Star.
London, England, 1830-06-24 00:00:00

I)
~J

11
litaL
1

N°. 13,508. THURSDAY EVENING, JUNE 24, 1830. PRICE 7D.

LUNACY COMMISSION.
Copy of the Report from the Metropolitan Commissioners in Lu-
nacy, made to the Right Hon. Robert Peel, his Majesty's Prin-
cipal Secretary of State for the Home Department, dated Ist
July, 1829.
Sir,—The important nature of the duties which under the pro-
visions of the Act of last Session have been imposed upon us as
Commissioners for the Licensing and Inspecting Lunatic Asylums
in London and its vicinity, induces us to report to you the general
state of the houses under our inspection, and briefly to communi-
cate an outline of our proceedings.
We cannot indeed but review our labours with some degree of
pleasure, when, having completed three regular visitations, and
having made several casual visits, we are enabled to state that our
inspections have been, with few exceptions' very satisfactory.
The establishments licensed by us have been 38, and the patients
who were confined in them, on the first of August, 1828, amounted
to 2,047 • and on the Ist of May last, to 2,038.
In so large a number of houses it is impossible but that a great
difference in their salubrity and in their genetal convenience, aris-
ing from local circumstances as well as from their management,
must esdar. But we have usually found a most ready attention on
the part of the proprietors to such suggestions as we have thought
it right to make ; and in many instances the improvements which
have been effecte spontaneously by the proprietors and managers
of these asylums, have evinced an anxious desire on their part to
place them on a better system, and have justly merited our ap-
probation.
But although the asylums, with regard to the comfort of the
patients, are generally as good as we could expect, we regret to say,
that in those establishments which arc more especially destined fur
the reception of poor and of parish patients, very little attention is
given to any curative process.
The number of patients either cured or materially relieved is so
small compared with the total number of those under confinement,
as to strengthen our own observations of the imperfection of the pre-
sent system, so far as it is connected with restoration to reason of
those who may be justly considered capable of recovery. It must
not, however, be supposed, that the managers are as negligent on
this point as the returns would imply; the permanence of the dis-
ease may be accounted for by the tardiness of the parishes and of the
relations of poor persons in sending them to these establishments,
where they can in no way contribute to their own support, and where
they arc necessarily maintained, at a greater cost than they would be
either in a parish workhouse or in their houses; the malady is thus
allowed to become inveterate before it is subjected to regular
treatment.

It is also but just to observe, that no inconsiderable number of the
patients in these private asylums have been received into them when
discharged as incurable from public institutions for the cure of
madness.

