A while ago, I did some research on the early days of Barnsley Hall Asylum, in Bromsgrove, and I am revisiting it as I prepare to teach a module on psychology and literature. Though not many records are available, I’ve tried to put together some information from what I have been able to find.
Barnsley Hall Asylum (later known as Barnsley Hall Hospital) was opened in 1907 to take patients from the overcrowded Powick Hospital, near Malvern. Records show that as early as December 1898, a ‘Lunatic Asylum Special Committee’ had been set up to investigate the possibility of building a new asylum in Worcestershire, and ‘to make inquiries on the subject of the employment of skilled assistance, and of an Architect specially versed in the construction of public Lunatic Asylums, and also to take steps to secure the option to purchase a number of suitable sites for the proposed new Asylum.’ Over the course of several months a number of sites were proposed, including ones near Northfield and Kidderminster. The Bromsgrove site was not initially popular with the committee, despite being 317 acres. However, by July 1899 the committee had begun proceedings to buy the site, at a price of £17,400. The total area of land purchased was 324 acres, for £17,298 19s 11d, including the farm. This was apparently the site of a much earlier ‘Barndesley Hall’, seat of local nobility since before the Elizabethan period.
By September of that year, an eminent London architect specialising in asylums, George T. Hine, had been chosen, and plans for the new Asylum were well underway. It was to be of the ‘compact arrow’ layout, as the ground floor plan shows. Based on the Claybury Asylum in Essex, also designed by Hine, it was a popular design which became for a while the standard for asylums. The design of asylum buildings, allowing patients privacy and space as well as opportunities for recreation and socialising, were considered to be an intrinsic part of their treatment. In the 1907 ‘Report of the Commissioners in Lunacy’, the writers say that they are:
…well pleased with what we have seen. In our judgment the Asylum is well planned and constructed and provides excellent accommodation for the care and treatment of the insane.
Barnsley Hall was to house 256 male patients and 320 female patients, and when it opened in 1907 it took 200 ‘pauper’ patients from Powick, reserving 250 beds for paying patients. It employed 11 male and 9 female attendants, 3 kitchen servants, 4 artisans and 2 laundresses. When it opened, it began with 41 male and 67 female patients. The asylum was opened by the Countess of Coventry on June 27th 1907.
The ‘County Asylums’ website describes the buildings at Barnsley Hall:
George Hine’s design consisted of equal provision for Men and Women in three blocks on either side of the Recreation Hall which occupied the centre of the south front. Located behind this were Kitchens, Stores and the Administrative Block. The Engineering Department, Water Tower and Boiler House were located to the west, alongside the Male wards, with Laundry, Sewing Room and Nurses Block to the East. The Buildings were constructed from red brick with terracotta faience detailing on the principal buildings and Water Tower. The Administrative Block displays the county crest and bears a louvred cupola. Ward blocks bore strong resemblence to other Hine asylums with multiple paned sash windows and banding from courses of lintels, almost identical in style to Netherne (Surrey CC 1909). Airing Courts contained typical octagonal wooden shelters.
The record books give us some indication of the diagnosis and treatment of patients, as well as their day to day lives:
Every case upon admission is subjected to an examination of the physical state as thorough as that in vogue at the hospitals attached to the large Medical Schools, and, in addition, an exhaustive enquiry is made into the mental condition.
Patients were required to stay in bed for one week at least after admission, being closely monitored, for both the medical and ‘moral’ benefit of the patients. Later, male patients worked on the farm, ‘stores, bakery and workshops’ while women worked ‘in the kitchen and laundry’ and making things in the needle-room. In the 1910 Medical Superintendent’s Report, the doctor was keen to emphasise that the asylum treated patients for bodily as well as mental disorders:
The moral effect of this system is also of great benefit, as the patients at once recognise that they are not merely ‘put away’, but that they are regarded as being seriously ill and therefore sent here to receive medical treatment.
This indicates how seriously the patients’ lives and health were taken by the medical staff, and also explains the (relatively) comfortable accommodation with plenty of activities available.
