Case notes for the Norfolk Lunatic Asylum show that the admission of a significant number of female patients in 1845-1870, was due to women’s mental health after childbirth. The notes suggest that their physical condition was frail and the physical demands of parturition and lactation further drained their strength, already weakened by hard labour and malnourishment.
Harriet D, a patient on five occasions, was first admitted when she was 25 years old in March 1858. She returned in 1859 following childbirth when ‘the attack was brought about by puerperal causes’ and was sent home recovered after eight months (NRO, SAH 262). Five years elapsed before her next admission which was brief, just two months in the asylum before being discharged recovered, followed by another three years of mental health before admission in May 1867 with the cause listed as poverty. On this occasion she remained in the asylum five years before discharge and her final admission was in September 1873, 16 months after her last discharge when it was stated she was the mother of seven children, the youngest 12 weeks old; her weight was 7 st 10 lbs, and she was ‘badly nourished’. Immediately on admission her health improved: ‘She works very well in the laundry and is very useful. Is essentially being cheerful, rational, contented and no trouble whatever. Under ordinary circumstances she would therefore be discharged, but as she invariably relapses when sent out,…. she will at all events be kept on here for the present.’. (NRO, SAH 265)
Another woman admitted with the cause of insanity stated as ‘accouchement’, i.e. the act of giving birth, was Lydia D. On admission Lydia D was ‘exceedingly thin and weak being unable to stand’. She was discharged recovered after nine months, having received regular meals, a consistent pattern of rest, and encouragement to participate in the daily routine of the asylum, which for Lydia included work in the laundry.
There was an additional factor in Lydia’s illness: ‘she is very bitter towards her husband who has ill-treated her and is much addicted to drink, she frets much about him’ and when he visited her two months after her admission ‘he threatened to go to London and put his children in the workhouse if she did not come out of the asylum’, causing Lydia to suffer a relapse. (NRO, SAH 264).
Jane F’s husband was identified as a contributory cause in her admission after the birth of her third child when she was aged 21. She had ‘a very bad husband and she has no desire to return home where she is badly treated by him and is nearly starved.’ Fortunately for Jane, her father ‘came forward and offered her a comfortable home and she was therefore discharged recovered.’ (NRO, SAH 262).
It was not only the women admitted with post-natal conditions who made startling recoveries; many patients with diverse causes of insanity also responded positively to the combination of sufficient food, regular exercise and adequate rest; medication was rarely given, because there had been little developed for mental illness at this time.
Very few patients were admitted with poverty as the given cause of insanity, but many implications of poverty were cited such as ‘reduced circumstances’, ‘reverses’, ‘pecuniary problems’, ‘want’ and so on. Norfolk suffered a decline in craft employment in the mid-Victorian era and agriculture became the predominant means of making a living, despite offering poor wages and poor housing conditions.[i] As patients at the Norfolk Lunatic Asylum were drawn from rural Norfolk the severe hardship suffered in terms of overwork, malnourishment and physical exhaustion may well have affected not only their physical health but also diminished their mental ability to cope with the harsh realities of life.
Today mental health problems remain as prolific as ever: depression, stress, an inability to cope with the requirements of modern living – the result of pressure continuing to have the same effect although the causes may have altered in the last hundred and fifty years. Physical exhaustion and starvation are less likely to be diagnosed as causes of mental illness nowadays, yet the pressure of daily living continues to affect our society: intense media pressure has been identified as just one contemporary cause of anxiety and distress.
Compiled by NRO Research Blogger, Julie Jakeway.
[i] A. Armstrong, The Population of Victorian and Edwardian Norfolk (Norwich, 2000)