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Authors: Sarah Wise

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As for the lunacy experts, until the misuses of Darwinist theory began to make their impact in the early twentieth century, little ‘advance’, or significant change, can be traced in psychological medicine. The range of explanations and classifications available in the 1820s was remarkably similar to those still in use at the start of the twentieth century; and even that great cause for self-celebration, the introduction of ‘non-restraint’, was more an aspiration than a reality, as many patients and inspectors testified down the years. No clear
trajectory in the stories of lunacy and of wrongful incarceration is discernible between 1829 and 1890. Instances of greed, dishonesty and arrogance were evidently not unusual among the alienists in the stories in these pages, but trying to make monsters of such men as the Winslows, John Conolly, Henry Maudsley, George Man Burrows and the other celebrated mad-doctors would be as unwise as trying to demonise a barrister for the stances adopted while defending or prosecuting during a criminal trial: they would say whatever they needed to say in order to win a result. Lunacy decisions had an unfortunate adversarial quality to them, and so experts could become highly flexible if a wealthy alleged lunatic, or his/her family, employed them to give substance to a specific point of view. But in any case, as men at the coalface of perhaps the most uncertain science of all, their views on what constituted in/sanity were almost bound to be changeful – a Mad Hatter’s tea party of shifting positions. It is immensely cheering to see the scientific attempt to define and promote ‘normality’ of behaviour failing spectacularly every time it was tested.

With regard to mental illness (but not mental disability, of which more shortly), the 1890 Lunacy Act remained in force until the passing of the Mental Health Act in 1959. Continental psychoanalysis had slowly gained acceptance in the initially unimpressed British Isles by the 1920s, while the understanding of psychological trauma was deepened by the study of ‘shell-shocked’ troops from the First World War. Greater knowledge and lessening embarrassment about mental ill health meant that by 1938 over one-third of all psychiatric admissions in England were voluntary. Five years before the passing of the 1959 Act, the asylum population of England and Wales reached its peak, at 148,000 patients. The new Act encouraged many of the large asylums to reassess their long-stay patients – a move that revealed the shocking extent of unnecessary incarceration. Between 1959 and the mid-1980s, a whole cohort was discovered – like the shaggy-haired and whiskered victims of the
ancien régime
found in the bowels of the Bastille in 1789, condemned for life by an arbitrary power and brought blinking into a world they scarcely recognised. There was the lad who had stolen a postal order in 1917 and was labelled first a ‘moral defective’ and then diagnosed ‘of unsound mind’; the girl who was deemed ‘subnormal’ after her second illegitimate child; the teenage boy who had broken
a window in Moss Side in 1948, and was discovered thirty-five years later in a top-security mental hospital.
The Times
described as ‘barbaric’ the imprisonment for life of three women discovered in a mental hospital near Doncaster in 1972, who between them had served 110 years for each having a child out of wedlock in the 1920s. The hospital was in the process of reviewing all 520 patients, and anticipated that around one-fifth would be released. Many elderly women were found who had passed their entire reproductive life in a psychiatric hospital, having become helpless through decades of institutionalisation. It is perhaps one of the most common phenomena of the genealogical explosion of the past twenty years: the discovery of a great-grandmother, great-aunt or other female ancestor who was ‘put away’ for having an illegitimate baby. Time and again, these twentieth-century tragedies are brought to light by those researching their family history. The Victorian era has famously been dubbed ‘the age of incarceration’ by Michel Foucault; and yet to judge by the numbers of those detained in mental hospitals and homes for most of their lives, it is the middle decades of the twentieth century that deserve that unhappy title.

