Scholarship of child mental health

The literatures of madness, poverty and childhood are vast and ever-growing fields, yet they infrequently intersect. The history of madness and psychiatry has focused heavily on the impact of institutions and their philosophies. Perhaps the most compelling argument has been that of Michel Foucault, who contended that asylums developed as instruments to control deviant members of society who failed to adapt to the needs and structures of industrialisation (Foucault, Reference Foucault1961). Such a narrative is fascinating, but has been mostly refuted by scholars such as Roy Porter (Reference Porter1987), Edward Shorter (Reference Shorter1997) and Pieter Spierenburg (Reference Spierenburg and Spierenburg1984), who observe the influence of private initiatives, chronological anomalies and the reliance on the French experience to draw Europe-wide conclusions. A further influential argument has been offered by Andrew Scull, who observed pauper lunatic asylums as spaces where alienists (doctors for the mad) consolidated their expertise and with it professional control over the insane. Of course, such a goal failed to materialise due to the rapid growth in asylum populations and the inabilities of the nascent psychiatrists to cure the vast numbers of chronic and elderly cases, often certified by Poor Law Medical Officers, who were sent to these newly founded institutions (Scull, Reference Scull1979).

Whereas this literature has focused on the crossroads of poverty and mental impairment, there have also been wider studies that have specifically considered the institutional experiences of society’s better-off members. Charlotte MacKenzie’s study of Ticehurst Asylum (Reference MacKenzie1992) provides a comprehensive overview of this asylum’s affluent members, with patients keeping private carriages on the grounds of the institution and paying in excess of £450 per annum for care (MacKenzie, Reference MacKenzie, Porter, Bynum and Shepherd1985; A. Shepherd, Reference Shepherd, Borsay and Shapely2007). Of course this experience is far removed from that of the patients and their families who were admitted to the asylums, to be examined later in this article. In fact, Cathy Smith has observed that ‘poverty and material deprivation were widely considered as both catalyst to and a consequence of periods of mental ill-health’ (Reference Smith, Gestrich, Hurren and King2012: 118).

More recently scholars have attempted to move outside of the asylum when exploring the experience of insanity. These studies have concentrated on discussions about the familiarity of families with committal processes in the nineteenth century, rather than arguments about medical professionalisation and social control (Coleborne, Reference Coleborne2015; C. Smith, Reference Smith2006; Walton, Reference Walton1979; Mellet, Reference Mellet1982). In his seminal article, Mark Finnane observed the complexities of asylum certification and emphasised the centrality of families in the process of committing their loved ones (Finnane, Reference Finnane1985). He noted that the vast majority of the insane in post-famine Ireland were committed directly from their own homes rather than via other institutions. Moving to the experience of England, David Wright identified that families of the upwardly mobile middle class in south-east England were among those who accessed the private and fee-paying idiot institution of Earlswood Idiot Asylum (Wright, Reference Wright1998). Akihito Suzuki has explored familial awareness of the stigma attached to lunacy in the eighteenth and nineteenth centuries, and how families often sought to shield insane relatives from the public gaze (Suzuki, Reference Suzuki, Horden and Smith1997; Suzuki, Reference Suzuki, Bartlett and Wright1999). These useful insights into the care arrangements of prosperous families reveal little about the institutional experiences of mentally impaired children or those accessing pauper lunatic asylums during this period.

Historical studies of community and domestic care were the focus of Wright and Peter Bartlett’s edited volume Outside the Walls of the Asylum. The contributors to this collection observed that despite the growth and importance of asylums in the nineteenth century, the majority of the insane population were still cared for outside its walls and usually within the domestic sphere (Bartlett and Wright, Reference Bartlett and Wright1999). Meanwhile, Jade Shepherd has demonstrated the causative impact of mental illness on family breakdown, with children being the victims of neglect and violence when parents experienced domestic crisis (J. Shepherd, Reference Shepherd2013). Evidently, the domestic arena was a crucial element in understanding how families, society and institutions reacted to insanity, but gaining retrospective insight into this private sphere is complex. Previous studies have extended the focus by concentrating on the circulation of children between institutions of welfare, medicine and the domestic sphere in an attempt to demonstrate the interconnectedness of the mixed economy of welfare and the home in managing children of the poor (Taylor, Reference Taylor2017a: 139–72). This article represents an extension of this approach in order to build a more detailed picture of the socio-economic circumstances of mentally ill and disabled children.

