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Andrew Solomon, author of ‘The Noonday Tree’, said during his Ted Talks: “the treatments we have for depression are appalling… I hope people will hear about my treatments and be appalled that anyone endured such primitive science”


For many the drugs prescribed to treat psychiatric disease either do not work, have difficult side effects or both.

With that said the current treatments of mental illness compare favorably with the atrocities of the earliest state run institutions.


Bethlem Royal Hospital, better known as Bedlam, is widely considered the oldest psychiatric hospital in Europe. It was notorious for its inhumane and at times torturous conditions.

Historians say there are records of the mentally ill being confined there from as early as 1403. In that year a charity commission visiting the hospital reported 6 male inmates suffering from “mente capti” a latin term for insanity. The same report details four pairs of manacles, 11 chains, six locks and two pairs of stocks.

The original Bedlam was built over a sewer that served both the hospital and the nearby street. This common drain was infamous for overflows of waste that filled the entrance of the hospital.

Reports by Thomas Moore confirm that for the poorest inmates, family and friends were expected to visit regularly to bring food and clothes. At the same time wealthy individuals paid a fee to wander the corridors and view the sick inmates for entertainment.

According to Andrew Scull author of ‘Madness in Civilisation’ inspections throughout the 17th Century found patients starving and chained to the walls.


The Bethlem Royal Hospital, building now home to the Imperial War Museum

The death of Hannah Mills

Hannah Mills was widowed in her 20’s, she suffered from “melancholy” a term probably describing severe depression. She was admitted to the York Asylum, a similar institute to Bedlam on 15 March 1790.

Those in charge of her care refused to let her relatives visit. At the time it was a commonly believed madness could be cured by purges like vomiting, painful blistering and sudden immersion in cold baths. She died a month later on 29 April.

Accredited to David Becker

Accredited to David Becker. “Tranquilliser Chair” Used for holding people still for prolonged periods.

Hannah was a Quaker, a christian group involved in the abolition of slavery. This led fellow Quaker William Tuke, a businessman and philanthropist, to investigate the treatment of the insane.

Horrified by what he found William educated himself on contemporary research into the the treatment of mental illness and with his son Henry he founded The York Retreat in 1796.

Together they pioneered the principles of restoring self-esteem and self-control through attention and reward. In The York Retreat physical punishment and manacles were banned although in extreme cases straitjackets were used.

Activities included walks and farm work in the large and quite grounds. Treatment included a social environment where residents were part of a family unit.

People were accepted as potentially rational beings who could recover proper social conduct through self-restraint and moral strength rather than punishment.

Samuel Tuke, Henry’s son and William’s grandson, carried on the family interest in the treatment of the insane. In 1813 he wrote about the York Retreat, a report that was used to publicise the principles of this’moral therapy’, which were considered to be the basis of the therapeutic environment there. The report also focused on the condition of  ‘madhouses’ of the time, and drew public attention to the urgent need for reform.

Featured Image: The Rake’s Progress. Accredited to William Hoggarth