APS member and clinical psychologist Jill Giese recently won the Victorian Premier’s History Award for a book illuminating the world of Victoria’s colonial lunatic asylums. The young colony, grappling with alarming rates of insanity, embarked on a grand project to cure lunacy with an enlightened treatment. The award judges praised Jill’s book, The Maddest Place on Earth, for “elevating a shunned subject to centre stage through a brilliant fusion of serious scholarship and imaginative writing”. InPsych spoke to Jill about her research and writing exploration of 19th century efforts to treat mental disturbance.
Why did you decide to write the book?
I found a remarkable story of humanity at the foundations of Victoria’s mental health system. Among the many poignant lives my research unearthed were three people who particularly moved me, each questing for something ennobling in their lives – the ambitious doctor in charge, toiling valiantly to implement the enlightened treatment in his overflowing asylums; a gifted artist who was banished from England for his madness and regained sanity under the modern treatment; and a mysterious journalist and champion of the underdog, who somehow procured a job working undercover at the asylums and sensationally exposed the patients’ plight in Melbourne’s press.
These compelling individuals became my guides to the asylums and energies of the times. I decided to craft their interwoven experiences into an engaging real-life story, aiming to attract a general audience so this history could be more widely known – and in the process appealing for more compassion for people struggling with mental ill-health as well as those working to ameliorate it. It’s been such an enlivening writing challenge, treading the tightrope of recreating history in vivid colour while sticking to the facts.
Your book’s title is pretty provocative!
The Maddest Place on Earth is based on a quote from a royal commission, established in the 1880s to investigate Victoria’s soaring rate of insanity. The head of Victoria’s asylums presented a comparison of international insanity statistics that left the commission’s chairman aghast. “This gives us the most unenviable position of being the maddest place in the world?” he asked the asylum chief. “Yes”, was the blunt reply. The story of insanity in Victoria can’t be told without appreciating just how many patients there were!
Tell us about the ‘enlightened’ treatment in the asylums.
The treatment was transported from Britain, where a revolution in managing mental illness had occurred in the early 1800s following dark centuries of brutal, subhuman abuse. The British reforms had their unlikely origins in the notions of a philanthropic Quaker, who believed people with insanity may have lost their minds to madness, but not their hearts. He set up his own asylum, speaking to patients’ hearts by treating them with dignity in an uplifting environment with something meaningful to do. Unsurprisingly, his innovative treatment got impressive results and added to other impetus for reform. The progressive among Britain’s medical men adopted the Quaker’s enlightened treatment with zeal, spearheading a wave of reformed asylums that eventually spread to the British colonies.
In Victoria, patients were placed in purpose-built grand asylums with uplifting views and landscaped gardens. The asylums’ treatment prescribed nourishing and plentiful food, strict daily routines, and meaningful occupation doing work around the asylum. A variety of amusements – such as the fortnightly asylum ball, lawn bowls and caged birds in the exercise yards – aimed to divert patients from fixating on their disturbed thoughts. The asylums were intended as therapeutic places of recovery to gradually restore unstable minds to sanity. Similar enlightened asylum treatment was attempted throughout the Australian colonies in the 19th century.
So did Victoria’s grand asylum project get results?
Victoria’s magnificent asylums, despite overflowing with patients, attained an impressive ‘cure rate’ of 54 per cent in 1876. But it was downhill from there. The grand project was eventually ambushed by the sheer number of patients, mostly ill-suited staff and a gradual accumulation of people with chronic mental illness. The asylums’ crumbling grandeur saw some dark chapters in the 20th century, until they finally closed their doors in the 1980s and ’90s in the new age of community care.
As a psychologist, what surprised you most in this history?
Undoubtedly there were many shadows associated with the asylums in colonial days, but they were built with sincere intentions as humane institutions. The colonials’ enlightened treatment principles recognised the importance of social connection, structured routines and purposeful activity to bolster defences against mental affliction. And the asylums, as their names suggest, aimed to provide a place of refuge and recovery for people ravaged by mental turmoil. This treatment philosophy addressed fundamental human needs that are just as vital today for those struggling with mental ill-health. As we continue to grapple with treatment responses to this ancient human malady, there’s surprising relevance at the historical heart of our mental health system.