Given the fact that the world still isn't great with the treatment of mental illness
today, it's no surprise that the so-called "insane asylums" of the Victorian era were
It's almost impossible to imagine just what went on behind closed doors, but here's what
really happened, according to those who were there.
In 1887, journalist Nellie Bly went undercover to spend ten days in an asylum on Blackwell's
Island in New York.
While she was there, she witnessed and was subjected to some incredibly inhumane treatment.
But she noticed something: others who were suffering the same treatment had no more cause
to be committed than she did.
She wrote not just of the ice baths and the physical abuse, but of the women who were
there for no real reason.
One woman she met had been committed only because she spoke French, and the little English
she did know wasn't enough to allow her to tell anyone her story.
Others were there simply because their families could no longer care for them or wanted them,
and some were there just because they had no other place to go.
Bly wrote that doctors conducting interviews tended to assume something was mentally wrong
with the women they were talking to, so they questioned them in such a way that would ultimately
confirm the diagnosis.
In preparation for her stint in the asylum, Bly had practiced acting in a way that would
keep her committed.
Once there, though, she found there was no need for it.
"Yet strange to say, the more sanely I talked and acted the crazier I was thought to be."
When it came to feeding patients, different asylums had different strategies.
There were asylums like Blackwell's, where Bly was served food that was only vaguely
food: slightly spoiled meat, broth, tea, and bread she described as
"Black and dirty, [...] hard, and in places nothing more than dried dough."
There were sometimes spiders in the bread, but starving patients still ate.
Other asylums were a little different.
English asylums tended to strive for self-sufficiency, and patients grew most of their own food.
The result was a diet that was much better than most working class people had, and it
was filled with fresh vegetables, cheese, bread, fish, meat, and beer.
Then, there were Australian asylums, like the ones inspected by Dr. George Tucker in
He described the food as
"Amply sufficient and sufficiently cooked, [but the service was] demoralizing."
Groups of eight patients at a time took turns eating at a single table, where they used
broken tins, shared three mugs, and ate with dirty utensils.
Tucker called for changes, but nothing happened.
"If you do open that window it will illuminate everything in Briarcliff… and I mean everything."
In 1900, one patient wrote about his three-week stay in Kew, and noted something he found
particularly difficult: every cup and plate was labeled "Lunatic Asylum," leading him
to make the dismaying observation,
"We were never able to get away from the fact that we were lunatics."
It's tough to know what really, truly goes on behind doors closed to the outside world,
but fortunately, many of the patients committed to asylum life were not only literate, but
wrote extensively on their experiences there.
Historians still have hundreds of letters written by the Victorian-era patients at the
Royal Edinburgh Asylum, and they give a fascinating glimpse into the patients' daily lives.
Letters give first-hand accounts about their care, their treatment, and oftentimes, patients
wrote about why they didn't belong there.
They wrote about how their families sent them there, they wrote about how they wanted their
families to get them out, and they wrote poignant, heartbreaking pleas to those on the outside.
And they undoubtedly waited for responses that never came — not because their friends
and family had ceased to care, but because their letters never got delivered.
Letters were often intercepted and read by asylum staff, and any found to be inappropriate
for reading outside asylum walls were kept and stored in an archive, all without patients
knowing that their messages never reached the intended recipients.
Beer was an almost shockingly important part of asylum life, and Niall McCrae of the Institute
of Psychiatry, London, says that asylum staff even had part of their wages paid in beer.
British asylums gave their patients a daily ration of beer, with extra rations given to
those who worked on the asylum grounds in some capacity.
Most asylums even had their own brewhouses, and they tended to make light beer for daily
drinking, along with extra beer and cider to serve to patient workers when it was time
to harvest the summer's crops.
The practice fell out of fashion when the temperance movement kicked into high gear,
but alcohol wasn't just for daily diets and rewarding work well done.
It was medicinal, too.
Alcohol in the Victorian era was prescribed for all kinds of things, and asylums used
it as part of a prescription for those diagnosed as melancholic.
According to archival documents saved by St. Joseph's Regional Mental Health Care London
in Ontario, medicinal alcohol and spirits were a regular part of the budget.
In 1874, they spent a reported $1,850 on "spirits, wine, and beer," and when that number is adjusted
for inflation, it's a whopping $40,700 in today's money.
It was commonly used as a sedative, but when attitudes began to shift, many patients were
being taken off alcohol instead of being encouraged to use it.
When Nellie Bly put herself in the shoes of an asylum patient, she found that part of
their daily routine was sitting.
Not reading, not talking, not being occupied by any leisurely activity that might be a
bit of fun.
Just sitting on hard, straight-backed benches.
"I was never so tired as I grew sitting on those benches.
Several of the patients would sit on one foot or sideways to make a change, but they were
always reproved and told to sit straight up.
If they talked they were scolded and told to shut up.
[...] What, excepting torture, would produce insanity quicker than this treatment?"
