Children in Insane Asylums, 1854-1900

JF Ptak Science Books   Post 2071

I came upon this remarkable article, written by Kate Gingell, on the reason for admitting children to insane asylums between in the middle/late 19th century. The article, "The forgotten children: children admitted to a county asylum between 1854 and 1900", appeared in The Psychiastrist¹ in 2001, and stipulates the causes for admittance, as well as the causes for the mental disorder².  It is all quite upsetting, in a quiet and determined way, even when presented in tables--even without Gingell's commentary and conclusions. It is really the stuff of nightmares³.

A total of 195 case notes were identified from a total of 6573 admissions to the Powick Asylum in the years 1854-1900. (Powick, Worcestershire, was founded in 1847 as the Worcester County Pauper and Lunatic Asylum, and had a long life, closing only in 1989.)

"During the 19th century the attention paid to the mental health of children was influenced by the physical health of the population, the cultural climate of the day and beliefs about children and child rearing. The fact that children were admitted to an asylum for years and frequently died there without apparent contact with their family must be set in the context of a high infant mortality (156 per 1000 live births in 1897) and difficulties in travel and communication among pauper families..."

Explanation given for the cause of some admissions  (Table 2)

	n
Mania	63
Sunstroke	1
Measles	1
By being thrown from a trap	1
Fright and uterine derangement	1
Loss of employment	1
Abdominal tumour	1
Fright by a dog	1
Over study	1
Non-appearance of menses	1
Uterine functional derangement	1
Frightened by a cow	1
Epilepsy	86
By being put inside a recently killed pig	1
Scarlet fever	1
Worms	1
Fright of mother during pregnancy	2
Tossed by a cow	1
Imbecility	21
Cutting teeth	1
Fright at being almost drowned	1
Idiocy	54
Enlarged thyroid gland	1

 

Diagnostic categories used on admission notes (from Table #1)

Diagnosis	Age 4-10 (n=34)*	Age 11-16 (n=161)*
*70 children were given more than one diagnosis.
Epilepsy	22	64
Idiocy	20	34
Mania	3	60
Dementia	6	28
Delusions	—	4
Moral imbecility	1	1
Melancholia	1	—
Imbecility	3	18

"It is highly unlikely that asylums provided a sympathetic environment for children. Children were treated in exactly the same way as adults, with the difference that boys were kept on the female wards until they were about 7 or 8 years old. Admission procedures were identical for adults and children. The method of assessment of dangerousness is not detailed, but children as young as 4 were identified as dangerous and this is recorded in the same way as for adults."

Notes

1.  The Psychiatrist (2001) 25: 432-434 doi: 10.1192/pb.25.11.432, and located here.

2.  See also the lists of patients and their aliments and the causes of same in the New Orelans Public History website, 1882-1908.   See also: http://nutrias.org/inv/cityinsaneasylum1_50.htm 

And also, the long and reworked list of the Trans-Allegheny Insane Asylum, located here.

3. "It is not possible to equate the diagnoses of the day with recognisable contemporary diagnoses. The very high prevalence of epilepsy (Table 1) may be a real finding, indicating the high level of organic disease causing behavioural problems, or may be a misdiagnosis. Idiocy was found to be a common diagnosis for those under the age of 10, but does not necessarily indicate cognitive deficits. Idiocy was a term given to less dangerous inmates, whose cost on the public purse was less because they could contribute to the functioning of the hospital by doing jobs such as gardening or working on the farm. Some of the children diagnosed as idiots could read and write, and were thus discharged cured. The general view was that idiocy was an example of reversion to a lower type in the evolutionary scale. Another reason for diagnosing most children as idiots was the prevailing belief that insanity only occurred in those who could lose their reason. Children were considered to be born without reason, which gradually grew in them as they developed to adulthood. They could not then, by definition, be insane."

Comments

[Allan Smithee]

Wow. Epilepsy had most for admittance.