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A History of Local Mental Health Provision

Three Counties Asylum the west end seen from the south-west in 1870 [Z50/2/13]
Three Counties Asylum, the west end seen from the south-west in 1870 [Z50/2/13]

On 5th July 1948 the new National Health Service began work in Bedfordshire. For the first time everyone could receive free medical care as of right. For the first time, also, both public hospitals and general practices were financed from central funds and not from locally collected rates.

Concern about the "afflicted and distressed in minde" (the phrase comes from a book of 1619 by Robert Yarrow, a man who wrote from personal experience of mental illness), extended far back into the Middle Ages. In 1246 the Hospital of Saint Mary of Bethlem was founded in London to care for the insane. This is the hospital; commonly known as "Bedlam" and until 1751 was the only public institution devoted to caring for the mentally ill. The cost of sending patients there from as far away as Bedfordshire meant that very few were sent. However John Saye was sent at the expense of Francis Nycolls of Hardwick, Northamptonshire, for a short stay from February to May 1589 [TW837].

Most pauper "idiots" or lunatics (the words were medical terms before their degeneration into insults) were looked after by their parish, like anyone else in distress such as the old, the infirm and the unemployed. Remedial care seemed to be considered unnecessary. Elizabeth Stodge, for example, when in 1793 she became "so far Disordered in her senses" that she was "Dangerous to be permitted to go Abroad" was ordered to be "safely locked up in her house at Arlesey" [P37/18/1]. No thought of her receiving expert care to help her recover!

In 1751 Saint Luke's Hospital was founded, again in London and thereafter to the end of the century a small trickle of asylums were founded in the main provincial centres such as Bristol and York. Many more patients were treated in an increasing number of privately run asylums or in private houses, often parsonages, specially licensed by the Archbishop of Canterbury.

One of the latter kind was run over three generations of the Lord family, Rectors of Drayton Parslow [Buckinghamshire]. John's mother was the daughter of Robert Crawley, a physician who had married the grand niece of Dr. John Symcotts, who was the family physician of Oliver Cromwell. They were naturally interested in medicine therefore and specialised in the care of the mentally ill. Their account book [X125/13] lists each patient that stayed at the Rectory with the bills for maintenance and sometimes some brief description of their condition.

Miss Carter arrived on 9th September 1769 "raving" and left on 13th March 1770 "well". Her 26½ week stay at 1½ guineas peer week cost her family £40/19/- [X125/13]. Only the very well off could afford such sums. Others obviously suffered from depressive states such as Nancy Foster, admitted 29th February 1773: "Melancholy in Love". She left after sixteen weeks [X125/13]. Mr. Swindall was an alcoholic. He was described as "hard drinking". Afters even weeks drying out he went away "well" [X125/13].

A number the Lords could do nothing with. Mr. Acton for example "came 29th October 1769 – had had three strokes of the palsy which took away his memory and sense – gone away incurable" [X125/13]. Others there passed on to Bedlam itself. These one suspects were the more violent ones, who required the greater security a public institution afforded. James Stapleton of Maulden was sent to Drayton Parslow by Mrs. Mary Coleman of Cranfield under the certificate of George Hicks, surgeon of Shefford on 16th March 1779. On 17th September he was taken to Bedlam at a cost of £7/12/3 [X125/13].

The Lords only had a few long term patients, the chief of these were two students of Christchurch [Dorset], who had suffered mental breakdowns and a Mrs. Mary Doddington. Mary was the daughter of an important local figure, Henry Brandreth of Houghton Regis. Her husband Samuel came from Somerset and is described as "Esquire". She arrived at the Rectory on 4th June 1767 having travelled by post chaise. She was described as "melancholy" and whatever her particular disease was, it kept her at the Rectory until her death on 23rd March 1802. She was buried at Drayton Parslow, but no tombstone has survived. The bills for her upkeep give a fascinating insight into 18th century prices, especially for clothes.

17th and 18th century people did not look upon mental illness in quite the same way as we do. "Raving madness" was clearly recognisable and restraint of the patient from doing harm to himself/herself or others was the major concern. Both raving madness and melancholia were considered to be caused by physical malfunction just like any other disease. Purges and vomiting were therefore prescribed for mental illness as well as for constipation.  Rev. John Lord copied down an extract from a treatise of Thomas Crawley: "On Madness" [X125/68]. This was again copied in the19th century by a C. Lord. The treatise appears never to have been published. In characteristic 17th century style he suggests a vomit and a smoke inhalation as sovereign remedies for madness. In advocating a purgative he was not alone. A celebrated writer Sir Theodore de Mayne wrote a book, published in 1655, entitled: Let Vomitives lead the Van which prescribed just that.

