The Scottish Influence on New Zealand Psychiatry before World War II
2011; Taylor & Francis; Volume: 29; Issue: 3 Linguagem: Inglês
10.1080/02619288.2011.615488
ISSN1744-0521
Autores Tópico(s)Neurology and Historical Studies
ResumoAbstract Histories of British mental health policy and services in Georgian and Victorian times until recently have been strongly Anglocentric. In the nineteenth century, however, the Scottish system remained proudly distinctive within a broadly British framework. This article discusses elements of the Scottish model that were adopted in New Zealand up until the Second World War. Both countries retained a somatic orthodoxy and strongly institutional focus of care, within which efforts were made to open locked wards, liberalise parole and activate patients. The villa system, reception homes, voluntary admission and some ideas on staff training and deployment also owe something to contemporary Scottish practice. Scottish-born or Scottish-trained top administrators and medical staff did much to introduce these ideas from 'hame' to New Zealand's mental hospital service. Keywords: ScotlandNew Zealandmental healthpolicypsychiatryhistory Notes [1] R.A. Lawson, 'Evidence to Commission of Inquiry into the Condition of the Seacliff Lunatic Asylum Building', Appendices to the Journals of the House of Representatives [hereafter known as AJHR, (Auckland: House of Representatives, 1858 onwards)], (1888), H-7: 167. [2] CitationAndrews, 'They're in the Trade', 40, 46–7, 62; CitationSturdy and Parry-Jones, 'Boarding-out Insane Patients', 86, 112. [3] See CitationHouston, Madness and Society, 409–10; also CitationWalker, Legal History of Scotland 2: 584–5. [4] 55 o Geo. III, c.69, s. 8; 20 o & 21 o Vict., c.71, ss. 34, 85. [5] 25 o & 26 o Vict., c.54, s. 6 (Lunacy Act (Scotland) Amendment Act 1862) and 29 o & 30 o Vict., c.89, s. 15 (Lunacy Act (Scotland) Amendment Act 1866). Voluntary admission was mandated for English licensed houses in 1890 and 1930 for county or public asylums. [6] CitationMcNiven, 'The First Commissioners', 460–1, 465–8. [7] CitationCampbell, 'On Escapes, Liberty, Happiness, and "Unlocked Doors"', 209. [8] '[Review of the] Twenty-sixth Annual Report of the General Board of Commissioners', Citation592. [9] CitationLindsay, 'Suggestions', 484–5. [10] Enoch Powell, United Kingdom Minister of Health (1960–1963), cited in CitationJones, History of the Mental Health Services, 322. [11] Lindsay qualified as an MD from Edinburgh in 1852 after a distinguished academic record. He was a Fellow of the Royal Society of Edinburgh, the Linnean Society and the Royal Geographical Society. Lindsay's contributions to the development of the mental health and general scientific fields in New Zealand are the subject of a University of Otago multidisciplinary project. [12] Scottish Press, September 5, 1856, citing [Lindsay], Supplement to Dr. Lauder Lindsay's Testimonials, Citation4. [13] Minutes of General Quarterly Meeting of Directors, 12 December 1859, Murray Royal Hospital Directors' Minute Book [MRHDMB] 3, NHS Tayside Collection. Murray Royal Hospital Archives, Perth [TB 29], University of Dundee Archives, Dundee. [14] Report by Her Majesty's Commissioners appointed to Inquire into the State of Lunatic Asylums in Scotland and the Existing Law in reference to Lunatics and Lunatic Asylums in that part of the United Kingdom [hereafter Royal Commission Report] (Edinburgh: HMSO, 1857, reprinted in series of British Parliamentary papers, Health Mental, Shannon: Irish University Press, 1968), Vol. 7 (of reprint). See also Minutes of Quarterly Directors' Meeting, 12 March 1855 and notes to the annual financial report, General Annual Meeting, 11 June 1855, MRHDMB 2. [15] [Lindsay], 'Report of the Physician', Citation72. [16] Minutes of Special or Extraordinary Meeting of Directors, 16 May 1861, Weekly Committee report, 16 May 1861, MRHDMB 3; and Lindsay to Sir Walter Trevelyan, 24 May and 7 June 1861, Sir Walter Trevelyan Papers, Robinson Library, University of Newcastle on Tyne, 173/25 and 173/27. [17] CitationLindsay, 'Colonial Lunacy