The Victorians favoured treating the insane in the large, forbidding institutions that persisted into the middle of this century. In the 1860s psychiatry was undergoing a slow change in attitude, growing from the work of Pinel who had introduced the radical notion that the insane were still people and that they deserved a much more humane treatment than they had endured at the turn of the century. As late as the 1820s the insane were exhibited like freak show attractions at Bedlam (Bethlehem Hospital, London). By the 1860s this horrific practice has died out, however humane conditions for the inmates are spreading more slowly. Some of the smaller establishments less in the spotlight of the psychiatric world are positively dragging their heels at the prospect of treating their patients with any degree of dignity or compassion.
Understanding of the causes of mental illness is very limited and as such the treatment is mostly ineffectual by today's standards. It is remarkably difficult for a patient to recover their former life after an amount of time in one of the asylums. This can be a result of being cocooned in a world so different from that outside that it becomes a terrifying prospect to leave, or from the disorder being complicated and worsened by the experience of the patient under 'care'. Drugs to treat and control mental disorders have not yet been developed and so release into the community under medication is not an option.
Treatment in the more backward establishments is horrific by today's standards, the patients often suffering prolonged periods of restraint and solitary confinement if they are noisy or violent. For those who do not quieten after such treatment, they are exposed to devices more akin to those of medieval torture than to care. These include the use of water in various methods, thought to somehow wash away the violent impulses. One is a chair in which a patient is strapped and then exposed to gallons of freezing water being poured on them for up to ten minutes, or being submerged up to the neck until the early stages of hypothermia quieten the patient. Various methods of sensory deprivation are employed to achieve the same results. In addition, a culture of abuse existed amongst those who worked in the asylums, the patients having been reduced to nothing more than cattle in their eyes.
The pervasive attitude of the time was that society should not have to endure the presence of these individuals, and so locking them away to be forgotten in the asylums was the easiest way to protect the sensibilities of the Victorians. For the family of a person that falls into madness, it is a great embarrassment, financial burden and source of social anxiety. Patients were frequently abandoned by their loved ones once it became clear that they were beyond the point that they could readily recover, and often declared dead to the outside world. For many who remarried, the former spouse, now insane and locked away from their life is a bad memory to be suppressed and unacknowledged. Amongst the general populace there is little compassion, and for those who sense that they are on the edge of what is considered normal, fear of being 'taken away' is only too real a threat.
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