Care in the community

When institutionalised care for the mentally disabled was phased out under Margaret Thatcher in 1983, and the responsibility for care shifted principally to family members, the policy was considered to be one of the biggest political changes in the history of mental healthcare. But the approach to care was really coming full circle.

Mental illness and disability were family problems for English people living between 1660 and 1800. While mental illness was a subject of morbid fascination to the English public, and queues formed to see incarcerated women, the reality was more mundane. Most women and men who were afflicted by mental illness were not institutionalised, as this was the period before the extensive building of asylums. Instead, they were housed at home, and cared for by other family members.

Now a new study by Cambridge historian Dr Elizabeth Foyster will reveal the impact on families of caring for mentally ill and disabled relatives.

Much has been written about the insane themselves but few studies have considered mental illness from the perspective of the carers. The lifetime burden of caring for those individuals whose mental development did not progress beyond childhood, and who contemporaries labelled as ‘idiots’, ‘naturals’ or ‘fools’, has been little explored by historians. Foyster’s research, which has been funded by the Leverhulme Trust, will unpick the emotional and economic consequences for families at a time when the Poor Law bound them to look after their mentally ill and disabled family members.

By asking key questions about the impact of ‘care in the community’ in the 18th century, Foyster hopes that her research will bridge social and medical history. Specifically, she aims to provide an historical perspective to contemporary debates such as how resources can be stretched to provide for children with learning difficulties and an ageing population.

“The stresses and strains of family life were exacerbated by high infant mortality and low life expectancy, and many individuals were pushed towards mental breakdown,” she explained. “Moreover, inherited conditions, senility and what today would be described as ‘special needs’ could put great emotional demands on family members who had primary responsibility for their sick or disabled relatives.”

The research will shed light upon how caring for the mentally ill and disabled raised difficult issues for families about the limits of intergenerational responsibility, and whether family ties were weakened or strengthened by the experience. The questions of how far shame was attached to having insanity or idiocy within a family, and at what point families began to seek outside help, will also be addressed.

“The family must have seemed an inescapable feature of daily life between 1660 and 1800,” said Foyster. “Although there were those who were abandoned and rejected, for the majority, mental disability was accommodated within the family unit. I aim to get to the heart of what this really meant for people’s lives.”

For more information, please contact Louise Walsh (louise.walsh@admin.cam.ac.uk) at the University of Cambridge Office of External Affairs and Communications.