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U3A Project 2014 | Long Stay Institutions for People with Learning Disabilities: Earlswood Asylum
Prompted by a parishioner, Mrs Plumbe, who had read an article by Samuel Gaskell (see below) and had a son who was admitted to the asylum in 1848, Rev. Andrew Reed founded the “Asylum for Idiots” charity in 1847. Reed had already founded three charities for orphans and also “The Royal Hospital for Incurables’ as well. He raised funds for building chapels and wrote hymns that became well known, such as “Spirit divine attend our prayers”.
Reed was also active politically, campaigning against slavery in America, helping the cause of native South Africans and supporting repeal of the corn laws.
Andrew visited asylums in France, Switzerland and Denmark. He became convinced that special and individual attention would help the idiot develop as far as possible, and he corresponded with the French doctors Itard and his pupil Seguin. Seguin experimented with methods of teaching idiot children, concentrating on sensory experience and object association, using colours and numbers.The ideas of the first special educators were truly revolutionary for their time. It had been thought that the idiot was uneducable. Some of the revolutionary ideas of Itard, Seguin, and their successors that formed the foundation for present-day special education are:
Individualized instruction- the child’s characteristics, rather than prescribed academic content, provide the basis for teaching techniques
A carefully sequenced series of educational tasks- beginning with tasks the child can perform and gradually leading to more difficult learning
Emphasis on stimulation and awakening of the child’s senses- help the child become more aware of and responsive to educational stimuli
Meticulous arrangement of the child’s environment- the environment and the child’s experience lead naturally to learning
Immediate reward for correct performance- providing reinforcement for desirable behaviour
Tutoring in functional skills- to help the child be self sufficient and productive in everyday life
Belief that every child should be educated to the greatest extent possible- every child can improve to some degree
It had become obvious that the harsh conditions in workhouses, designed to encourage people to find work in the community, did not help those with mental disabilities. Additionally, in 1847 the Lunacy Commissioners’ report focussed on congenital mental defectives and pointed out that “though persons of this description are seldom fit objects for a curative asylum, they are in general capable of being greatly improved, both intellectually and morally, by a judicious system of training and instruction”.
Samuel Gaskell of the Lancaster Asylum and John Conolly, resident superintendent of the Middlesex County Lunatic Asylum at Hanwell, were also influenced by Itard and Seguin. Conolly was in the forefront of the non-restraint movement. When the Asylum for Idiots opened with fifty patients in Park House, Highgate in 1848 it was supported by both Samuel Gaskell and John Conolly. The aim was not merely to take the idiot and the imbecile under its care, but especially by the “skilful and earnest application of the best means in his education, to prepare him, as far as possible, for the duties and enjoyments of life.” The principle of non-restraint was introduced.
Gaskell wrote “Although apparently an unmoved spectator, yet that strange mixture of feeling arising from sympathy with affliction, and rejoicing at its relief, was powerfully excited within me. I could not help thinking that if it were to serve no other purpose than that of illuminating, by a momentary consciousness of happiness, an existence otherwise dark, blank and joyless, it would be desirable to institute such exercises.” Gaskell was a member of the Royal College of Surgeons and “a very warm promoter” of the first English association of asylum doctors, founded in 1841. Gaskell became Commissioner of Lunacy in 1849, and was the commission’s medical expert on asylum management and design.
After his appointment as Commissioner, Gaskell carried out, by his strenuous advice and support, a practical reform in the management of the insane. He caused each patient who was liable to be wet or dirty to be aroused, and placed in a condition to attend to the calls of nature at stated intervals, with the result that wet and dirty beds were reduced to units where they had been counted by scores, or even by hundreds. This alone was a vast step in asylum management, but it does not quite stand by itself, seeing that it led, too gradually perhaps, to a revolution in the system of night-nursing in asylums, which was put on quite a different footing from the perfunctory pretence of night-watching and nursing with which superintendents were more or less satisfied, with the general result of decrease of suicides, decrease of noise and violence at night, and a very general increase in the comfort and well-being of the inmates of all well-managed public asylums and hospitals for the insane. It should never be forgotten that what is designated the non-restraint system is not alone the abolition of mechanical restraint, but that it connotes a revolution in the treatment of the insane in a great number of particulars.
Meetings called by Andrew Reed were held in the Kings Head Tavern, Poultry on 20/7/1847 and 28/7/1847 with 5 people present, where a paper Reed produced was agreed. He said that despite charitable efforts being made for many afflictions, “we have done nothing for the idiot…it must be that we have laboured under the appalling conviction that idiocy is without remedy.” It is “a delightful fact that the Idiot may be educated (he cites experiments in France, Germany and Switzerland)….the very young are greatly susceptible of improvement….We ask that he may be elevated from existence to life, from animal being to manhood, from vacancy and unconsciousness to reason and reflection.” Subsequently they sought support from Lord Palmerston (later the Prime Minister), the Lord Mayor, Baronet Rothschild and many others. Reed visited France and Belgium. Drs Conolly and Little became involved. 7 more meetings were held in September and October. A board was formed, a constitution written and subscriptions sought. The first board meeting was on 1st November 1847. Three further board meetings took place in November, 4 in December, and cases for admission were discussed.
5 meetings in January and 4 in February continued the pace, and the Commissioners for Lunacy wrote to them, Legal advice was taken: the Asylum was within the scope of the Acts of Parliament relating to lunacy, it must be registered as a hospital and comply with regulations. An office was rented. 5000 circulars and 200 rulebooks were printed. It took until the 18th of February before a premises was agreed, a house on Highgate Hill with 16 acres of land was to be leased for 11 years; the agreement was signed by 17th March. The Commissioners for Lunacy wrote in March that the Asylum would come under their jurisdiction. There were 5 meetings in March. The Duke of Cambridge (10th chid of George III) gave a donation and his support. In April advertisements were placed to recruit a headmaster, gymnastic master and singing master. Opening was planned for 26th April. A master was appointed on 18th April at a salary of £100 pa plus board and lodging. A matron was appointed on 20th April at a salary of £40.
By 1849 Park House was full, and after a temporary stay in Essex Hall, Colchester (which was full by 1853, with 123 inmates), the patients were gradually moved between 1855 and 1858 to the purpose built Earlswood Asylum near Reigate, designed by William Bonython Moffat, the architect and partner of Sir George Gilbert Scott. By 1859 there were 276 patients and 74 staff in the “family” at Earlswood and Essex Hall was reopened as the Eastern Counties Asylum servicing four counties.
Earlswood was chosen for its elevated site, space for exercise and accessibility from London, it was 2 hours by train from Victoria Station. In 1847 John Conolly had published the bible of asylum construction “On the Construction and Government of Asylums and Hospitals for the insane.” in which he wrote “There can be no doubt that the best site for an asylum is a gentle eminence, of which the soil is naturally dry, and in a fertile and agreeable country, near enough to high roads, a railway, or a canal, and a town, to facilitate the supply of stores and the occasional visits of the friends of the patients, and to diversify the scene without causing disturbance.”
