Throughout the
eighteenth and nineteenth centuries the policy of segregating severely disabled
people into institutions slowly increased and was subsequently extended to
other disadvantaged groups.[1]
The term ‘institution’ can refer to a variety of social organisations but refers
here to ‘any long term provision of a highly organized kind on a residential
basis with the expressed aims of ‘care’, ‘treatment’ or ‘custody’.[2]
They included hospitals, asylums, workhouses and prisons. One explanation for
this important break with the past links it to the breakdown of early forms of
state welfare in the face of large-scale industrialisation and the inevitable
spread of poverty that followed.[3]
But the impetus to build institutions came before the growth of cities and was
more pronounced in rural communities.[4]
The widespread incarceration of disabled people is directly attributable to the
transition from agriculture and cottage-based industries to the large-scale
factory type system: The speed of factory work, the enforced discipline and
time-keeping were a highly unfavourable change from the slower, more
self-determined and flexible methods of work into which many handicapped people
had been integrated.[5]
Such arguments tend to play down the general antipathy that surrounded
disability before the Industrial Revolution but it is clear that the economic
and social conditions created by the new system compounded the difficulties
faced by disabled people.[6]
The system of Poor Law relief
that had survived since Elizabethan times was directly at odds with the
ascending free market economy.[7]
Waged labour made the distinction between able-bodied and non-able-bodied poor important
since parochial relief to the able-bodied poor interfered with labour mobility.
Segregating the poor into institutions had several advantages over domestic
relief; it was efficient, acted as deterrent to the able-bodied malingerer and could
instill good work habits into the inmates. These conclusions are reflected in
the Report of the Poor Law Commission and the Poor Law Amendment Act of 1834. The
Poor Law Commission ruled that the workhouses should separate the inmates into
four different groupings--able-bodied males, able-bodied females, children, and
the ‘aged and infirm’. It was intended that the latter, or those perceived as
the ‘deserving poor’, were to be housed in different buildings and accorded
different treatment. These categories were later refined.
Poor Law Officials developed
four specific categories for dealing with the non-able bodied poor. They were
the ‘sick’, the ‘insane’, ‘defectives’, and the ‘aged and infirm’.[8]
The term ‘sick’ described people with acute, temporary or infectious diseases
who automatically qualified for outdoor relief if it was available. But where
incarceration was deemed necessary, separate accommodation was usually
provided, although the conditions in these facilities were rarely better than
those in the workhouse. The ‘insane’ were singled out for special treatment
from the outset. Despite the difficulties of definition and diagnosis, there
was already a universal recognition of the ‘problem’ posed by people with
mental illness. There were two main strategies for dealing with it. People
termed. ‘idiots’,[9]
‘lunatics’, ‘mad’, ‘mentally infirm’, or ‘suffering from diseases of the brain’[10]
were either admitted to an asylum or boarded out on contract to families
willing to be held responsible for them.
Several private asylums had been
established in the seventeenth century. But the public outcry over the
atrocious conditions in many of these establishments, brought to light by
Evangelical reformers, forced the Government into setting up a state-run system
in 1845 under the Lunacy Commission.[11]
The cruelty accorded to people perceived as mentally ill inside institutions
was often no worse than that which they encountered in the community at large.
Until 1871 Poor Law officials had no right to detain citizens in an institution
against their will, but this did not apply to people termed insane. Prior to
the Lunacy Legislation of 1845, the certification of insanity was the
responsibility of local lay officials but confirmation of mental illness was now
valid only if a doctor was involved. This change has been attributed to doctors’
assertions that mental illness had physiological causes and was responsive to
medical treatment, and their successful struggle for control within private and
public institutions.[12]
Once defined as mentally ill, individuals could be detained on a doctor’s
recommendation and moved from one institution to another against their will.[13]
The term ‘defectives’ was used to describe
people with sensory impairments such as blindness, deafness and the lack of
speech. After 1903, people with epilepsy and children termed ‘mentally sub-normal’
were also included in this category. Individuals in this group were still
liable to be institutionalised and their treatment was no different from that
of other inmates but they were frequently singled out for special attention by
Victorian philanthropists and charities. Many of the charities that exist today
were founded during this period. For instance, the British and Foreign
Association for Promoting the Education of the Blind, now known as the Royal
National Institute for the Blind (RNIB), was formed in 1863 and the National
Institute for the Deaf in 1924.[14]
‘Aged and infirm’, the oldest of the four categories, referred to people with
chronic illness and/or permanent impairments. While there was little official
controversy over their eligibility for outdoor relief, more often than not they
too were directed into an institutional setting.
