to be signed by two doctors or, if special circumstances prevented, by one doctor. If only one signed, the special circumstances were to be stated on the certificate, and another was to sign within seven days of admission. To sign a certificate with any false particulars, knowingly and with intention to deceive, was a misdemeanour.7  

    1834 – Poor Law Act again leads to pressure to establish asylums, as many long-term Poor Law union workhouse inmates are the disabled and mentally ill.

    1845 – Both the Lunacy Act and County Asylums Acts required counties to provide for lunatics by building asylums for their lunatic poor and criminally insane inhabitants, which also reduced the need for pauper farms. It became cheaper for parishes to send their mentally ill to county or private lunatic asylums.8

    1845 – Lunacy Act. The Commissioners in Lunacy replaced the Metropolitan Commissioners and comprised three medical men, three lawyers, and up to five unpaid laymen. Two doctors must separately interview the alleged lunatic within seven days of each other. Single patients were required to be registerd to the Commissioners.9

    One of their main functions was to oversee the building of publicly owned county asylums and to inspect all asylums and hospitals for the insane.  Another function was to ensure that lunatics whose estates were protected by the Court of Chancery had a coherent medical strategy and did not suffer any detriment to their standard of living.10 

    Non-Paupers: People of means could still arrange for their mentally ill relatives to be admitted to private asylums. The law respecting non-paupers required an order and (one or two) medical certificates signed by two physicians, surgeons, or apothecaries.

    The Medical Certificate accompanying a detained patient had to state that the patient was a “Lunatic, or an Idiot, or a Person of unsound Mind”. The medical practitioner also had to explicitly state the “Facts indicating Insanity observed by myself”, as well as “Other Facts indicating Insanity communicated to me by others”.11

    Paupers: Another responsibility of the Committees of Visitors was ensure the welfare of their inmates. For example: “Every Committee of Visitors shall fix a weekly Sum to be charged for the Lodging, Maintenance, Medicine, Clothing, and Care of each Pauper Lunatic confined in such Asylum.” This sum was not to exceed “Fourteen Shillings per Week.” 

    Pauper Lunatics also had to have the appropriate paperwork for their detention to be legal. This included an order from a Justice, a clergyman, an Overseer, or the Relieving Officer (under the Poor Law), along with a medical certificate signed by “One Physician, Surgeon, or Apothecary, who shall have personally examined him not more than Seven clear Days previously”. It was a misdemeanour to admit to an asylum without such order and medical certificate.

    Both pauper and non-pauper asylums were required to produce the “Form of Annual Return” which consisted of “A True List of all Lunatics, Idiots, and other Persons of Unsound Mind” within their walls. This form included such headings as “Weekly cost of maintenance and clothing”, “Whether lunatic or idiot”, “Dangerous to himself or others”, and “For what length of time supposed to be of unsound mind.”

    1853 – The Lunacy Amendment Act stipulated that all heresay evidence was now forbidden on a certificate of lunacy, with doctors required to state the observations they themselves had made of the alleged lunatic’s behaviour.12
    Ex-patients could be received in licensed houses on a voluntary basis as boarders without certificates with the consent of the Commission. This Act also allowed the Commission to give its consent to relatives or friends of a patient to stay in a house as boarders “for the benefit of” the patient.13


    Glossary

    Chancery Lunatics: a sub-category of ‘private patient’ – a wealthy private patient who had been found insane by ‘inquisition’ and whose large estate/income was deemed to be at risk as a result of the patient’s incapacity to manage his/her affairs, thereby requiring the protection of the Lord Chancellor. Such cases were dealt with by the Lord Chancellor’s Visitors. Chancery lunatics were generally members of rich families. It was generally invoked in connection with the preservation of property.

    County Asylums: funded by rate payers (taxes). Some were supported partly by voluntary subscriptions.

    Home care: the lunatic is confined in his or her own home, with or without the assistance of a paid attendant or attendants.

    Hospitals: a variety of institutions receiving lunatics that were neither licensed houses nor county asylums. Some were used exclusively for lunatics whilst others were general hospitals with accommodation for lunatics. The financial arrangements of hospitals varied considerably. In some, patients were supported, wholly or in part, by voluntary contributions and/or the income from endowments. In some, the poorer patients were supported, in whole or in part, out of the charges of richer patients. Hospitals received relatively few paupers.

    Idiots: natural fools from birth; a person unable to protect himself or herself from common dangers.

    Imbecile: a person who was ‘unable to take care of himself or herself’. ‘Iimbecile wards’ accommodated those not lunatic or idiot enough to require an asylum.

    Insanity: primarily a legal definition of mental disorder.