So how did this happen, when the whole drift from the 1880s had been towards policing the mad-doctors, placing emphasis on patients’ rights to be heard, and ever-tighter scrutiny of psychiatric admissions? The answer lies in the uncertainty of where the boundary lay between ‘lunacy’ and all other types of ‘unsoundness’ of mind. Conditions in which the brain was in some way not deemed to be fully and correctly functioning were, throughout the nineteenth century, mixed together: ‘idiocy’, ‘imbecility’ and ‘weak-mindedness’ were terms that were never satisfactorily winnowed apart from ‘lunacy’ in legalistic and bureaucratic language. Each of these three conditions was understood to be a malfunction of the mind, which was present either from birth or from an early age and was untreatable. Idiots, imbeciles and the weak-minded could be confined under the 1845 Lunatics Act; and the loose wording of the 1890 Act did nothing to settle this unsatisfactory blending of very different diagnoses – which we today would divide into ‘illness’ and ‘disability’. But in the late 1890s, a new category was devised that incorporated all those who were not delusional, manic or melancholic, but whose behaviour appeared to show either a level of intellect so low that they could not function in society, or a diseased psychology that rendered the sufferer unable to demonstrate
any social or moral intelligence whatsoever. The terms ‘mental deficiency’, ‘moral defective’ and ‘feeble-minded’ were the late-Victorian/Edwardian reclassification of the earlier terms ‘idiocy’ and its fellow travellers ‘moral idiocy’ and ‘moral insanity’. Alcoholics, sexual deviants, thieves, unmarried mothers, the habitually work-shy – all those with a record of persistent antisocial activities could be seen as victims of their own incurable, inherited mental structure and mental processes.

As we saw in
Chapter Nine
, Lord Shaftesbury – much maligned in these pages – had said: ‘If ever you have special doctors, they will shut up people by the score.’ And what happened between the turn of the century and the outbreak of the First World War with regard to the new ‘feeble-minded’ category suggests that he was right: the scientific expert was allowed into the driving seat of policy – ‘proving’ that the British race was in danger of degeneration and eventual extinction if its defectives were not taken out of circulation. The highly illiberal notion of ‘detention for life’ was being put forward as early as 1881, when it was firmly rejected by policymakers. But the eugenicist movement was able to make great capital out of a series of alarming events in late-nineteenth-century Britain. The arrival of compulsory education had incidentally provided the means by which to survey the ‘fitness’ of the nation’s infants, and the discovery of high levels of shattered health and mental ‘dullness’ stunned even the most pessimistic; the difficulty in recruiting fit young males to fight the Boer Wars added to the panic. Looking south to Germany, and west to America, Britain deduced that its working/fighting population was falling behind in the competition for economic supremacy.

From 1904 to 1908 the Royal Commission on the Care and Control of the Feeble-Minded heard testimony from prison governors, schoolteachers, charity and local government workers who expressed their fears that the working classes were being swamped by the offspring of hideously fecund ‘idiots’, ‘imbeciles’, ‘half-wits’, or even the simply ‘dull’. The girls – too retarded to give or withhold consent, and unaware of where babies came from – were taken advantage of by licentious males; the boys were hereditary petty criminals who grew up to be lifelong vicious recidivists. Even if these girls’ and boys’ intelligence quotients and reasoning skills appeared ‘normal’,
persistent delinquency was an indicator of moral defectiveness – a condition that would be passed down to the defective’s many offspring. The nation had to be protected from this internal threat; but it also had a duty to protect this blighted stock, by immuring them for their own good. ‘Care and Control’ went hand in hand in the Edwardian racial degeneracy debates.

Despite the frightening testimony of the hereditarian witnesses at the Royal Commission, the final report, published in 1908, threw out the notion of compulsory sterilisation for the feeble-minded, suggesting instead the building of gender-segregated ‘colonies’ where education and occupation would be provided for those deemed capable of improvement, and safe shelter for those who were not. A system of ‘guardianship’ within the young person’s own community or home town was the best mode of proceeding; but local authorities should be given the right to impose detention for life – or at least until the defective was no longer able to reproduce. However, there were concerns about the state of ‘public opinion’: ‘It would be very difficult in the present state of public feeling on the question of the liberty of the subject and so on, to enforce a wholesale detention of feeble-minded persons,’ one medical officer told the Royal Commission. But eugenicists were extremely active at a local as well as national level, and most sizeable cities had a society ‘For the Permanent Care of the Feeble Minded’. The panic engendered by eugenics supporters inspired Winston Churchill to write to Prime Minister Asquith in 1910, when the Royal Commission had still not resulted in any legislation: ‘The unnatural and increasingly rapid growth of the feeble-minded classes, coupled with a steady restriction among all the thrifty, energetic and superior stocks, constitute a race danger which it is impossible to exaggerate. I feel that the sources from which the stream of madness is fed should be cut off and sealed up before another year has passed.’