Despite focus on family involvement in the certification process, explicit attention from scholars towards the mental ill health of children has been rare. My previous work has demonstrated that relationships between the young, families and institutions functioned according to a rural/urban dichotomy and was more likely centred on the ubiquity of available provision rather than medical need (Taylor, Reference Taylor2017a). While constructions of child mental health and institutional experience feature heavily in this study, family backgrounds are less frequently explored (Taylor, Reference Taylor2017b). Likewise, in Amy Rebok Rosenthal’s exploration of families and insanity in late Victorian Britain, the economic circumstances of those who sent their children to the East Kent County Asylum do not feature (Rebok Rosenthal, Reference Rebok Rosenthal, Borsay and Dale2012). Moreover, Melling et al. accurately observed that the majority of insane children, both in their Devon case study and the country more widely, remained outside of pauper lunatic asylums and were cared for in domestic arrangements or workhouses (Melling et al., Reference Melling, Adair and Forsythe1997). Yet, like previous studies there was no robust analysis of the families that were accessing lunatic asylums.

By its very nature then, this is not an article that focuses on children explicitly but instead is an attempt to use children as a prism through which to ask wider questions about the types of families that were making use of pauper lunatic asylum provision for their offspring. It does this by asking three core questions. First, how does the admission of children to asylums contribute to the core debates about institutionalisation, psychiatry and childhood? Secondly, does knowledge of the socio-economic position of children and their families help to improve understanding of mental health and the institution in this period? Finally, what does childhood experience tell us about family circumstances in the mid- to late nineteenth century?

Four asylums and their young patients

The analysis will be conducted using the records of child patients admitted to four pauper lunatic asylums across England. Confinement of the insane and the building of asylums became compulsory elements of medical provision in the counties of England and Wales following the Lunacy Acts of 1845. These stated that pauper lunatics had to be confined in specialist institutions that were funded from public expense. Consequently, the identification and certification of the insane took place within the mechanisms of the New Poor Law, and was completed mostly by Poor Law Relieving Officers and Medical Officers, rather than asylum doctors (Bartlett, Reference Bartlett1999b). As the nineteenth century progressed it became evident through the ever-expanding asylum population that these institutions were seen as the solution to mental illness and disability. In 1859 asylum patients consisted of 1.6 per every 1,000 people living in the country but by 1909 this had expanded to 3.7 per 1,000 (Shorter, Reference Shorter1997: 47). Despite the considerable increase in certification, at no point was any allowance made for issues of age (Melling et al., Reference Melling, Adair and Forsythe1997). Children were therefore part of this rapid expansion and were admitted into asylums alongside the manically violent, the morbidly melancholic and the suicidal.

The four institutions examined in this article were diverse in geography and experience. The All Saints Asylum in Birmingham was a borough asylum that provided care for the pauper insane of the city. It had a catchment area of three urban and densely populated poor law unions (Aston, Birmingham and Kings Heath). The Berrywood Asylum in Northamptonshire that served a predominantly rural county dominated by the vested interests of the landed aristocracy, although there was some proto-industry centred around boot and shoe manufacturing (Hurren, Reference Hurren2008; C. Smith, Reference Smith2007). The Prestwich Asylum in Lancashire was located just outside of Manchester and was one of four institutions that served the county. The rapid rate of industrialisation meant that poverty was acutely felt both in the city but also in the rural areas of the county and as such the demand for pauper lunatic provision was high and diverse. The pressures on asylum space in Lancashire were further magnified by the large number of Irish migrants who came to England following the famine of 1845–7 (Cox et al., Reference Cox, Marland and York2012; Cox et al., Reference Cox, Marland, York, Cox and Marland2013; Cox and Marland, Reference Cox and Marland2015). Finally, the Three Counties Asylum catered for the needs of Bedfordshire, Hertfordshire and Huntingdonshire. These were three relatively small rural counties without major cities or much industry and thus they provide a contrasting lens for the analysis here.