Private patients were admitted as well as many others who were means tested and either paid part or no fees. These were paid for by charitable subscribers to the charity, who had a say in who was admitted, the process being called “election”. Admission was for five years or for life. In the early years there was controversy over life admissions due to expense, but ten a year were admitted until 1872, when the practice tailed off, ceasing in 1882. Initially children up to the age of twelve were admitted, in 1865 that was increased to sixteen, though exceptions were allowed for older people.
A patient at Earlswood photographed by John Langdon Down c.1865
There were 5 board meetings in April 1848. On the 26th the minutes state that 8 patients were received, 7 by election and one on payment of 50 guineas. There was a girl of 9, and males aged 8, 12, 14, 14, 15, 17 and 25.
Six more were elected on May 5th, but one boy was to be removed and the fee repaid. On May 12th another payment case was accepted for 50 guineas. A further 9 patients had been admitted, one on election, 8 on payment of 25 guineas. 6 more will be admitted on the 26th May. 20 other cases were rejected on grounds of age, hopelessness, unfitness, too unfavourable, epileptic, badness, on parish relief. 21 cases were referred for enquiry. One 14 year old boy, “who had appeared to improve since his admission to the asylum” had died.
There were 3 board meetings in May, 5 in June. Some of the land was let. A tender was taken for meat, bread, milk, coal and shoes. The cook was to be paid £15, a housemaid and two nurses £10 each, a kitchen maid £9, a head nurse £20, 2 assistants at £20 and 1 at £25. Cases for election were reviewed. Payment cases were accepted from 25 guineas to “not less than 100 guineas”. 150 guineas entitled the resident to a private sitting room and bedroom, and an individual attendant.
Sadly Emily, a patient. died; “the friends of the child were highly satisfied with the care and attention which had been given to her case.” An assistant was dismissed for harshness and violence.Tenders were invited to convert the stables to a washing room, workshop, playroom and infirmary, and the winning one was for £332 with work to be done within 6 weeks.
Lord Ashley of the Commissioners for lunacy said “that the Board must feel itself under an obligation to secure a Resident Medical Superintendent…as soon our means and numbers would justify it. ” The Commissioners “would rejoice to assist in every way to make so desirable and important an experiment.” Double sashes were to be obtained for the windows of the boardroom. A house committee was formed. An assistant teacher was appointed at £70 if he boarded out, otherwise £40. 2 patients were considered by the medical officers “to be unfit subjects for the institution.” The father of one was to be asked for “five guineas extra… for the additional trouble and expense involved in his case”, a grandfather later paid this.
The House Committee meeting on 28th June reported that there were 30 males and 3 females in the house. Dr Reed said the well water should be tried. Gas was 6 shillings for 1000 feet. The Matron needed “an additional dozen of bedsteads and bedding one half large and the other small.” The parlour boarders needed an additional sitting room “the present one being too small and which she was anxious to convert into a Store and Clothes room. She had in the meantime arranged the sleeping rooms which the committee would see at the conclusion of the meeting, as also the fireguards which had been ordered.”
“It was agreed that the friends of pupils may see them every Wednesday Afternoon between the hours of 2 and 5 o’clock by presenting a regular admission ticket, but that the same family shall not be eligible to obtain more than three tickets in the quarter.”
Dr Little that he had along with Dr Brendon examined three inmates. “Peakome was clearly a lunatic (subject to hallucinations), the case of Lewis was even more unfortunate from his uncontrollable fits of passion, and that Lawrence was hopeless being an epileptic.” and they are “of the opinion that they are not fit subjects for the asylum.”
“Dr Reed suggested that Dr Brendon be requested to prepare a Diet Table. Those pupils who had received their new clothing were seen and approved of….however.. prices were high, it was agreed that in future the clothing should be taken by contract.”
14th July & 21st July 1848 Board Meetings
The friends of another inmate, John Lawrence, were persuaded he was not a fit subject and they agreed to make the necessary arrangements to have him removed. His father, though in humble circumstance, helped and the Board gave him 10 guineas. The sister of another ex-inmate was refunded the balance of her payment. A referral by Dr Conolly was accepted on a months trial.
Dr Richard, one of the Commissioners in Lunacy, visited Hanwell (where Conolly worked) and offered to be a subscriber.
Payment for inmate Henry Ellis was being chased, if not received he would be removed. Many cases for admission are considered and accepted for election subject to medical report. Gas fittings were going on. Two payment cases (25 guineas each) were accepted subject to medical report. Clothes of payment cases to incur charges of 3 guineas for 25 guinea cases and 5 guineas for 50 guinea cases. The matron will take charge of the petty cash book. The matrons needs were stated and agreed to. A clock was agreed for the School Rooms, as was additional frniture for the infirmary.
Attendance at Church and Chapel was to be limited to those who, under a medical opinion, can do so safely. Religious instruction to be given according to the conscience of the relations or friends of the pupil, and limited to the Lord’s Prayer, the Ten Commandments and the Apostle’s Creed.
5th & 20th October 1848 Board Meetings
The case of Eustace Day accepted as a payment case of 50 guineas and under special circumstances an order be given for his immediate admission. The cases of Martha Roe and William Gentry were finally accepted as payment cases of 25 guineas. Other cases were accepted for election or referred to Dr Conolly, Mr Mann, Mr King, the Medical Officer, the Officers; another case was ineligible.
Dr Foreman was offered a salary of 200 guineas pa plus accommodation for himself and a servant in the house but he is to find his own provisions.
“It was understood that Mr Lyne should in future have Tea with the parlour pupils, in order that the institution might have his full services.”
Contracts for Beef, Bread, Coals, Shoes and Grocery goods referred to Officers.
3rd & 17th November 1848 Board Meetings
The Third Election had taken place at the London Tavern and 10 pupils elected, 3 of them female. They will be admitted on the 16th. The next public dinner was planned. Mr Stone and Mr Abbiss joined the board.
Terms and conditions for the medical superintendent were agreed. “He would be of the medical profession, of good and approved standing and prepared by his professional predilections to sympathise with the class of objects which we are seeking to benefit.” It would be a full time position, he would be in charge of the Institution but subject to report to the Officers or House Committee. He would be “generally present at the meals of the pupils since so much depends in their case not merely on the food they take but on the manner in which it is received and masticated.” He will “have the entire charge “ of communications with the Commissioners of Lunacy, and receive all visitors, including friends of the pupils. He is to keep a register to “record most exactly everything material in the state of the pupils particularly marking their original condition, their treatment and their state on leaving.” He is to supply evidence for the use of the Board “on the benefit of a wise persevering and benevolent treatment of the Idiotic portion of the human family.” “That he in conference with the Master is to have a augment on the numbers, the qualifications and the duties of the attendants and is to see that the children are at no time without supervision.”
