Story: Mental health services
Page 2 – Lunatic asylums, 1840s to 1900s
In early colonial New Zealand the authorities tried to respond in a practical way to mentally ill people (known at that time as lunatics) who threatened public safety, could not look after themselves or had no one to care for them.
The earliest home for ‘lunatics’ in New Zealand was a wooden building attached to the Wellington gaol in 1844, with a similar facility opening at Auckland gaol that same year. Inmates received no treatment, apart from being confined and watched to stop them harming themselves and others. Soon other city gaols also held mentally ill people along with debtors, drunkards and vagrants. Gaolers found them hard to deal with and wanted them removed, but the only alternative was the overcrowded wards of public hospitals.
A disappointing country?
In 1871, at an inquiry into New Zealand’s lunatic asylums, Dr M. S. Grace offered this comment on the country’s rate of mental illness: ‘Insanity is much more common in [New Zealand] than it is [in Britain], chiefly on account of the limited range of sympathy which the isolation of individuals and families in the country gives rise to, and also on account of the oppressive loneliness which many newcomers experience even in our crowded towns. Many immigrants, too, form the most extravagant anticipations of their new home and are proportionally depressed by the result of actual experience.1
The Lunatics Ordinance 1846 stated that after certification by two doctors and a magistrate, a ‘lunatic’ could be held either in a gaol or other prison, or in a public hospital or asylum. New Zealand then had no specialist asylums, so the ordinance foresaw a system where the insane would be cared for at state expense.
Asylums aimed to provide better care for mentally ill people than the gaols, with a minimum of physical restraint. The only treatment given was ‘moral management’ – quiet routines of physical work and exercise, church services, and dances and other recreation, with the staff providing role models for orderly behaviour.
In the 1860s and 1870s small purpose-built asylums were set up around the country, usually on the edge of the main towns to encourage community involvement. They included Karori, near Wellington (1854), Dunedin and Sunnyside, Christchurch (1863), the Whau, Auckland (1867), Seaview, Hokitika (1872), and Nelson (1876).
The next generation of buildings were in more remote areas and were much larger, for example Seacliff, near Dunedin (1879), and Porirua, near Wellington (1887).
From 1876 all public mental institutions came under the control of a government department.
James Hume, the superintendent of the Dunedin Asylum, believed that ‘Patience, gentle treatment, nourishing diet, Cleanliness with light employment or Exercise goes far to recover the Lunatic and in Chronic Cases serves to make them Comfortable or even happy. Amusements for the insane are indispensable …and where space can be found in an asylum, a weekly concert with dance – both sexes carefully chosen can join in the entertainment and conduct themselves with the greatest decorum. Good example in the attendants is the greatest guide, and gives confidence to the patients.’’2
Treatment in asylums
The early asylums were staffed mainly by people with no medical training, although medical advice was available. Some achieved very high standards in implementing ‘moral management’. Seclusion and restraint of dangerous or destructive patients in locked gloves or cloths (strait or soft jackets) was sometimes practised.
The buildings were surrounded by their own farms and gardens. Patients were expected to work both inside and outdoors to the extent they were able, helping with domestic chores, farming and gardening.
Strong humanitarian sentiment underpinned the moves to establish proper asylums. In 1864 a select committee of the Otago Provincial Council advised that ‘lunatics should be regarded by the state as objects of tender solicitude, and that no pains or expense should be spared in ameliorating their condition. They wholly condemn their being treated as paupers or prisoners.’3 The Lunatics Act 1868 introduced regular independent inspection of asylums.
Patients in asylums
By the late 19th century public asylums came to hold all kinds and ages of mentally ill people, including children, together in the same areas. The emphasis was less on treatment and cure than on long-term care and custody of patients. Asylums provided some advantages over families caring for mentally ill members themselves, but they were also used to confine categories of people outcast by society, for example, elderly people been suffering from mild confusion.