Bly found very quickly that they were expected to sit for at least a few hours every day,
usually after doing a round of cleaning that included every part of the asylum, right down
to the nurses' private bedrooms.
She predicted that if a patient didn't have real problems when they entered,
"Two months would make her a mental and physical wreck".
Archival documents saved by St. Joseph's tell of the terrifying and widespread use of restraints,
including everything from cuffs and straps to leather mitts and straightjackets.
Patients were restrained if staff thought they were violent and a danger to themselves
or others, but they were also restrained for other things.
Anyone refusing to eat would be restrained and force-fed with a feeding tube, because
nutrition was seen as a major part of ironically named and so-called "moral therapy."
Restraints were also used on patients who injured themselves, particularly during recovery
if they showed a tendency to tear at their own bandages.
Sometimes, cuffs and mitts weren't enough, and in those extreme cases, crib beds were
Those are exactly what they sound like — beds with bars on them, which confined patients
with the help of still more restraints.
By the 1880s, restraint use was beginning to be phased out — officially, at least.
Not everyone on the outside turned a blind eye to the abuse going on inside asylums,
and in the 1870s, the medical press started looking into what they thought was a disturbing
A startling number of people were dying in asylums, and many had one thing in common:
broken bones, and broken ribs in particular.
The most damning evidence of abuse came when former patients started writing letters to
the powers that be, and many told a similar story of attendants who would kneel on unruly
patients until they got complete and total submission.
The trend was so widespread that in 1887, a jury suggested that all cases involving
patients dying with broken ribs should be eligible for charges of manslaughter.
It wasn't the only deadly trend that was seen in Victorian-era asylums, either.
Chloroform had been used as an anesthetic beginning in 1847, but there were huge risks
that went along with it.
The first officially documented chloroform fatality happened just the next year, and
it became so common throughout the 1850s that the trend was simply known as "the chloroform
When the outside world started looking at what was really happening to the people confined
in asylums, they found that the attendants were a huge part of the problem.
Not all were bad, and some were struggling to care for patients in a violent, overcrowded
environment and still trying to do their best.
There were plenty of horribly sadistic stories told about others.
Attendants were the non-medical staff responsible for everyday care, who tended to be uneducated.
It was a hard job with a high turnover rate.
Since asylums had trouble retaining staff, they usually took whoever they could get.
Case files and accounts tell stories of attendants who regularly stole from patients, and there
are even accounts of attendants who gave patients weapons and encouraged them to fight amongst
Novelist Charles Reade wrote Hard Cash in 1863.
And even though the character he committed to an asylum was fictional, the research he
Former patients vouched for the reality of Reade's story, in which the attendants prone
to violence were extremely good at what they did.
They knew exactly how to hit to cause the maximum amount of pain without leaving visible
In 2018, the BBC investigated how electroconvulsive therapy actually had benefits for some people,
particularly those suffering from depression and mania.
But there's a stigma attached to it, and it's really no wonder.
Electroshock therapies have been used for a long time, centuries before we really knew
what kind of good — or damage — it could do.
According to an article in The British Journal of Psychiatry, countless 19th century asylum
doctors were so impressed by the use of electricity as treatment that they jumped at the chance
to include it in their arsenal.
Patients were prescribed sessions of shock therapy that lasted 10 to 20 minutes, conducted
every day or every other day.
The electric shock was often constant, and while early techniques involved stimulating
the skin by putting electrodes on the hands, it got worse.
Gradually, the electrodes were moved to the head, and in 1873 doctors at the Sussex Asylum
reported the effects of the treatment were even greater when the patient sat with their
hands and feet in water.
“You'll have no memory of this, nor of this treatment, nor of your crimes, nor of your sins, nor of your time in this horrid place."
These treatments could last for weeks or even months, and case files indicate doctors saw
a fair amount of success in patients diagnosed with melancholia.
That actually seems to fall in line with 21st century research, so there may have been a
kernel of truth to the thinking… not that it makes the methods of application any less
Victorian-era asylums tend to be painted with a wide, sweeping brush that casts the entire
system into darkness.
While that's certainly deserved in many ways, it's also important to note that not everyone
Sift through the hundreds of letters written by patients at the Royal Edinburgh Asylum,
and you'll find there's a number of people who spoke about how they were excited to be
learning a trade, how the staff made sure there were regularly scheduled dances and
entertainments, and how many were eating well for the first time in their lives.
Then, there were people like George Longmore.
He spent some time in the Broadmoor Criminal Lunatic Asylum, and in 1884, he re-admitted
himself after four years outside.
He wrote to his family that he was terribly sorry, but he had found comfort and safety
within the asylum walls.
Letters like his suggest that asylum living wasn't all bad for every patient, and that
some actually found a place and a community they felt comfortable belonging to.
While historians and psychologists as a whole agree that the treatment methods of the Victorian
era failed and that the confinement was inhumane, degrading, and dirty, it's just as undeniable
that for some people who found themselves there, it was better than the outside world.
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