From morality to madness: a reappraisal of the asylum movement in psychiatry 1800-1940.

This essay outlines the history of the asylum movement in psychiatry, but from a somewhat different angle than usual. It attempts to delineate the historical interactions between perceptions of morality and of madness. Changes in these interactions relate to the rise of the asylum movement, around 1800, and its demise, just after World War II. I argue that, whilst insanity was defined against the rational, secular morality of the eighteenth century, it could be separated from immorality and put aside into its asylum. Once mechanistic science and medical scientism began, during the nineteenth century, to include immorality in the systems of disease, the distinction could not hold. The asylums became flooded with the immoral, and management became custodial and nihilistic. This nexus was broken when the asylums were defined, by a few revolutionary superintendents, as instruments of social control. Nevertheless, intellectual paradigms derived from asylum psychiatry persist.