The regional differences of these institutions inevitably affected their individual evolutions (Taylor, Reference Taylor2017a). For instance, the two asylums located near to urban centres opened their doors (Birmingham, 1850; Manchester, 1851) considerably earlier than their rural counterparts (Berrywood, 1876; Three Counties, 1860). They were also significantly larger, with Birmingham built to house 300 pauper lunatics and Manchester 350. However, by the turn of the century, the number of pauper insane had multiplied exponentially with Birmingham having room for 1,200 patients and Manchester holding 2,300. Meanwhile, the rural Berrywood and Three Counties Asylums experienced growth, albeit on a much more modest scale. At its opening in 1876 Berrywood was designed for 115 patients and by 1900 contained 900 (C. Smith, Reference Smith2007). The Three Counties Asylum could hold 466 pauper lunatics when it first opened its doors and by the turn of the twentieth century was home to 1,000 residents.

The extensive record keeping of Victorian institutions and the subsequent survival of documentation means that asylum archives are a treasure trove for historians. The child patients of each institution were located through extensive and systematic analyses of admission registers, patient indexes and patient case files. The names, ages, admission numbers and diagnosis of each child on their arrival at the asylum were located using the registers and indexes. From this information the admission numbers acted as a guide to locate individual patient case files that were contained in the much larger and much more extensive patient casebooks. The contents of these related to the medical and everyday experiences of the individuals living inside the asylums. If they are read closely and against the grain these documents offer an opportunity to uncover the lost stories and narratives of each child patient. By looking past their purpose as repositories of mental health information, each case file becomes an expansive document that reveals much wider detail about behaviour, families, institutions, habits and everyday life, from the perspectives of both medical professionals and lay observers. Subsequently, the content must be painstakingly sifted through in order to learn more about the patients who were confined.

At times information about the socio-economic backgrounds of patients stands out in these records. However, this is usually because a relative of the patient had been previously certified and confined as insane; at a surface level therefore, socio-economic circumstances were used as an aetiological lens. Using the non-medical information contained in case files it is occasionally possible to gain insight into lived experience of the child within the family prior to admission. Each patient was examined upon entry to the asylum and the findings were recorded in a section of the case file titled ‘Mental State on Admission’. A subsection of this area was the ‘History of Case’ where lay and other medical professions, if any had previously treated the patient, could note salient details. It is these details that are used quantitatively in this article to understand the socio-demographic make-up of the child patients in asylums, but also qualitatively to understand the lived experience of mental illness inside and outside the institution (Porter, Reference Porter1985).

Using this method of identification there were 560 children, under the age of fourteen, certified as ‘insane’ and admitted to the four asylums. The age of fourteen, while it might appear arbitrary and a little on the conservative side by modern standards, has been selected to represent the historical experience of when childhood ended for children of the working class between the years 1850–1907 (Taylor, Reference Taylor2017a). Of these, 433 (77 per cent) were diagnosed with the learning disabilities of idiocy and imbecility, rather than mental illness. While these terms have evolved to have different meanings in the present day, they were part of the medical lexicon in the nineteenth and early twentieth centuries. Those diagnosed as idiots or imbeciles were thought to be in a permanent state of disability, usually from birth, and with little chance of improvement (Seguin, Reference Seguin1866; Wright, Reference Wright2001; M. Thomson, Reference Thomson1998; Taylor, Reference Taylor2017b). Other diagnoses, such as mania (reckless, impulsive and possibly dangerous behaviour) and melancholia (depression of various degrees of severity), were deemed non-permanent and curable within the correct medical setting. The language and behaviours that were used to construct these diagnoses were surprisingly consistent across the period and institutions (Taylor, Reference Taylor2017a).

