In the progressive 21st century, most mental illnesses and disorders are not plagued by the social stigma that shamed patients hundreds of years ago.
In fact, the treatment of the mentally ill in the 19th century went beyond the figurative mark of disgrace that afflicted these patients, it was brutal and physical.
In the 1800s mentally unwell people in Great Britain and Ireland were manacled in outhouses, treated like wild animals, and kept in appallingly squalid conditions in madhouses or private asylums.
They were chained to the wall by an arm or leg in nothing but a blanket-gown open in the front with fastening.
They were left to lie in their own excrement, with little water and no heat, and if they had any life left in their body, they could moan and bellow but attendants would not care.
The Wightman family were discovered by the Inspector of Lunacy at the Hallcross Madhouse in Musselburgh, Midlothain in 1860, Scotland. They were considered 'in different degrees, imbecile; ineducable; irresponsible and incapable of guiding or maintaining themselves'- Inbreeding was suspected of being the cause
The Murray Royal Lunatic Asylum at Perth, Scotland was designed 'so that the meanest patient could be well fed and clothed, and those among the higher classes who could pay for it were lodged and cared for as they could be in a palace'. Pictured are female patients at the asylum dressed in clothing that made them feel comfortable 1860
Male patients at the Murray Asylum, Perth, 1860, where the aim was to provide a homely and safe environment and avoid 'any gloomy appearance of confinement'
Harrowing details of the inhumane and gruesome treatment of these patients are revealed in Lunatics, Imbeciles and Idiots: A History of Insanity in Nineteenth Century Britain & Ireland, by Kathryn Burtinshaw and Dr. John Burt.
'The derangement of their mind, either from birth or acquired through injury or illness, was a condition that should be cared for and where possible treated', they write.
However, the attention these patients were receiving was a far cry from adequate care.
Mittens were used to prevent the patient from scratching or attempt to induce vomiting, strait jackets held their arms tightly folded flat against their chest.
Small wooden closets or 'pens', confined violent patients who were subjected to a jack, leg-locks, as well as forced to wear leather masks that covered the face and fastened by leather straps in the back.
There was no running water, no circulating air, no heat – and there were cruel asylum attendants who not only ridiculed the mentally afflicted but beat and even brutally murdered them in front of other patients.
The Orphanage and Asylum for Idiot Children at Baldovan near Dundee was the first of its kind in Scotland, the second in Britain. The asylum specialized in the care of imbecile and idiot children. A child with a disability was a hardship for the working class who could scarcely afford care so they were often packed off to the poorhouse or the asylum. 'Out of sight and out of mind' was an important consideration for the working class as well as the middle and upper class families
It took more than one hundred years for philanthropic and influential people to recognize the predicament of those considered insane – which even included sufferers of congenital disorders such as Down syndrome, deaf mutes and epileptics.
They were subjected to the same primitive treatment and sent to asylums to hide them away.
The 19th century and progressive attitudes ushered in change.
'An understanding developed that these people were human beings who, through little fault of their own, had become the most vulnerable class of society in Great Britain and Ireland.
Private asylums or madhouses had existed in England for centuries before county asylums were built to resemble castles except for the watertower.
Asylum staff lived with the patients night and day under the same roof and needed to be literate as well as be able to play a musical instrument and speak a foreign language so they could be encouraging and participate in activities. Pictured is staff at Murray Asylum, Perth, Scotland, 1860
Asylum staff were expected to provide a role model of upright and decent behaviour and not deviate and use excessive force when dealing with violent patients.They put their lives at risk even on a stroll. In one case, a suicidal lunatic jumped in a lake, the nurse followed, the lunatic jumped on the nurse, stood on her to drown her. Luckily, passing youths rescued the staff member. A staff outing at Monrose Royal Asylum depicts a well-groomed but stern-faced group
Madness fascinated people and spectators paid an admission fee to visit asylums in the same way they visited zoos or the theater.
Some private madhouses were only interested in financial gain from taking large fees from the family.
There was little incentive to help patients recover because that would put an end to their financial allowance.
The insane also often received harsh treatment within their family homes where they were hidden away from public view because of the stigma of mental illness.
If there were no surviving relatives, 'half-wits' were allowed to roam freely around the countryside.