    Keeper and Nurse: patient attendants. Nurse was only used for a female attendant or keeper.

    Licensed Houses: a place licensed to receive lunatics under one of the Acts of Parliament from 1774 onwards. London houses and county houses were licensed by different authorities.  Licensed houses were usually privately owned asylums or madhouses. Some publicly owned asylums chose to be licensed. Most licensed houses did not take paupers.

    Lodgings and/or Single Houses: the lunatic is confined in a house (not his or her original home) under the care of a paid attendant or attendants.

    Lunatic: ‘a mentally ill person with periods of lucidity.

    Mad houses and/or Asylums: more than one lunatic is confined under the care of a paid attendant or attendants.

    Melancholia: a state of mental depression, in which misery is unreasonable either in relation to its apparent cause, or in the peculiar form it assumes. It was regarded as a form of insanity, characterised by depression and an intensity of ideas. Often in cases of melancholia intense depression was for a considerable time free from any suicidal desire.

        • Simple melancholia: the incipient stage of the disease and was characterised by depression. Those afflicted with the condition experienced feelings of misery that were only a slight exaggeration of their natural state of mind, but nonetheless provided no pleasure in life. The simple melancholic retained a calm, if pensive demeanor.

        • Active melancholia: the confirmed stage of the condition. The patient was plunged into a deep state of depression that was accompanied by delusions or voices. Patients suffering from active melancholia repeatedly bemoaned their miserable existence rather than internalising their melancholy.

      Pauper farm: a private, for-profit workhouse.

      Pauper lunatic: maintained out of the poor rates. Confined in a lunatic ward of the local workhouse, or in a county asylum, or in a private asylum with fees paid by the parish, out of the ‘poor rates’. This was by far the most numerous category of lunatics.

      Private patient: able to pay fees, or to have fees paid by family, and usually ranging in social class from regularly employed artisan/tradesman to aristocrat.

      Single House:  just one lunatic is confined for profit. They did not require a licence. One of the most expensive forms of confinement.

      Single patient: usually implied a wealthy lunatic in non-asylum care, as the ‘single house’ was the most expensive form of custody. However, poorer communities also boarded their lunatics in private domiciles and ‘single patient’ is often used regardless of social class.  

      Workhouse: from the mid- 17th century, a place set up to provide work for the unemployed poor. Later, a place where the destitute could live and be fed, usually in return for work.

      Workhouse Asylums and Lunatic Wards: exclusively used for lunatics and in some places a separate building (belonging to and administered by the local Poor Law authority. workhouse asylums and most county asylums were exclusively occupied by paupers.

      References (Alphabetical)

          1. The Age of the Madhouse – Home of the Well-Attired Ploughman | Historic England, https://historicengland.org.uk/research/inclusive-heritage/disability-history/1660-1832/the-age-of-the-madhouse/

          1. Bakewell, MD, Samuel Glover: An Essay on Insanity; Edinburgh; 1831.

          1. Bolivar, Robin, by Assistant Professor at the University of New Brunswick Faculty of Law: The Madhouse Divorce: Property, Lunacy, and Divorce Laws and Their Portrayal in Popular Culture

          1. Digby, Anne. Madness, Morality and Medicine: A Study of the York Retreat, 1796–1914. Cambridge: Cambridge University Press, 1985.

          1. Elmer, Joseph: An Outline of the Practice in Lunacy; London; 1844.

          1. English Poor Laws https://en.wikipedia.org/wiki/English_Poor_Laws

          1. Family Search: England Lunatic Asylums – International Institute, 27 April 2023 https://www.familysearch.org/en/wiki/England_Lunatic_Asylums_-_International_Institute

          1. Gray, Jonathan, A History of the York Lunatic Asylum, W. Hargrove & Co, 1815.

          1. Hamlett, Jane: At Home in the Institution: Material Life in Asylums, Lodging Houses and Schools in Victorian and Edwardian England; ISBN: 978-1-137-32239-5. https://link.springer.com/book/10.1057/9781137322395

          1. Hay, Michael George: Understanding Madness: Some Approaches to Understanding Mental Illness Circa 1650-1800; Thesis, Univ York 1979. https://core.ac.uk/download/pdf/30267521.pdf

          1. Higgs, Michelle: The Trade in Lunacy: Private Madhouses in 18th and 19th Century England; History Hit 21 Jan 2020. https://www.historyhit.com/the-trade-in-lunacy-private-madhouses-in-18th-and-19th-century-england/

          1. Historic England: The Age of the Madhouse – Home of the Well-Attired Ploughman. The Age of the Madhouse – Home of the Well-Attired Ploughman | Historic England

          1. Hook Norton Local History Group. https://hook-norton.org.uk/wp-content/uploads/2015/03/Mad-Houses.pdf

          1. Kibria AA, Metcalfe NH. A biography of William Tuke (1732-1822): Founder of the modern mental asylum. J Med Biogr. 2016 Aug;24(3):384-8. doi: 10.1177/0967772014533059. Epub 2014 Jun 18. PMID: 24944052.