In addition to work and treatments, there were also entertainments to be had; Barnsley Hall was considered to have the finest ballroom in Worcestershire, and weekly dances and ‘weekly smoking concerts for male patients’ were held. Services in the chapel were well-attended, with a choir formed of nursing staff. The asylum organised a staff ball, which was very popular, and football and cricket matches for staff and patients alike. There was an annual Carnival, and many ward entertainments. The Lunacy Commissioners’ Report for 1908 comments on the availability of books for patients and the billiard tables, as well as commending the hospital for being ‘clean and fresh’ with good food. The report adds that though many patients express a desire to be discharged, there were few complaints. Later Reports also commend the food, which, like the grounds, was seen as crucial to the patients’ well-being.
In 1911 the Visiting Committee Report mentions a scheme for ‘entertaining the Asylum Officers in connection with the celebration of the Coronation of His Majesty the King’. The buildings and airing court shelter were repainted by grounds staff as part of the preparation for this celebration.
The Medical Superintendent was Dr. Percy T. Hughes. Dr. Hughes (1872 – 1933) was an eminent doctor, the son of a vicar, educated at Haileybury and the University of Edinburgh, who specialised in the treatment of mental disorders. He was appointed Medical Superintendent of Barnsley Hall at its inception in 1906 after having worked in the London County Mental Hospital. In 1911 he was married to Emily Middlemore (1885 – 1948) at the parish church (St John’s). His wife was the daughter of a Worcestershire MP and philanthropist, Sir John Throgmorton Middlemore (1844 – 1924), who lived at The Forelands, Bromsgrove. The couple had a daughter, Joanna Middlemore Hughes (1914 – 1987) and a son, John McCulloch Middlemore Hughes (1917 – 1940), born at the asylum, who became an RAF bomber pilot during WWII and died in a plane crash. The 1911 census lists the Hughes household separately to the asylum itself, and includes a domestic cook (Emma Mason), housemaid (Alice Beddall) and upholstress (Edith Wood) as well as Percy and Emily Hughes. The census also shows how many staff the asylum had at the time. In addition to 2 clerks, a deputy medical superintendent and an assistant medical officer, a Matron and a few housemaids, there were 46 male ‘mental nurses’ and 44 female, mostly in their 20s and 30s (after all, this was a job for the fit and well).
Hughes was clearly an innovative, experienced and well-meaning doctor who was interested in new methods of treating his patients. He wrote articles and travelled to America for conferences, and is listed as a part of a national committee investigating the dietary requirements and effects in mental hospitals. From 1900 he was a member of the Medico-Psychological Association, and was also a lecturer at the University of Birmingham’s Medical School. He attempted to understand his patients and if not to cure them then at least to enable them to live comfortably, and the Reports of the Commissioners in Lunacy, on visiting Barnsley Hall, describe him as ‘exemplary’, ‘efficient’ and ‘excellent’. Dr. Hughes’ obituary, in the British Medical Journal (15th April 1933) concludes:
Hughes was well fitted, both by his natural gifts and by his training and experience, to carry out the task which now lay before him. He was a remarkably capable organizer and administrator, and he had those attributes of personality and of character which won the loyal support and unstinted co-operation of his officers and staff. He was thorough in all he undertook. The hospital in 1907 was up to date, but its functions were not suffered to become stereotyped. Suggestions for improvement were constantly being considered, and, if approved, they were adopted as soon as practicable. Hughes fully realized the importance of skilled nursing in the treatment of mental diseases, and he paid great attention to the training of the nursing staff. In 1909 he contributed a valuable article on mental nursing to The Science and Art of Nursing.
Barnsley Hall was one of the first mental hospitals to possess its own permanent cinematograph installation. Dr. Hughes always did his utmost to promote the welfare and comfort of his patients, and he was rewarded by their confidence in and affection for him. He loved good music, and took a keen interest in training and practising with the choir of the’ hospital chapel. He was lecturer on mental diseases in the University of Birmingham, and his advice in consultation was frequently sought throughout a wide area.