1st, 15th and 29th December 1848 Board Meetings
More cases considered. Mr Callaway was accepted as successor to his father. Building expenses were discussed. John Thomson was accepted as a 25 guinea payment case. “Ten guineas were unanimously voted for gravel to the playground”. Auditors were elected. “No communications are to go forth from he Institution relative to its state, progress or pupils for publication, or with the likelihood of publication, without the sanction either of the Board, the Secretaries or the Medical Officers.”
A timetable was agreed: 6- rise, 7- School exercises and breakfast, 9- Prayers and exercises in school or gymnasium, 11- recreation, 11:30- school exercise, 12:30- play, 1- dinner, 2:30- school, 4:30- play, 6- supper, 6:30- occupation, 7:30- prayer, 8 to 9- bed. But during the winter (November to February) pupils would rise at 7. Wednesday afternoon would be free to receive the children’s friends; Saturday afternoon free for washing and cleaning. “The gymnastic exercises tare to be taken as much as possible in open air. The servants and attendants to dine at 2 o’clock, the Master and Assistants to have entire charge during that time.”
The diet was:
Breakfast: Cocoa or Scotch Porridge, or milk and water with bread.
Dinner: Five or six ounces of cooked meat with vegetable and bread, occasionally varied with rice, fruit or other puddings.
Supper: Cocoa, porridge or milk and water with plain cake or bread and cheese, bread and butter or bread and treacle.
The beverage to be water, or table ale or bitter ale. The meat, bread and milk to be of the very best quality. “The pupils are not to be allowanced.” “Soups may be occasionally used especially in winter but they must be meat soups of the most nourishing character.” The superintendent may vary the diet on medical grounds. “Preparations of rice, sage and arrowroot to be made for such cases as may require it – broth – beef tea.”
Pupils are to be washed on rising and on going to bed, and use the bath room at least once a week (more often if thought medically beneficial). They are to be thoroughly combed at least twice a week; have a change of shirts and stockings twice a week, their shoes changed and cleaned every other day.
Reports of the Board
Annual reports were produced for subscribers, distinct from Board Meeting minutes. They document who was elected to the board, what legacies had been received, how many patients and staff were resident, and the progress made and dificulties encountered. The summary accounts are included showing income from from subscriptions, payments etc and outgoings on housekeeping (board, clothing, education etc), furniture, repairs and alterations, salaries, wages, office rent, washing, school books etc. Most of the information in this history from 1849 comes from these reports, another source is the board minutes; from 1859 the board meetings were six monthly. Additional statistical information culled from the reports is in the appended documents “annual report stats” and “Earlswood elections”, both starting from 1849.
1849 First Report of the Board
Two visiting physicians, Dr Conolly and Dr Little, as well as a surgeon and dentist (Edwin Saunders), were appointed. Additionally a resident physician, Dr Foreman, was appointed, as required by legislation. There were 60 in the family of patients and pupils, the entire household was eighty strong. There was a matron, a master, a gymnastics and singing teacher, two assistant masters and four attendants.
There had already been four elections. Paupers were not admitted, as there was other provision. The annual fee was 50 guineas. There was means testing for candidates for election, who if accepted paid £25 guineas. All were treated the same, though extra could be paid if separate accommodation or attendance was required. The fees covered
The board felt they were on an “untrodden and difficult course”. The first gathering had been a discouraging spectacle, full of disorder and noise, people shouting, breaking windows and generally crossing boundaries. But there is now order. Every hour has its duties; doors are safe without locks, all achieved without the aid of coercion or correction.
Education “acted on the principle that always there is mind, and that in itself is perfect, and that it has imperfect and defective expression for imperfect or deranged organisation”. Education was “principally physical”, educating the eye, the ear, the mouth, the muscle, the limb, “and have thus endeavored to reach the better portion of our natures that it also might be trained to moral and spiritual exercise”. People were classified and separated, by the “particular defect”. Patience was needed to overcome the power of habit and weakness of nature. At first some had defective sight, most had defective or no utterance, most were lame in limb or muscle and all were of weak and perverted mind.
There was partial success, with “some instances of a marked and delightful character. It has been their happiness to observe the eye that had no useful sight begin to see; the ear to relish sweet sounds; the tongue that was dumb, begin to articulate the language of men, and the limb that was crippled or inert put forth to useful and active service. In some cases bad habits have been overcome; power has been created for the care of the person; the body has been brought under the control of the will, and both have become subject to a mild authority. The power of imitation has been fostered, music and drawing are beginning to find their place in the school. Reading, writing and even figures, which are the severest test to the weak mind, are now claiming general attention. Above all the the moral affections have been exercised, and the effects are found in the harmony of the family, and the greater readiness to worship an invisible and gracious presence.”
There were benefits for society of providing a facility to look after patients for the community. Public feeling would change as the mentally handicapped “can never again be the forlorn, abandoned, scorned, imprisoned creature he once was. The sublime of benevolence is to pity the lowest and to bless the worst. The price of freedom is pity for the oppressed.”
There were visits from Prince Albert and the Duke of Cambridge (who was asked to preside at the first anniversary dinner at the London Tavern), as well as visitors from Germany, France and the USA. The Duchess of Gloucester became a patron. The Bishop of Oxford preached a sermon or the charity at Whitechapel Church.
Extracts from the minutes of the 28 Board meetings in 1849
Inmate Charles Chilcott died of dysentery. Charles Petty, 19 years old, died of “Chronic Mesenteric affection, with partial softening of the brain.” A child disappeared. Richard Endall (10 years old) died of “inflammation and ulceration of the tongue and mouth and a complicated skin disease.” Jane Colmer (9 years old) died from general consumption, she had bee sickly from her birth.” Dr Conolly “read the Report of the Medical Officer respecting the case of Elizabeth Longland who was decidedly insane and therefore should at once be placed in a Lunatic Asylum.”
A dispensary with equipment as provided. Eleven candidates applied for the post of sub-secretary with at least 100 pa, William Nicholas was appointed; Mr Downing was appointed as collector with at least £80pa. They will receive more if they raise enough from subscriptions, donations, collections and legacies, 5% of these to be used for the purpose.
