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Workhouse or asylum: the nineteenth century battle for the care of the pauper insane

Department of Postgraduate Medicine and Biological Sciences, University of Keele, North Staffordshire Hospital, Thornburrow Drive, Hartshill, Stoke-on-Trent ST4 7QB

Throughout the 19th century some 20–25% of all known pauper lunatics in England and Wales were accommodated in workhouses. Early on, the lunacy commissioners considered that all pauper lunatics should be admitted to asylums and were highly critical of the conditions under which they were kept in workhouses. As the century progressed the lunacy commissioners were forced to compromise because of the lack of space in asylums and diminishing confidence in the results of asylum treatment. By the end of the century the lunacy commissioners were reconciled to the accommodation of feeble-minded, imbecile, idiot, chronic psychotic and demented paupers in workhouses, but held to the view that the acute pauper insane should be admitted to asylums.