This paper investigates the nexus between the legal provisions for the certification of insanity and the introduction of psychological medicine into British medical education. Considering legal and published sources, it shows that the 1853 Lunatic Asylums Act proved fundamental for the promotion of medical psychology as part of medical training.

The 1853 Act gave practitioners with no special preparation or interest in lunacy the power to confine individuals based on “facts of insanity personally observed”. This put doctors into a risky position as they could be subject to law actions and reputation damages. Such a provision also exposed their insufficient knowledge on lunacy Several asylum doctors quickly realized this point and linked the necessity of formal education in medical psychology to the certification of insanity. Their argument was that since every practitioner could be called upon to certify, every doctor should be introduced to the principles of medical psychology.

This paper shows that the introduction of formal education in medical psychology depended not so much on theoretical advancements or alleged efficacy as on legal responsibilities. Specifically, by giving practitioners the authority to report “facts of insanity”, British legislation created the need for trained psychological physicians capable of writing convincing certificates. The institutionalization of medical psychology in British medical schools thus responded more to legal consequences rather than laboratory results.

Full Link

Filippo Maria Sposini, “The rise of psychological physicians: The certification of insanity and the teaching of medical psychology,” International Journal of Law and Psychiatry (2021), 74, 101667. https://doi.org/10.1016/j.ijlp.2020.101667