The institutional experience of admission was, of course, uneven. In the rural areas considered here, the Berrywood Asylum admitted 229 children (140 boys and 89 girls), while the Three Counties Asylum accommodated 164 (97 boys and 67 girls). In more urban settings the All Saints Asylum was home to 95 (55 boys and 40 girls), and Prestwich 72 (37 boys and 35 girls). There are a couple of significant issues to explore further in these figures. First, the two rural asylums witnessed a greater influx of child patients and in a shorter space of time than those institutions located near cities. This is striking, as it had been thought that asylum populations increased due to the social pressures of industrialisation and urbanisation (Scull, Reference Scull1979). Secondly, the predominance of boys is somewhat surprising, as historians had argued that women were more likely to be confined than men (Showalter, Reference Showalter1987). This disparity can be explained in a number of ways. First, Melling et al. (Reference Melling, Adair and Forsythe1997) suggested that child admissions were a tool to control adolescent male behaviour. A closer look at the children admitted to the four institutions used here reveals that the situation was more nuanced. The average age of a child was 10.2 years old when they entered the asylum – if broken down by gender this shifts slightly to 10.7 years for boys and 9.6 years for girls. The nature of diagnosis appears to suggest that the picture was more complicated than simply controlling unruly behaviour. Idiocy and imbecility were diagnoses associated with ‘harmless’ behaviour and the high percentage of the cohort admitted with these conditions suggests that unruly behaviour was not a dominant factor, even if it was sometimes recorded in the case file (Taylor, Reference Taylor2017a). Wild or dangerous behaviour, more commonly associated with a diagnosis of mania, was only received by 8 per cent (47) of children. Therefore a further explanation is required to explain the gender imbalance. This leads to the second point, suggested by Wright, that idiot or imbecile patients, often described as harmless, could be of some use within the domestic environment engaging in chores such as housework or childcare that could ease the burden on stretched household economies (Wright, Reference Wright2001: 82; Wright, Reference Wright1997: 183). In line with the socio-cultural climate and gender norms of the time these duties were regularly completed by females and therefore the predominance of boys may be explained.

Insights into background and the qualitative experience of domestic life prior to admission are difficult to glean. Surviving personal correspondence between patients and their families during a period of confinement has been one way to do this, but letters to and from children occur infrequently in the records (L. Smith, Reference Smith2008). From those that do exist we can glimpse into the nature of family life and the relationship between child and parent. For example, Abraham Creighton’s father wrote to the Three Counties Asylum upon the admission of his 10-year-old son in July of 1893 (BLAS LF31/12, 1893). The first page of the letter is missing but the second reads as follows:

Numerous themes run through the content of this letter, such as education, leisure activities, diet, notions of respectability and gender roles. What can most clearly be observed is the element of parental concern from father to son and a developed awareness of methods that will improve his well-being and comfort inside of the asylum. Access to, and an ability to play music appears to belie the diagnosis of idiocy, as patients were supposed to be unable to learn or develop intellectually. Further, looking more into the socio-economic background of the family, the availability of music and the education to play what is assumed to be a piano, hints at the family holding a degree of respectability. This works in combination with the eloquence of the father who was employed as a ‘photographic artist’ according to census returns (Census, 1891a). What we take forward from here is the underlying expectation that the asylum would improve the condition of his child, despite asylums being proven to be largely ineffective at doing this.

Sources such as Creighton’s letter are, however, few and far between and raise more questions than they answer. There are obvious issues concerning the extent to which they represent the typical experiences of children and there are questions about the existence of the letters that do survive. Were these the only ones that the asylum received, or the only ones saved, and if so why? Therefore while the content of the few letters that exist are interesting and help us relate to the lived experiences of the subject, sender and recipient, their overall value in drawing broader conclusions is fairly limited.

To reveal more about the background of the children and their families the records of the lunatic asylum have been linked with census-enumeration data to create a subsample consisting of 10 per cent of the children identified. This was not a feasible task for all 560 due to space and time restrictions and the fact that some were born and died in the inter-census years, but it will nevertheless build a more detailed picture of the domestic context prior to, during and after confinement. From the census greater detail about family make-up, parental occupations and socio-economic status can be accessed. Such a methodology has been used before in the history of psychiatry. Joe Melling and Bill Forsythe used it in their study of the Devon Asylum to draw conclusions about the household, and Wright used it in relation to children admitted to the Earlswood Asylum (Melling and Forsythe, Reference Melling and Forsythe2006; Wright, Reference Wright2001). This article differs by using this approach to elucidate the socio-economic circumstances of children admitted to publicly funded pauper lunatic institutions.

