In a recent issue of Social History of Medicine, 21(2), Brendan D. Kelly reports the findings of his examination of the case records for all women admitted to Dublin’s Central Criminal Lunatic Asylum between 1910 and 1948.

The majority of women were Roman Catholic (85.4 per cent) and had a mean age of 36.4 years. The majority were convicted of a crime (85.7 per cent), of whom 75.0 per cent were convicted of killing, most commonly child-killing. The majority of women detained ‘at the Lord Lieutenant’s Pleasure’ (indefinitely) were convicted of murder (51.7 per cent), assault (20.7 per cent) or infanticide (13.8 per cent); mean duration of detention was 5.6 years. The most common diagnoses were ‘mania’ or ‘delusional insanity’ (38.1 per cent) and ‘melancholia’ (23.8 per cent); 7.1 per cent were considered ‘sane’. Following their detention, 28.1 per cent of women were transferred to district asylums and the remainder were released under various different circumstances. In common with similar studies from other countries, these data demonstrate that the fate of these women was largely determined by a combination of societal, legal and medical circumstances, as evidenced by the socio-economic profile of women admitted and changes in admission patterns following the introduction of the Mental Treatment Act 1945. The role of other factors (such as religion) in determining their fate merits further study.

To help build on Kelly’s findings, a selection of readings on “religion and madness” are provided below the fold.

Select Bibliography: Religion and Madness

• Bainbridge, W. S. (1984). Religious insanity in America: The official nineteenth-century theory. Sociological Analysis, 45(3), 223-239. Throughout much of the nineteenth century, psychiatrists and ordinary citizens agreed that one of the chief causes of mental illness was religious excitement. Discovery of hitherto untouched data from the 1860 census, giving supposed cause of insanity for 2,258 inmates of 17 asylums, provides the opportunity for exploring the alleged role of religion in producing insanity. Enshrined in publications of the U.S. government and in the chief psychiatric texts as part of the official theory of madness, the idea of religious insanity may have served a number of functions for the new profession of psychiatry, as well as offering afflicted families an optimistic interpretation of mental problems. A mixture of medical, moral and religious ideas, the dominant psychiatric theory cast opposition to high-tension, sectarian religion in an apparently scientific context.
• Belkin, G. S. (1996). Moral insanity, science and religion in nineteenth-century America: the Gray-Ray debate. History of Psychiatry, 7, 591-613. Presents a debate between alienists John P. Gray and Isaac Ray on the doctrines of moral insanity and moral treatment. These doctrines gave the 19th century American physician unique claim to expertise in insanity and provided the rationale for the asylum. It is argued that theoretical assumptions are of greater importance in properly understanding these debates historically than are the participant’s professional interests, advocacy for their profession’s authority, or basic assumptions. These theological positions also explained varying philosophical and clinical views, but they were also formulated and exercised through a clinical discourse and identity specific to mid to late 19th century America.
• Digby, A. (1985). Madness, morality and medicine: A study of the York Retreat, 1796-1914. Cambridge University Press. This book presents a scholarly historical description of the development of the asylum movement in England in the latter part of the 18th century and the 19th century, recounting the institutional and medical developments of the York institution. The volume is filled with interesting information and some relatively obscure photographs depicting life at the institution from both the staff and patient perspectives. (From a review by James Butcher, published in Contemporary Psychology in 1986.)
• Lipsedge, M. (1996). Religion and madness in history. In D. Bughra (Ed.) Psychiatry and religion: Context, consensus and controversies. New York: Routledge.
• Rollin, H. R. (1994). Religion as an index of the rise and fall of ‘moral treatment’ in 19th century lunatic asylums in England. Psychiatric Bulletin, 18, 627-631. Describes the history of the influence of religion on treatment and asylums for the mentally ill. Topics discussed include the status of the chaplain, the exclusivity of religious services, and the decline in the role of religion in 19th century asylums.
• Taubes, T. (1998). “Healthy avenues of the mind”: Psychological theory building and the influence of religion during the era of moral treatment. American Journal of Psychiatry, 155, 1001-1008. This article delineates the main psychological interventions used by American asylum superintendents practicing moral treatment between 1815 and 1875. It explores the impact of Protestant ideas on specific aspects of moral treatment’s theory and practice. Asylum annual reports written by superintendents (physicians dedicated to the treatment of the mentally ill) were studied along with volumes of the American Journal of Insanity from its premier issue in 1844 to the 1890s. The writings of T. Gallaudet and H. Mann, both committed advocates of moral treatment, were also examined. The superintendents espoused complex theories about individual psychology and the nature of the self based on their observations. Protestant religious thought was a major influence, helping to catalyze original psychological propositions. The superintendents voiced surprisingly modern psychotherapeutic insights. Religious worship as well as religious notions about the inviolability of the soul greatly influenced their views of patients. Rather than being an impediment to formulating psychological ideas, religious concepts proved to be a rich framework for evolving theories about aspects of patients’ internal psychological functioning.

-JLB.