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28 April 2009
It's still a taboo subject to many people, but mental illness, and the treatment of it, is a big part of Southwark's history. For over 100 years Southwark was home to Bethlem Hospital - an asylum that was famous for its methods of caring for the mentally ill, writes Dejla Kadhim...
Bethlem Hospital was first founded as "The Priory of St Mary of Bethlehem" in Bishopsgate on 12 October, 1247, by Simon FitzMary. It was set up as a daughter house of the "Church of St Mary of Bethlehem" in Palestine as a way of linking it with the Holy Land. It also provided a base in England for the Bethlehemite Order.
An enquiry into the hospital in 1403 first recorded it as having six insane male patients. It was from this point that the hospital had a reputation of looking after the mentally ill. However, at that time looking after mentally ill patients usually meant leaving them in dark rooms, chained to the walls or floors and when they became violent they were whipped or ducked in water. Ironically, this almost certainly would've done more damage than good and prevented patients from recovering. The hospital became known as "Bedlam" to represent a place of uproar and confusion.
In 1547 King Henry VIII granted that the order and government of the hospital be given to the City of London, on the condition that some of the revenue would be used on new buildings. This change also led to a change in name and it became known as the "Bethlem Royal Hospital".
Over 100 years had passed and the hospital had become neglected and filthy. This eventually led to the hospital moving to a new building in Moorfields in 1676 and was known as the "new Bethlem". It was at this building that visitors had to pay a fee to enter the hospital. People who were not related to any of the patients paid the fee in order to see the patients for their own amusement. This was stopped in 1770 because it did not help the patients' recovery.
During his time visiting hospitals and asylums John Howard, a prison reformer, visited Bethlem and gave it a bleak report. He found many structural problems including leaking roofs and lack of water supplies on the top floor. After a year's investigation, a surveyor, Henry Holland, gave the hospital's governors a fourteen-page report listing a long and expensive list of repairs that were necessary for the building.
The governors were increasingly alarmed by the large costs, so only some repairs were made, but it was not enough. In 1800 James Lewis, a surveyor and architect said: "The present building is not formed of convenience and a proper connection of all its parts, for the business to be done in the readiest manner… it is incurable". The Governors decided that the Bethlem Royal Hospital should move into a new building. In August 1815 the Bethlem moved to it's new location in St George's Fields in Southwark - now home to the Imperial War Museum.
The building opened for 200 patients and had similar designs to the building in Moorfields. However, changes in St George's Fields included a larger number of wards with fewer patients in each, offices, committee rooms, a room where patients could see their visitors and residences for some officers.
It cost over £122,000. In this building patients were split into three groups. The "furious and mischievous and those who have no regard to cleanliness" were placed in the basement. Ordinary patients were placed on the first floor. The second floor was for patients "who are most advanced towards recovery". The remaining galleries were used for incurables - ordinary ones were upstairs and the violent and dirty ones were in the basement.
The building also had the new State Criminal Lunatic Asylum, which was paid for by the government and controlled by the Home Office.
The Asylum stayed in the St George's Field building from 1816 until 1864, when a new institution in Broadmoor in Berkshire replaced it. One of its patients included James Hadfield, who had tried to kill King George III in 1800. He was a patient in the Asylum from 1816 until he died in 1841. He was known for having pet animals and birds in his cell, including cats, dogs and a squirrel. When his squirrel died he wrote several poems about its death, which he later sold to visitors.
The artist Richard Dadd was also a patient in the Asylum from 1844, aged 27, after he killed his father, believing he was the devil in disguise. He left Bethlem in 1864, when he transferred to Broadmoor until his death in 1886. Throughout his 42 years as a patient he continued to paint and draw.
In the early 1900s the Southwark location of Bethlem was seen as unsuitable for it's patients. Southwark was becoming overcrowded and increased transport problems. The building of an extension of the underground, which is now the Bakerloo tube line, between Elephant and Castle and Lambeth North kept patients awake due to the sound of the drilling. When trains went through the tunnels the hospital wards felt like "miniature earthquakes". Educated middle class patients staying at Bethlem needed somewhere modern in appearance, in a quiet location, with satisfactory sanitary arrangements and St George's Field no longer had these. In 1930 Bethlem moved to a former country house estate in Monks Orchard, in Beckenham, Kent.
One of the criticisms Bethlem received was that it was unable to care for early and acute cases of mental illness. In 1907 Dr Henry Maudsley gave £30,000 to the London County Council for the set up of a hospital that would be able to do this. The Maudsley Hospital was set up on 1915 in Denmark Hill and was first used for the military. In 1923 it opened as a LCC hospital for mental illness.
In 1924 both the Bethlem and Maudsley hospitals became medical schools of the University of London, creating further competition between them. However, after the introduction of the NHS in 1948, both hospitals were merged to form a single postgraduate psychiatric teaching hospital.
In 1994 the Bethlem and Maudsley NHS Trust was established. But after only five years in April 1999 the Trust changed again. After the merging of the Bethlem and Maudsley NHS Trust, Lewisham and Guy's Mental Health NHS Trust and mental health services of Lambeth Healthcare NHS Trust, the South London and Maudsley NHS Trust was established. The Trust has a high reputation around the world for its quality of teaching and treatment of mental illness, ensuring excellent care for patients, with the best possible outcomes.
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