Patients, policy and practice in public mental hospitals in England, 1918–1930
Claire Hilton
UCL Press
Publication date: 1 July 2025
High expectations for a better world followed the First World War. Many changes took place aligned with ‘progress’, but in England the poorest benefited little from them. This was all too evident in the nation’s public mental hospitals. Patients were their raison d’ȇtre, yet their experiences show that they sat at the foot of the country’s priorities.
Petty Tyranny and Soulless Discipline? places patients at its centre to explore their daily lives, including their admission, care, treatment, discharge and after-care, or death. These narratives, drawn from a range of primary sources, are contextualised in an historical analysis of how and why a mixture of stagnating and changing knowledge, attitudes and ideals affected patients’ experiences. The Lunacy Act 1890 underpinned life in the mental hospitals by setting out their organisation, regulation and funding. A variety of professionals, campaigners for reform, central government departments, local authorities, trades unions and voluntary organisations, often with competing agendas, influenced what happened to patients. There was also new medical knowledge, from Britain and beyond. This book weaves these strands into a coherent whole, to reveal the complexity of mental health provision in the past and enable reflection that might inform debate today.
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