Boards,' 807; and W.C. McIntosh diary, 25 July 1862, William Carmichael McIntosh Papers, University of St Andrews, Special Collections Library, MS 37105/4. [18] Lindsay, 'Suggestions', 480. He later claimed that he left New Zealand far from being 'one penny the richer' for all the advice he had given. See Lindsay, 'Colonial Lunacy Boards', 824. [19] Lindsay met provincial government officials at Nelson on 28 January 1862 and he visited the lunatic asylum annexe at Auckland Hospital on 10 and 22 February 1862. See Lindsay, 'Suggestions', 481–3; and Lindsay, 'Colonial Lunacy Boards', 807. [20] Nelson Provincial Secretary reported in Nelson Examiner, May 24, 1862. [21] Lindsay, 'Otago Provincial Hospital', Otago Colonist, Citation26 September 1862, 3. [22] Lindsay, 'Suggestions', 481, 485. [23] Provincial Surgeon's annual report, Auckland Provincial Council Journal, 1862, A-1: 6; and Philson in evidence, Auckland Provincial Council Journal, 14 (1862), 15–16. [24] Provincial Surgeon to Provincial Superintendent, 23 January 1860, Otago Provincial Government Archives [OP] 6/6, Letter 60/52; and Provincial Surgeon's report on the Hospital, 1861–62, Otago Provincial Council Votes and Proceedings [OVP], XVI (1861–2), 48. [25] It is unlikely to have been leading politician Julius Vogel as he favoured a central lunatic asylum at that time. Lindsay's views were set out in a rival newspaper to Vogel's editorial mouthpiece, the Otago Daily Times. See editorial, Otago Daily Times, January 24, 1863. [26] Lindsay, 'Otago Provincial Hospital for the Insane at Dunedin', Citation3. [27] Ibid. [28] Lindsay, 'Otago Provincial Hospital', Otago Colonist, Citation26 September 1862, 3. [29] Provincial Surgeon's report on Dunedin Hospital, 1861–1862, OVP, XVI (1862), 48. [30] OVP, XVII (29 September 1863), 130; and Dunedin Daily Telegraph, September 30, 1863. [31] Lindsay, 'Colonial Lunacy Boards', 828. [32] Lindsay, 'Suggestions', 484–5. [33] [Lindsay], 'Appointments', Citation6. [34] For further information on Hokitika, see CitationBrunton, Sitivation 125, 13. [35] Lindsay to Provincial Secretary, 21 October 1864, Nelson Provincial Government Archives, NP 7/12, L.64/915. [36] Provincial Surgeon to Provincial Secretary, 17 September 1863, OP 7/13, L. 2427/6. [37] I am grateful to Alistair Tough, Senior Research Fellow in the University of Glasgow, and Archivist and Records Manager, NHS Greater Glasgow, for tracing these details. [38] I have been unable to verify this point. [39] CitationAndrews and Smith, 'Let There Be Light Again', 17. For a succinct statement of Hume's philosophy of care, see Dunedin Asylum Keeper's Journal, 20 April 1864, Healthcare Otago Ltd Archives, DAHI D264. [40] Dunedin Daily Telegraph, September 15, 1863; and AJHR (1881), H-13: 3. [41] Hume to Clerk, Legislative Council, n.d., AJHR (1871), H-10: 15–6. [42] CitationSnedden, 'Environment and Architecture'; Royal Commission Report, Appendix B, 72–80 and Dr Alexander McIntosh in evidence, Appendix M, 468–9. [43] Provincial Surgeon to Provincial Treasurer, 19 June 1868, and Provincial Executive Council minute, 26 June 1868, OP 7/44, Letter 9035/1. [44] Lindsay, 'Suggestions', 481. [45] CitationLindsay, Recent Publications on Insanity and its Treatment, 7, notes that works on lunacy legislation and the lunatic asylums in New Zealand were 'in preparation'. [46] Inspector, Otago to Provincial Superintendent, 14 [?] July 1875, OP 7/77, Letter 13063/6. [47] Lindsay attached great importance to his extensive correspondence, instructing that after his death, a medical practitioner, scientist or literary man should carefully assess the merit of his letters and manuscripts for publication. See Citation'Addendum to Lindsay's Trust Settlement'. I have been unable to trace any of this correspondence. [48] Lindsay, 'Colonial Lunacy Boards', 810–1, 813. Emphases in the original. [49] Lindsay, 'Otago Provincial Hospital for the Insane at Dunedin', 3. [50] CitationBrunton, 'The Place of Public Inquiries'. [51] Colonial Hospitals and Lunatic Asylums, 14 January 1864, CO [Colonial Office Archives] 885/3, National Archives, London. The significance of the report is addressed in CitationBrunton, 'If Institutions of Mercy Do Not Conform'. [52] Lindsay, 'Colonial Lunacy Boards', 813–22. Skae accepted a salary of £700, AJHR (1876), H-4C: 4. [53] CitationBeveridge, 'Thomas Clouston and the Edinburgh School of Psychiatry', 369. [54] CitationRenvoize, 'The Association of Medical Officers', 47. [55] CitationFish, 'David Skae', 46–8. [56] CitationComrie, History of Scottish Medicine, 709. [57] Citation'Obituary: Frederick W.A. Skae, M.D., F.R.C.S.E.'