RCN centenary

Inpatient mental health care in the first world war

Claire Chatterton looks at the sometimes traumatic impact on patients and staff of the decision by the War Office to requisition asylums for use as military hospitals

Claire Chatterton looks at the sometimes traumatic impact on patients and staff of the decision by the War Office to requisition asylums for use as military hospitals.

Abstract

The rising casualty rates during the first world war caused a major problem for the British government. As the numbers of soldiers affected grew, the War Office began requisitioning large public psychiatric asylums to be used as war hospitals to treat soldiers. One after another the institutions were emptied, often rapidly. The patients were dispersed to other public asylums across the country. This article investigates the impact of this policy on inpatients and nursing staff in asylums.

As the centenary of the first world war is commemorated, many stories are being told and significant events marked. However, one aspect of the war is rarely discussed: its impact on the inpatients and staff of the large public mental health institutions. More than 17,000 asylum patients died during the last two years of the 1914-18 war and it could be said that they were casualties ‘without a war memorial’ (Cranmer 1992).

The causes may be traced back to the War Office’s decision in 1915 to requisition some of the large asylums for use as military hospitals. This was in response to the rising war casualty rates, which were overwhelming the existing hospital provision (Mayhew 2014). The Board of Control, which oversaw the 92 public lunatic asylums across England and Wales, divided these institutions into nine groups. One asylum per group was to become a military hospital, thus providing 15,000 extra beds (Thomson 1916). Later in the war further asylums were taken over, including Scottish ones.

It has been estimated that 12,000 inpatients had to be moved to provide the additional beds (Murphy 2010). The chosen asylums were emptied in a few weeks. For example, in group five, East Anglia, the decision to use the Norfolk County Asylum was made on February 15 1915.

On March 1 telegrams from the War Office triggered the dispersal of patients with ‘all haste’ and by March 31 nearly all of the hospital’s 1,050 patients had gone (Thomson 1916). Sixty patients were selected to be discharged home to their families and ‘a certain number of quiet, useful patients’ were retained to work on the hospital farm (Cherry 2003).

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This article was first published in print in Mental Health Practice: volume 19, issue 1

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