To read the article on this research in History Scotland, see here.
If you didn’t already know, I’m a funded PhD researcher on a studentship, which means that I came into the fray with a general research area all picked out for me. Twentieth century mental health in Scotland, possibly a closer focus on civilians in the war…
But when I discovered the use of public county/district asylums as war hospitals, that’s when my research really began to take shape. In this process the fundamental questions about the ‘value’ of men and women, of patients in institutions and the relationships different classes and cohorts could have with the ‘lunacy authorities’, doctors and government became very clear.
What happened to the transferred asylum patients constitutes one of the hidden histories of the Great War…The profile of the mentally ill and concern for them was reduced and, within the asylums, those patients transferred from other institutions received even less priority.
Steven Cherry (2003).
Exploring two-hundred years of Norfolk country asylum, Cherry directly acknowledge a hidden history of British asylums in wartime: the history of forced patient migration, of the prioritisation of servicemen and the marginalisation of civilians and of civilian patient experience in wartime. Historians have neglected these questions in favour of nervous disorders, servicemen and, within Britain, experiences in England.
Initially, asylums were taken over, not specifically for the psychologically-injured, but to answer the desperate need for more beds. Bangour Village Hospital was receiving military patients by May 1915.
Yet the mental health of the troops was deteriorating at an alarming rate. News of this couldn’t be confined to the Front as men returned home, and public outcry encouraged the military authorities to act (Barham, 2004). This seemed a lesser problem in Scotland yet nevertheless, eight months after ‘Edinburgh War Hospital’ opened its doors, asylums in Scotland were being used specifically for the treatment of acute mental disorders in servicemen.
Despite the great need for effective treatment however, approving and codifying the use of asylums as hospitals, either medical or mental, was no smooth process. The stigma of entering the asylum at all, never mind as a ‘pauper
lunatic’ brought honourable servicemen and their families ‘opprobrium’, conceded Harold Tennant. Accommodating these men alongside the ‘rank and file’ asylum resident and subjecting them to the same treatment would render them mad, insisted Laurence Ginnell. But it was Athelstan Rendall, like a dog with a bone and a thorn in the side of the Under-Secretary of State for War, who fought doggedly against any association between serving men and the asylum.
What then was to be done, but change the image of the asylum as far as possible?
Lt. Col. DG Thompson was medical superintendent of Norfolk country asylum, and Major RD Hotchkiss, of Renfrew district asylum at Dykebar. To those like Thompson or John Keay at Bangour, who were to head medical rather than psychiatric hospitals, Sir Alfred Keogh was unequivocal. No trace of the asylum ‘character’ was to remain. Yet to Hotchkiss and co. caring for the mental health of servicemen, no such demands were made.
Yet did this mean that such asylums had an easier conversion from civil to military institutions? Not necessarily. Where Thompson was eager to please military authority and described his fellow superintendents as ‘patriotic spirits’, Hotchkiss and others were far more frank about their disagreements with the military approach, especially regarding the acquisition of nurses, attendants and other staff.
The time came for patients to be transferred out of the newly acquired war hospitals and into their temporary host institutions. At times the decision or where to transfer patients was simple. By January 1916 they couldn’t be sent to the district asylum at Stirling as sections were still under construction. Kirklands asylum had low staffing levels so there was no night supervision for any patients who would require it. And to get to Argyll and Bute asylum, patients had to be mentally and physically well enough to travel with a small cohort of nurses by boat. Yet sometimes consideration was given to motivations not so practical.
After appealing for beds for the civilian patients he had to displace, Hotchkiss was inundated by requests for ‘cherry-picking’: superintendents looking for able-bodied, non-troublesome patients who wold contribute, who wouldn’t become a burden.
He also actively tried to ease the burden upon others from the ‘Glasgow School’ of psychiatry. Fellow Glasgow graduate, JH MacDonald, like so many others, did not want the bed-ridden, chronic patients under his care. Neither however, did former Head Attendant George Pirie. The three seemed to come to a stalemate, with Hotchkiss trying to push Pirie into accepting more such patients than he claimed he could. It took the General Board of Control for Scotland to step in and decide in Pirie’s favour. Hotchkiss however was allowed to add the caveat that if the patients were unfit for travel, to Pirie they would go.
Former Matron and superintendent at East Lothian asylum Jean Sinclair didn’t engage in any such bartering. Yet all the same, despite the relatively easy distance between Glasgow and Edinburgh, Hotchkiss sent her only ten, quiet-tempered patients in comparison to the 88 he sent to Dr Kerr at Hartwood. The comparable sizes of East Lothian and Lanark district asylums undoubtedly played a role here, but equally as certain was Hotchkiss’ deference to ‘Miss’ Sinclair’s sex.
This led to another question however. Did superintendents like Hotchkiss give as much consideration to the patients themselves, as they did their colleagues?
Being forced from the new war hospitals to other asylums was clearly a stressful business for all involved. Yet in Scotland, ‘moving day’ was reported with a far more positive spin than in Norfolk.
Perhaps it was because the report in Scotland was published in the national media, and not a specialised, professional periodical. But patients were sent to new asylums at the opposite end of the country. Inverness district asylum was a popular port of call. Patients who were kept close to home were, first, those who had people to visit them. Hotchkiss did try to consider patient welfare. He refused to usher patients out the door before they were well enough. He petitioned the families of those he deemed suitable to return home to reclaim their relative. He refused requests for discharge if he felt a relapse was likely. But, realistically, he was strapped for time and had the military and national lunacy authorities waiting. There was only so much he could do to make these transfers as painless as possible, and it was inevitable that for some it was a uniquely traumatic event.