The foundation of the DCLA in 1845 was not without its difficulties. Plans for its construction date back to 1829 (Trewman’s Exeter Flying Post), inspired probably by the therapeutic optimism following the acknowledgement of mental illness as a product of societal changes (Rothman, 2001), in particular the increasing concerns about the treatment of the insane for whom up to the 19th century very little care had been provided. Unless dangerous, they had been cared for in the community, most commonly by their families.
‘Insanity’, as mental illness at that time was broadly described, was believed to run in families and consequently some people suffered considerable abuse. Graphic descriptions of such abuse encountered in Devon include the chaining of a man to the floor of a cell for almost a decade by his relatives and locking people up in tiny rooms without fire, often in complete darkness and sitting in their own waste (Forsythe, 2001; Melling, Forsythe & Adair, 1999).
Institutional care, mainly provided in prisons and workhouses, was either the result of the insane being perceived as a danger to society or the breakdown of domestic care (Suzuki, 1997). Physical and emotional ill-treatment of inmates was a common occurrence, calling for groundbreaking reforms. At the same time, the idea of ‘partial’ insanity, i.e. insanity affecting only a section of the brain, gave hope of curing insanity through isolation of the insane in an environment which would allow them to regain their self-control.
When the money to fund the DCLA had finally been found eight years after the initial plan, careful consideration was therefore given to its location and architecture. Charles Fowler, the architect, based it on the model prison of Pentonville. Its landscaped gardens with beautiful views provided a therapeutic rural routine granting space for exercise and isolation from the evils of society. The large grounds also provided therapeutic employment and self-sufficiency.
Yet, its darker custodial function was omnipresent in the arrangement of the buildings radiating from a central administrative block as well as in the form of locks, well remembered by former staff: ‘All the doors of the wards were locked. All cupboards were locked. Rooms leading off from the main dormitories were locked. The bathrooms were locked’ (Interview with WS). In spite of this, the DCLA was built as ‘a place where curative treatment is applied […] not a place of confinement or punishment’ (Devon Minute Book, 1844), setting it apart from previous forms of ‘care’ for the insane when the protection of society clearly took precedence over the provision for the insane.
John Charles Bucknill (1817 – 1897) was the DCLA’s first Medical Superintendent. Young and fairly inexperienced though academically brilliant, he embarked on a journey that would turn the DCLA into a model institution providing social care in addition to medical treatment – a move that would gain Bucknill international fame and the benevolence of the Lunacy Commissioners. Once the DCLA opened in July 1845, Bucknill initiated a vigorous campaign to have inmates from workhouses transferred to his institution where, he argued, treatment was superior to anything the insane could expect anywhere else. He also used his many publications to openly expose the abuse of the insane by their relatives.
The workhouses, initially reluctant to transfer their lunatics to the more expensive County Asylum, later adopted a policy of ridding themselves of the elderly infirm by sending them to the DCLA (Mortimer Granville, 1877). Many arrived in extremely poor conditions and, although they were strictly speaking not in need of psychiatric treatment (5th Annual Report of Inspectors of Lunatics, 1851; Medical Superintendent’s Annual Report, 1854), Bucknill refused to send them back. Often he could do little for them but watch them die.
Early case notes and annual reports suggest that he was equally open to people, particularly women, in need of respite care or seeking refuge from violent partners. In his 1850 annual report he states that ‘it is probable that, amongst the poor, the domestic cares occasioned by narrow means and scanty diet, press far more heavily upon the woman than upon her husband. Sometimes, indeed, the intemperance and bad conduct of the husband is the cause of the insanity […]’ (Medical Superintendent’s Annual Report, 1850). He is particularly concerned with people returning to such a broken home ‘it is painful to feel, when recovery has taken place, that the poor woman will again be exposed to the exciting causes of her malady’ (Medical Superintendent’s Annual Report, 1850).