In establishments for a more wealthy class of patients their cure
is more attended to. The results are, nevertheless, less satisfactory
than might be hoped. For, as considerations of economy may be
supposed to cause delay in the other class, so in this, the indisposi.
tion to cast the imputation of insanity on a near relation, and the
natural feelings of reluctance at being separated from the objects of
their affection, are not unfrequently the cause of recourse to these
establishments being deferred until the disease of the unfortunate
patient has become so formidable and permanent in its rfature as to
be with difficulty, if at all subdued.
The want of occupation for the superior description :of patients,
and more especially for the male sex, is a defect not very easily re.
medied ; and although the poorer classes are in many instances use-
fully employed in domestic services, it is not practicable to extend
that mode of occupation to any great proportion of the patients, nor
indeed is there always a willingness on their past to w0rk,....
Some of those who are in a state of mind capable of exertion, are
represented to us as frequently considering employment a hard.
ship unjustly imposed upon them : coercion fur the purpose of
effecting this object would, for the most obvious reasons, lead to
the greatest abuses; we have not thought it cxrdient therefore to
urge it so strongly as we should otherwise have felt inclined to have
done, although we have taken every occasion to express our appro-
bation when we have seen the patients employed apparently to their
own satisfaction, and with cheerfulness and goodwill. The sepa-
ration of parents of the same class of life, but labouring under dif-
ferent degrees and descriptions of insanity, has not escaped our at.
tention ; great difficulties occur in carrying this into very complete
effect. In the large establishments classification to a certain extent
is attended to, but it is not universally conceded by those who
have the management of these Asylums that the entire separation
of the patients who are dejected from those who are excited is be-
neficial to either class. Classification, however, in our opinion, is
an object never to be lost sight of, and more particularly in that
rank of life where previous education and habit make the :distinc.
lion of manners, of appearance, and of conduct,'more perceptible
to the patients; the strictest attention should be paid to keep those
individuals who, from the peculiar tendency of their malady, are
me...warily objects of disgust, apart from those who, labouring
under aberration of intellect, arc nevertheless fully capable of feeling
most sensibly the misery of living with such associates.
In the large establishments, the strictest attention is paid to the
entire separation of the two sexes ; in some of the smaller, the na.
ture of the premises and of the building prevent so complete a
distinction of the apartments and of the airing grounds as we could
desire, thus leaving to the vigilante . of the attendants that which
we should muct► prefer to rest, in addition to their constant attcn.
tion, on the construction and allotment of the asylum. We are
well aware that there are reasons for the union of establishments for
male and female patients, but the preponderance of good appears to
us so decisively in favour of the separation, that we hare taken
every opportunity of urging it, and we have received as•urances
from several of the proprietors, that they would do every thing in
their power to effectuate this desirable object. To attempt it pre.
cipitately would occasion such serious sacrifices of property, and so
much inconvenience, that we have not thought it just to urge an
immediate attention to it, more especially as we have not the slightest
reason to suspect any abuse under the present system.
From our Visitation Reports it will appear that we have made the
prescribed inquiries respecting the religious consolation afforded to
patients. Some attempt is made in most of the establishments to
attend to this point. The opinions of its utility to the patients are,
nevertheless, various. It it, obvious that to a large class of them it
cannot be useful, and to those who are insane on religious points it
Is stated to us to be not unfrequently prejudicial ; indeed, we are of
opinion that even with regard to those patients who are capable of
behaving with decency during the celebration of divine service, very
few, if any, derive real benefit from it. We are, nevertheless, most
anxious that whenever they can attend with decorum, religious ser-
vice should be regularly performed ; and we feel this the more de-
sirable, ns we cannot but contemplate the probability of such a prat-
tike being most advantageous in its effects on the keepers, and on
other persons concerned in the care of the patients.
We have had occasion to exercise the powers confided to us, of
releasing patients whose state of mind appeared to justify our inter-
ference, and to have caused, either by our own authority or by com-
munication with the friends of the patients, the release from con-
finement of nine individuals; of these, unfortunately, it has been
necessary to replace three in confinement, but we cannot regret that
even in these cases of failure the experiment was tried. When we
caused their release, we were aware of the possibility of the recur.
rence of their malady, but we felt ourselves called upon, in the dis-
charge of our duty, not to permit persons to continue in confine-
ment whose sanity at that moment we did not doubt, and who were
also stated to us to have shown no symptoms of aberration of intel-
lect for a length of time antecedent to their release. This power
ought always to be exercised after the greatest consideration, and
with due caution ' • it is one, however, of so much value, as well in
preventing theimproperconfinement of persons, as in remedying the
negligence of friends, who, though reluctant to consign their rela-
tions to these asylums, are not unfrequently equally reluctant to re-
move them, that the Commissioners would be violating a most im-
portant ?art of their duty, if they hesitated to incur the responsibi.
lily arising out of its exercise.
It is right to observe, that in many of the above cases, as well as
In others, in which, upon examination, the conditiou of mind of the
individuals did not appear such as to justify our interference, the
possible sanity of their patients has been suggested by the propel.
etors and managers of the asylums ; and in no instance have we
found any indisposition on their part to state all the circumstances
which might citable us to form just conelusioes on the soundness of
the minds of the persona whose cases were under our consideration.
Indeed, with regard to pauper patient., we think much more exer.
tion is required to induce parishes to send their lunatic poor to these
asylums, than to prevent their Confining them there impmperly, of
retaining them there beyond the period of their recovery.
This observation, nevertheless, must not be extended to distant
parishes, where the expense of removal operates disadvantageously,

