Understanding the past

1 A brief history of institutions

By the early years of this twenty-first century, the great institutions of the eighteenth, nineteenth and twentieth centuries ? the asylums and ‘mental handicap hospitals?, as they used to be called ? had mostly ceased to exist. For much of the previous 150 years they dominated the skyline of health and social care and were etched into the memories not only of people who lived and worked in them, but also of those who lived nearby.

Early developments, such as the Foundling Hospital of Thomas Coram in London, which opened in 1742, were followed by an extensive period of building which resulted in the Victorian asylums; these included workhouses, prisons and, for children, the type of residential ‘district school? which Charlie Chaplin experienced at the ‘Lambeth Union Institution for Boys?, as well as children?s homes run by charities such as Dr Barnardo?s Homes (now known just as Barnardo?s) and the Church of England?s Waifs and Strays Society. This form of provision continued well into the twentieth century, with the construction of large-scale building complexes designed for people with learning disabilities, of which Lennox Castle Hospital was a typical example (Alaszewski, 1986; Gladstone, 1996; Atkinson et al., 1997; Borsay, 2005).

You might be wondering whether, if this kind of care is no longer typical, there is any point in studying how things used to be. From what follows, you will perhaps see why it?s sometimes important to look back into the past. For example:

• There is a need to recognise that the kind of care that was provided in places like Lennox Castle, and the policies which determined what happened, continue to affect some people?s lives and experiences.
• It isn?t just buildings, of course, but the way in which people behave and act towards each other in those buildings that needs to be considered.
• The ‘hidden histories? of the people who lived in those buildings tell us something about the consequences of such care policies in human terms.
• Finding out about the past means learning how to ask the right sort of questions, where to find evidence and how to evaluate what we find.
• Looking back to the past provides us with the opportunity to make comparisons and reflect on policies, practice and values today.

Core questions to consider are:

• What is a ‘total institution??
• What was the thinking that led to the construction of places like Lennox Castle Hospital?
• What kinds of evidence are available for finding out how life was organised for residents and staff at a place like Lennox Castle?
• What were the main historical landmarks that led to the setting up and replacement of long-term institutional care as a form of provision for people with learning disabilities?

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