Just pause for a moment and think about who gets segregated in society today, where, and why. Write down any groups of people you can think of.
I thought of people convicted of criminal behaviour serving prison sentences, some people with learning difficulties, disabled children at special schools, young offenders, asylum seekers, illegal immigrants, people who are unable to pay their debts or who have been convicted of fraud, children in care or boarding schools, homeless people in night shelters and hostels, women who are victims of domestic violence who live in refuges, frail older people in nursing homes and residential care. I also thought of people detained under the Mental Health Act because they are diagnosed by doctors as being a danger to themselves or to others, and people detained under Section 47 of the 1948 National Assistance Act because they are neglecting themselves.
These days they may not be so great in number and the buildings they live in may be less imposing, but have all the reasons for segregation changed so very much?
So far we've discussed asylums and large-scale institutions simply in terms of the policies which gave rise to them and the philosophies which supported them, both inside and out. But these institutions were also places of employment. How did the job of nursing develop under such conditions?
The nineteenth century saw the development of large-scale institutions designed to segregate, control and in some cases, cure, their inmates.
The philosophy of institutional care meant that people from most sections of society tended to be catered for, from the youngest to the oldest, although care at home in the community was still the most likely form of care.
Social Darwinism and eugenics were influential philosophies which, together with an increase in the power of the medical professions, led to policies which segregated particular groups from society and which also imposed sexual segregation within institutions to prevent interbreeding.
Policies of segregation still operate today and affect certain individuals and groups within society.
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