The 1845 County Asylums Act made it mandatory for every county in England and Wales to build at least one asylum large enough to contain its “pauper lunatics”—the official term used for those too poor to afford private care.
Soon after, over 130 immense buildings appeared across Britain, housing between 350 and 3,500 patients each. As their gothic towers loomed from secluded hilltops, the terrifying notion of the lunatic asylum lodged itself in the public imagination forever.
While they deserve their reputation for the very real horrors inflicted on tens of thousands of patients, either through direct abuse or the many horrific and ultimately discredited “cures” used in asylums at one time or another , this list attempts to show that not everything about them was negative. It will also reveal how rumor, imagination, and popular fiction still stoke misconceptions that make their legend appear even darker.
10 Committal
While many believe that an “inconvenient” family member or spurned lover could be locked up in an asylum almost on a whim, this was not the case, by Victorian times at least.
The County Asylums Act saw standardized regulations applied to all buildings housing patients. All were regularly inspected by the Lunacy Commissioners to check adherence to the legislation and minimum standards of food, exercise, entertainment, etc. However, inspections were made without notice and not considered complete until they had seen or accounted for every single patient in the case files.
The asylums were always overcrowded, and those who ran the building understood overcrowding was bad for the “recovery rates” they would have to publicize each year. As a result, those who paid for the asylums and those inspecting them were not keen to allow people to be taken in and be clothed, fed, and managed purely because some family member had dumped them at their door, claiming they were insane.[1]
9 Padded Cells
Little evokes the horror of the asylum quite like the padded cell. Popular fiction and film, in particular, present them as the ultimate embodiment of a human life discarded and left to suffer in terrifyingly absolute isolation. However, they were created as a solution to a far worse problem.
“Mechanical restraints” have been used to prevent patients from harming themselves or others since the earliest days of the asylums. Manacles held hands and feet together, and brutal strait jackets, leather harnesses, or chains bound patients to chairs or beds. Eventually, pioneering superintendents such as Dr. Robert Gardiner-Hill and Dr. John Connolly rejected the medical thinking of their day and began reducing their use, having padded cells fitted instead.
Although open to abuse or misuse, they served the same function but with far less risk to patients and staff—both often injured as patients were wrestled into awkward mechanical restraints in the past. The padded cells were introduced because they were believed to be safer, more dignified, and generally more humane than what preceded them.[2]
8 Alcohol
Alcohol may not seem an obvious substance to introduce into a lunatic asylum, but all would have kept “medicinal” spirits such as brandy in locked cupboards. And up until the 1880s, many even had their own breweries. For example, at Bedlam, the corridors contained pipes with taps on them, and each attendant working there had a special key so they could pour themselves a glass whenever they wished.
Beer was viewed differently in the past and seen as a food supplement and a way of providing something safe to drink when clean water was harder to come by. Generally speaking, it would be a weak ale at only 2-3% alcohol and served with meals, so it wasn’t intended to get anyone tipsy. Male patients who worked on the asylums’ farms were often given a pint of beer with their evening meal. It was phased out in the 1880s as asylums began increasingly treating mental health problems believed to have been caused or exacerbated by alcohol.[3]
7 Pregnancy
Perhaps the most commonly-repeated story regarding committal to an asylum is that of the young girl or unmarried woman who finds herself there due to pregnancy. As noted in the first entry, by the 1840s, all asylums were subject to scrutiny by the Lunacy Commissioners, and reasons for admittance had to be documented and justifiable.
Pregnancy outside marriage was certainly a taboo topic in Victorian society. Still, the workhouses, orphanages, and the Poor Law schools were set up to cater to people in such a position. Birth outside wedlock was not a category for certification as a lunatic. Doing so would have required the collusion of a doctor, a judge, the committee, and the staff at the asylum.
However, pregnancy was listed as a potential cause of madness, so in combination with the thinking of the time (and based on many unconfirmed testimonies), prejudiced doctors may have assumed that any girl or woman must surely be mad to have become pregnant before marriage. Those with money may indeed have been able to pull a few strings and grease a few palms to have a “shameful” family secret quietly disposed of in a private asylum.[4]
6 Secret Tunnels
Many county asylums are said to have had “secret” tunnels running underneath them, built to provide a hidden entrance away from public view. At London’s Colney Hatch Asylum, for example, a tunnel ran between the railway station and the asylum, rumored to have been used to bring in members of the royal family, politicians, or other VIPs in secret if they had some sort of mental breakdown.
