Skip to main content Accessibility help
Hostname: page-component-684899dbb8-662rr Total loading time: 0.491 Render date: 2022-05-29T06:56:41.458Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904

Published online by Cambridge University Press:  15 January 2020

Joseph Rehling
School of Health and Social Care, University of Essex, Wivenhoe Park, Colchester, EssexCO4 3SQ, UK
Joanna Moncrieff*
Division of Psychiatry, University College London, Gower Street, LondonWC1E 6BT, UK
Author for correspondence: Joanna Moncrieff, E-mail:



Contrasting historical views represent the asylum as a manifestation of humanitarian and therapeutic progress or as an institution of social control designed to bolster the capitalist economic order. More extreme critics suggest it was used to incarcerate people exhibiting only political or social deviance.


Case notes of 200 consecutive male and female admissions to the Essex County Asylum in 1904 were inspected. The nature of presentations was classified in contemporary terms into broad categories of disorder. Outcomes were identified and differences between men and women were explored.


We found no evidence that patients were admitted without signs of significant mental and behavioural disturbance. In total, 44% of admissions had signs of an organic condition, and these were more frequent among men. Women were admitted at a faster rate and were 1.6 times more likely to have mania or a psychotic disorder. Overall, 45.5% of patients were discharged, with 62% of patients with non-organic disorders discharged recovered or improved.


Evidence partially supports both views of the asylum. In line with other studies, there is no evidence that the asylum was used to incarcerate people who did not show significant signs of disorder, but it did provide care and containment for those who could not be accommodated elsewhere, including many with organic conditions. The asylum also had a therapeutic orientation, however, and encouraged discharge where possible. In contrast to some other studies, women were more likely to be institutionalised than men, possibly reflecting their greater economic dependency.

