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The ‘Open-Door System’: Innovation and Controversy

Published online by Cambridge University Press:  02 January 2018

William Parry-Jones
William Parry-Jones*
Affiliation:
Warneford Hospital, Oxford
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During the third quarter of the 19th century it became clear that the problem of pauper lunacy was not being contained by the county asylums. Despite much new building, accommodation in asylums was over-crowded; the patient population had become increasingly heterogeneous and therapeutic optimism was waning. The proportion of curable patients in county asylums declined steadily—for example, from 1844 to 1870 the proportion fell from 15 per cent to 7 per cent. The prospect of large-scale institutional confinement, however, did not go unnoticed and alarm was expressed by many contemporary writers. J. T. Arlidge, formerly of St Luke's Hospital, for example, observed that: ‘Many asylums have grown to such a magnitude, that their general management is unwieldy, and their due medical and moral care and supervision an impossibility … in a colossal refuge for the insane, a patient may be said to lose his individuality, and to become a member of a machine … In all cases admitting of recovery, or a material amelioration, a gigantic asylum is a gigantic evil, and, figuratively speaking, a manufactory of chronic insanity.’

Type
Psychiatry in the 1880s
Information
Bulletin of the Royal College of Psychiatrists , Volume 8 , Issue 11 , November 1984 , pp. 208 - 209
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1984

References

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