Trade in Lunacy
William Parry-Jones's characterization of private provision for mentally disordered people in England in the 18th and 19th centuries as the “trade in lunacy” aptly described a key element in the history of Western psychiatry. The development of public institutions for the insane poor in industrializing Britain was not adequate to meet growing demand from all classes in society. Individual practitioners and businessmen saw lucrative commercial opportunities and stepped in to fill the gaps, bringing both benefits and problems. One hundred years of almost unchecked expansion followed, but by the mid-19th century, the lunacy trade faced significant challenges. The new Bethlem Hospital in London was opened in 1676, providing charitable care for the insane poor. By 1700, several private “madhouses” had been established in London and elsewhere to meet the needs for incarceration of mad relatives of the wealthier classes. The numbers of these madhouses grew steadily through the century, particularly ...