Original Article
Copyright © Cambridge University Press 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Anderson, K. K., Fuhrer, R., Abrahamowicz, M., & Malla, A. K. (2012). The incidence of first-episode schizophrenia-spectrum psychosis in adolescents and young adults in Montreal: An estimate from an administrative claims database. Canadian Journal of Psychiatry, 57(10), 626633.CrossRefGoogle Scholar
Appelquist, M., Bradvik, L., Ottosson, I., & Asberg, M. (2019). As good as it gets: An empirical study on mentally-ill patients and their stay at a general hospital in Sweden, 1896–1905. History of Psychiatry, 30(2), 205226.CrossRefGoogle Scholar
Bartlett, P. (1998). The asylum, the workhouse, and the voice of the insane poor in nineteenth century England. International Journal of Law and Psychiatry, 21(4), 421432.CrossRefGoogle Scholar
Busfield, J. (1994). The female malady? Men, women and madness in 19th century Britain. Sociology, 28, 259277.CrossRefGoogle Scholar
Bynum, W. F. (1974). Rationales for therapy in British psychiatry: 1780–1835. Medical History, 18(4), 317334.CrossRefGoogle ScholarPubMed
Chesler, P. (2005). Women and madness. London: Palgrave Macmillan.Google Scholar
Cohen, B. M. Z. (2016). Psychiatric hegemony: A Marxist theory of mental illness. London: Palgrave Macmillan.CrossRefGoogle Scholar
Diflorio, A., & Jones, I. (2010). Is sex important? Gender differences in bipolar disorder. International Review of Psychiatry, 22(5), 437452.CrossRefGoogle ScholarPubMed
Doody, G. A., Beveridge, A., & Johnstone, E. C. (1996). Poor and mad: A study of patients admitted to the Fife and Kinross District Asylum between 1874 and 1899. Psychological Medicine, 26(5), 887897.CrossRefGoogle ScholarPubMed
Eloise, M. (2017). Why women were put in asylums in the 19th century. Dazed, 24th March 2017. Retrieved August 22, 2019, from Scholar
Foucault, M. (1988). Madness and civilization: A history of insanity in the Age of reason, trans. Howard, R.. New York: Random House. Originally published in 1961 as Histoire de la folie à l’âge classique.Google Scholar
Gibson-Brydon, T. R. (2016). The moral mapping of Victorian and Edwardian London: Charles Booth, Christian charity, and the poor-but-respectable. Montreal: McGill-Queen's Press-MQUP.Google Scholar
Harris, M., Chandran, S., Chakraborty, N., & Healy, D. (2005). The impact of mood stabilizers on bipolar disorder: The 1890s and 1990s compared. History of Psychiatry, 16, 423434.CrossRefGoogle ScholarPubMed
Healy, D., Harris, M., Michael, P., Cattell, D., Savage, M., Chalasani, P., & Hirst, D. (2005). Service utilization in 1896 and 1996: Morbidity and mortality data from North Wales. History of Psychiatry, 16(1), 2741.CrossRefGoogle ScholarPubMed
Hegarty, J. D., Baldessarini, R. J., Tohen, M., Waternaux, C., & Oepen, G. (1994). One hundred years of schizophrenia: A meta-analysis of the outcome literature. American Journal of Psychiatry, 151(10), 14091416.Google ScholarPubMed
Hollander, B. (1905). The asylum treatment of insane. The Monthly Review, 21(62), 115122.Google Scholar
House Committee. (1901–1904). Essex County Lunatic Asylum House Committee Minute Book Number 16 (it was accessed in the National Records Office Kew, London).Google Scholar
Jones, K. (1993). Asylums and after: A revised history of the mental health services: From the early 18th century to the 1990s. London: Athlone Press.Google Scholar
Kendler, K. S. (2018). The genealogy of the clinical syndrome of mania: Signs and symptoms described in psychiatric textbooks from 1880 to 1900. Psychological Medicine, 48, 15731591.CrossRefGoogle ScholarPubMed
Melling, J., & Forsythe, B. (2006). The politics of madness: The state, insanity and society in England, 1845–1914. London: Routledge.CrossRefGoogle Scholar
Moncrieff, J. (2008). The creation of the concept of the antidepressant: An historical analysis. Social Science and Medicine, 66, 23462355.CrossRefGoogle ScholarPubMed
Nightingale, G. S. (1953). Warley Hospital, Brentwood. The first hundred years 1853–1953. Unpublished manuscript accessed at Essex Record Office, Chelmsford, Essex, UK.Google Scholar
Porter, R. (1987). A social history of madness. London: Weidenfeld and Nicolson.Google Scholar
Pouba, K. T., & Tianen, A. (2006). Lunacy in the 19th century: Women's admission to asylums in United States of America. Oshkosh Scholar, 1, 95103.Google Scholar
Priebe, S., Badesconyi, A., Fioritti, A., Hansson, L., Kilian, R., Torres-Gonzales, F., … Wiersma, D. (2005). Reinstitutionalisation in mental health care: Comparison of data on service provision from six European countries. British Medical Journal, 330(7483), 123126.CrossRefGoogle ScholarPubMed
Renvoize, E. B., & Beveridge, A. W. (1989). Mental illness and the late Victorians: A study of patients admitted to three asylums in York, 1880–1884. Psychological Medicine, 19(1), 1928.CrossRefGoogle Scholar
Rollin, H. R. (2003). Psychiatry in Britain one hundred years ago. The British Journal of Psychiatry, 183(4), 292298.CrossRefGoogle ScholarPubMed
Russell, D. (1995). Women, madness and medicine. Oxford: Polity Press.Google Scholar
Schmidt, M., Wlhelmy, S., & Gross, D. (2019). Retrospective diagnosis of mental illness: past and present. Lancet Psychiatry, published online 19th August 2019. doi: Retrieved November 15, 2019, from Scholar
Scull, A. (1977). Madness and segregative control: The rise of the insane asylum. Social Problems, 24(3), 337351.CrossRefGoogle ScholarPubMed
Scull, A. (1993). The most solitary of afflictions: Madness and society in Britain 1700–1900. London: Yale University Press.Google Scholar
Shorter, E. (1997). A history of psychiatry: From the Era of the asylum to the Age of Prozac. New York: John Wiley & Sons.Google Scholar
Showalter, E. (1985). The female malady: Women, madness and English culture, 1830–1980. London: Random House.Google Scholar
The Commissioners in Lunacy (1894). Inspection report. Available in House Committee Minute Book of Essex County Lunatic Asylum, number 13 (accessed in the Essex record Office).Google Scholar
The Commissioners in Lunacy (1901). Lunacy in England and Wales. The British Medical Journal, 2(2125), 816817.CrossRefGoogle Scholar
Turner, T. H. (1992). A diagnostic analysis of the Casebooks of Ticehurst House Asylum, 1845–1890. Psychological Medicine Monograph Supplement, 21, 170.CrossRefGoogle Scholar
University of Cambridge. (2019). Populations past – atlas of Victorian and Edwardian population. Retrieved August 22, 2019, from Scholar
Wiersma, D., Wanderling, J., Dragomirecka, E., Ganev, K., Harrison, G., An Der Heiden, W., … Walsh, D. (2000). Social disability in schizophrenia: Its development and prediction over 15 years in incidence cohorts in six European centres. Psychological Medicine, 30(5), 11551167.CrossRefGoogle ScholarPubMed
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904
Available formats

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904
Available formats

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

The functions of an asylum: an analysis of male and female admissions to Essex County Asylum in 1904
Available formats

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *