- Learning outcomes
- 1 Lennox Castle Hospital: a twentieth century institution
- 2 Institutions: an outline history
- 2.1 Institutions and segregation
- 2.2 1 Social Darwinism and eugenics
- 2.2.2 Treatment regimes
- 2.2.4 Activity: segregation today
- Current section: 2.2.5 The emergence of asylum professionals
- 2.2.6 Skills for the attendants
- 2.2.7 Resistance to institutions
- 2.2.8 Campaigns for change
- 2.2.9 Professionalisation
- 2.2.10 Civil liberties campaigns
- 2.2.11 Scandals, treatments and cost saving
- 2.2.12 Activity: living through change
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Lennox Castle Hospital
This unit looks at the history of institutions in the twentieth century, starting with...
This unit looks at the history of institutions in the twentieth century, starting with a case study of Lennox Castle Hospital. It tries to make sense of the history of Lennox Castle, and of institutional life in general, through testimony of those who experienced institutions as inmates and as nurses, as well as through Erving Goffman's medel of the 'total institution'. It examines the social bases of segragation, the professionalisation of staff in asylums and institutions, and campaigns for change in the treatment of those segragated from society in institutions.
After studying this unit you should be able to:
- use Goffman’s model of ‘the total institution’ to organise and explain information that has been observed and recorded;
- describe the development of large-scale institutions in the nineteenth century which were designed to segregate, control and in some cases, cure, their inmates.
2.2.5 The emergence of asylum professionals
Asylums and institutions were not only sites of care and control, they were also places where people worked as staff and developed professional expertise. The people who worked there also experienced segregation, professionally speaking. In this section we take a brief look at the development of caring professions in the institutions.
Low status patients, frequently paupers, with low status illnesses and conditions, such as mental illness, mental frailty or mental handicap, provided no prestige to doctors and other staff who worked with them. These socially stigmatising conditions meant that asylum doctors in mid-nineteenth century England occupied a lower social and professional status than doctors who worked in general hospitals. They could not, for example, offer their services to the large public charities or other bodies. They could not become consultants. Assistant medical officers in the asylums were paid at a lower rate, had to live in, had to delay marriage and had few opportunities for research or professional development. Since doctors at the large general and teaching hospitals did not see people with mental illness, there was also a tendency towards segregation of knowledge and professional skills (Hurt, 1988, p. 115).
If the medical staff were regarded as low in status, the attendants, as asylum nurses were still being called until well after the Second World War, who looked after the patients were very much lower, both within the institutions and within nursing generally. Though the Medico-Psychological Association (MPA), the asylum doctors’ own organisation, was ostensibly in support of training and education for attendants, with several members running their own evening classes during the mid to late nineteenth century, there was concern that successful nurses might challenge the position of doctors. However, by 1899 over a hundred asylums were taking part in a training scheme which led to an examination and certification. Attendants who took part were almost exclusively from the public asylums and were supervised and trained by doctors. This was in contrast with general nurses who, led by such pioneers as Florence Nightingale, had set up training schools which were controlled by nurses. Few private institutions trained their own attendants. Nursing had its own professional organisation by 1887 with the establishment of the British Nursing Association. But asylum nurses were excluded from membership on the grounds that they did not have appropriate experience and were also socially inferior.
This is an extract from an Open University course which is no longer available to new students. If you found this interesting you could explore more free Social Care course units or view the range of currently available OU Social Care courses.