. I am indebted to Miss S.G. Rowe and Dr Norman Reid of the University of St Andrews Library for information on degrees in medicine at St Andrews. [58] I am grateful to Dr Michael Barfoot and Laura Brouard of the Lothian Health Service Archive, University of Edinburgh Library, for obtaining these details from the minute books of the Asylum managers. [59] 'Obituary' [Frederick W.A. Skae], Citation481. [60] CitationGuthrie, History of the Royal Medical Society, 322. [61] Clouston, Laycock, David Yellowlees, Robert Jamieson, W.W. Ireland, Alexander Robertson and John Batty Tuke were among those listed. See AJHR (1876), H-4c: 2–3. [62] MacGregor's course included classes in Botany, Natural History, Chemistry, Practical Chemistry, Anatomy, Practical Anatomy, Institutes of Medicine, Materia Medica, Practical Pharmacy, Pathology, Surgery, Clinical Surgery, Midwifery, Practical Midwifery, Practice of Physic, Clinical Medicine, Medical Jurisprudence, Hospital, Dispensary and Vaccination. I appreciate the assistance of Mrs Irene Ferguson, Assistant to the University Archivist, University of Edinburgh, for providing details of MacGregor's student record. For a general account of the development of psychiatry in medical education at Edinburgh, see CitationRobertson, 'History of the Teaching of Psychiatry in Edinburgh'. [63] New Zealand Gazette (1876), 481; Otago Provincial Government Gazette (1876), 399, 426. [64] The inspectorate of hospitals and charitable institutions was added to the responsibilities of the Inspector-General of Asylums in 1880. The dual inspectorate was divided after MacGregor's death. Separate Mental Hospitals and Hospitals Departments were created in 1907. [65] CitationJones, Annals of the University of Otago Medical School, 95. [66] King in evidence, Regina v. S. Maxwell, 31 August 1893, Mental Hospitals Department File MH 1891/2511, 16, 91, formerly held at the Department of Health Head Office but current whereabouts unknown. The course was optional for medical students until 1892. See Robertson, 'History of the Teaching of Psychiatry in Edinburgh', 202. [67] King to [his] wife, 10 July 1894, Sir Truby King Papers, Alexander Turnbull Library, Wellington, MS 1004; and King to [his] wife, 21 July 1894, cited in CitationKing, Truby King The Man, 97–8. [68] Aberdeen University Calendar for the Year Citation 1904 –1905, 331–3. I greatly appreciate the assistance of Michelle Gait of the Library and Historic Collections, King's College, University of Aberdeen for kindly providing this information. [69] CitationClark, 'The Rejection of Psychological Approaches'. [70] AJHR (1877), H-8: 4. [71] Director-General to Controller-General of Prisons, 18 February 1929, MH [old Mental Hospitals Department File] 8/652 ([Closed File No.] 28382), Health Department Archives,[AAFB/W3464]. [72] Director-General to Minister, 17 October 1929, Department of Health, Mental Health Division Archives [HMH], 8/1041. [73] Medical Superintendent, Seacliff to Minister, 19 February 1902, DAHI D 264/66. Cf. AJHR (1925), H-7: 7. [74] Clouston (1880), cited in Beveridge, 'Thomas Clouston and the Edinburgh School of Psychiatry', 365. King's views, expressed as an official swansong, are set out in AJHR (1926), H-7: 7–8. [75] CitationKing, 'Corrupt and Immoral Publications'. [76] Clouston, Clinical Lectures, 533–8; '[Review of] "T.S. Clouston"', 102Citation'[Review of] "T.S. Clouston"', Citation102; and King in evidence to the Commission on Education, AJHR (1912), E-12: 651–2. [77] AJHR (1877), H-8: 5. [78] AJHR (1878), H-10: 11. [79] AJHR (1877), H-8: 4; and AJHR (1878), H-10: 11. [80] Skae was scapegoated by politicians and the press after the inquiry. He died of 'mental shock' and erysipelas before serving out his notice. [81] AJHR (1877), H-8: 3. [82] AJHR (1877), H-8: 5. [83] AJHR (1879), H-4: 5. [84] AJHR (1880), H-6: 9. [85] Illustrated New Zealand Herald, July 13, 1882. [86] 'New Private Lunatic Asylum', Otago Daily Times, October 28, 1882, 2. See also Somerville, 'Ashburn Hall 1882–1904', 87–8. [87] Jones, Annals of the University of Otago Medical School, 95, 99 [88] Director-General to Professor D'Ath (confidential), 19 April 1945, Health Department Archives, File H 30/5 (34271). [89] AJHR (1910), H-7: 5. [90] Medical Superintendent's report, Seacliff, AJHR (1910), H-7: 16. [91] King in evidence, Regina v. W.F. Kitchen, MH 1891/2511, transcript of evidence, 312; Director-General to Attorney-General, 2 September 1931, H 30/28/21 (34252). [92] AJHR (1926), H-7: 7. [93] Those figures also reflect the expanded role of institutions in the care of persons with intellectual handicap or psychogeriatric conditions. [94] This arose from the large proportion of mentally infirm patients and from the natural ageing of psychiatric patients with a chronic condition. There was a corresponding decrease in the proportion of recoveries from 64% to 49% during the same period. [95] '[Review of] The Blue Books in Lunacy', Citation568. [96] CitationIbid. [97] CitationSibbald, 'Gheel and Lierneux'. For an assessment of Sibbald's contribution, see Andrews, 'They're in the Trade', 18–9, 40–2. [98] CitationSteen, 'The Evolution of Asylum Architecture', 98. [99] '[Review of the] Twenty-second Report of the General Board of Commissioners', Citation610. [100] 'Asylum Reports… Crichton Royal Institution', Citation249. [101] Citation'Asylum Reports… Montrose'; Citation'Edinburgh District Lunacy Board'; Citation'Edinburgh District Asylum'; and Citation'Notes of Scottish Division Meeting'. [102] CitationBridges. People and Places in Newmachar Past and Present. [103] Citation'Reviews… Thirty-fourth Annual Report of the General Board of Commissioners'. These ingredients appeared in different combinations. See 'Notes of Meeting of the Psychological Section of the British Medical Association', Citation891. [104] CitationMacpherson, 'The Hospital Treatment of the Insane in Asylums', 778–91. [105] CitationSibbald, 'The Treatment of Incipient Mental Disorder'; CitationClouston, 'The Possibility of Providing Suitable Means of Treatment', 697–703, and discussion 704–9; 'The Proposed Psychological Clique at Edinburgh'. [106] 'Minutes of the Quarterly Meetings of the Medico-Psychological Association, November Citation1883 and February 1884'; CitationClark, 'The Special Training of Asylum Attendants'; and 'Occasional Notes of the Quarter – The Brighton Meeting', Citation395. [107] CitationDingwall, Rafferty, and Webster, Introduction to the Social History of Nursing, 128. [108] CitationTurnbull, 'Female Nursing of Male Patients', 635. [109] CitationTurnbull, 'Note on Female Nursing' , 789. '[Minutes of the] Scottish Division, 29 November 1901'. [110] CitationGray, The Very Error of the Moon, 83–4. [111] Seventeenth Report of the General Board of Commissioners in Lunacy for Scotland, 1875, Cmd Ppr 1259, British Parliamentary Papers (1875), Vol. XXXIII, 216. [112] AJHR (1881), H-13: 2. So did his successors. See AJHR (1885), H-10: 3, (1892), H-4: 2, and (1905), H-7: 2; Inspector-General to J. Hooper, 22 November 1927, HMH, File 4/4/1. [113] AJHR (1877), H-8: 6. [114] 'Minutes of the Scottish Branch of the Medico-Psychological Association', Citation322. [115] AJHR (1880), H-6: 4–5. [116] AJHR (1907), H-7: 17. [117] AJHR (1903), H-7: 4. MacGregor's discussants included Clouston and C.L. Robertson. He also explored the toxic theory of the causation of insanity; new methods for nursing at Larbert Asylum, and the construction of 'cheap wood-and-iron buildings' for the treatment of consumptives. [118] Inspector-General's report, Seacliff, 5 September 1889, AJHR (1890), H-12: 6. [119] '[Review of the] Twenty-third