In February 1849 Mr Belford was forced off the Board due to financial irregularities amounting to £72, which he later appears to have partly paid; he was refused a testimonial as to his character in April. Later in April “A letter having been read from Mr Belford explaining his distressing position, it was resolved, after some discussion, that the sum of five pounds be given to him but only as an act of relief in his present necessity, and on condition that he remove from off the premises at once. In June “it was proposed that the Secretaries be requested to write to Mr Belford’s Securities relative to his defalcations previous to other proceedings. In July further discoveries were made and the audit committee was asked to report. In August there was a request for payment without delay, and later in the month his “deficiencies were brought under notice” and referred to the Finance Committee. In September The Hon SS Rice was “requested to press for immediate payment.” The Chairman “communicated information showing the inability of Mr Colin G Belford to meet the liabilities of his brother.” In October Belford “promised to remit £50 by the 26th.” If he failed proceedings would commence. In November his brother offered to settle. Later Mr Belford requested another month as “he was arranging to effect a life Assurance.” Also “The cheque for £3.11.4 which had been improperly made use of by Mr Belford as reported by the Finance Committee was produced when it was resolved that Mt Barron who changed it should be called upon for payment.” In January 1850 a final letter was to be written; following which “It was resolved to commence active legal proceedings.” In April they ordered that the solicitors proceed. In July 1850 his brother offered £20 down and £10 quarterly until the £120 be paid off, an offer accepted by the board. In August they asked the solicitors if the £20 had been received. It had, two sets of solicitors were involved and they sent a cheque for the balance of £11.1.6. The Board returned the cheque, saying that charges should not have been deducted. Many Board meetings referred to Belford’s deficiencies, then in May 1852 two cheques were received totalling £15.13.0. “Further proceedings in this case were referred to Dr Reed.”
In May “The urgency of taking another house was considered and Dr Reed undertook to visit two residences at Highgate.” In June “Mr Peacock refused to let his house in Highgate to the Society” but Mr Peto wanted Dr Reed to accompany him to see a house in Colchester. On 11th July one case was refused on grounds of fits, and four cases on age, four others refused unless they paid a fee of 50 guineas; five others were referred to the Medical Officers and two Mr Galliff and one to Mr Post (both board members). One case was “finally accepted”. On the 18th the cases of John Rix and HR Blackman were referred to Dr Reed. Another case “was declined at present, can come forward at a future time.” Mrs Longland was directed to remove her daughter as soon as possible & the Balance due should be repaid her.” Mr Post undertook to supply Garden tools for the use of Pupils.
In August they decided not to take a house in Highgate. Dr Reed had a friendly meeting with Mr Peto, who wanted his house “The Tap” in Colchester to be used, and offered £200 pa and an interest free loan of £1000 for 7 years, and would also give the £1200 to £1400 he had already expended. The Board cordially approved and resolved “that such Gentlemen as can visit Colchester…to inquire and report.” Two weeks later the report was approved. Twelve children would be admitted at the next election. Dr Freeman had leave of absence due to illness, and another resident doctor was needed during his absence.
In September there was a request to return part of the payment made for Ann Lowe, who had died, the board refused “on account of the additional trouble and expense caused by her illness.” Mr Callaway was thanked for “his kind services during the absence of Dr Foreman”, and presented with two Life Votes.
In October “he conduct of George Workham at the asylum was reported when it was resolved that Dr Foreman be requested to see that he be withheld from any opportunities of communicating with any of the female portion of the family.” Mr Peto would bid for land from the Eastern Counties Railway next to “The Tap”.
In November the Park House matron resigned, a new matron Mrs Grimshaw was appointed in December for £40 pa “on probation for 3 months on either side.” Mrs Bellingham was appointed as a matron of the Asylum at Colchester (Essex Hall) starting next week, though the Agreement “was not yet signed but would shortly be completed.” A “further supply of chlorine and lime was ordered” due to “defective drainage.” Pupils would be received at Colchester at the start of January.
1850 Report of the Board
There were now 96 patients in a household of 130. Park House was full and Essex Hall opened. A final location was to be sought. Safety and comfort was not enough, they “need to ascertain how far the idiot and imbecile may be elevated to physical enjoyment and rational life…No expense shall be spared… Their object is attainable… decided success in most of the cases”.
Only 15 could be admitted out of 170 applicants. “In fact there is at present no proportion between the want felt in society and the relief afforded.” There was a special appeal for a building fund. An anniversary dinner was to be presided over by the Duke of Cambridge. “Her Majesty subscribed 250 guineas to constitute the Prince of Wales, then 9 years old, a full life member with the right of presentation to one bed and subsequently Her Majesty has condescended to become its patroness.”
“When the sense of a great public want takes hold of the English mind, it is met with great determination, great effort and great self denying generosity. Such a temper of mind is all that we need. The work that we have begun, arduous though it be, will be carried to a triumphant conclusion… many a dumb sufferer will be relieved, many a prison bound spirit will be set at liberty, many a saddened family will awake to joy and gratitude for the child that was lost and is found – and England will preserve her high and blessed pre-eminence – not as the proud Mistress of Nations – but as the Gracious Friend and Comforter of Suffering Humanity.”
Extracts from the minutes of the 27 Board meetings in 1850
The Eastern Counties Railway offered half price travel to and from Colchester for the House Committee, officers and patients and in January 28 children and 5 adults were safely conveyed to Essex Hall “& they were left with every prospect of comfort & happiness.” A “Manipulator & shampooer” was engaged.
In February there was wind damage at Colchester and Highgate.There were 23 males and 5 females at Colchester, 58 at Park House totalling 86 children. A hedge and fence was being erected at Essex Hall. 15 more children would be admitted at the next election. “Dr Reed stated that Colonel Phipps, Private Secretary to Prince Albert had written for a deputation to wait upon him tomorrow at 3 o’clock – when it was agreed that Drs Conolly, Holloway, Reed and Mr Wilks should form the deputation.” Six days later a special board meeting reported that Colonel Phipps “remarked that the report of the charity had been read with pleasure and that he was instructed by Her Majesty to learn something more of the charity, its progress, its resources and its likelihood of receiving a permanent character.” Her Majesty wished to associate the name of the Prince of Wales with the charity “from his early life” which “is most gratifying in itself and most auspicious to the infant institution.”
In March her Majesty “has been graciously pleased to grant Her patronage to the Asylum for Idiots.” The Bishop of Oxford “donated £5 and “consented to become a President.” James Austin “could not be retained on account of his frequent and violent fits.” One case, IL Andrews “was finally accepted when vaccinated.” A building fund was started. “Dr Reed stated: That it is desirable for the female election cases to be transferred to Colchester.” Honorary Medical Officers to inspect quarterly. “The case of ‘Savage’ was declared to be insanity, agreed that she be removed forthwith.” “HRH The Duke of Cambridge had visited Park House & expressed great satisfaction.” Bedsteads were ordered for Colchester.
In April the both matrons’ probation was over and they were confirmed in their position. A lightning conductor was proposed for Essex Hall, Dr Reed would correspond with Mr Peto. Colonel Phipps wrote “he had received the Queens command to notify that His Royal Highness the Prince of Wales (then 9 years old) has been pleased to nominate Robert Williams for admission into the Asylum for Idiots for a period of three years.”