          1. MacKenzie, Charlotte: Psychiatry for the Rich: A History of Ticehurst Private Asylum 1792-1917. https://books.google.com/books?id=E40rl6fBNNIC&printsec=copyright#v=onepage&q&f=false

          1. Mander, Joe: The History of Mental Asylums, Beyond the Point, 26 July 2020. https://beyondthepoint.co.uk/a-history-of-mental-asylums/Houston_2019_Asylums_Lancet_Psychiatry_AAM.pdf

          1. McBeath, Val: Victorian Era Lunatic Asylums: The Rise of the Lunatic Asylum (The Victorian Era). https://www.valmcbeath.com/victorian-era-england-1837-1901/victorian-era-lunatic-asylums/

          1. Murphy, Elaine: The Administration of Insanity in East London 1800-1870; thesis submission History of Medicine University College London, The Administration of Insanity in East London 1800-1870; Thesis submitted for the degree of PhD in History of Medicine University College London, Wellcome Institute for the History of Medicine, Department of Anatomy and Developmental Biology University College London, 2000.

          1. Parry-Jones MD MRcPsych, William L: English Private Madhouses in the Eighteenth and Nineteenth Centuries; Proc. roy. Soc. Med. Volume 66, July 1973. https://journals.sagepub.com/doi/pdf/10.1177/003591577306600730

          1. Parry-Jones, William L: The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries; Routledge, 2013.

          1. Roberts, Andrew 1981: Mental Health History Words. http://www.studymore.org.uk/mhhglo.htm

          1. Roberts, Andrew: 1981: Chronological and alphabetical bibliographies of lunacy. http://studymore.org.uk/7.HTM

          1. Roberts, Andrew: 1981: The Lunacy Commission: A Study of Its Origin, Emergence and Character. http://studymore.org.uk/01.htm#4.13.TA

          1. Rogers, J.W., Surgeon: A Statement of the Cruelties, Abuses, and Frauds, which are Practiced in Mad-houses, 1816, Wilson, Royal Exchange. https://www.google.com/books/edition/A_Statement_of_the_cruelties_abuses_and/2DFfAAAAcAAJ?hl=en&gbpv=1&printsec=frontcover

          1. Science Museum: A Victorian Madhouse; 13 June 2018. https://www.sciencemuseum.org.uk/objects-and-stories/medicine/victorian-mental-asylum

          1. Shelford, Leonard, Esq.: A Practical Treatise on the Law Concerning Lunatics; Law Booksellers and Publishers; 1847.

          1. Smith, Leonard D: Private Madhouses in England, 1640–1815: Commercialised Care for the Insane (Gewerbestrasse, Switzerland: Palgrave Macmillan, 2020. Staffordshire’s Asylums: https://staffordshireasylumrecords.wordpress.com/tag/1818/

          1. Stafford Casebook 1818-1827. https://staffordshireasylumrecords.wordpress.com/tag/1818/

          1. Suzuki, Akihito: Madness at Home: The Psychiatrist, the Patient, & the Family in England, 1820-1860; University of California Press, London; 2006.

          1. Types of Institutions. https://ezitis.myzen.co.uk/briefhistorymental.html

          1. Victorian Era Lunatic Asylums: The Rise of the Lunatic Asylum (The Victorian Era). https://www.valmcbeath.com/victorian-era-england-1837-1901/victorian-era-lunatic-asylums/

          1. Winslow, Lyttleton S., M.B. & M.L.: Manual of Lunacy: A Handbook Relating to the Care and Treatment of the Insane; London, 1874.

          1. Wise, Sara: Inconvenient People: Lunacy, Liberty, and the Mad-Doctors in England; the Bodley Head 2012.

        Special Thanks

        Diane Halford, Caroline Maillard, Erin Quilliam, Leila Straub, Martin Walker, Deb Woolson

        Trish Rafa

        I live in the US near Seattle and am a lifelong history nerd. Like many, I met the Ann(e)s through “Gentlemen Jack” and their story resonated with me on a deeply personal level. While Anne Lister’s story is unparalleled, I found Ann Walker's bravery and commitment in the face of so many obstacles extraordinary. I’m thrilled to be a part of honoring her story.