Hospitals, Madhouses and Asylums: Cycles in the Care of the Insane

The received version of the history of the care of the insane consists largely of myth and folklore, tempered by a strong dash of wilful ignorance, and is capable of absorbing any number of incongruous features. It runs roughly as follows, give or take a century or two here or there (which is about the accepted level of precision): from the dawn of history, or just before, or just after, until about the middle of the nineteenth century, nothing happened at all: or (depending on where you received your version) the mentally disordered were indiscriminately exorcised, or burnt, or left to wander at will, or chained up and beaten, or all four. From the middle of the nineteenth century they were all rounded up and driven into enormous asylums (where, according to a subtle sociological variation, mental illness was invented) and were left to vegetate until the 1950s. Around 1960 dawned the enlightenment, and it was suddenly revealed that everything that had ever happened before—whatever it was—was completely wrong, and probably intentionally malicious too: and over the years following there were gradually also revealed a number of brand-new ways of putting it right, all different and mutually incompatible (not to mention expensive), and revealed respectively to different Departments of State, working parties, committees and unions—or sometimes successively to the same one.