There are complexities and pitfalls to using the census in this way and it must not have too much emphasis placed upon it (Higgs, Reference Higgs1996). One of the key problems here is the diverse nature of family life in the nineteenth century. For instance, Mildred Ayres was admitted to the Berrywood Asylum at the age of nine following the death of her mother in 1900 (NRO NCLA/6/2/1/9, 1900: 223). Her father can be located on the census using his full name and the street address that he provided for the asylum certification. (Census, 1901a). He was, however, a lodger living with Thomas Smith and his family. It is unclear whether following the death of the mother the family had disintegrated and if any other children had been distributed elsewhere, perhaps to other family members or public institutions. The census therefore can only be trusted for the information that it contains and its many silences should noted. Ayres may have had brothers or sisters, but she could have just as easily have been an only child, and from the census data we simply cannot tell.

Socio-economic circumstances of child patients and their families

To some observers, it might appear intuitive that the children admitted to pauper lunatics came from society’s poorest families. After all, the asylum operated within the framework of the New Poor Law and Relieving and Medical Officers were crucial players in the certification process (Bartlett, Reference Bartlett1999b). By way of example, Emily Liberty might be considered a textbook case. In 1878 she was admitted to the Three Counties Asylum at the age of thirteen from the St Albans workhouse, where she had been residing for three months. Her father was a low-waged agricultural labourer and she was the third out of five children (BLAS LF29/5, 1878: 72). Yet, while she was a pauper in the true sense of the word, her case was not typical of the wider experience and over half of children in the patient sample (51 per cent) resided in their own homes before certification. This compared with 13 per cent who were admitted directly from workhouses, 20 per cent for whom the location of admission could not be determined (these were predominantly in urban asylums), and the remainder coming from other institutions such as county asylums, private asylums, infirmaries and residential schools. It is thus not possible to conclude simply that child admissions occurred due to the intersection of mental ill health and poverty. Something more complex was occurring and the label of pauper, in this context at least, was administrative rather than descriptive. The process of certification needs to be considered also in conjunction with the stigma that was attached to receiving assistance from the New Poor Law, something that many working families avoided at all costs.

The socio-economic background of families accessing asylum provision for their children might not come as a great surprise. Those with parents working in low-paid and low-skilled occupations such as labourers, manual workers, factory operatives or charwomen made up the largest number, with 58 per cent (thirty-one) of children included in the subsample coming from these backgrounds. It might be concluded that these were not pauper institutions, but that for children the asylums operated more as general hospitals for the mentally impaired, rather than an as extension of poor law provision. Such a situation has resonance with an argument put forward by Bartlett. He suggested that for adults the asylum space had a dual function. For the respectable it could function as a place to get back on their feet and seek employment, while for the residuum it could be punitive and controlling (Bartlett, Reference Bartlett, Melling and Forsythe1999a). In our subsample, a third of families (nineteen) had the head of household working in skilled or what might have been considered ‘respectable’ work, such as a shoe clicker, grocer, or tailor, and their motive for seeking publicly funded asylum confinement needs to be further explained. Perhaps if we consider the experience of Arthur George Weed, who was admitted to the Berrywood Asylum on 2^nd May 1877, it will be possible to observe more of the spectrum of socio-economic diversity that the asylum accommodated (NRO NCLA/6/2/2/1, 1877: 210).

From his case file we learn that Weed was aged nine years old when he entered the asylum and was diagnosed as an idiot. Upon admission his father stated that he had ‘been very strange in his conduct for some time past – that he throws things at byestanders [sic] and is dangerous to himself and others’ (NRO NCLA/6/2/2/1, 1877: 210). The final part of the parental testimony should not come as a shock, often being dangerous was invoked as a method to ensure certification. The Poor Law Amendment Act (1834) stated that any dangerous pauper lunatics should be removed from workhouses within fourteen days (Bartlett, Reference Bartlett, Melling and Forsythe1999a). The adoption of being dangerous as a mechanism to ensure asylum admission demonstrates how working people quickly became acquainted with the laws that affected their lives and manipulated them for their own purposes (Jones and King, Reference Jones, King, Jones and King2015). The Weed case, however, is more fascinating than the tropes that were used to secure admission.