Towards the end of the
nineteenth century, pressures to detain people classified as belonging to one
of these categories increased dramatically. First, the transition from
relatively light industries such as textiles to the much heavier capital goods
industries like iron, steel and the railways, in what has been called the ‘second
phase of industrialization’, further emphasised the importance of physical
fitness as a condition for finding work among working people. Welfare policies,
particularly with regard to outdoor relief, were also severely tightened during
the 1870s and 1880s due to escalating costs because of rising unemployment.
after a decade of economic depression that began with the severe winter of
1860-1861. This put more pressure on local authorities to apply the ‘workhouse
test’ to anyone seeking aid. Thirdly, there was a further expansion of
segregated institutions for the non-able-bodied poor following another set of
public scandals and government enquiries exposing the appalling conditions in
workhouses.
The number of disabled people
consigned to these establishments rose and did not fall until the 1950s.[15]
Ideological legitimacy for the intensified oppression of disabled people during
the eighteenth and nineteenth centuries can be found in contemporary philosophies
that stressed the rights and privileges of the individual over those of the
group or state in relation to property rights, politics and culture. Charles
Darwin’s On the Origin of Species published
in 1859 provided ‘scientific’
authenticity placing emphasis on the process of natural selection, the survival
of the fittest, the notion that evolution is progress and that progress is
inherently beneficial. It was adapted from the biological domain to apply to
human societies into what later became known as ‘Social Darwinism’. [16]
The Eugenics movement emerged from the general tendency to apply Darwin’s
theories to human affairs. Concerned mainly with what they saw as racial
degeneration through the birth of disabled children, the Eugenicists reiterated
ancient fears that disabled people were a serious threat to British and
European society.
The Eugenics Society was founded in 1907 arguing that women
were the guardians of the future of the British ‘race’ and that they should be
both chaste and fruitful. Although the focus was on the working-classes, there
were public denunciations by Rudyard Kipling and others of the debilitating ‘sloth and
pleasure-seeking’ of the upper classes. Eugenics, the science of race
improvement through human selective breeding saw women
largely as mothers rather than as citizens.[17]
At its height in the early-twentieth century, the eugenics movement swept up individuals of all political
persuasions including H. G. Wells, Harold Laski, John Maynard
Keynes, Arthur Balfour, Conservative Prime Minister
and the young Neville Chamberlain who looked to this branch of biology to
achieve that qualitative improvement in human beings necessary for the
advancement of national efficiency.[18]
Preventive societies utilised the rhetoric of eugenics and medicine to persuade governments to enact
legislation on sexual matters when they were not always willing to legislate on
such issues. This was evident in the Mental Deficiency Act of 1913 that gave
local authorities powers over pregnant women who were homeless, destitute or
immoral and many were admitted to hospitals for the mentally ill, where some
became long-term residents. Most of the
policies were dealt pragmatically with particular issues rather than as part of
a national strategy.
The work of Galton,[19]
Dugdale[20]
and Goddard[21]
reinforced traditional myths that there were genetic links between physical and
mental impairments, crime, unemployment and other social evils. The stated aim
of the Eugenicists was to improve the British race by preventing the
reproduction of ‘defectives’ by means of sterilization and segregation. In
1896, the National Association for the Care and Control of the Feeble Minded
was set up as a pressure group for the life time segregation of disabled
people. During the 1910 General Election it campaigned vigorously on these
issues. In the following two decades eugenic fears were further endorsed by the
invention and widespread use of Intelligence Quotient (IQ) tests in British
schools. Their inventors, the French psychologists Binet and Simon and
principal advocates, notably the psychologist Cyril Burt, asserted confidently
that intelligence is innate and that the majority of defectives were
uneducable.[22]
Eugenic fears were prevalent throughout the 1920s and 1930s. For instance, in
1934, the Report of the Departmental Committee on Sterilization chaired by Lord
Brock recommended legislation to ensure the ‘voluntary’ sterilisation of
‘mentally defective women’.[23]
Although such legislation was never passed in Britain--unlike America, where
sterilisation was legalised in 32 states[24]--this
did not prevent many such operations being carried out under various degrres of
coercion.
