Elvina May-Yin Chu1,2,3, Joeke van Santen4, Vijay Harbishettar5,6. 1. St Andrew's Healthcare, Northampton, UK. e.chu@ucl.ac.uk. 2. Department of Neurosurgery 6th floor (room 690), Montreal Neurological Institute, 1280 Rue Université, Montreal, QC, Canada. e.chu@ucl.ac.uk. 3. University College London, London, UK. e.chu@ucl.ac.uk. 4. Department of Psychiatry, VU University Medical Center, GGZ inGeest Dienst Onderzoek en Innovatie, Oldenaller 1 (room H1.09), 1081 HJ, Amsterdam, The Netherlands. 5. Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and NeuroSciences (NIMHANS), Hosur Road, Bengaluru, 560029, India. 6. South Essex Partnership NHS Foundation Trust, Grays, UK.
Abstract
PURPOSE: To investigate whether lifelong admission to psychiatric asylum care was usual practice before community psychiatric care was introduced. METHODS: Historical archives (1838-1938) for 50 patients at the Northampton General Lunatic Asylum in England were studied. Regression analyses were performed to investigate associations between predictor variables (age, gender, marital status, social class) and outcomes (diagnoses, length of stay and admission outcomes). RESULTS: 30 patients (70%) were discharged into the community. 15 (31%) patients were admitted longer than 1 year. Diagnosis of mania was significantly higher in patients who were married. Trend associations were observed for melancholia being diagnosed in higher social class patients and monomania being diagnosed in unmarried patients. No associations were found between predictor variables and length of stay or admission outcomes. CONCLUSIONS: These findings challenge the myth that asylum incarceration was a usual practice before the advent of community care. Most patients were discharged from psychiatric asylum hospital within a year of admission even before the advent of psychotropic medication.
PURPOSE: To investigate whether lifelong admission to psychiatric asylum care was usual practice before community psychiatric care was introduced. METHODS: Historical archives (1838-1938) for 50 patients at the Northampton General Lunatic Asylum in England were studied. Regression analyses were performed to investigate associations between predictor variables (age, gender, marital status, social class) and outcomes (diagnoses, length of stay and admission outcomes). RESULTS: 30 patients (70%) were discharged into the community. 15 (31%) patients were admitted longer than 1 year. Diagnosis of mania was significantly higher in patients who were married. Trend associations were observed for melancholia being diagnosed in higher social class patients and monomania being diagnosed in unmarried patients. No associations were found between predictor variables and length of stay or admission outcomes. CONCLUSIONS: These findings challenge the myth that asylum incarceration was a usual practice before the advent of community care. Most patients were discharged from psychiatric asylum hospital within a year of admission even before the advent of psychotropic medication.
Entities:
Keywords:
Admission; Asylum; Community care; Psychiatric in-patients