Restorative reading

Back in 2016, a post which featured an image listing various reasons for admission to the Trans-Allegheny Lunatic Asylum in West Virginia went viral on social media. Among the more usual suspects such as the death of family members, injuries sustained through war, and venereal disease - ‘novel reading’ was listed. These ‘reasons for admission’ are more accurately the situation which caused the mental illness with which patients were diagnosed, rather than the sole reason for their admission - but it shows how reading could be considered injurious to a person’s mental health to the point of requiring institutionalisation. Roy Porter gives other examples: a woman named Sarah Oakey was admitted to Gloucester Asylum with melancholia due to novel reading; John Daft supposedly drove his mind ‘morbid’ through reading too much Carlyle.¹ However, if reading the wrong things in the wrong way could have a powerful negative effect on the mind, it stands to reason that reading the right things in the right way might be able to produce positive results, too.

Men reading at Bethlem Hospital. The Hospital of Bethlem [Bedlam], St. George's Fields, Lambeth: the men's ward of the infirmary. Wood engraving by F. Vizetelly, 1860 (Wellcome Collection CC BY)

This was the thought that appealed to many asylum practitioners. Under moral treatment, patients were to be taught discipline, self-improvement, and given moral guidance by asylum staff. Books, with their powerful influence over the mind and morals of a reader, could therefore became an ideal addition to the alienist’s arsenal. Samuel Tuke, grandson of the founder of the York Retreat, encouraged reading (especially ‘useful knowledge’) as a form of amusement but specifies that ‘works of imagination’ and anything connected to a patient’s delusions would be ‘decidedly objectionable’.² Asylum keeper George Man Burrows likewise encouraged controlled reading. He believed that ‘nervous’ patients could induce hypochondria in themselves through reading, and blamed the periodical press’ reporting on coroners’ inquests for normalising suicide and describing successful methods.³ This is an issue the press remains criticised for; the Samaritans now provide guidelines for the reporting of suicides.

At Colney Hatch Asylum in 1857, Superintendent W. G. Marshall takes a more lenient view. Reading shouldn’t be simply an informative pursuit; rather, it is a primary means of entertainment, aiding in providing a ‘homely’ atmosphere and engendering patients’ positive feelings towards their treatment.⁴ It also had the additional benefit of calming patients down, presumably appreciated by the staff. The Royal Edinburgh Asylum’s David Skae sees reading as a socially and morally acceptable form of amusement, labelling it as a ‘constant source of intellectual improvement and recreation’.⁵

“[Books] solace many a discontented and dejected spirit, to place the deluded and misanthropic in connection with real events […] and even more directly to act the part of a remedy, for whenever the judgement can be brought to receive and derive interest from the contemplations of other and these healthy minds, it is less attentive to, and less actuated by its own suggestions.”

— W. A. F Browne

Anne Campbell, Bethlem 20 May 1841, ‘monomania with pride’, illustration by C. Gow (Royal College of Physicians Edinburgh, RCPE Artefacts DEP/MOR/4/95) - with thanks to Isla Macfarlane, whose work brought me to this illustration.

W. A. F. Browne, Superintendent at Crichton Royal Institution, writes at length about the activities of the library, and provides perhaps the most enthusiastic endorsement of the power of reading. Browne’s reports encapsulate the potential that some practitioners felt reading offered not just as a casual activity, but as part of a mode of treatment: it is ‘as expedient’, Browne writes, ‘to bestow care upon the Library as upon the Laboratory’. Lists of patients soothed by the Library occur regularly: the ‘silent, solitary being’ who consistently steals books from other patients to have enough to read; the man plagued by delusions of persecution ‘laughs merrily over Harry Lorrequer’; the ‘well-educated gentleman’ over-applying himself to the ‘severer studies’ of Greek and Hebrew persuaded to learn French instead; the suicidal patient ‘seduced into temporary forgetfulness of his woes’ through translating Guizot and Vertot; the ‘reveriest’ who was ‘tempted from his dream, and from his corner and carpet’ through the provision of his favourite literature.⁶

My PhD project seeks to examine the wider views of asylum practitioners from across Britain and Ireland; to establish how these views (along with external factors) were framed as medical directives for patients; how reading was facilitated for patients within the asylums; and how patients experienced print culture within the walls of their institutions.

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Sources:

¹ Roy Porter, ‘Reading is Bad for your Health’, Longman/History Today Lecture (1998) - available online.

² Samuel Tuke, Description of the Retreat (Isaac Pierce, 1813).

