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Confinement, Care, Cure: Psychiatric Institutions in the Twentieth Century

Module description

Before the adoption of ‘care in the community’ as government policy in 1980s Britain, psychiatric institutions played a central role in the management of mental illness. This module provides an introduction to the history of these institutions, and the people who lived and worked within them, in Britain and its colonies since the late nineteenth century. It focuses not just on the theories and practices of the medical professionals who ran these institutions, but on the experiences and perspectives of the patients who inhabited them, often for many years, and their families and wider communities too. To do so, this module presents you with a wide range of different kinds of sources, with which we will work closely in our seminars together, including patient case files, correspondence from families, architectural plans, material culture evidence, and documents and other historical artefacts produced by patients themselves. Over the course of this module you will develop an understanding of the value and limitations of different kinds of historical evidence, and have the opportunity to reflect on important ethical debates about how we as historians should work with such sensitive sources from the past.

Module aims - intentions of the module

This module aims to:

• Provide you with an overview of key developments in the history of psychiatry, particularly in the twentieth century and in the context of Britain and its colonies.
• Familiarise you with a range of different kinds of sources which historians have used to understand the history of psychiatric institutions, including written, visual, and material culture sources, and from the perspective of medical professionals, psychiatric patients, and families and wider communities
• Introduce you to key themes, debates, and methodological and ethical considerations in the history of psychiatry.
• Equip you with analytical and critical skills necessary for approaching future historical work

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

• 1. Understand and assess the development of different ways of understanding, treating, and experiencing mental illness in institutional contexts in late nineteenth- and twentieth-century Britain and its empire
• 2. Work critically with a range of sources of different kinds and from diverse perspectives which can be used to gain insight into psychiatry and mental illness in late nineteenth- and twentieth-century Britain and its empire

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

• 3. Identify the problems of using historical sources e.g. bias, reliability, etc., and compare the validity of different types of source (e.g. written, visual, material)
• 4. Demonstrate the ability to apply different methodological approaches to the analysis of historical sources

ILO: Personal and key skills

On successfully completing the module you will be able to...

• 5. Digest, select and organise material to produce, to a deadline, a coherent and cogent argument, delivered in written and oral form
• 6. Reflect critically on your own work, respond constructively to feedback, and to implement suggestions and improve work on this basis
• 7. Write to a tight word-limit

Syllabus plan

While the content may vary from year to year, it is envisioned that it will cover some or all of the following topics:

• Admissions papers and routes into the asylum
• Architectural plans and the space of the institution
• Petitions, letters, and the role of the family
• Clinical research publications and changing psychiatric treatments
• Material culture and psychiatry
• Patient case files: gender, ethnicity, class
• Scandals and the spotlight of investigations
• Asylum photography and research ethics
• Patient perspectives: memoirs and other first-hand sources
• Taking delusions seriously: methodological opportunities and challenges
• Fictional and film representations of the asylum
• Anti-psychiatry, critique, and de-institutionalisation

Learning activities and teaching methods (given in hours of study time)

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

Deferral – if you miss an assessment for certificated reasons judged acceptable by the Mitigation Committee, you will normally be either deferred in the assessment or an extension may be granted. The mark given for a re-assessment taken as a result of deferral will not be capped and will be treated as it would be if it were your first attempt at the assessment.

Referral – if you have failed the module overall (i.e. a final overall module mark of less than 40%) you will be required to submit a further assessment as necessary. If you are successful on referral, your overall module mark will be capped at 40%.

Indicative learning resources - Basic reading

1. Jonathan Andrews and Anne Digby, eds Sex and Seclusion, Class and Custody: Perspectives on Gender and Class in the History of British and Irish Psychiatry (Wellcome, 2004).
2. Monika Ankele and Benoît Majerus, eds Material Cultures of Psychiatry (transcript Verlag, 2020).
3. Catherine Cox and Hilary Marland, eds Migration, Health, and Ethnicity in the Modern World (Palgrave Macmillan, 2013).
4. Anne Digby and David Wright, eds From Idiocy to Mental Deficiency: Historical Perspectives on People with Learning Disabilities (Routledge, 1997).
5. Bill Forsythe and Joseph Melling, eds. Insanity, Institutions, and Society, 1800-1914: A Social History of Madness in Comparative Perspective (Routledge, 1999).
6. Louise Hide, Gender and Class in English Asylums, 1890-1914 (Palgrave Macmillan, 2014).
7. Angela McCarthy and Catharine Coleborne, eds Migration, Ethnicity, and Mental Health: International Perspectives, 1840-2010 (Routledge, 2012).
8. Roy Porter and David Wright, eds The Confinement of the Insane: International Perspectives, 1800-1965 (Cambridge University Press, 2003).
9. Andrew Scull, The Most Solitary of Afflictions: Madness and Society in Britain 1700-1900 (Yale University Press, 1993).
10. Leslie Topp, James Moran, and Jonathan Andrews, eds Madness, Architecture, and the Built Environment: Psychiatric Spaces in Historical Context (Routledge, 2007).

Indicative learning resources - Web based and electronic resources

• ELE – Faculty to provide hyperlink to appropriate pages
• Records from Bethlem Royal Hospital, 1559-1932 (access through Exeter) - https://microform-digital.uoelibrary.idm.oclc.org/boa/collections/104/records-from-bethlem-royal-hospital-1559-1932
• Wellcome Collection - https://wellcomecollection.org

Indicative learning resources - Other resources

• If you are interested, the Devon County Records Office hold archival material relating to the Devon County Lunatic Asylum and other local institutions from the nineteenth and twentieth centuries.

Key words search

Psychiatry; mental health; asylum; social history; cultural history; twentieth century