Review: History of asylums, insanity and psychiatry in Scotland, History of Psychiatry (2017)

By Ebba Högström

When reading the newly published special issue History of asylums, insanity and psychiatry in Scotland in the journal History of Psychiatry (SAGE, March 2017, vol 28, issue 1), edited by Chris Philo and Jonathan Andrews, it struck me how diverse this history is. There is not one consistent history working through towards the present on a linear trajectory; rather, it is about histories in the plural, as topics, time, spaces, people, laws, regulations, resistances and care regimes emerge differently through the array of different foci displayed by these eight papers display.

In the introduction, the guest editors point out that there is much in the history of Scottish psychiatry yet to be told, at the same time as they stress how such studies should move beyond simplistic national contextualisations. Rather, the significance of such studies should reveal broader patterns in “a pan-European, or geographically and conceptually wider, transformation of ideas and practices impinging on the mental health dimensions of human vulnerability” (p2).  Localised history became relevant “when set in a broader framing of how ideas and practices travel between places” (ibid.) and take place in shaping new landscapes of “cure and care or neglect and stigma” (ibid.). The combination of local situations connecting to general levels – into institutions, policies, illnesses and psychiatric care, wherever they might be situated around the globe – is a most significant feature of the field of history of psychiatry, and the papers in this special issue are no exception. Whereas all eight papers concentrate on events within the geographical area of Scotland, they simultaneously stretch out differently in time, situation, place and angle.

The contributions in this special issue thus range between overviewing work, addressing long-term trends and broader periods and systems, and detailed studies of specific ‘individuals and institutions’. Farquharson gives an overview of the ‘unfamiliar institutional spaces’ of the parochial asylum caught in between the two spheres of legislation, the Poor Law and the Lunacy Law, during the second half of the 19th century. She brings forward how this system was a way to take control over the care (and sometimes even the cure) of the poorest people who would otherwise have been caught up in poorhouses. At the turn of the nineteenth into the twentieth century, the spatial organisation of asylums of all kinds was under discussion, and Almond highlights one such spatial plan, the ‘village system’, as mirroring a specifically Scottish emphasis on liberty and freedom. Ideas of the ‘homely’ and the ‘individual’ are discussed with references to Calvinistic ideas of improvement by self-awareness which could be manifested in a distinctive institutional layout without enclosing spatial forms. Moving towards the 1960s and 1970s, Long shows us how changes within the institutional boundaries of Scottish mental hospitals took place due to deinstitutionalisation policies usually pressing care and treatment “outside the walls”. Political-legislative regulations from postwar times made deinstitutionalisation a slower process than in England, with the effect that asylums were renewed rather than rejected. During the same period patients started to fight for liberty and justice, a theme covered in Gallagher´s paper. Gallagher gives an overview and a detailed story of one specific individual as stories of the agitation by the Scottish Union of Mental Patients (SUMP) and the individual political struggle by Thomas Richie, a patient and the founder of SUMP are unfolded.

Through individual accounts of women patients from Dundee Royal Lunatic Asylum diagnosed as suffering from ‘puerperal insanity’, Campbell moves to the mid-nineteenth century and poses questions about the motives for such a diagnosis. She wonders whether this diagnosis was more likely to ‘fit’ the middle and upper-class woman, as precedents of a Victorian motherhood ideal, thus excluding working class women. Morrison’s contribution places itself  in the beginning of twentieth century, when the emergence of so-called ‘dynamic psychiatry took place. Morrison outlines the early career of the psychiatrist, and later superintendent at Gartnavel Royal Hospital (GRA) in Glasgow, David Henderson, the linkage to the leading figure of North American psychiatry Adolf Meyer, and the deployment of the ‘case conference approach’. Another influential psychiatrist, Thomas Ferguson Rodger, also connected to Henderson and Meyer and, as the editors formulate it, a possible ‘missing link’ between Henderson and R.D. Laing, is the theme of Phelan’s paper.  She considers the eclectic psychiatric approach of Fergusson, in many cases more psychodynamic and socially-oriented than were his predecessors, and (because of that) more alert to psychiatry’s limitations. Another angle of psychiatric care and cure is presented by McGeachan through the “Art extraordinary” works collected by Joyce Laing, Scotland’s first psychiatric art therapist. McGeachan reconstructs the ‘voice’ of Adam Christie, a patient at the Royal Montrose Asylum, through his stone-head carvings, highlighting the importance of ‘small spaces’ – e.g. gardens, paths, studios and boats – for the everyday life of patients, a valuable and underused source in tracing geographical histories of asylum experiences.

This compilation of Scottish history of psychiatry is completed by a Classic Text, here an excerpt from a 1860 text Philosophy of Insanity by the GRA patient James Frame. Patient voices are seldom heard in the history of psychiatry, most often they arrive indirectly through case notes, or sometimes more directly through letters kept in the case notes records. Frame’s chronicle of mental health care of the past, and the many themes addressed, echoes in an intriguing way contemporary public debates, marking a line of continuity. So, as mentioned in the beginning of this review, it is striking to contemplate the many ways in which the history of psychiatry can be told, and at the same time the range of similarities of these histories over time and space.


Twitter: @ebba_hogstrom




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