³ George Man Burrows, Commentaries on the causes, forms, symptoms, and treatment, moral and medical, of insanity (Thomas and George Underwood, 1828).

⁴ W. G. Marshall, ‘Medical Report of the Female Side’, Annual Report of Colney Hatch Asylum, 1857.

⁵ David Skae, ‘Physician’s Report’, Annual Report of the Royal Edinburgh Asylum, 1852.

⁶ W. A. F. Browne, ‘Physician’s Report’, Annual Report of Crichton Royal Institution, years 1839-1845.

Dangerous reading

Illustration showing incorrect reading posture, Nicolas Andry de Boisregard, L'orthopedie, 1741 (Wellcome Collection CC BY)

As long as reading has existed, there has been concern that it will do people harm. As literacy rates increased and the number of readers grew, they were warned about the terrible damage they might do to their posture, or their digestive systems - Robert Burton cautioned that students might be struck down by all kinds of bodily complaints due to their study.¹ Outbreaks of ‘overpressure’ were reported at schools throughout the nineteenth-century, and well-known asylum doctors were concerned with the phenomenon. Overseer of the York Retreat James Hack Tuke gave a speech relating to overpressure to the British Medical Association in 1879; James Crichton-Browne, former superintendent of the West Riding Asylum, produced a report on the subject in 1884 (though the Government later denied commissioning it). Women were seen by some as particularly at risk of physical consequences of their mental efforts. John Conolly, asylum doctor and pioneer of non-restraint in British asylums, suggested that over-study could cause damage to women’s reproductive organs and cause them to give birth to weak children.² However, though overpressure was traditionally associated with women and girls, most occurrences of overpressure took place in boys’ schools. Instead, class was a decisive factor; some took the existence of overpressure as an indication that the working classes were not naturally suited to schooling.³

“[...] hard students are commonly troubled with gouts, catarrhs, rheums, cachexia, bradiopepsia, bad eyes, stone and colic, crudities, oppilations, vertigo, winds, consumptions, and all such diseases as come by overmuch sitting; they are most part lean, dry, ill-coloured, spend their fortunes, lose their wits, and many times their lives, and all through immoderate pains, and extraordinary studies”

— Robert Burton, The Anatomy of Melancholy

Much like the modern moral panics we’ve seen (Metal music indoctrinates teenagers into Satanism! Video games turn children into mass murderers!), the development of a mass reading public in the nineteenth century also stirred concern for the moral wellbeing of society. This anxiety provoked a flood of essays and articles about the ‘right kind’ of reading, and all the ways in which people were failing to engage in it. Wilkie Collins lamented that the ‘Unknown Public’, reading penny magazines rather than Literature, simply hadn’t been taught ‘the difference between a good book and a bad’.⁴ This was somewhat ironic, given Collins was the author of The Woman in White, one of the most famous pieces of sensation fiction; this genre was criticised by highbrow critics for what they considered a lack of true literary value.

It wasn’t just an issue of taste: the wrong things read the wrong way also posed a risk to the reader’s mind and spirit. Poet John Ferriar described the addictive ‘book-disease’ of upper class collectors in his poem ‘Bibliomania’ - perhaps this might have been the diagnosis of a nineteenth-century physician if they’d been faced with 1990’s Book Bandit, Stephen Blumberg. For those at the other end of the social classes, especially women, an obsession with reading wasn’t considered as acceptably eccentric. John Kellogg (of anti-masturbatory cereal fame) compared the ‘pernicious habit’ of novel-reading to the consumption of alcohol or opium.⁵ Reading excessively was not just an addiction, but a disease - Johann Gottfried Hoche described reading addiction as ‘a truly large evil as contagious as the yellow fever in Philadelphia’.⁶

There were also sexual undertones, as the ‘promiscuous’ circulation of texts was particularly damaging to the morality of women.⁷ One article entitled ‘Novel Reading: a cause of female depravity’, reprinted several times in the late eighteenth and early nineteenth centuries, suggested that books could make young women ‘slaves of vice(s)’ such as extra-marital sex and adultery.⁸ The overconsumption of printed material and the effects of such a habit were described in terms of ingestion, painting pictures of the gluttonous reader gobbling texts, unable to control their appetite.⁹ The problem of the voracious reader was one of primal urges, lack of self-control and discipline - exactly like the problem of the ‘lunatic’ under the moral theory of insanity.

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Sources:

¹ Alexander Burton, The Anatomy of Melancholy, first published 1621 - 1883 edition via Archive.org & the Library of Congress.

