Introduction

This chapter aims to provide the essential background against which the scandals that took place in mental health institutions during the 1960s and 1970s can be understood and assessed. As Chapter One suggested, scandals are the product of culturally and historically specific reactions to particular events. Such events are themselves shaped by the social policy context within which services are provided in any era. This chapter will end by identifying the key currents running in the social welfare world that produced the first major institutional scandal of modern times – that at Ely Hospital in Cardiff. In order to understand these events, however, the roots of mental health policy over a longer period need to be identified and discussed.

More, perhaps, than in any other branch of social welfare, a social constructionist understanding is capable of yielding rich insights when applied to changing understanding of madness. Jones (1996, pp 126-7) suggests that for nearly three hundred years after the closure of the monasteries in the English Reformation, attitudes towards mad people were characterised by harshness:

Foucault, in particular, has been highly influential in suggesting that, throughout Europe, the 18th and 19th centuries were characterised by a great confinement in which mad people were rounded up into asylums or prisons. The evidence for such a development in 18thcentury Britain has been contested but it does seem clear that, even during an era of undiluted laissez-fairism, growth took place in the provision of private madhouses, catering for the better off in society. Confinement of poor people who were mad was still likely to be within pauper workhouses. The reputation, and the operation, of private madhouses was highly variable but even at the more humane institutions treatment was predicated on what Jones (1996, p 127) describes as “the assumption that the mad were sub human and punishable”.