Admission

Towards the end of the 19th century it had become evident that the construction of the DCLA contributed little to alleviate the problem of mental illness, but rather seemed to have provided an additional option for families and communities to cope with their insane members. Some revisionists examined the steadily rising admissions to asylums and concluded that 19th century lunatic asylums were used as ‘dumping grounds’ for unwanted and economically unproductive relatives (Scull, 1979). Partly as a response to such accusations of ‘false imprisonment’, the Lunacy Act 1890 introduced significant changes to asylum admissions in Britain. Every patient admitted under this Act had to be certified insane by a magistrate and the certificate had to be signed by a medical practitioner. This process had a variety of consequences. Firstly, it turned the medical decision about admission into a purely legal one, i.e. magistrates without medical training decided about a patient’s admission. Secondly, the magistrates would only commit people who were either a danger to the public or themselves, showing clear signs of insanity, thus excluding anyone suffering from a more moderate form of mental disturbance and reducing their chances of recovery. This is even more striking because when the new Act was discussed in Parliament, Dr Farguharson of Aberdeenshire declared the late treatment as an existing problem: ‘at present, so much time is occupied in bringing an acute case under medical treatment that very often it reaches the incurable stage or the chronic stage before a chance of proper treatment has been brought about’ (Historic Hansard, 03rd June 1889). Finally, certification could also impact significantly on a patient’s and their family’s future life, as it labelled and stigmatised patients. The only way to avoid stigmatisation was to enter the hospital as a ‘voluntary boarder’ – an option open exclusively to fee-paying patients.