² Katharina Rowold, The Educated Woman: Minds, Bodies, and Women’s Higher Education in Britain, Germany, and Spain, 1865-1914 (Routledge, 2010).

³ J. Middleton, ‘The overpressure epidemic of 1884 and the culture of nineteenth-century schooling’, History of Education (2004).

⁴ Wilkie Collins, ‘The Unknown Public’, Household Words, 21 August 1858.

⁵ Kelly J. Mays, ‘The disease of reading and Victorian periodicals’, in Literature in the Marketplace: Nineteenth-century British publishing and reading practices, ed. by John O. Jordan and Robert L. Patten (Cambridge University, 1995).

⁶ Stefan Andriopoulos, Ghostly Apparitions: German Idealism, the Gothic Novel, and Optical Media (Zone Books/MIT, 2013).

⁷ [A. Innes Shand], ‘Contemporary Literature, VII: Readers’, Blackwoods Magazine (1879).

⁸ Anonymous, ‘Novel Reading: a cause of female depravity’, originally published in 1797 and reprinted in La Belle Assemblée (1817), available to read online (p. 172).

⁹ Janice Radway, ‘Reading Is Not Eating: Mass-Produced Literature and the Theoretical, Methodological, and Political Consequences of a Metaphor’, Book Research Quarterly (1986).

Nineteenth-century print culture

A mechanized, shaft-driven printing-press. Wood engraving by H. Linton after E. Bourdelin, mid-1800s. (Wellcome Collection CC BY)

The nineteenth century witnessed an explosion of technological advancements, and for print culture this signalled some of the most important developments since Gutenberg brought together the elements required to create the printing press in around 1450. New iron printing presses were developed, giving greater stability in printing and allowing the introduction of steam power to vastly speed up production times. Processes for creating metal type, previously relying on hand labour, were automated. Paper could be made at greater quantities and far faster than before. After a £1000 reward was offered by The Times in 1854 for a cheap alternative to rags, esparto grass provided less expensive - though lower quality - paper throughout the nineteenth century (experiments using wood pulp, today’s most recognisable paper ingredient, were ongoing).¹

William Johnson Neale, The Captain’s Wife (Routledge Railway Library, 1862), digitised by Emory University Libraries.

It wasn’t just printing-related technology which impacted the trade: the railway system was instrumental in spreading printed material across Britain. Trains could heavy printing machines, metal type, or large amounts of paper. Metropolitan papers could now reach across the country in a timeframe where they were still relevant, and provincial presses could be set up to serve local areas.² As commuting increased, passengers also needed entertainment: this provided a greater demand for newspapers and magazines, and cheap entertaining books for longer journeys. W. H. Smiths became a household name through their railway news stands, beginning in Euston and spreading across the network - these carried cheaper titles often called ‘yellowbacks’, for their distinctive cover designs.

These factors led to greater production of books, newspapers, magazines and ephemera than ever before. Between 1800 and 1835, twenty-five thousand titles were published in Britain; between 1835 and 1862, this figure more than doubled, at 64,000. In 1801, the number of copies of stamped newspapers was 16 million, but by 1849 newspapers numbered at 78 million. Still, books weren’t cheap enough for everyone to be buying them for their own collections. The ‘triple decker’ novel of the early nineteenth century, published in three volumes, might cost between fifteen and eighteen shillings - over half the weekly wage of a printer, and nearly all of a teacher’s. Even the cheaper yellowbacks weren’t appealing to everyone as a purchase item.

Customers in Mr Mudie’s new hall, from the Illustrated London News, 29th December 1860, p. 619 (Wellcome Collection CC BY)

Readers across Britain were keen to find ways to access printed material, even if they didn’t have the money to purchase themselves. Whilst the term ‘literacy’ has some complicated connotations, the nineteenth century provided a growing literate audience - in part due to the improvement of education provision.³ It can be estimated that around two thirds of men and half of women were literate by 1840, giving an audience of roughly more than ten million.⁴ Even prior to the establishment of the first public library system, readers had options. Those with a little more cash to spare could join book clubs or subscription libraries. Circulating libraries like Mudie’s often satisfied more ‘popular’ tastes, and offered cheaper subscriptions for varying periods. Philanthropic efforts resulted in libraries for the benefit of the working classes, such as the Mechanics’ Institutes. However, working class readers also pooled their resources to purchase texts of their own choice, setting up reading rooms and libraries within their own communities.⁵