The patient was also subjected to being forced to inhale the fumes of burning Saint John's Wort. Not surprisingly, to administer this cure "it is necessary to put on a straight waistcoat, and to secure the hands or he (the patient) covers his nose to exclude the smoke". The nineteenth century copyist remarks that the "above was copyed [sic] from an old book in the handwriting of John Lord, Rector of Drayton Parslow. Judging from the number of patients stated in this Book to have been returned to their homes in a state of sound mind, the method of treatment is worthy of consideration". It was probably the kindness of the Rectors and the peace of the Rectory that were the best healers!

By 1807 there were 57 private asylums in London and elsewhere, including Mr. Burrow of Hoxton [Middlesex]. A number of Bedfordshire patients were sent there, as well as two servants of Samuel Whitbread of Southill, the famous reformer. He seems to have been well satisfied with the treatment they got there, as when private asylums came under general criticism in 1814, Whitbread went out of his way to praise Burrows' establishment. Perhaps he could have benefited from it himself: he committed suicide in 1815.

However, by 1807 it had become quite clear that something more was required to deal with the problem of caring for the mentally sick than maintaining a few large asylums in London and major provincial cities, backed up by private asylums, also mainly in London. In that year a select committee of the House of Commons met, which included Samuel Whitbread. Their recommendations were embodied in the Lunacy Act 1808. This empowered counties to build asylums out of money collected from rates. Most unfortunately this was not compulsory on counties but only permissive.

Samuel Whitbread, who fully supported the findings of the select committee, was determined that Bedfordshire should have an asylum, fitted to the best standards of the day. The act passed its third reading on 6th April 1808 and at the next Michaelmas Sessions the building of an asylum for Bedfordshire was being actively discussed. On 11th January 1809 it was resolved that a "Lunatic Asylum should be erected in and for this county sole" [QGE1]. A select committee of the magistrates was formed to superintend the building of the Asylum, headed needless to say by Samuel Whitbread. On 12th April 1809 John Wing, the architect of the Town Bridge and the Bedford Infirmary was chosen as architect of the asylum as well [QGE1]. By May 1809 the site at Ampthill Road, Bedford had been chosen. It is bounded today by the Ampthill Road, Offa Road, Mable Road and Muswell Road. Building seems to have taken place, but slowly and it was not until 8th April 1812 that the shell was completed. This was because during 1811 John Wing was busy at Colworth House, Sharnbrook, "improving" it for William Lee Antonie, friend of and fellow Member of Parliament for Bedford with Samuel Whitbread.

Bedford Asylum about 1820 [Z49-442]
Bedford Asylum about 1820 [Z49/442]

Samuel Whitbread wrote a detailed letter to the committee advising them to model the fittings of the asylum on Saint Luke's in London [QGE1]. He had also considered possible candidates for the key posts of Keeper and Matron of the Asylum. The posts eventually went to William Pether "a young man not thirty years of age, of a modest and unassuming nature" and Mary his wife. They were chosen over a man named Jackson and his wife about whom Whitbread wrote her "appearance was not exactly such as pleased me" [W1/144-146]. They received a salary of sixty guineas between them. The asylum was fit for use on 27th April 1812 and thus became the second county asylum to be opened in England, Northampton beat it by a year, opening in 1811. Bedford Asylum cost £11,798/19/9 to build [W1/166].

An inventory taken in 1834 [LB6/1] shows that restraint of the patients was still a primary if not the primary task of the asylum. In the women's gallery, locked up, were: "six new strait waistcoats, twelve old ones; twelve wrist locks; eleven pairs of Police Handcuffs". Forcible feeding bottles were used. The new women's gallery had four locks on the door. Medieval medicine still influenced medical practice even as late as this as "two bleeding pans" and "six bleeding towels" bear witness.