Annual Report of the General Board of Commissioners', 570–83 cited by the Medical Superintendent, Seacliff to the Minister of Native Affairs, 29 August 1891, AJHR (1891), H-29: 8–10. [120] Deputy Inspector's report, Seacliff, 1 April 1893, DAHI D 264/6. [121] '[Review of] A. Paetz, The Colonization of the Insane; and Medical Superintendent, Seacliff to Dr A. Paetz, Alt Scherbitz, 28 October 1897, DAHI D 264/20. I am grateful to Mr Holger Steinberg of the Archiv für Leipziger Psychiatriegeschichte, Universität Leipzig Klinik und Poliklinik für Psychiatrie, for attempting to trace the correspondence between King and Paetz. [122] Medical Superintendent to Inspector-General, 3 September 1898, DAHI D264/20. [123] AJHR (1896), H-7: 9 (Nelson), (1898), H-7: (Ashburn Hall), and (1906), H-7: 11 (Porirua). [124] AJHR (1909), H-7: 17. [125] AJHR (1905), H-7: 3–4. [126] New Zealand Parliamentary Debates [NZPD], 122 (23 September 1902), 556; 123, (3 and 17 July 1903), 164, and 125 (18 September 1903), 605. [127] AJHR (1887), H-9: 1–2. [128] AJHR (1897), H-7: 12. [129] 'Asylum Reports… Murray's Royal Asylum', Citation428. The first villas were built at the Murray Royal in 1904. See CitationChambers, History of Murray Royal Hospital 1827–1977, 30. [130] Medico-Psychological Association Council minutes, May and July 1896, 43–4, 55–6, Archives of the Royal College of Psychiatrists, London. I appreciate the assistance of Margaret Williams at the College Archives for providing this information. [131] Minister to Agent-General, London, 28 November 1895, and Inspector-General, Circular, 27 April 1896, Inspector-General's Letter Book 6, 275, 384, formerly held at the Department of Health head office but current whereabouts unknown. [132] Deputy Inspector-General, Circular, 15 June 1905, HMH 8/97/1. [133] AJHR (1907), H-7: 7. The term was probably borrowed from New South Wales. [134] Inspector-General to Chairman, Hospitals Commission, 23 May 1921, HMH 4/4/2. [135] AJHR (1925), H-7: 2–3. [136] NZPD, 142 (15 November 1907), 948. [137] AJHR (1909), H-7: 6. [138] AJHR (1909), H-7: 6 [139] Medical Superintendent's report, Porirua, AJHR (1918), H-7: 8. The reception house held the same number of patients as the hospital block at the Montrose Royal Asylum. See '[Obituary] James C. Howden', Citation223. [140] AJHR (1900), H-7: 4. [141] R.M. Beattie, interview, New Zealand Herald, September 27, 1905; and AJHR (1904), H-7: 4, 10. [142] Medical Superintendent, Seacliff to H. Gall, 14 March 1894, DAHI D 264/24; New Zealand Medical Journal, 1 (1900): 54–6; and Medical Superintendent, Seacliff to Minister, 28 May 1902, DAHI D 264/14. [143] Deputy Inspector-General to J.T. Fowler, Masterton, 19 September 1906, HMH 1906/1123; Mental Hospitals Bill 1906, cc. 31–2; and Mental Defectives Act 1911, ss. 39–40. [144] Mental Health Amendment Act 1950, s. 3(1). [145] Institutional weekly reports, Health Department Archives, W 4415 ABQU, Boxes 614–17. [146] New Zealand Times, April 14, 1910. [147] Gray, The Very Error of the Moon, 64, 88–91, 96. [148] AJHR (1927), H-7: 3 and (1928), H-7: 2. [149] AJHR (1948), H-7: 2, 22. [150] Director-General of Health to Minister, 20 July 1944, HMH 25/16/2. [151] CitationBlake-Palmer, 'Hospitals, Mental'; 525–6; and [S.W.P. Mirams], CitationNew Zealand Department of Health, Review of Hospital and Related Services in New Zealand, 14–5. [152] At Nelson Mental Hospital (now Braemar Centre) Montrose and Falkirk replaced the names of M and F Ward respectively. The tradition has continued at Braemar, with new buildings being named Iona, Argyle, Elgin, Leith and Caithness. Male villas at Ngawhatu Hospital, Stoke, had Scottish names – Clovelly, Airdrie, Viewmont, Dunoon, Kinross, Lanark and Stirling. Montrose and Nairn were built at Porirua in 1925. Craig and Lomond villas are more recent. [153] Skae was buried in St Mary's [Anglican] Churchyard at Karori, Wellington. A marble obelisk, erected by officers of the Department, can be found in the grounds of Porirua Hospital. [154] Lindsay, 'Suggestions', 484.
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