Weed and his family can be found in the 1871 census living on Kettering Road in Northampton (Census, 1871). The father, George Weed, was recorded as head of the household with his wife and three children, of which Arthur was the middle child. George Weed’s occupation was recorded as a ‘boot and shoe maker’, a common profession in Northampton at that time (Greenall, Reference Greenall2000: 114–16). At this point the family situation appears somewhat unremarkable, but in the 1881 census George Weed was listed as a ‘shoe manufacturer’, a subtle, yet more prestigious and respectable variation than merely a ‘shoe maker’(Census, 1881b). Obviously this could have been the slip of a pen from a very busy census enumerator, but further searches reveal that the George Weed Pedestrian Boot Factory was located at 72 St Michael’s Road, Northampton (Industrial Heritage of Northampton, 2018). A short walk from the family home, the factory was three storeys high and still stands, although it no longer makes boots and has been renovated into boutique apartments. Therefore, in Northampton at least, we witness the asylum being accessed by families who had financial resources as well as those without. Furthermore, it was not as though the only option for the family was the Berrywood Asylum. The Northampton General Lunatic Asylum, a privately funded institution, was well established and located much nearer to the family home (C. Smith, Reference Smith2007; C. Smith, Reference Smith, Gestrich, Hurren and King2012).

Evidently, the asylum fulfilled a function for those at many levels of society, and by delving deeper into the backgrounds of the families that used this provision it is possible to ascertain the circumstances that drove them to seek institutional care. From the wider sample it is clear that the asylum was by no means the first option for families caring for a mentally disabled child. The average length of time between a child displaying evidence of mental illness or disability and then being certified was on average three years and nine months. Usually the admission process was triggered by a shift in domestic circumstances. Finnane, Wright and Smith have referred to this as strategic use of the institution, and Cathy Coleborne has more recently termed the ‘calamity of insanity’ (Finnane, Reference Finnane1985; Wright, Reference Wright1998; Coleborne, Reference Coleborne2009). By way of example, Edith Shatford was admitted to the Berrywood Asylum in March 1898 at the age of thirteen (NRO NCLA/6/2/1/9, 1898: 13). She was directly taken from the workhouse, rather than her own home, and was diagnosed with idiocy. Prior to her certification there was no evidence in the patient case file to suggest that she had previously received medical attention for her condition. Seven years before, in the 1891 census, she had been living with both of her parents, her father being a shoemaker, and her six siblings, of which she was the third youngest (Census, 1891c). By 1901, however, the family dynamic had been shattered. Three years before the census Edith was admitted to the asylum, just after her father had died from phthisis. Her mother appears to have started a new relationship and can be found on the 1901 census living with Thomas Bates, with none of her seven children were living with her (Census, 1901b). From this situation it might be inferred that Thomas Bates was unwilling or unable to accommodate the seven children and they therefore had to be found alternative spaces in which to live. Edith’s home was now the Berrywood Asylum from which she was eventually discharged in 1915 after spending seventeen years there as a patient.

The complexity of family living arrangements in urban areas may at times have exacerbated family tensions and facilitated admissions to the asylum. David Walford, aged six, was admitted to the Birmingham Borough Asylum in 1907 from the home of his grandparents (BCA MS344/12/29, 1907: 633–4). In this instance, it might be speculated that the boy’s condition, described as ‘congenital insanity’, was becoming too difficult for his ageing grandparents to manage. Living in more diverse domestic arrangements was Edward Felton. He was admitted to the Birmingham Asylum in April 1888 at the age of nine (BCA MS344/12/9, 1888: 421–4). Felton lived with his father Edward, a confectionist, and mother Clara, as well as his aunt and uncle, Henry who was an engine driver, and Emily Felton and their four children. Also in the household was Francis Gatehead, a twenty-year-old lodger, who was working as a machinist. In total there were five adults and five children living in the home. According to the census returns the heads of neighbouring households were working in skilled occupations and also employed domestic servants, so there may have been a degree of affluence in the family, yet nevertheless this was still a crowded domestic space (Census, 1881b). Unfortunately, Felton’s parents cannot be found in later censuses. There may have been a shift in family dynamics that served as a catalyst for asylum admission, or they may have relocated to a new area. The boy himself was transferred after six years to the Rubery Hill Asylum, an institution built near Birmingham to accommodate harmless patients suffering from mental disability.

