We live in an age of mental health. We live in an age where over 8 million people in the UK deal with anxiety, where 1 in 6 adults live with depression and over 700,000 people takes their lives each year, according to Champion Health. But we are lucky, a fact which we often forget. We are lucky because, despite these statistics, we have the understanding that these struggles have massive impacts on people’s lives, and because of this, we are able to regard them with care and compassion. 200 years ago, this was not the case. So, when was the turning point? Well, it all began in Lincoln, specifically, Lincoln Asylum. Yet, despite this very few of us know the revolutionary history of our city. I argue that the Lincoln Lunatic Asylum needs more recognition for its role in mental health care, lest we forget how lucky we are.

According to the National Archives Hospital Records, Lincoln Lunatic Asylum was opened in 1819 and carried out practices until 1948 as a private institution. After the establishment of the NHS, however, it was taken over and became a public hospital, until its closure in 1988. But for today, we are most focused a on specific 20 years the hospital’s history – its opening in 1819 until around 1840. During this period, many patients were ‘treated’, and I say treated very loosely, as the method of treatment for so many of these patients was highly brutal, including bleeding, leeching, shaving the head, bathing in ice, chains and arguably the worst, the straitjacket. This was a method of physical restraint that had been used since the 17th century to control patients who may be violent, prone to anti-social behaviour or at risk of self-harm and suicide. The National Science and Media Museum describe straitjackets as ‘a garment with extremely long sleeves, crossed over the chest and tied or buckled at the back’, designed to restrict movement and limit the damage patients could cause. I would like you now to close your eyes and wrap your hands around your torso. Imagine that they are clasped there, and you cannot move your arms no matter how hard you try. Imagine your rising panic as you realise your body has been rendered vulnerable and completely at the mercy of doctors who will come at you with syringes and needles. Imagine the sense of claustrophobia, of being trapped both physically and metaphorically, inside your own body. Just imagine for a moment. We used to do this to women classified as hysterical, to men with suicidal thoughts. Could you imagine inflicting this kind of torture on people today?

The breaking point came in 1829. A patient at Lincoln Lunatic Asylum named William Scrivinger was found dead from strangulation after being trapped in a straitjacket and left overnight without supervision. Already, reformers had been petitioning for less use of restraint and greater use moral treatment methods, saying that they demoralised and brutalised attendants as well as patients. This provided a spark to light their beacon. A patient was dead. This inhumane treatment had to stop. And Lincoln, the site of this death, led the charge for the reform. Under the leadership of Edward Parker Charlesworth, a physician who had devoted many years to improving the system at Lincoln, and Robert Gardiner Hill, a specialist in the treatment of lunacy, a revolution began. Restraints were used for 25,485 hours in 1830, but this dramatically decreased, falling to almost zero in a matter of a few years and much of the equipment such as iron handcuffs were also destroyed to prevent their use. This was recognised by the Lancet, a famous medical journal, as a pioneering step in mental health treatment and other institutions such as The Retreat in York, and the Hanwell Asylum in Middlesex followed suit. These establishments are much more widely discussed in the context of mental health treatment, but it was Lincoln Lunatic Asylum they looked to for this first step.

Moreover, a recent article in the Lincolnite, researching the Asylum, expresses that ‘patients in the complex weren’t meant to feel as though they were caged – the walls were out of sight below the hills brow, giving a feeling of freedom’. Additionally, the establishment held less than 100 patients at any one time, which allowed the staff more time to attend to each one. This is a stark contrast to most asylums at the time, each of which holding between 500 and 2000 patients, with the largest in Whittingham holding over 3000 patients. With more time and resources to devote to each patient, rapid progress was made and in 1837, the Lincoln Lunatic Asylum became the first in the country to achieve total abolition of mechanical restraint. As a result of this progression, patients were no longer seen as prisoners, providing a massive leap to advance understanding of mental health. This starting point created a domino effect, leading at long last, 200 years later, to the mental health care we know today.

Straitjackets are no longer used in psychiatric settings, with the last use in 1950 in America. The Lincoln Asylum had created an effect that none can dispute it provided a starting point for lasting change to mental health systems across the country and arguably the world, but do we remember this? No. But we should. This story needs to be told. Counselling, therapy, CBT, all of it is possible because officials and normal people alike in Lincoln said, ‘No. This is not right.’ Without them, how much longer would it have taken to get here, to this point of understanding and compassion for those with poor mental health? How many more people would be suffering silently if these first steps were not taken? For this, more recognition should be given to the Lincoln Lunatic Asylum, a pioneering institute in the role of mental health care.
 

Image: Lunatic Asylum Lincoln; Coloured line engraving by W. Watkins after J. Livesey (Wellcome Collection)