A personal tribute in the same paper reads:
In particular, it was largely he who suggested that a trial might be made of various new forms of occupations for the patients which hitherto had not been practised in mental hospitals, and, being given a considerably free hand in these endeavours, it was in no small measure due to his tireless efforts that Bexley won the fame it did as an example of what could be done for the systematic organization of occupations for the patients – differing, however, from the conception now commonly spoken of as occupational therapy.
Dr. Hughes’s own views tell us a lot about mental health treatment at that time, and at Barnsley Hall in particular. His annual Medical Superintendent’s Reports are often interesting for this reason. In his report of 1908, for example, he discusses the causes of insanity, a topic of considerable interest in a society which felt it was dealing with a growing number of lunatics. Of the patients currently in the asylum, he says that the cause of insanity for 87 of them (or 45%) was ‘defective heredity’ (though he is quoted elsewhere as saying to blame a patient’s mental illness on their heritage ‘is merely a confession that the true cause of the patient’s trouble is unknown.’) Of these, 67 patients were classified as suffering from ‘insane and alcoholic heredity’. Hughes’ report also considers the effects of childhood deprivation and malnutrition as a cause of physical and mental defects. He has some ideas which seem quite shocking to modern audiences, though they were common at the time he was writing: for example, under the heading ‘Prevention’ he writes:
Defective Heredity being so potent a factor in the causation of insanity it has become a serious and difficult social problem as how best to cope with this evil. The physiological laws which govern the reproduction of sound stock are the same for both man and animal, yet few of the elaborate precautions taken to secure sound pedigree stock find a counterpart in the reproduction of the human race. Sentimental and legal reasons insist upon the discharge of individuals from Asylums as ‘Recovered’ who appear to be sane whilst surrounded by the specially adapted Asylum environment, but who are really deficient and unfitted to be the parents of children. It is a matter for very serious consideration whether any patient who has had more than one mental breakdown should be given a further opportunity of reproducing defective stock.
These views seem to be indicative of a movement towards eugenics, the science of breeding and the importance of heredity in order to strengthen livestock, originally; by the 1920s and 30s the term was applied to humans, and reached its sinister apotheosis in the Nazi concentration camps. Eugenics was not as popular in the UK as in some other countries, but there were some who felt that certain parts of the population (such as ‘mental defectives’) should be curbed and discouraged from reproducing. A long-standing undercurrent of concern about this led to the 1913 Mental Deficiency Act, which only a few MPs voted against; one who did was Josiah Wedgwood, who said ‘It is a spirit of the Horrible Eugenic Society which is setting out to breed up the working class as though they were cattle.’ The Act meant that those who were considered Idiots, Imbeciles, Feeble-minded or Moral Imbeciles could be placed in colonies where they were segregated from the rest of society. The Act remained in place until 1959. Some people subject to this Act were placed in the care of asylums such as Barnsley Hall.
In the 1909 Medical Superintendent’s Report, a similar stance is taken:
It is to be hoped that more dramatic legislative action will be taken in the near future with the object of prevention of insanity. No more fitting example of this improvidence can be given than the case of a patient who, aged 75, recently died in this asylum. She had 10 children, and either during each pregnancy or immediately after each confinement broke down mentally, was certified as insane and sent to an Asylum.
With the increasing stress of modern existence the birth rate among the intellectual classes is steadily declining. The value of the ‘heredity of intellect’ has been fully demonstrated, and with a decreasing intellectual heredity and an increasing, though largely preventable, mental degeneracy a serious danger to the national welfare is developing.
By his 1911 Report, however, he discusses ‘the question of the compulsory sterilization of patients by surgical operation’ but makes it clear that he is against this, despite his earlier comments (though he adds that this is partly because most people lose their sanity after they have had children!) Hughes also comments on his low discharge rate; the number of patients discharged as ‘cured’ was one of the ways in which an asylum was considered to measure its success, but he defends his rates by explaining that he prefers to wait until the patients ‘have truly recovered’, rather than needing to readmit them at a later date.