A similar situation occurred in the case of Frederick Hall, aged nine, who was admitted to the Birmingham Asylum in February 1892 (BCA MS344/12/12, 1892: 673–6). He had been living with his mother, Sarah French, and her husband James French. It is unclear what happened to Frederick’s father, as he does not feature either in the census or asylum documentation, but Frederick was living in the home along with his three siblings, of which he was second youngest and all of whom shared the surname Hall (Census, 1891d). By the time of the 1901 census the family was still living together, but the eldest child had left and Frederick was residing within the asylum. His older sisters, Florence, fourteen, and Lily, nine, were still living with their mother and step-father, but additionally Sara and Thomas Brown and their young child Horace were now living in the household. Sara was recorded as being Sarah’s eldest daughter and was not living with the family in the earlier census, thus further highlighting the difficulties of using the census as a source to analyse family situations (Census, 1901c). In this situation it is possible that a burgeoning household and the presence of Horace, a new grandchild, were the factors that pushed the family to seek the asylum for Frederick.

Moving beyond the complexities of household living arrangements, it is also important to explore in more detail the nature of family life in this period. Since Finnane’s work (Reference Finnane1985) there have been arguments about strategic use of the asylum and families depositing members at specific points in the life cycle, such as the birth of a new child, times of illness and bereavement. David Wright (Reference Wright1998: 199–200) found that for the privately funded Earlswood Idiot Asylum it was most commonly the first or second born child that was likely to be institutionalised. The experience of children certified and sent to pauper lunatic asylums, however, does not correlate with these findings. The census subsamples reveal that the opposite was most common, and that it was the youngest child in the family who was most regularly certified and confined. This is of course significant as domestic roles in working families were often crucial in the smooth running of the household. An older child could be capable of bringing home a wage or at least could contribute to household chores or childcare responsibilities so that parents would have more freedom to bring home an extra wage. The youngest child usually required the most care and attention and therefore their removal would lift a burden on the domestic sphere, especially if the family was in a time of hardship. A further explanation for the dominance of younger children within the sample might also have been that the family unit was still expanding and the birth of a sibling may have been imminent. This is more difficult to quantify, as pregnancy was not recorded by the census. However, many of the families were young and the dependency of a mentally disabled child and a newborn baby, as in the example of Frederick Hall, might have been too much to cope with at that point in the life cycle.

Overall, the youngest child in a family accounted for 34 per cent of admissions to the asylums. In comparison the eldest child was only admitted 19 per cent of the time. The middle child out of three occurred 7 per cent of the time; a middle child with three to five siblings 17 per cent; and a child with more than six siblings who was not the eldest or youngest featured 7 per cent of the time. None of those that made up the subsample was the only child living in a household. Breaking this down to an institutional level, the rural Berrywood Asylum had the highest number of youngest children (43 per cent) and the urban Prestwich Asylum (13 per cent) the fewest. In fact in Manchester it was more common for either the eldest child or a middling middle child to be confined, both accounting for 25 per cent of admissions. However, the smallness of the sample for the Manchester institution might, in this situation, distort the figures somewhat.

These data regarding the place of the child in the family also mask an issue of gender. If the sample is divided between boys and girls then the story is somewhat different. Youngest boys made up 44 per cent of all boys certified and 21 per cent of girls were the youngest. Perhaps, the fear of male adolescent behaviour and the usefulness of girls in the domestic sphere led to the disparity between the genders at the point of admission. With regard to girls more generally, the youngest and eldest were admitted at the same frequency (21 per cent), as were girls who came from large families with four to six children, but they were neither the eldest nor youngest. Those who were the middle child out of three made up 8 per cent of the sample, suggesting that they may have been capable of domestic responsibilities, and those who came from families with seven or more offspring made up 13 per cent.Footnote ¹ By adopting such a detailed look at the family lives of those children who were admitted to asylums, we see that living arrangements were complex, family dynamics often fluid, and that pressures of economy and survival often were important factors in the decision to seek certification.