Photo: Bethlem Hospital, The Billiard Room, Illustrated Times, 2 June 1860 Source: http://catalogue.wellcomelibrary.org/record=b1197083

Ute Oswald: Entertaining the Insane: Recreation as Therapy in British Asylums c. 1780-1890

“During the nineteenth century the theory and treatment of madness underwent ‘enormous, even revolutionary’ change. In response to cases of neglect and unnecessary restraint of patients, Philippe Pinel, superintendent at the Salpêtriere in Paris, and William Tuke, founder of the Quaker Retreat in York, concurrently yet independently introduced the so-called moral treatment regime in search of a more humane cure. Based on improved patient-doctor relationships and new approaches to the occupation of patients, further emphasis was put on location, architecture and social activities. In 1834 W.A.F. Browne, superintendent at Crichton Royal Institution in Dumfries, praised asylums where ‘music and […] games are encouraged as much as possible’; extensive recreational programmes included creative writing, lectures, excursions, sports fixtures, balls and plays. Art and book clubs were formed, and fêtes and concerts became regular features.

This thesis will assess the role of these activities, establishing their function, variety and accessibility. It will locate them within the larger context of early psychiatric treatment options, ascertaining at which point they became part of moral management, or if they perhaps predated it. It will trace their development throughout the nineteenth century across different institutions (county, subscription and private) in England and Scotland, such as the Retreat, Ticehurst, Crichton, new Bethlem, Hanwell and Colney Hatch. As social activities were assigned rehabilitative and sometimes curative powers, I will suggest that the asylum environment could be dynamic and permeable, enabling patients to exercise agency if they so wished. By comparing recreations inside and outside the asylum walls, this study will also interrogate to what extent these reflected concurrent leisure developments within the institutional microcosm, and how this might have impacted on participation with regards to gender and class.

In exposing the effect and supposed reformative qualities of such varied entertainments on the nineteenth-century insane, this project hopes to contribute to the growing body of research in the field of Medical Humanities. Identifying the forerunners of art, music and drama therapy, it seeks to challenge current perceptions and inform future policy-making in public mental health.”

Ute Oswald is a PHD candidate in History of Medicine at the University of Warwick. Her thesis is being supervised by Professor Hilary Marland. You can find Ute at http://warwick.ac.uk/uteoswald