That sense of a demographic emergency led to the formulation of the Mental Deficiency Bill two years later. The creation of a monster, the whipping up of public terror, is often the spur to liberty-curbing legislation, and during the parliamentary debates, few rose to their feet to defend English Liberty. Liberal MP for Newcastle-under-Lyme, Josiah Wedgwood, was one of the very few members who took an
old-fashioned line on this. He told the House that attempts to prevent the ‘feeble-minded’ from breeding was

about the most abominable thing ever suggested . . . There is an entire absence throughout the whole of the Bill of any suggestion that it would not be perfectly right and just on the part of the State to make what regulations they like for the lives of these people . . . The safeguards for the people themselves are remarkable by their absence . . . I think it is most important that the House should put its foot down firmly on the growing authority of specialists in the legislation of the country. You cannot argue the question. You are not on the same footing with them. Public opinion is absolutely valueless and unable to cope with the dictum of the specialist.

But Wedgwood was part of a tiny, albeit loud, minority, and after the third reading, only two other MPs joined him to vote against the Bill in August 1913; 180 voted in favour. Typical criticisms made of those who used the English liberty argument were that they were speaking ‘nonsense’ – that such talk was ‘idle’, ‘specious’, a mere ‘play upon words’, ‘drivel’. Feeble-minded youngsters were ‘at liberty’ only to be neglected, abused and sexually exploited, and if libertarians had their way, all that would be guaranteed was ‘the liberty to abuse liberty’ and ‘the liberty to breed lunatics’.

The Mental Deficiency Act of 1913 replaced the Commissioners in Lunacy with the Board of Control. Local authorities were obliged to identify feeble-minded children between seven and sixteen years of age, and if incarceration was felt to be required, the parents were to be enjoined to petition the local magistrate. If parents were deemed to be incorrigibly neglectful, or cruel, their permission was overridden. Young people coming before the juvenile courts were now liable to be labelled ‘morally defective’ and sent to permanent institutional care. Parents, too, could ask a JP to order their child into a colony, and many did decide to do so, unable to cope or, as in the notorious case of the Queen’s cousins, Katherine and Nerissa Bowes-Lyon, simply unwilling to acknowledge handicap within the family.

The Act also contained a clause aimed at preventing any defective released on licence forming an attachment to a person of the opposite
sex. When such relationships were discovered, a return to the custodial colony would follow.

The National Council for Civil Liberties estimated in 1947 that the number of confined ‘mental deficiency’ cases stood at 54,000, with a further 43,700 ‘under statutory supervision’ in the community, and 5,700 under guardianship in their own homes or with foster carers. The Council believed that many had been confined on moral grounds alone, and had, in fact, a perfectly normal intelligence quotient.

Defectives were routinely transferred from the ‘colony’ institutions to lunatic asylums when accommodation became scarce in the former, or when the local authority decided not to spend its mental health budget on community-based care. In 1929 it was estimated that as many as a quarter of institutionalised ‘defectives’ were in lunatic asylums and not their own specialist institutions, or colonies. Some ‘dull’, ‘feeble-minded’ or otherwise tearaway youngsters confined under the Mental Deficiency Act did simply become insane as a result of inexplicable detention with no prospect of release, while having their babies forcibly taken from them will have psychologically damaged the young mothers in detention. We believe that the Victorians ‘put away’ in asylums the wayward young; but in fact it was the doctors and administrators of the twentieth century who were misusing the institutions of the former age.

George Dangerfield would identify 1913 as the date of the Strange Death of Liberal England, although he did not single out the Mental Deficiency Act as dealing the fatal blow. As war loomed, collectivism in all sorts of policy areas became the norm astoundingly swiftly. Perhaps liberty was the privilege of wealth; in an internationally competitive new century, and with conflict looming, it was a luxury the nation felt less able to afford. ‘The convenience of society comes second,’ Josiah Wedgwood had argued, in the debate on the Mental Deficiency Bill, ‘the liberty of the British citizen first.’ But not any longer, it seemed, if that citizen was in any way ‘unfit’.

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