Members of the House Committee are unhappy about Dr Foreman; he requested “the opportunity of replying to any and every objection.” He offered his explanations to the board, “but afterwards withdrew and respectfully tendered his resignation.” The Board “in accepting his resignation desire to record their sense of the zeal with which he has attended to the interests of this institution, and to the welfare of the patients therein.”
In May 15 children were elected, 8 of them female, they were to go to Colchester. There were now 53 boys and 11 girls at Highgate, 32 boys and 20 girls at Colchester, 116 in all. In June the Duke of Newcastle became a president. The Board was unhappy with the way their solicitors had disposed of the £1000 cheque from Mr Peto. “Miss Jones, governess at Essex Hall, was to be allowed a Salary of 20 guineas a year” but Mr Bellinger was to get £40. “Dr Reed reported that the state of things at Colchester was most gratifying and the Children happy as well.” Dr Foreman was “requested to leave in writing a clear and full account of the physical condition of the patients – especially of such as have required most of his care as a direction for future treatment.”
In July an assistant at Colchester was dismissed. The Board replied to the Commissioners in Lunacy report saying they were obliged to them “for its comprehensive nature, for the details that indicate extensive and careful investigation and for the very valuable practical suggestions.”
Prince Adolphus, the 1st Duke of Cambridge died and the Board wrote to the Duchess describing his contribution: “the early, generous & persevering patron..his personal visits…his careful inquiries and useful suggestions…his liberal contributions and his hearty co-operation….while they unite in the universal lamentation that the country has been mournfully deprived of an all-honoured exemplary enlightened generous patriotic and Christian Prince.”
In August it was resolved to apply to the 2nd Duke of Cambridge for his patronage.
Mrs Bailey, whose child died after being elected but not yet admitted, was granted £2 towards the funeral. The carpenter who erected Gymnastic Apparatus at Highgate would do the same at Colchester. There are now 127 children altogether, 15 more to be elected. Following interviews with 3 candidates, Dr Maxwell was appointed as a replacement for Dr Foreman.
In September a consulting physician, surgeon and dentist were appointed to Essex Hall, all offering their services free. The House Committee at Essex Hall was expanded. In October Mr Picket was asked to increase his 25 guineas to 35 as his son “requires such care”; it would have been 50 guineas but it was reduced after a statement of circumstances. A Special Board meeting was called in November “to consider a letter from Mr Justice Talfound respecting an estate at Reigate.” Reed had previously written to Talfound, who had just bought the land, asking for his help. He said his representative “strangely” had not bid at the auction. He said that the Lord of the Manor would grant favourable terms to the charity. The Special meeting agreed to buy the land and were grateful as Talfound had “laid aside all private consideration”. Talfound later donated £50 and became a patron.
In December Mr King reported on his visit to Norway, Sweden and Denmark.
In October Dr Foreman had been requested to return the casts (of the cases under his care) he had taken, which he did in January, requesting that the costs he had incurred be considered a donation. Now the Board agreed “It is of the first importance to the success of this institution that the public should be able to exercise perfect confidence in the Board, it be fully understood that all casts, registers, journals and memoranda taken of the patients committed to them are their exclusive property; and that they are on no account lent, or duplicates given, or taken away without their express permission; and that to prevent the possibility of any mistake, such persons as are engaged for principal situations to the Board shall have this rule read to them and their assent taken as bound in honour to its careful observation.”
Dr Reed submitted that the objects of the charity should be promoted in the Eastern Counties.
1851 Report of the Board and extracts from the 24 board meeting minutes
There were now 141 patients in a household of 180, with over twice as many boys as girls. A new site had been bought, but £10,000 was still needed for erecting the building, The plan was that patients would be moved to the new site and Essex Hall would become an asylum for the four eastern counties. “It is an occasion, not merely for beneficence, but for magnificent action. Shall more be done from selfish fear and superstitious error than from the pleadings of Divine Charity?” The imbecile “has rights in the one human family…the lame do walk and leap for joy.”
There were donations of 100 guineas from the Worshipful Company of Drapers, 200 guineas from the Corporation of the City of London and 250 guineas from Her Majesty the Queen. The Earl of Carlisle would preside at the annual dinner; Dr Conolly would ask Charles Dickens to assist as a Steward, which he consented to. Discussions were held about Prince Albert visiting Essex Hall.
Education had been expanded to include natural and scriptural history, ciphering and singing. There were classes for gardeners, carpenters, shoemakers, basket makers, knitters and netters.
Of the patients 25 had initially been unable to walk, 114 unable to feed, dress or take care of their person, 20 were epileptic, 12 paralysed and 68 dumb. All had physical infirmity and mental imbecility. 25 were under 9 years old. Some scream, bark, dance nervously, beat themselves, destroy everything. All are wilful and unruly, most have dirty or disagreeable habits.
“So helpless and so unpromising a family perhaps was never before brought together”. Untreated, all would regress and “fall into a state of dementation and fatuity, and sink away from society and from life to a premature grave.”
6 had been taught to walk, 14 cripples were much improved. 27 dumb were beginning to speak, 48 taught to feed, dress and observe cleanly habits, 23 to read, 27 to write, 11 to cipher, 16 to draw. Noisy and destructive habits are eradicated. Nearly all are singing and drill in the gym. 90 can attend with propriety on domestic worship, 50 on public worship and all have pleasure in doing so. They have improved health and happiness, and they are very open to kindness and glad to return it. Withdrawal of approval and threats to be put in a lower class were some of the tactics used to improve behaviour. Rights to games, excursions and sports could be terminated in response to poor behaviour. Langdon Down said that the idiot must learn that “doing right is productive of pleasure and that wrong is followed by deprivation thereof.”
Those who had been taught to eat properly put peer pressure on those who didn’t. If someone didn’t eat properly their peers complained and they were put on a separate table until they improved. And they wanted to feel included.
The medical report was written by Drs Conolly, Little and Callaway : “the fate of everyone of these afflicted children will be ameliorated, some of them will be restored to their families capable of being usefully employed.” 13 case studies of patients from age 4 to 27 were appended, detailing improvements made.
Medical examinations were to be conducted quarterly and recorded. Post mortems needed written consent of friends, disfigurement should be minimised and no parts removed; the results to be recorded. The Matron would provide medicines under the supervision of the physician, and that treatments would be alike in both divisions of the institution. In December “2 or 3 of the children are suffering from Hooping Cough.”
A boy, Eustace Day, fell off a ladder during drill and fractured his leg, which swelled greatly. One night a week later, an attendant called Gaskin was woken by Eustace’s screams, he had upset a candle, his nightclothes caught fire, and he suffered severe burns, as did the attendant to his hands. Eustace’s father hoped the attendant would be excused. Dr Maxwell stated that the child was progressing favourably. A Special Committee was convened to report on Gaskin’s actions, and he was discharged. The matron was instructed that no night lights be used without suitable guards.