Whilst widespread literacy today is usually considered a benchmark of an equal and progressive society, historically the idea has proven contentious with those holding societal power. There was concern that giving the working classes access to printed material could educate them above their accepted station, or even inspire revolutionary action. However, utilitarian principles ultimately won out. Wider education could reduce the time that the working classes spent on ‘base’ pleasures and induct them into a more morally disciplined lifestyle, conducive to the wider success of industrial society. An early supporter of the public library system even described it as ‘the cheapest police that could be established’.⁶

But would reading cure the unruly working classes of their taste for the pub? The reality, as ever, was more complex. Middle class readers devoured ‘sensation’ fiction, gripped by crime and questionable romance; the working classes, whose tastes supposedly tended naturally toward the immoral, frequently sought out the ‘classic’ Literature-with-a-capital-L.⁷ Readers are notoriously rebellious, and for those who were worried about the public, no one (working class or not) ever seemed to be reading what they ought to be.

Reading for self-improvement might have unintended consequences on your other duties! ‘The rise, and fall, of literature’, T. L. Busby, 1826 (Wellcome Collection CC BY)

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Sources:

¹ For excellent overviews, see Rob Banham, ‘The Industrialisation of the Book’, in A Companion to the History of the Book, ed. by Simon Eliot and Jonathan Rose (Blackwell, 2007), and James Raven, ‘The industrial revolution of the book’, in The Cambridge Companion to the History of the Book, ed. by Leslie Howsam (Cambridge University, 2015).

² Simon Eliot, ‘From Few and Expensive to Many and Cheap: The British Book Market 1800-1900’, in A Companion to the History of the Book.

³ The British Library’s explanation of education in Victorian Britain gives a good summary of changes in the nineteenth century.

⁴ Lawrence Stone, ‘Literacy and Education in England, 1640-1900’, Past and Present, (1969).

⁵ Chris Baggs, ‘Radical reading? Working-class libraries in the nineteenth and early twentieth centuries’, in The Cambridge History of Libraries in Britain and Ireland Volume 3: 1850–2000 (Cambridge University, 2006).

⁶ Joseph Brotherton in the Parliamentary Debate on the Public Libraries Act, quoted in Alistair Black, Simon Pepper, and Kaye Bagshaw, Books, Buildings and Social Engineering: Early Public Libraries in Britain from Past to Present (Ashgate, 2009).

⁷ Jonathan Rose, The Intellectual Life of the British Working Classes (Yale University, 2001).

Other interesting resources:

• Tom Shillam’s post for the National Railway Museum about yellowbacks; ‘The Yellowback: Sensational Stories on the Railways’

• Matthew Taunton’s post, ‘Print Culture’, for the British Library

The 'exceptional' asylum?

Photograph of a corridor at the Crichton Royal Institution, taken by John Rutherford of Jardington some time in the 1890s. (Wellcome Library DHG1/8/1/4)

Due to the general impression of the historic asylum system, most of us don’t imagine an asylum as a place where people would have been allowed recreation and entertainment. We picture dim rooms, manacles, straitjackets. Most people I’ve spoken to about my research certainly wouldn’t think of large grounds, farms or sports facilities, or libraries. But, under the developing regime of ‘moral treatment’, the nineteenth century saw new approaches in the architecture and management of asylums, and the therapeutic approaches utilised within their walls. Of course, many problems still existed in institutional mental health care, and much was still to be learned about mental illness - but much of the nineteenth century remains somewhat an anomaly in the context of our conception of the history of the asylum.

W. A. F. Browne’s What asylums were, are, and ought to be, 1837 (Cushing/Whitney Medical Library, Yale University, digitised by the Hathi Trust)

The formation of ‘moral treatment’ is generally attributed to Phillipe Pinel, who in the late eighteenth century France revolutionised attitudes towards mental health treatment.¹ Until this point, patients were frequently treated as closer to animals than humans, responding better to punishment than to reason, and requiring control through physical restraint. Pinel promoted the idea that mental illness was often curable, and that doctors should take more time to understand each patient personally in order to provide effective treatment. Doctors such as Robert Gardiner Hill, John Conolly, and William Alexander Francis Browne were influenced by these ideas, and helped introduce them to to the medical establishment in Britain and Ireland. Among others, these doctors eventually prompted huge change in the asylum system.

