Male admissions to an English public assistance hospital mental ward 1926-1948 : diagnosis and disposal

E.D. MYERS

North Staffordshire Medical Institute, St. Davis, 96 Lancaster Road, Newcastle ST5 ID5, England
Tel. 01182-619434

 

Prior to the establishment of the National Health Service in 1948, the psychiatric needs of most districts in England were served by beds or wards in workhouse infirmaries which in 1930 became public assistance hospitals, and by asylums. In North Staffordshire the public assistance hospital had male and female mental wards, each accommodating some 45 patients. The following details are derived from a Register of Admissions to the male mental wards for the years 1926-1948.

Total number of admissions : 2,293 averaging 102 per annum.

Age on admission: This remained constant until 1941 when there was a sudden increase in the numbers aged 70 and over. In 1926 this group constituted 6.5% of admissions; in 1947 it constituted 25.6% of admissions.

Diagnosis : During these years there were no psychiatrically qualified medical officers on the mental wards; the diagnosis was made by the senior medical officer for the hospital who was essentially a surgeon. His diagnoses were as follows:

Mental State Number Percentage
Deluded 432 19
Mania/manic depression 332 14
Senile dementia 224 10
Dementia praecox/schizophrenia 156 7
Mental deficiency 153 7
Epilepsy 146 6
Confusion 125 5
Melancholia/depression 115 5
Dementia 90 4
GPI 89 4
Alcoholism 72 3
Religious mania 39 2
Neurosis 36 2
Encephalitis lethargica 15 1
Totals 2024 89

Among the remaining 11% were patients described as uncontrollable (11), wandering (8), homicidal (36), paranoid (10), violent (9), loss of memory (4), noisy (4), destructive (6), hallucinated (20). There were 18 admitted as the result of sexual misbehaviour.

Attempted suicide : There were 294 entries of attempted suicide, giving an average of 19 per year :

Method Number Percentage
Cut throat 60 20.4
Self poisoning 27 9.2
Coal gas 26 8.8
Other self-inflicted wound 25 8.5
Drowning 14 4.8
Hanging 12 4.1
Jumping from a height 5 1.7
Unspecified 125 42.5

Totals 294 100.0

Discharge: 61% were transferred to the asylum under certification ; 15% returned home in the care of relatives ; 9% (mainly elderly patients) died in the mental ward ; 4% were transferred to other wards in the hospital ; 2% were discharged to find their own accommodation in the town and 1% were discharged into the hands of the police. The remainder were transferred to what was described as "the body of the house" which was a term for those parts of the building housing inmates who were not ill but unable to support themselves on account of poverty.

 

Poster Session
Tuesday, 14 September 1999
14.00-15.40

The Neurosciences and Psychiatry: Crossing the Boundaries

Joint Congress of the European Association for the History of Psychiatry (EAHP), the European Club for the History of Neurology (ECHN), and the International Society for the History of the Neurosciences (ISHN)

Zurich and Lausanne, Switzerland, 13-18 September 1999