not merely on account of a reluctance to send the poor to these Ass,'
lums as soon as desirable, but also by their disinclination to incur
additional charges by the removal of the persona whose recovery may
not prove permanent.
We have found it necessary to obtain your sanction to the revoca-
tion of one license, and the discontinuance of another. In neither
of these cases did we proceed to this extremity without giving se-
rious and repeated warnings to the parties interested.
We strongly intimated the necessity of correcting great irregu-
larities in the management, and of improving the accommodation of
the patients.
Had our suggestions been attended to, and the improprieties of
which we had reason to complain been amended, we should not have
called. for your sanction to so severe a measure.
The continued perseverance in arrangements which called fur our
decided reprobation, and a very insufficient attempt at any alteration
of the buildings, left us no alternative but to exercise a power which,
although affecting severely the property of individuals, U never-
' theless indispcasable for controlling persons who consider profit their
only object in keeping these asylums, and who will not he deterred
from negligence or malpractices, unless their pecuniary interests
force them to regard the comfort of those unfortunate beings who are
confided to their cue.
The exercise of this power, which is vested in us, under the con.
trol of the Secretary of State, appeared to us important, not merely
in correcting cases of flagrant abuse, but also in preventing less ob-
jectionable irregularities, and in impressing on the minds of pro.
prietors and managers oilunatic asylums, that we were resolved, if
more lenient measures and strong admonition did not produce due
attention to the care and comfort of their patients, that their power
of deriving profit from their negligence or their misconduct should
no longer exist. Indeed we have good grounds for believing that
these instances of severity have excited sufficient attention to justify
our opinion of their importarvx, in creating in all those connected'
with or interested in these establishments the greatest desire to con-
duct them in the best manner, and to follow, as far as they are able,
the suggestions which, in the discharge of our duty, we have felt
ourselves called upon to make. In saying this, we do not wish to
impute to coercion that care and attention which we doubt not, in
very many instances, proceed from much better motives. Still, how.
ever, where so much depends on the constant and unwearied exertion
of the superintendents, and so much misery may be inflicted by
casual neglect or habitual inattention to what may be esteemed
minor or trivial points of management, every stimulus should be
added that inspection, remonstrance, and positive though temperate
authority, can produce.
In this, the first year of the provisions of the recent statute
coming into action, every fair allowance should be made for irregn.
larities and imperfections ; and from the general disposition which
we have found to make improvements, and to mend those parts of
the management to which we have objected, we cannot but hope,
that few instances will hereafter occur in which it may be neces.
sary to exercise this just severity, although a more rigorous attention
to various minute points, and an improvement in the manner of
conducting some of the establishments, ought to be most strictly en-
forced in future.

We cannot conclude our observations without adverting to the
practice of placing criminal lunatics in private asylums. At our
suggestion you have milled some of them to be removed to other
places of confinement, and in one of these instances we were ob
to call for your interference, by the necessity which existed of us
more constant coercion than should ever be generally adopted wi
i respect to patients so slightly affected by aberration of intellect, as
I was the case with this individual.
We are aware that a certain part of Bethlem is appropriated to
the reception of criminal lunatics, but its extent is so inadequate to
the confinement of all those who are guilty of serious offences, but
who are acquitted on the ground of insanity, that we cannot forbear
from remarking how very desirable it is, on every account, that some
establishment should be set apart for the confinement of this class
of Insane persons. It is indeed a subject well worthy of serious con-
sideration, whether the moral effect on insane persons, either in or
out of confinement, would not be considerable, if those who had
committed offences were confined in 'a prison expressly adapted for
their reception. Many are the individuals, who labouring under
mental malady, are nevertheless fully capable of judging how far
their being guilty of crime is likely to conduce to their future dis-
comfort, and of appreciating the difference of an establishment set
apart for the confinement of criminal lunatics alone, and of those
asylums which receive within their walls those only whose insanity
has never lcd them to acts punishable by the law.
We are aware of the difficulties and expense attending the forma.
tion of public establishments of this nature, but we esteem it an
object of so much importance*, to justify our calling your serious
attention to it ; nor should we have felt that we discharged our duty
to the public, without stating our opinion of the necessity of effect.
ing some alteration in the present system of confining criminal
lunatics.

We have thus brought to a close the observations which our li-
mited experience of the establishments placed under our inspection
and control have enabled us to suggest.
We trust that the experiment which the legislature is making by
establishing a new system of inspection of lunatic asylums, not
merely in the metropolitan district, but throughout England, is
likely to be attended with success.
There are fcw subjects on which legislation is more necessary,
and none attended with greater difficuity ; so as at once to ensure
the comfort of the patients, and not unnecessarily to annoy the feel-
ings of relatives by useless publicity.
Whether the present provisions of the law have held a just me-
dium between these two points is a matter worthy of further and
of serious consideration.

We only hope, that the exertions which we have made, and which
we shall continue to make so long as we have these duties confided
to us, will have the tendency of mitigating the severity of one of
the greatest ills to which humanity Is subject ; and trust that this
great object may be obtained without improper interference with is.
wily feelings, and without allowing our commisseration of the un-
happy objects under our protection unfairly to warp our judgments,
or cause us intemperately to disregard any one of the complicated
interests which may be affected by our decisions
0. C. H. SOMERSET
0. H. ROSE
FRANCIS BARING
0. F. HA Al PSON
H. H. SOUTHEY
J. BRIGHT
J. R. HI.ThIE
O. BYNO
CHARLES ROSS
THOMAS TURNER
ASHLEY
C. W. WILLIAMS WYNN.