Bethlem Royal Hospital
London’s Bethlem Royal Hospital, long called Bedlam, is one of the oldest mental institutions in the world. It was founded by Christians in 1247 to shelter and care for homeless people, but gradually began to focus on those considered ‘mad’. Patients did not often stay longer than 12 months. Ex-patients were called ‘Bedlamites’ and were licensed to beg on main routes between towns. Bedlam came under the control of the City of London in 1547. It was the only public mental institution in England until well into the 1800s.
Despite its large reputation, Bedlam remained small for centuries - there were no more than 24 patients in 1620. Its location near the walls of London (on land now occupied by Liverpool Street Station) and status as a public institution ensured a stream of visitors eager to view ‘madness’. In 1676 Bedlam moved to a new and larger building at Moorfields with a baroque facade by natural philosopher Robert Hooke that was designed to impress visitors. Commentators have noted visitors and artists often projected onto Bedlam their hopes and fears about ‘madness’.
Bedlam’s high profile saw it repeatedly criticised and mired in scandal. Some of its most outspoken patients were confined because their political enemies wanted to silence or discredit them. Government inquiries into the abuse of Bedlam patients inspired reforms in the 1700s and 1800s. ‘Bedlam’ came to describe any out-of-control situation.
The hospital moved again in 1815 to improve patient conditions. It was further away from the city centre, so patients had more space for indoor and outdoor activities. This was central to moral treatment. In 1930 it moved to its current home, a large campus in the London suburbs housing patients in small, separate, home-like buildings rather than a single fortress-like structure. Bethlem Royal Hospital is now a research and treatment centre, and its small museum holds a renowned collection of art made by people diagnosed with mental illness.
J Andrews, ‘Hardly a Hospital, but a Charity for Pauper Lunatics’? Therapeutics at Bethlem in the Seventeenth and Eighteenth Centuries’, in J Barry and C Jones (eds), Medicine and Charity Before the Welfare State (London and New York: Routledge, 1991), pp 63-81
J Andrews et al., The History of Bethlem (London and New York: Routledge, 1997)
A Scull, C MacKenzie and N Hervey, Masters of Bedlam: The Transformation of the Mad-Doctoring Trade (Princeton University Press, 1996)
P Allderidge, ‘Management and Mismanagement at Bedlam, 1547-1633’, in C Webster (ed.), Health, Medicine and Mortality in the Sixteenth Century (Cambridge University Press, 1979), pp. 141-64.
P Allderidge, ‘Bedlam: Fact or Fantasy?’, in R Porter et al (eds), Anatomy of Madness: essays in the history of psychiatry, vol. 1 (London; New York: Tavistock Publications, 1985) pp 17-33