The number of patients from one family were limited to two. One of the payment pupils was placed on the election list.
1852 – extracts from 10 board meeting minutes from January to May
£500 was invested on behalf of the building fund. “Dr Reed stated that he had spent several days at Colchester during the Christmas, that all was proceeding well and the children were very happy and improving.” Thomas Dickinson left a legacy of £2000; he had a ward named after him “in commemoration of his great kindness and liberality.” A donation of £400 was received “from a gentleman who gave his name as JW Shepherd without an address… it was agreed that an Advertisement acknowledging the same should be placed in the usual Morning Papers.” The Annual Dinner presided over by the Earl of Carlisle raised “a liberal amount.” The Atheneum donated advertisement space “amounting to 10 guineas.” Mr Peto decided that his loan of £1000 should become a donation. Peto became the largest subscriber to the charity.
An application was made to the Commissioners of Inland Revenue for a return of the duty paid on the insurance, as other charities had done this and had obtained it.
“Dr Reed reported that Dr Little had visited the asylum and was much gratified.” Mr King offered to donate 50 guineas if 39 others would do the same. Architects were invited to send in plans for the new asylum at Reigate at a cost of £20,000. Charles Carling of Clapham Common consented to be on the Board.
“Mrs Griffiths the mother of Helen Griffiths admitted at the last election, is in possession of good property.” This turned out to be several houses which gave her an income of £200 pa. The Board “resolved to apply for a statement of her affairs and income.” This was done, and a request was made for 25 guineas pa “to commence from Lady Day next.” She paid £6.11.6 for a quarter and was told that if she didn’t keep up the payments her daughter would be removed from Essex Hall.
Mrs Crockett asked for her son, now in Park House, to be placed on the election list for October, and that was granted. Mr Robinson asked that John Harvey be passed over for the April election and stand for October, which was allowed. Miles Bracewell, whose friends were unable to keep up the payment, was removed from Park House. Another inmate left for Australia. “Permission was granted for the friends of Richard Hopkins and Emma Stout to have their children home for a short time.”
Extensions were made at Colchester for 60 more pupils, there now being 198 in total. The grounds of Earlwood are now fully purchased, Prince Albert will lay the first stone and 30 gentlemen will lay 100 guineas each on it, 200 ladies will lay 5 guineas each. New patrons include Earl Darnley and the Bishops of Peterborough, Norwich and Gloucester. £800 was received from legacies.
Lessons were added in sewing, geography, domestic work, dancing, object lessons, willow plaiting, tailoring and harmonium playing. 5 are learning shoemaking. Air, diet and medical treatment have had a marked effect.
For one quarter of the patients little can be done beyond protection and comfort; for the rest much can be done.
Farm House near Essex Hall has been made into an infirmary for 30-40 cases, out of 242 patients. Presumably these are for those for whom little can be done. Political and social pressure over the last 2 years caused financial difficulties.
The first Earlswood stone was laid “by the hand of royalty amidst the cheers and rejoicings of gratified multitudes.” Interest was created in Lancashire, Yorkshire, Edinburgh and Dublin. “The poor idiot will have found an inheritance in the land, the provinces and other nations will follow.”
An oculist and an aurist were added to the honorary medical staff, and 5 more servants joined the family. Hatmaking, bonnet making and housemaid training were added. 87 trousers, 55 baskets and 22 slippers were made. Of the 60 dumb, 30 began to speak. Some patients have completed their term of education – after 5 years; a second selection for a further 5 years was allowed – it is not stated how many were returned to the community.
Rev. Edwin Sydney toured the country giving lectures to promote the charity, as he did for many years, with great success.
The “stream of beneficence” lessened causing a crisis. There are 259 patients and 63 employees. Assistants formed a brass band. Cricket was played. There was mat making, rope making, writing in copybooks and on slates, training for house lads. 57 straw bonnets and 82 trousers were made as well as 48 dozen articles of clothing and house linen and 96 fancy work articles. All the older girls make their own beds and sweep and clean their rooms in rotation. Patients “attained such order, such intelligence, such harmony, such usefulness…Those who could not walk now run.”
Earlswood, though incomplete, has opened. There is debt, but the anniversary dinner raised £600. Now the Crimea War is over, the financial situation should improve (much charity went to widows and orphans of the war). Household numbers are down slightly from last year at 257 patients and 61 employees. 60 patients are employed in the workshops.
Sign language is used. Object lessons teach by presenting objects repeatedly until they are familiar and recognised, with their characteristics of form, colour, taste, smell, size, weight and use. The alphabet is taught in a similar manner. Thus the advance to writing, reading, drawing and arithmetic is rendered comparatively easy. “Conscious of possessing power, the child is anxious to exercise it.” There are many candidates for cleaning shoes, sweeping rooms and walking, and “the successful one regards himself as highly favoured.” Of course there are many for whom nothing can be done, beyond keeping them clean, comfortable and as far as possible happy.
However the Commissioners in Lunacy were critical. They had not been informed of the move to Earlswood, and considered it to be “unfinished, unfurnished and unfit.” Some of the boys were dirty, untidy and offensive; the bedding was much stained and some was rotten, lavatories were not working, the dining room could not be used in winter as it lacked heating, the water was brown, turbid and quite unsuited for drinking etc. No records of medical treatment had been kept and improvements in management were needed. The Commissioners drew the attention of Dr Maxwell, the Medical Superintendent, to the Act of Parliament (Regulation of Care and Treatment of Lunatics 1845) which made him personally liable to very heavy financial penalties (£10).
A drawing by a pupil is exhibited in the palace, Her Majesty pronounced it extraordinary. Roads and pathways are made, the farm is in good and profitable occupation. The new building is in general readiness, but furniture and fittings are needed.
The building was beautiful, in contrast to the asylums criticised by John Conolly in 1847 as resembling prisons. Inside it was thought the symmetry of the wards would impart a similar orderliness in the minds of its inmates. Behind the grand central staircase was a large dining hall, also used as a chapel and music hall. The female wards were to the left of the main entrance, the male wards to the right. Children were divided by intellectual capacity, allowing for specialised training, and each ward was a relatively separate unit with its own entrances.
70 boys improved so 21 have perfect speech. 9 use signs and sounds, 7 are dumb. Some now tell the time, and are not a little proud of their acquirement. Cocoa nut matting is being made and put in the corridors; handsome wool mats are in demand for carriages and drawing room doors.
The Prince Consort, Duke of Cambridge and Duke of Wellington visit. There are concerts and magic lantern entertainments.
The Commissioners in Lunacy continued their criticisms. They recommended that residents be employed in useful tasks, and should be taught to wash and dress themselves.
