York, Sarah Hayley
Doctor of Philosophy, The University of Birmingham, December (2009)
Suicidal patients constituted a significant proportion of the annual admissions to nineteenth-century public lunatic asylums. They formed a distinct patient category that required treatment and management strategies that were capable of frustrating their suicidal propensity and alleviating their mental affliction. Yet despite being relatively large in number, the suicidal population of public asylums has received only nominal attention in the history of nineteenth-century psychiatry. This thesis examines the admission, discharge, treatment and management of suicidal lunatics over the course of the nineteenth century. It locates suicide and suicidal behaviour within the context of the asylum and uncovers the experiences of patients, their families and asylum staff. There is a distinct appreciation of the broader social and political context in which the asylum operated and how this affected suicide prevention and management. This thesis argues that suicidal behaviour, because of the danger associated with it, triggered admission to the asylum and, once admitted, dangerousness and risk continued to dictate the asylum’s handling of suicidal patients. Rather than cure and custody, it was protection and prevention versus control that dominated the asylum’s treatment of suicidal lunatics. Conclusions are drawn based on evidence from five asylum case studies and contemporary publications.