Legislative reform in the British Isles during the early to mid nineteenth century paved the way for a new asylum system - one supported and inspected by the state. In England in 1808, the first County Asylums Act allowed counties to use local taxes to build asylums; the 1845 Act compelled them to do so.² Further Acts affecting the rest of the British Isles followed, resulting in widespread building programs. The new asylums were modelled on new ideas, and reformers embedded moral treatment into the buildings from the ground up, literally. The asylum environment was able to influence the behaviour of the patients within, and so architecture and design required careful consideration.³ In developing the Retreat at York, the Tuke family believed that replacing a dark, dingy, prison-like atmosphere with one which exuded familiarity and homeliness would put patients at ease and allow their minds to heal. As new asylums sprang up around the British Isles, ‘cheerfulness’ was a key aspect. Inspecting Commissioners of Lunacy criticised poorly lit and ventilated wards and praised decorative efforts such as wallpapers, prints and illustrations.

Men at the Crichton Royal Institution on the curling lake, 20th century. Curling was a regular activity at Crichton from the nineteenth century, often written about in the Superintendents’ reports. (Wellcome Library, DGH1/8/5)

A central element of the ‘moral treatment’ system was the provision of occupation for patients (as well as leisure time.) Michel Foucault characterised this element as essential to the ‘tethering of the spirit’ which he argued moral treatment aimed to enact: by forcing patients to engage in work with no ‘production value’, imposed on a strict timetable, those running the asylum would control patients’ liberty mentally, rather than physically as previously.⁴ However, things were more complex in practice. Patients were encouraged, but not forced, to work, and usually on more flexible timetables.⁵ In a report for The Lancet in 1877, J. M. Granville noted that work in asylums should not have the ‘measured haste of an industrial regime, nor the monotony of prison discipline.’⁶ In many asylums, such as at Hanwell Asylum in London, considerable effort was made to provide a large variety of options - from farm work and gardening to upholstery, shoemaking and even printing and bookbinding. Those who chose not to work, or were unable, did not have to. Leisure activities were available in most institutions, and encouraged. The Crichton Royal Institution had space for cricket and even curling; The Royal Edinburgh Asylum had its own collection of natural history specimens and held educational lectures.⁷ Crucially for my research, most asylums of this period also developed their own, often sizeable, libraries for patient use, as well as providing newspapers and periodicals.

Moral treatment is now largely dismissed as a ‘failure’, due to an intense focus of both asylum authorities of the time and their successors on the notion of ‘cure’. Its existence has largely disappeared from mainstream discussions of the asylum. However, the evidence within asylum archives can provide a more nuanced view, and a growing body of historical scholarship challenges some of the assumptions of the past. Whilst curative effects weren’t necessarily gained, and motivations were contested, many practitioners did aim to improve the lives of their patients humanely, and the day to day experiences of many patients were much more positive than they had been decades earlier.

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Sources:

¹ Dora B. Weiner, ‘Phillipe Pinel’s “Memoir on Madness” of December 11th, 1794: A Fundamental Text of Modern Psychiatry’, American Journal of Psychiatry (1992)

² Leonard D. Smith, Cure, Comfort and Safe Custody: Public Lunatic Asylums in Early Nineteenth-Century England (Leicester University Press, 1999)

³ Barry Edginton, ‘The Design of Moral Architecture at The York Retreat’, Journal of Design History (2003)

⁴ Michel Foucault, History of Madness, translated by Jonathan Murphy and Jean Khalfa (Routledge, 2006)

⁵ Pranjali Srivastava, ‘“Work as Therapy” in the Asylums of Colonial India, 1858-1910’, Proceedings of the Indian History Congress (2014)

⁶ J. M. Granville, The Care and Cure of the Insane: Being the Reports of The Lancet Commission on Lunatic Asylums, 1875-6-7 (Hardewicke and Bogue, 1877)

⁷ Maureen Park and Robert Hamilton, ‘Moral treatment of the insane: Provisions for lifelong learning, cultural engagement, and creativity in nineteenth-century asylums’, Journal of Adult and Continuing Education (2010)

Cultural conceptions of the asylum

'Hogarth's The Rake's Progress; scene at Bedlam.' by T. Cook. (Wellcome Collection, CC BY)

Our cultural conception of the asylum paints it - often fairly - as a place of unjust confinement and institutional abuse. When we talk about something being in a state of chaos or irrationality, we might describe it as ‘Bedlam’ - a word derived directly from the name of London’s Bethlem Royal Hospital.¹ Long before the advent of ‘moral treatment’ in the late eighteenth century, and its widespread use in the nineteenth century, the asylum had already gained a reputation as either somewhere to be feared, or for the more fortunate, somewhere to visit on a day trip to gawp at ‘lunatics’.

