600 years of psychiatric hospital records – psychiatry in history

Valencia's Asylum is unique in the history of psychiatry. Founded in 1410, it was, as far as we know, the first asylum in the Western world built for the care of the mentally ill. Other hospitals did accept patients with mental health problems, but Valencia's Asylum is distinct in that it was created precisely for such patients. Moreover, the archival sources remain intact, which is quite unusual given what happened in the Spanish Civil War (1936–1939). This fact has allowed various scholars to study the history of Valencia's Asylum exhaustively.

In Fig. 1, from a volume that compiled the most important studies on the subject some years ago,¹ we can see the evolution of the total number of inmates, the number of men and women, and the population of the city of Valencia and the Old Kingdom of Valencia, which correspond to the current Valencian Community. The number of inmates is very strongly correlated with the population of Valencia, but the correlation is even stronger with the population of the Valencian Community. This is logical if we consider that the asylum received patients from all over the world, but especially from the Kingdom of Valencia.

Fig. 1 Numbers of inmates in Valencia's Asylum over almost 600 years.¹

These data represent the number of mentally ill people with a serious illness, taking into account that not all were admitted to hospital but could remain at home, in prisons or in hospice facilities for the elderly and others of scarce resources.