In truth, all would have been built for more disappointingly mundane reasons, such as bringing in or moving around supplies that needed to be kept dry. Also, county asylums were designed for paupers, and anyone well-off enough to need to be hidden from the public would have sought more discreet private treatment elsewhere.[5]
5 Broadmoor
Broadmoor is often referred to as a “prison” due to the horrific acts committed by many who have resided there over the decades. However, although it has gone by various names over the years, it has always been a high-security psychiatric institution and never a prison.
Opening in 1863 as “Broadmoor Criminal Lunatic Asylum,” it took all of the criminal lunatic patients formerly housed at Bedlam in central London. The M’Naghten trial of 1843 eventually led to laws that essentially meant a person could be either a criminal (responsible for their actions) or a lunatic (unable at the time of the offense to fully understand or control their actions) but not both at once. So the “criminal” component of the name was later dropped. Strangely, Britain’s second such institution opened as “Rampton Criminal Lunatic Asylum” decades later in 1912, giving more insight into how unclear legislation relating to crime and insanity has traditionally been.
Broadmoor has housed many of Britain’s most notorious law-breakers, including the “Moors murderer” Ian Brady, the “Yorkshire Ripper” Peter Sutcliffe, and two patients incidentally both portrayed on film by the actor Tom Hardy. These include London gangster Ronnie Kray in Legend (2015), and Charles Bronson, dubbed “the most violent prisoner in Britain,” in Bronson (2008).[6]
4 Labor
The county asylums were planned to be as self-sufficient as possible, producing most of their own food, completing their own laundry, providing most of their own services and amenities, and making or repairing the buildings themselves and the clothing patients wore. It is often assumed this was “forced labor,” tantamount to slavery, but although it was certainly strongly encouraged, forcing the patients to work was not legal.
Men tended to be allocated to work on the grounds and landscaping, farms, and occupations such as woodworking, boot and shoe-making, painting and decorating, etc. In keeping with the notions of the time, women were usually given domestic roles such as needlework and hair-picking (for mattresses), along with work in the laundries and kitchens.
While some patients saw it as a chore, rewards of extra food, alcohol, tobacco, or even money were usually offered as incentives, and some patients enjoyed their roles. Patients even participated in building parts of the asylum, including some beautiful chapels constructed with completely willing patient labor.
While their massive in-situ workforce conveniently kept running costs down, it was also genuinely seen as beneficial to the patients, as idleness was viewed as being detrimental to both their recovery and general well-being.[7]
3 Cells
Film and other media favor images of patients perpetually locked up in dark, dank cells unless being dragged off for some arcane medical experiment or torturous therapy.
By Victorian times, most patients slept in dormitories with as many as fifty other patients. Some were given individual cells, usually because they could not be trusted during the night. But in the daytime, all patients were moved into the day-rooms, verandahs, courtyards or gardens, or out to work.
It was not permitted to keep patients locked in cells for extended periods without documenting exactly how long they had been kept there and for what reasons. Since an attendant or nurse had to be constantly posted outside any cell where a patient was kept during the day, it was not something the asylum’s management wanted to do any more than they (rightly or wrongly) believed they had to.[8]
2 Clock Towers
The clocktower is another pervading and often chilling image of the Victorian lunatic asylum. These ornate but austere Gothic constructions, some as tall as 140 feet (42 meters), appear to survey the surrounding landscape, inevitably stoking speculation about exactly what unseen horrors might exist beneath them.
Most were actually water towers, with the clock added as a convenient secondary function. Water towers drew from deep wells, and some had filtration to provide cleaner water, but the main reason they were introduced to most asylums from the 1860s onward was to fight fires. In the days before motorized fire engines, and bearing in mind most asylums were located some distance from towns and cities, the tower had to be tall enough so that an attached hose would offer enough pressure to project a jet of water up to the highest floors of the building.[9]
1 Patients
Even without considering what any given patient may have suffered due to their particular mental illness, it is almost universally accepted that no patient would ever want to be locked in an asylum. Who would?
However, there are many reports spread throughout history (going back as far as Bedlam in the 17th century) of patients who begged not to be discharged or to be allowed to return. While institutionalization sometimes played a role here (the person had been in some institution so long, it becomes unthinkable to live outside it), the appalling conditions for the poor outside the asylum from Medieval times until even as late as the 1970s in some cases are also telling.
For all its restrictions and regimens, the asylum offered three square meals a day, a clean bed and clothing, and many luxuries we would now take for granted, such as indoor toilets, bathing facilities, lighting, and central heating. Some patients even left the asylums cured and went on to lead happy and fulfilling lives because of or despite their time there.
Two other things many former patients also expressed their appreciation for were the beautiful grounds in which they could escape the trappings and pressures of daily life. And perhaps above all else, a community of people who understood them and were therefore far less judgemental than many of those outside, something often so lacking to those suffering from mental health problems today.[10]