Admissions are enlarged to 25. He number of payment cases should not exceed the number of elections. Payment cases provide a surplus. Her Majesty donates another 250 guineas. A bazaar at the Crystal Palace is organised by “a large body of ladies.” The annual festival is presided over by the Duke of Wellington. Regular subscriptions are “decidedly advanced”, but due to the high price of money and provisions during the war still more are needed.
General health is remarkable with only 2 or 3 with serious illness. “The rule is to treat the cases physically, to begin with the body, and to help the mind through the body.” There is a baby class; periodicals are provided. 13 rugs, 200 mats and 349 yards of cocoa nut fibre matting have been produced.
However five of the toes of Matilda, a patient, became gangrenous and were lost. Dr Conolly was upset that the Institution had got into bad repute. Dr Maxwell resigned and Langdon Down was appointed. His responsibilities extended into every area of management, including the farm and all appointments. He explored in depth the proposals of the Commissioners in Lunacy. He felt that every aspect of life should contribute to education, and trade sure that during meals there were enough plates and that cups and saucers were used. He thought one competent member of staff was better than two incompetents, and he ensured staff used their time productively. Increased wages were paid for by the reduction in numbers, bringing them up to accepted norms.
There are 276 patients, 185 boys and 91 girls., as well as 94 staff. There are bagatelle boards (an old form of pool) and other indoor games.
J Langdon Down, now the resident medical superintendent, commented “very many boys whose lives had heretofore been passed in neglectful exclusion at their homes, or who, in their native villages, were the subject of cruel tyranny or pitiless scorn from their fellows, may now be seen working in joyous mirth, glad to be employed, proud of the products of their handicraft, and confiding in those who in kindness devote themselves to their instruction.” He hopes they will increasingly support themselves. The girls are employed in domestic labour. He arranged that the worst cases have their meals in a separate room “where they can have all the attention their peculiarities require, and at the same time preserving the peace of the major part of the family.”
Dr Conolly helped by chairing the House Committee meetings, and was an important support to Langdon Down.
Patient numbers have increased by 30, as have staff numbers. There is a bazaar in Brighton, the Duke of Cambridge (cousin of the Queen) presides over the annual festival. 5 life cases will be elected. Paths in the lawn are extended. Punch and Judy is performed. The “Association of Ladies” was created to raise funds.
The medical superintendent (Langdon Down) reports : the imbecile is better off in Earlswood than at home or in a lunatic asylum. Weights and measures are taught. 5 boys make panelled doors. 6 at least of the boys will be able to earn their livelihood. Pupils write to their friends. Indolent activity contrasts with cheerful willinghood. The law of kindness which rules through the house draws on their affections. The companionships which they form weave potent ties. Life inmates render valuable services, though unable to do battle in the competition of the world due to slender knowledge of money affairs.
The dialogue for the Christmas pageant was written by Langdon Down, the costumes designed by his wife. Attendants took the leading roles.
The Board Minutes record there was argument in 1860 about the cost of the farm. It was defended on the grounds that though the set up costs had been expensive, now the farm provided much useful occupation for a portion of the “family”, and recreation for many others. There was a vote, and the farm was saved with “acclamation”.
The Commissioners in Lunacy were impressed. “The pupils were, without exception, cheerful, happy, well dressed and clean and neat in their persons. The medical visitation book is now properly and carefully kept.” The Commissioners were appreciative of the emphasis on physical rather than mental instruction.
5 out of 15 cases of typhoid died.
Langdon Down visits France and declares that Earlswood is superior. He starts a “study of the mental and physical state of the largest idiot population in the world.” He had already carried out 100 post mortem examinations of the brains of patients as part of his search for understanding. He took photographs of the brains, and kept 8 skulls.
Langdon Down states that “A lessened cost, at the price of diminished efficiency, would be parsimony but not economy.”
Numbers increase again by 30 patients and 20 staff. There are 217 boy and 97 girl patients. Lord Stanley MP presides at the festival. General health is good though there are mortalities due to consumption, diet is important. More workshop space is needed, as is a covered gym – as provided abroad. A drill manual for teaching idiots was published by Martin Duncan. Langdon Down wrote of the extension of gymnastics to speech, where “tongue gymnastics” could improve defective speech. Physical exercise was directed at subjecting mind and body to the will.
Nurses look after 44 young children of whom 10 can’t walk, 18 can’t feed themselves 38 can’t dress. There is a sanatorium for 77 girls, 35 of them require food to be minced, they feed themselves with spoons; 16 can dress but require assistance for hairdressing and ablutions. The sanatorium for boys has 188 patients. 74 of them require food to be minced, only 8 can dress themselves. On admission many tear their clothes.
The farm occupies 12 inmates; 40 when harvesting, haymaking etc. The retention of the farm has undoubted value (even if an expense). The “work stands characteristic of the benignant influence of modern civilisation.”
The Board minutes record that an application was made for James Pullen’s model ship to be at the 1862 International Exhibition to be held in Kensington.
The Commissioners in Lunacy noted that there were only 4 dirty and 15 wet beds when they visited.
“A larger establishment is necessary due to its nature.” Patient numbers decrease by 216 to 320. Prince Albert and Andrew Reed die, Andrew in a house in the Earlswood grounds. “He could rest soundly, knowing that the Asylum which he contemplated as ‘the last golden link in the chain of charity’ was securely established.” Langdon Down reports that the farm is now not a financial burden. The stock of cows is increased and several patients are taught to milk, prepare fodder and clean the animals. There is a new washhouse for laundry that cleans 6000 pieces a week. There is a new sewing machine.
Shrubs and trees are planted. In the corridors there are singing birds in cages and goldfish in glass globes, and baskets of flowers and ferns in the windows. There is play at shopkeeping, so learning about goods, coins, money, weights etc. There is a savings bank for patients. 3 boys have left, capable of self support as mechanics.
Summer fetes include games of agility and processions with flags and banners. The brass band includes a few patients. There are visits to Crystal Palace of 100 residents, shadow pantomime, the galanti show (lightbox?), Punch and Judy, magic lantern, oxi-calcium microscope (the oxy-calcium lamp was the earliest and simplest form of limelight), a string band, concerts by staff for patients and the public.
The Board Minutes record that attempts to sell places at Earlswood were quashed.
The Commissioners in Lunacy reported that 300 residents attended Sunday morning service. Additionally there were twice daily prayers, and once a month 100 of the children went to a nearby church. Langdon Down reported that of 31 patients discharged 29 were improved to some degree, 12 of these able to work for a livelihood in domestic service and as carpenters, tailors and mat makers.
There was a measles epidemic with 120 cases and 16 deaths. The Board Minutes state that scarlatina cases were isolated. Also Earlswood joined other charities to defend against the Chancellor of the Exchequer’s attempt to tax charities.