What sort of people worked at the asylum? Here is a settlement examination - designed to show that the subject had lived in a parish long enough to received poor relief from that parish. It dates to October 1840 and is for the asylum keeper George Franklin [PUBZ3/9/79]: "I am 32 years of age and was born in the parish of Saint Mary, Bedford. When I was 14 years of age I was removed with my father by order of removal from the Bedford Workhouse to the parish of Northill in this County, from which order I believe there was no appeal. My father has resided at Bedford ever since. At the age of seventeen I enlisted as a soldier and served in the East Indies for fourteen years. I returned a year ago from the East Indies and have lived as Keeper at the Lunatic Asylum. I now occupy a house in Gas Street, Saint Paul, at the annual rent of five pounds. I was married on Sunday last the eighteenth day of October instant at the parish Church of Saint Mary to my wife Matilda, formerly Matilda Howard of the parish of Saint Mary, Spinster".

The Manual of Duties of Ward Staff of 1851 shows a complete change of attitude to treatment from the bleeding pand and towels of 1834. Rule 3 states: "They must always bear in mind the insane are ill, and not responsible for what they say or do. That they are sent to the asylum for their cure and to be taken care of. That they are afflicted and deserve our pity and consideration". Life on the ward was still hard for the attendant – up at 5.30 in the morning, they had to wash and dress their patients; give them a bath once a week and do their nails once a fortnight (quite a problem with a difficult patient in the pre-drug age) and give them their daily exercise in the yard. They were allowed free every second Sunday after dinner, so long as they were not wanted in the Hospital. Married men were allowed home every other night but had to be back at the asylum by 6 a.m.!

The wages ranged from £23/16/- to £25 per annum for male ward attendants and £9/12/9 to £12/10/- for female attendants.

A dietary of 1857 shows that by this date patients were getting and adequate, balanced diet, including a reasonable amount of meat. Much of the vegetables would have been potatoes, but the soup also included peas, carrots and onions. Extra protein would have been got for the men from their half pint of beer and the cheese they had with their supper. Women only got those rations if they worked!

Not all counties were as progressive as Bedfordshire and Northamptonshire and in 1828 only ten out of fifty two counties had built their own asylums. By 1844 the county asylums had only risen to seventeen out of a total of one hundred and sixty six asylums of all types and the number of insane still kept in the general union workhouses outnumbered those in the asylums by a factor of two to one. Ac act of 1845 forced all counties to either build asylums or join together with other counties to provide one. Hertfordshire and Huntingdonshire decided to join Bedfordshire for this purpose in 1847. These three counties remained in union until 1948.

As a result patients at the Bedford Asylum rose dramatically from 188 at the end of 1846 to a peak of 313 at the end of 1848. Major extensions were put in hand immediately. Dayrooms, washing and drying rooms were added [LBP3]. A further extension was completed by Thomas Smith of Hertford in 1850. Further extensions were mooted in 1852 but on the advice of Mr. Hill, Superintendent of the North and East Ridings of Yorkshire Asylum, it was decided to abandon the old site and build a new hospital doe six hundred patients. The architect for the new hospital was George Fowler Jones of Sar Hill, York, who was evidently recommended by Hill. In 1858 the site was bought on the boundaries of Stotfold and Arlesey, being conveniently close to the Great Northern Railway with its connections to all three of the counties in union [X67/671]. By the 19th March 1860 the new Three Counties Asylum, later called Fairfield Hospital, was built. The original estimate was £70,000. The attitude of the patients to the move is captured in the chaplain's book [LB7/8]: "A party of ten patients were taken this week to view the New Asylum at Arlesey. They were highly delighted and have told me their opinion of the Chapel and the new arrangements. Some seem to think it will be a most complete and cheerful residence. One woman said that she thought the effect upon the patients would be most salutary; another said it would be very dull, there would be no society for it was a long way from any Town".

Three Counties Asylum central section seen from the north in 1872 [Z50/2/15]
Three Counties Asylum central section seen from the north in 1872 [Z50/2/15]

During April 1860, 308 patients were transferred from the Bedford Asylum to Arlesey by railway and on 18th June 1860 the asylum was formally opened. The redundant site at Ampthill Road was sold off for building land and the asylum pulled down. From 1860 to 1998 the Three Counties Asylum, or Fairfield Hospital, was the main mental hospital for the area. Their magnificent run of records is held by Bedfordshire and Luton Archives and Records Service enabling in-depth studies of many aspects of the institution [LF].

To supplement the Three Counties in 1930 Northamptonshire joined with Bedfordshire to run the Bromham House Colony for "mentally defective" adults and children, thus filling an important gap in local mental health care. This institution closed in 1997. From the 1930s also clinics in local towns were run by the ThreeCountiesHospital to help those patients suffering from mental illness who were not sufficiently ill to be hospitalised.