Some doctors were more interested in the nature of a patient's madness that could only be proven in post-mortem exams - so no need to keep them alive.
It was only after a visit to an asylum in 1815 by a Member of Parliament and Quaker philanthropist Edward Wakefield that the shocking truth was unearthed and a Select Committee inquiry was conducted.
It marked the shift towards reforms and new regulations to care for the mentally ill.
As part of the moral therapy program that evolved at asylums in the 19th century, patients were encouraged to work in trades they knew prior to admission. Here they are gathering potatos on the farm at the Dundee Lunatic Asylum, Dundee, U.K.
In the winter, male patients cleared the ice and curled at the Royal Edinburgh Asylum, Scotland. While the asylums encouraged sporting activities, they also had to take care that patients didn’t try to escape when out on the grounds.
With the evolution of madhouses pre-19th century to County asylums after the turn of the century, recreation and leisure activities such as dancing was considered a vital link to recovery and rehabilitation. Well-dressed patients welcomed the music and dancing pictured here at the Monrose Royal Asylum, Scotland
Some of the most heinous conditions included one woman chained to her bed for seven years and another woman in a strait jacket for ten years.
Patient bedsteads at the Glasgow Royal Asylum, had canvas bottoms and were positioned over troughs sunk in the floor which were flushed with water.
Dirty and destructive patients were left to lie naked in seclusion on the floor with no bedding other than straw and a blanket.
Patients were bathed no more often than once a week and the straw that they slept in was soaked in urine.
In one asylum in Musselburgh, six miles east of Edinburgh, Scotland, patients spent the day in their sleeping rooms. The atmosphere was contaminated due to no ventilation.
'The lower rooms are paved with bricks, impregnated with urine, and are constantly damp and offensive. There is no water on the premises; the supply for cooking and drinking is derived from a well in the street, and that for washing from the river', the authors quote from a Royal Commission Report.
'The male patients presented unmistakable signs of deficient vital power. Their skins were cold, their circulation feeble, and their flesh wasted. They were poorly clothed without flannels and drawers, and were underfed.
'Restraint is common use with handcuffs, straps and straight-waistcoats. Some patients are chained to their beds at night'.
A Fancy Dress Ball at the Brookwood Surrey Lunatic Asylum, U.K., pictured here in 1881, was held annually and encouraged the patients to dress in costume acting out their fantasies. The asylum band provided the music and everyone had to come in costume, including the medical superintendant who dressed as a Hunchback and his assistants came as a Japanese warrior and the Duke of Marlborough
As late as 1863, a thirty-four year old man called Dick Watterson, was discovered bricked up alive and alone for seventeen years on the Isle of Man, a British Crown dependency in the Irish Sea between England and Ireland.
Watterson was captive in a filthy cow-house and was 'naked save a loose sack which now and then he throws on his shivering shoulders', Manchester writer William Peacock wrote, when visiting the Isle of Man in 1863 to write a tourist guide.
'I forbear to speak of the ordure [excrement] of the place, of the countless vermin which inhabit his (otherwise fair and soft) skin, and of other even more disgusting matters'.
When an asylum was opened on the Isle five years later, Watterson was admitted.
It must have seemed like the Ritz Hotel.
Hundreds of thousands passed through the doors of Victorian lunatic asylums.
Many recovered, others were 'relieved' into the care of relatives, while still others with mental instability were incarcerated for life and eventually died within these lunatic asylums.
In 1869, John Hodgson, an attendant at the Lancaster Lunatic Asylum, along with another attendant killed a patient in their care who had only been admitted three days prior to his death. Both attendants swore they used no violence towards him but onepatient witnessed the brutal beating and was able to give testimony that convicted both men of manslaughter
The mentally ill in Ireland who did not have family to care for them, were left to wander the streets becoming destitute vagrants begging for food and shelter.
The Lunacy Commission in England and Wales kept registers from 1846 of patients in public and private asylums.
Sufferers of congenital disorders such as Down syndrome, deaf mutes and epileptics were subjected to the same primitive treatment and sent to asylums to hide them away.
In Wales in 1829, the lunatic poor were treated as no man would treat his dog.
One in 800 suffered from a form of mental health disorder attributed to hard labor and a bad diet.
Thomas Arnold, Doctor of Medicine at the University of Edinburgh as well as