Samuel Bruckshaw, One More Proof, written in 1774 following what he considered to be an unjust confinement in a private madhouse in Lancashire. (Stanford University Library, digitised by Google)

Historically, those deemed to have mental illnesses and intellectual disabilities might have been looked after in their communities, by family or charity - or, as the case was for many poorer people, not looked after at all, ending up on the street, in prison, or the workhouse. As the ‘trade in lunacy’ developed considerably through the eighteenth century, private madhouses began taking over responsibility for those deemed mentally ill.² These for-profit institutions tended to operate under policies of discretion, allowing families who could afford it to limit their caring responsibilities and avoid the stigma associated with having a relative with mental illness. However, the secrecy surrounding private madhouses could enable abuse, with patients treated inhumanely and kept in dire conditions.³ Wrongful confinement also was at the forefront of public imagination and remained so throughout the nineteenth century, exemplified by public interest in cases such as Rosina Bulwer Lytton’s and captured in literature like Wilkie Collins’ The Woman in White.⁴ Public institutions, growing in number throughout the century, also provided the public with plenty of anxiety; many faced criticism and public exposés of their treatment of patients and use of mechanical restraint.

Electroconvulsive therapy machine, mid-1900s (Science Museum, CC BY)

Twentieth century asylum-based treatments moved increasingly towards medicinal and surgical intervention. Physical treatments were used in asylums prior to this point, but methods became even more experimental as asylums became training centres for students and doctors aimed to provide cutting edge treatments.⁵ Techniques such as electro-convulsive therapy (ECT), insulin shock therapy, and the now infamous prefontal lobotomy gained traction. However, many of these procedures are now widely recognised to be both inhumane and largely ineffectual in most cases. Over the course of the century, deinstitutionalisation grew in popularity as part of an antipsychiatry and disability rights movement, and asylums began to close. In the UK, this process began wholesale in the 1980s with Thatcher’s ‘Care in the Community’ - though whether this change has been successful in improving conditions for mentally ill people in Britain is contested.⁶

In the twenty-first century, with the asylum system largely long gone, the ghost of the institution retains its strong influence on culture - and the abuses of previous eras are certainly not forgotten. Mention the word ‘asylum’ and most people’s minds will jump to One Flew Over the Cuckoo’s Nest, or possibly DC’s Arkham Asylum. Wrongful confinement remains a common trope for the thriller and horror genres, such the committal of lesbian journalist Lana Winters to the terrifying Briarcliff Manor of American Horror Story. With many asylum buildings in Britain and Europe now simply abandoned, they have also become an object of fascination for ‘urban exploration’ photographers documenting the remnants of our institutional history, and paranormal enthusiasts convinced they’ll find apparitions of patients past. Most media now relies on three stereotypes of the asylum: the ‘olden days’ of Bedlam-like institutions and shackled patients; the drastic medical interventions of early twentieth-century; and the abandoned ruin, relic of a time gone by. But is this terrifying picture of the asylum a complete one?

Grant Morrison, Arkham Asylum: a serious house on serious earth, illustrated by Dave McKean (DC Comics, 2014)

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Sources:

¹ Jonathan Andrews, Asa Briggs, Roy Porter, Penny Tucker and Keir Waddington, The History of Bethlem (Hove: Psychology Press, 1997).

² William Parry-Jones, The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries (London: Routledge, 1972).

³ Roy Porter, Mind-Forg’d Manacles: A History of Madness in England from the Restoration to the Regency (Penguin Books, 1990).

⁴ Rosina Bulwer Lytton, A Blighted Life (The London Publishing Office, 1880), full text available online at Wikisource.

⁵ The Mental Health History Timeline, developed by Andrew Roberts at Middlesex University, provides a very thorough outline of the history of mental health treatment from pre-history to the present day.

⁶ Robin Means, Sally Richards and Randall Smith, Community Care: Policy and Practice, 4th edition (Palgrave Macmillan, 2008).

Other interesting reading:

• Birkbeck’s excellent teaching resource, ‘Deviance, Disorder & the Self’, in particular the ‘Wrongful Confinement’ section

• Jade Shepherd’s blog, ‘Voices from Broadmoor’, including these posts focusing on wrongful confinement at the institution

• This post by Jennifer Crane for Warwick University’s Centre for the History of Medicine, on patients’ perceptions of their confinements