The evolution of the welfare
state during the 1940s led to official policy to disabled people move in favour
of a more overtly paternalistic approach. This can be explained by reference to
the humanitarian influence of the Victorian philanthropists, the general
concern felt toward disabled ex-servicemen during and after the 1914-1918 and
1939-1945 wars, the changing political climate and the prospect of a buoyant
economy.[25]
World War One exposed the public to disability on a massive scale and this led
to a change in attitude to disability. The state, wishing to save money, did not take a uniform
approach to the disabled and disability. For instance, disabled industrial
workers were not considered for pensions, benefits, or rehabilitation in the
same way that the war disabled were. Yet, the main funding for many disabled
ex-servicemen was left largely to charitable and voluntary agencies, a pattern
continued after World War One. An aspect of war disability is mentally disabled
ex-servicemen especially those suffering from shell shock.[26] The seeds of cooperation between doctors,
charities and government was established during and after the First World War
but it was not until World War Two that a modern,
organised system of rehabilitation was implemented. An expansion of
these and similar facilities was recommended by the Tomlinson Report.[27]
The economic and social
upheavals brought about by the depression in the 1930s, in conjunction with the
need for national unity during and immediately after the war stimulated a
concern for welfare programmes that had previously been absent. This resulted
in a flurry of legislation which was to have a significant impact on the lives
of disabled people. The first legislation to treat disabled people as a single
group was the Disabled Persons (Employment) Act 1944 that attemptied to ensure
that employers employed disabled people and made provision for a variety of
rehabilitation services and vocational training courses. The 1944 Education Act
stated that children should receive education suitable for their age, ability
and aptitude and obliged local education authorities to provide special
educational treatment for those thought to need it. The National Health Service
Act 1946 provided for the acute medical needs of disabled people and made it
possible for local authority health departments to provide any medical aids
necessary to enable disabled people to live in their own homes. Finally, the
National Assistance Act of 1948 made some provision for meeting the financial
needs of disabled people, and mandated local authorities to provide residential
facilities and services for people who are substantially and permanently
handicapped by illness, injury or congenital deformity.
[1]
Eghigian,
Greg, (ed.), The Routledge History of
Madness and Mental Health, (Routledge), 2017, pp. 1-16, 101-134,
Pietikainen, Petteri, Madness: A History,
(Routledge), 2015, provide useful overviews.
[2]
Jones,
K., and Fowles, A. J., Ideas on
Institutions: Analysing the Literature on Long-term Care and Custody,
(Routledge), 1984, p. 207.
[3] Mechanic, David,
‘The Influence of Mothers on Their Children's Health Attitudes and Behavior’, Pediatrics, Vol. 33, (1964), pp. 444-453.
[4] Ingelby, David,
‘Ideology and the human sciences: Some comments on the role of reification in
psychology and psychiatry’, Human Context,
Vol. 2, (2), (1970), pp. 159-187,
reprinted in Pateman, Trevor, (ed.), Counter
Course: a handbook for course criticism, (Penguin), 1972, pp. 51-81.
[5] Ryan J., and
Thomas F., The Politics of Mental
Handicap, (Free Association), 1987, p. 101.
[6] Stone, J., Precedent and Law: Dynamics of common law
growth (Butterworths), 1985, Borsay, Anne, Disability and Social Policy in Britain since 1750: A History of
Exclusion, (Palgrave), 2004.
[7]
Mounsey,
Chris, (ed.), The Idea of Disability in
the Eighteenth Century, (Bucknell University Press), 2014.
[8]
For
classification see, Martin Duncan, P., and Millard, A Manual for the Classification, Training and Education of the
Feeble-Minded, Imbecile and Idiotic, (), 1866. Bartlett, Peter,
The Poor Law of Lunacy, (Leicester
University Press), 1999, pp. 151-196.
[9]
McDonagh,
Patrick, Idiocy: A Cultural History,
(Liverpool University Press), 2008, pp. 1-23, 192-230.
