Mental diseases

In the 19th century, mental illness was not yet seen as a serious health problem. It was often overlooked, especially in the poor. When you entered the workhouse, you would be given a medical evaluation. From this evaluation the workhouse staff would decide if you had some type of mental illness.  If you attempted suicide, you would also be labeled mentally ill or “unstable.” Many people entered workhouse without mental health problem, but developed them while they were inmates. There was no thought that the harsh conditions in workhouses might cause or exacerbate mental illness.

These workers did not enter workhouses because they wanted to. The entered because they were in dire financial straits. According to Marjie Bloy, “The main feature of the new Poor Law was the establishment of deterrent workhouses. Anyone claiming relief would have to enter ‘the House’. If a man claimed relief, his entire family would also have to enter the workhouse and it would be split up in accordance with the rules of separation.”

The high rates of death in workhouses and other public institutions can be seen in the Medical Officer of Health report for the City of London in 1889:

During 1898, 132 persons died in City Workhouses, Workhouse Infirmaries or Lunatic
Asylums, or no less than 27.9 per cent. of the whole City mortality, the corresponding figure for the Metropolis being 16.8 per cent. This high percentage is caused in the City by the enormous proportion the number of inmates in these places (exclusive of officers and their families) bears to our population, the ratio being about 1: 19, as compared with 1: 109 in the Metropolis. In other words, these figures represent that 1 in every 19 citizens is an inmate of either a Workhouse, Workhouse Infirmary or a Lunatic Asylum, in comparison with 1 in every 109 inhabitants of the Metropolis. (pp. 14-15)

A lot of families chose the workhouse to look for help: “A widower with three young children, Mr. Tibbey was in serious financial straits when he sought help from the parish in which he had lived for many years. He became a workhouse inmate at the end of August, 1847, and was dead by the end of September.” Many died in the workhouse. “Of 491 inmates examined on admission, 312 subsequently made 1,257 visit for medical care.” Many did not know what they would face when they walked into the workhouse. They were welcomed there with harsh conditions and diseases.

To the poor and those in financial need the workhouse was the answer. “The only option for the destitute poor would be work in exchange for a thin subsistence, and only inside the workhouse.” The workhouse conditions were unethical. “The regime inside workhouses was deliberately harsh, so as to deter all but the most desperate. Families were broken up, belongings sold, children separated, heads were shaved, clothes boiled, uniforms issued.”

One can assume that rates of depression in workhouses were high. “Through questionnaire and number of visits and problem encounters a significant relationship was seen with depression.” Depression was not yet known as a disease in the 19t century. To the reality of many that is what they faced. The conditions of the workhouse were so bad that it lead to many having depression. Depression then later led to suicide.

The story of Mr. John Buckenham is an example of this. He was “incarcerated as a ‘lunatic,’ without being medically certified, after having tried to commit suicide.” He was than later put in confinement to try to “heal” him. He got very ill and “even the assistant medical man had often expressed his opinion that…confinement in the oakum room was highly injurious.” Still the parish doctor was “under the too powerful influence of the workhouse master to prevent further injury.” He soon met death, as did many workhouse inmates. It was not just actual diseases killing but the hard conditions that led to depression and suicide.

L0019069 Man in restraint chair; by H. Clarke; 1869
Man in restraint chair at West Riding Lunatic Asylum, Wakefield, Yorkshire; by Henry Clarke, 1869. Credit: Wellcome Library, London.

Written by Tatiana Prado


Marjie Bloy, The anti-Poor Law campaign

R. A. Derro, “Health problems in a city-county workhousePublic Health Rep. 1978 Jul-Aug; 93(4): 379–385.

MOH Report for the City of London for the year 1898

Ruth Richardson, “A dismal prospect: workhouse health careThe Lancet,
Volume 382, Issue 9886 , 20 – 21.