Bedlam: London and Its Mad

[Hazel]

Catharine Arnold charts the birth and death of the infamous asylum for the mad of London; its pauper, middle class and aristocrats. As well as a history of the asylum architecturally through its four guises, Arnold also provides many case studies of the lives, often very brief, of those who entered its wall and some never left.

This isn't an academic reading of Bethlem Hospital, it is very much a chatty, anecdotal narrative, with Arnold occasionally providing her own "I" opinions and asides. This all makes it a very easy, and enjoyable read, and she does appear to have done a lot of research which she slips into her narrative without making things to heavy or turgid.

Most interesting was the section devoted to King George III - the infamous mad King. It is fascinating to read how contemporary, warring doctors diagnosed, misdiagnosed, treated and maltreated the King. As a slight history of mental illness and its treatment alone, this book is worth the read.

I read this primarily because I like 19th C fiction, and I wanted a better idea of the madhouses and theories of psychiatry around this time. I can say that Arnold has broadened my 'experience' of such places and added to my readings. So, any fans of 19th C fiction should have a read of this neat book, and I guarantee you will find it useful.

[Squirls]

This sounds like a slightly voyeuristic, but none the less fascinating read.

It's interesting isn't it how incredibly barbaric the treatment of mental illness in the past seemed to be, however I do wonder how people in the future will view the treatment mental illness today.

Whilst we no longer chain people to beds I can't help wondering whether some of today's treatments amount to nothing more than chemical chains. We often hear tales in the press about the efficacy of SSRIs and the safety of Ritalin for the treatment of ADHD. It was also a surprise to me that there are still people who have been sectioned in this country who undergo electro convulsive therapy without informed consent - and how does anyone give informed consent to a form of therapy which isn't fully understood?

I'm not suggesting that modern mental health services are totally crap - there have clearly been tremendous strides forward with much more reliance on evidence based practise. However, I can't help feeling we've still a heck of a long way to go.

[Lady Lazarus]

Whilst we no longer chain people to beds

We don't physically chain them to the beds, but it seems to be done with medication, as many psychiatric patients are on heavy sedatives such that they are zombie-like...

It was also a surprise to me that there are still people who have been sectioned in this country who undergo electro convulsive therapy without informed consent - and how does anyone give informed consent to a form of therapy which isn't fully understood?

Well, my take on it is that if someone has severe psychosis, where they are totally out of touch with the real world, then they are not able to give true informed consent about going into hospital for treatment, as they have little or no insight into their condition. I too am still shocked about the use of ECT, but presumably there is research to back it up, otherwise they would not be able to use it in the NHS (which they definitely still do).

The book looks fascinating, Hazel, thanks for the recommendation.

[Hazel]

This sounds like a slightly voyeuristic, but none the less fascinating read.It is slighty voyeuristic and at times I felt a little like the visitors to the asylum touring the depravation and laughing at the inmates predicaments. But, the book is less on the sensational aspects and more on the reforms, the good doctors who tried to be different and as a history of how mental illness has been dealt with throughout the centuries.

My sister is a psychiatrist and from what she tells me, things are very, very different - I am not at all sure that it is quite as draconian as you suggest, Squirls, still. But yes, I am sure that there are still some dubious methods. Arnold is clearly disapproving of Care in the Community.

[Squirls]

I've been inside a couple of hospitals for the mentally ill, both in a professional & personal capacity, (to visit a friend). I don't think they're draconian places at all. I just feel that we've a long way to go to understand psychatric illness and I suspect future generations will at the very least, raise their eyebrows at treatments given today.

I'm not an expert in ECT, but the Wikipeadia (http://en.wikipedia.org/wiki/Electroconvulsive_therapy)site appears to give a very balanced write up on the subject if you're interested, with both the pros and cons of ECT. I found some of the quotes by those opposed to this form of therapy quite haunting.

[angel]

Thanks for sharing about this book, Hazel – I must get it.

I recently went down to Bethlem for a meeting. I spent the whole day there and I am pleased to say that all the places I visited had a lovely atmosphere. The grounds (not the original site) are quite beautiful and give a peaceful setting that pervades. I can only vouch for the clients I met, of course (adolescents) – and on that one day – but they were well cared for and the mood was positive.

Interestingly, in one room where we met, there were ‘before’ and ‘after’ portraits of earlier clients. The admission pictures showed dishevelled, unwashed men and women, with desperate expressions and haunted eyes: in the discharge pictures they were groomed, starched, demure citizens. These were fascinating historical pieces, and all the people shown had died long ago, but they did give a slight feeling of voyeurism, as you mentioned with regard to the book. I’m glad we don’t subject people to that particular indignity now – most people don’t really want a photograph of when they reach rock bottom.

I believe there’s a small museum at Bethlem-Maudsley, but I haven’t seen it.