[10] Scull, Andrew, Museums of Madness: The Social Organization
of Insanity in Nineteenth-century England, (Allen Lane), 1978, and ‘Museums
of Madness Revisited’, Social History of
Medicine, Vol. 6, (1993), pp. 3-23. Porter, Roy, Mind Forg’d Manacles: A History of Mandness
in England from the Restoration to the Regency, (Harvard University Press),
1987, Scull, Andrew T., MacKenzie, Charlotte, and Hervey, Nicholas, Masters of Bedlam: The Transformation of the
Mad-doctoring Trade, (Princeton University Press), 1996, Scull, Andrew, The Lost Solitary of Afflictions: Madness
and Society in Britain, 1700-1900, (Yale University Press), 1993.
[11]
Smith,
Leonard D., ‘Cure, Comfort and Safe
Custody’. Public Lunatic Asylums in
Early Nineteenth-Century England, (Leicester University Press), 1999,
excellent local studies of asylum management.
See also his Lunatic Hospitals in
Georgian England 1750-1830, (Routledge), 2007, pp. 21-48, 137-164.
[12] Scull, Andrew, Decarceration: Community Treatment and the
Deviant—A Radical View, (Polity Press), 1984.
[13]
Appignanesi,
Lisa, Mad, Bad and Sad: A History of
Women and the Mind Doctors from 1800 to the Present, (Virago), 2008,
Wright, David, Mental Disability in
Victorian England, (Oxford University Press), 2001.
[14]
Phillips,
G. A., The Blind in British Society:
Charity, State and Community c.1780-1930, (Ashgate), 2004, Reiss, Matthias, Blind Workers against Charity: The National
League of the Blind of Great Britain and Ireland, 1893-1970, (Springer),
2015, Gooday, Graeme, and Sayer, Karen, Managing the Experience of Hearing Loss in Britain 1830-1930,
(Palgrave Pivot), 2007.
[15] Ibid, Scull,
Andrew, Decarceration.
[16] Hawkins, Mike, Social Darwinism in European and American
Thought 1860-1945, (Cambridge University Press), 1997, pp. 3-60, and Paul,
Diane B., ‘Darwin, social Darwinism and eugenics’, in
Hodge, Jonathan, and Radick, Gregory, (eds.), The Cambridge Companion to Darwin, (Cambridge University Press),
2003, pp. 214-239.
[17] Richardson,
Angélique, Love and Eugenics in the late Nineteenth Century: Rational
reproduction and the New Woman,
(Oxford University Press), 2003.
[18]
Pearson,
Karl, Darwinism, medical progress and
eugenics: the Cavendish lecture 1912.
[19] Galton, Francis, Hereditary Genius: An Inquiry into its Laws
and Consequences, (D. Appleton), 1870, Bulmer, Michael, Francis Galton: Pioneer of Heredity and
Biometry, (JHU Press), 2004.
[20] Dugdale, R. L., The Jukes: A study in crime, pauperism,
disease, and heredity, (G. P. Putnam’s Sons), 1910.
[21] Goddard, H. H., Juvenile Delinquency, (Dodd, Mead), 1921.
[22]
Hearnshaw, L. S., Cyril Burt:
Psychologist, (Hodder and Stoughton), 1979, Fletcher, Ronald, Science, Ideology and the Media: The Cyril
Burt Scandal, (Routledge), 2017..
[23] L.
G. Brock, chairman, ‘Memorandum regarding foreign laws on the subject of
sterilisation’, p. 109-130, ‘Memorandum regarding foreign invesigations into
mental deficiency’, p. 131-134, Command paper: Cmd. 4485; Whitney, Leon F., The Case for Sterilisation, (Bodley Press),
1935.
[24]
Ladd-Taylor,
Molly, Fixing the Poor: Eugenic
Sterilization and Child Welfare in the Twentieth Century, (John Hopkins
University Press), 2017.
[25]
Anderson,
Judie, War, Disability and Rehabitation
in Britain: Soul of the Nation, (Manchester University Press), 2011.
[26]
Leese, P., Shell Shock, Traumatic Neurosis and the British
Soldiers of the First World War, (Palgrave Macmillan), 2002; Reid, F.,
Broken Men: Shell Shock, Treatment and Recovery in Britain
1914-1930,
(Continuum), 2010; and Holden, W., Shell Shock, (Channel 4
Books), 2001.
[27]
Tomlinson
Committee on Rehabilitation and Resettlement of Disabled Persons, 1941-1944.
