Mental health services in an English county borough before 1974

IN 1974, local government reorganization saw the end of Salford as a county borough and its transformation into a metropolitan district with a population more than twice as large.That year may be a suitable point from which to look back and examine the evolution of its mental health services.Though outwardly part of an endless conurbation which covers much of south-east Lancashire and neighbouring areas, Salford has a long history as a community, and has always been a place with which people identify strongly.Of overwhelmingly working-class composition, its culture has been characteristic of industrial Britain since the early nineteenth century.As the author has been personally associated with the psychiatric services there since 1961, this paper is, to some extent, the result of participant observation. EARLY DEVELOPMENTSEighteenth-century Salford was a very small town, with some cottage-type textile industry, surrounded by fertile agricultural land; in 1801, there were only 18,000 inhabitants, but with the onset of industrialization the population increased between 1821 and 1831 by sixty per cent, and in the next decade by seventy per cent.By 1881, it had reached 176,000 and was larger than that of Newcastle upon Tyne, all within an area of less than eight square miles.The local government situation was then chaotic, and it was not until 1891 that a unified county borough was fully established.As far as the care of the mentally ill was concerned, the county asylum in Lancaster was opened in 1816, but because of the rapid increase in population, which made Lancashire the most populous county in England by 1841, it soon became very overcrowded.A second hospital, at Prestwich, was inaugurated in 1851.Although no specific data are available, the numbers of mentally ill admitted from Salford to asylums must have been very small until about the last quarter of the century because of the small number of available beds; by then, additional mental hospitals had been opened -at Whitt- ingham, Rainhill, and Winwick -but they had many other large populations in Lancashire to serve as well as Salford.Undoubtedly, significant numbers of mentally ill paupers must have been admitted to the workhouse in Salford, as throughout the country, where they were part of a heterogeneous body of sick, disabled, and destitute people.The overcrowding of the workhouse, in spite of the inauguration of a large new one in 1852, and steadily increasing numbers of the sick resulted in the opening of the Salford Union Infirmary (now Hope Hospital) in 1882.