Despite unusual distress in manufacturing districts there has been no impact on the charity. The Asylum was now considered complete, 8 years after first admitting patients. The Prince of Wales has become a patron. Earlswood’s Royal Charter was granted. There are now 337 inmates of whom 236 patients are employed. The males number 170 of whom there are 16 carpenters, 13 shoemakers, 71 mat makers, 11 basket makers, 16 tailors, 25 in the farm and gardens, 1 plumber, 13 in household work, 4 in the laundry; of 66 females 20 carry out household work and 46 needlework. Those employed get wages. Mats, rugs and baskets are for sale. Sale of sundries brought £37, farm and kitchen garden produce £1087. 9 cows purchased for £150.
Meetings held in Sheffield, Bradford and Huddersfield raised money. There was a lecture at the Literary and Scientific Institution of Croydon. The Commissioners in Lunacy inspected Earlswood and gave their approbation. They suggested improvements but there must be “prudent administration of the funds”. Members of the National Association for the promotion of Social Science visited.The annual dinner raised £1980.
Families tend to keep children, in the hope they will become productive, until they are 14 or 15, when they become mischievous or dangerous; this delay has a tendency gradually to fill the Asylum with troublesome young men and women, brought up with no wholesome restraint; it would be better if the training and education of feeble and imperfect intellect be commenced at a very early age, and not deferred to the age of 7 or even 5 years. So age of admission is to be 12 years at most. The average age of admission fell from 14 in 1858 to 11 in 1866.
There is cheerful conformity to the rules of the resident physician by the matron, officers and attendants. There has been good health except for a measles epidemic, affecting 1/3 of the inmates, with some deaths affecting those of low mental and physical power. Previously isolation had excluded contagion of childhood illnesses. Many are of feeble disposition, so good and well prepared food, suitable clothing, an abundant supply of water, airiness of the rooms and ample space for exercise in all seasons are among the objects of constant regard; the farm and gardens have inestimable value.
Langdon Down wants more and better workshops, and opposes a proposal to reduce the amount of land. An acre of upland and 4 cottages have been purchased, they interfered with the privacy of the inmates and have now been let to work people of the asylum. There is a more powerful steam engine in the washhouse. The water supply from the Mole tributary has become impure, so it is supplemented by an artesian well and rain water collected from the roof.
Langdon Down was offered the Chair of Physiology at the London Hospital. He stayed at Earlswood but attended to his unpaid duties at the London Hospital 2 days a week.
Dr Conolly died. There are 365 inmates,, 259 are employed, 2 as assistant nurses. 147 had scarlet fever as well as 45 officers and servants. The proportion of deaths caused by scarlet fever was half the average, due to the treatment given by Langdon Down, to his creation of a special ward, and his use of seamstresses and housemaids in nursing duties. This is notable especially as imbecilic patients had a low resistance to disease, their life expectancy was 1/3 of normal. The asylum building is now completed as well as tailoring and shoemaker workshops. “Though the building has a great deal of architectural grace about it, the fact is, it is one of the cheapest buildings ever erected in this country.” “Desirable additions of various kinds are suggested in the interesting report of the Medical Superintendant (Langdon Down), but none of these will be attempted until the debt shall be extinguished.”
There have been meetings in Reading (raising £112), Newcastle (raising £110) and Liverpool (raising £1155, largely from “princely merchants”). This is a national, not a London institution. It is one of the most cheaply run according to the Commissioners in Lunacy. 14 acres and several cottages have been sold on very advantageous terms to the institution. The Prince and Princess of Wales will patronise the bazaar. The Duchess of Cambridge and the Princess Mary together with many Ladies of the Aristocracy have become patrons. Great efforts were made to pay off the £9000 debt (remaining from the original £20000). The Board conduct “so as to effect the greatest benefit of the inmates in the most economical manner.”
“The whole family is happy.” “The Managers have in Dr Down the right man in the right place. I could not help being forcibly struck by the great interest he took in all the inmates, and the pleasure they experienced in seeing him.”
Langdon Down says more work is needed including replacing the dilapidated farm buildings. Considerable staff are needed to look after infants, those of bad habits, those being taught, those with paralysis, chorea, epilepsy, scrofula or other maladies. Despite ill informed comments expenditure needs to be maintained. Cleanliness, good food, lack of restraint and market wages for staff are all needed. It should be remembered that the number of assistants is augmented by the reception of private patients. He calculated that it cost £46 pa to maintain a resident, and recommended acceptance of more payment cases, which had been kept to less than half of the total.
There are 39 more patients. Health is good, with mortality being considerably less than the UK average. There was a meeting at Birmingham. The debt has been paid. Monday evenings are set aside for entertainments. The Commissioners in Lunacy report “the condition and prospects of this Institution is favourable in a high degree.” The estate is 145 acres. The Board wishes to double the capacity of the building to 800 inmates. Current capacity is 445. Assets are worth £84549. Lord Palmerston dies.
Langdon Down reports that a spacious enclosed drying ground has been added to the laundry; other rooms are being added. All sewage added to grassland. Enlargement of Earlswood, rather than founding a new institution, is cost effective. Overcrowding is an evil. Expansion can be gradual. “Monthly winter concerts continue sources of great pleasure. The love of music is almost universal among the inmates….The entertainment at Christmas was not only a source of temporary pleasure, it had a powerful influence in stimulating the lethargic and in calling into activity the faculties of memory and imitation to a large degree.”
An assistant medical officer, a schoolmaster, a school mistress and an assistant were employed. Two thirds of the children were taught formally in school rooms for 10 hours a week. They were graded by ability into 6 classes.
The Institution was largely self sufficient, baking bread, making all the shoes, growing all the fruit and vegetables, producing milk, having its own laundry etc.
There are now 446 inmates. Earlswood is full. There have been meetings at Bath and Bristol. A turret clock and a piano have been donated, there is a fund for an organ. Sermons were preached on behalf of the charity by 8 reverends.
The Commissioners in Lunacy examined every patient and inspected all their wards. They report “very favourably”. 5 patients are away on leave. Only 14 deaths in the last year, 8 from phthisis (TB) and 6 from epilepsy. “To Dr Down every credit is due.”
Down reports “ a growing reputation throughout the British dominions.” Absence of epidemic disease. No accidental death for 8 years. Even the cows are healthy. New workshops being built. A new water tank for the laundry has been built. Drinking fountains needed in the gardens. 100 inmates paid for visits to Crystal Palace, their conduct was irreproachable. Trees, shrubs and 100 roses planted. An ex-inmate, now a carpenter, returned to give thanks; another inmate left to be a shoemaker. 223 inmates employed. Langdon Down was elected an Honorary Member of the Pharmaceutical Society.
The school master reports the average number of pupils to be 157. Whole time: 19, half time 130; occasional 2. They receive instruction in reading, writing, writing from dictation, arithmetic, shopkeeping, drawing, telling the time, collective object lessons, drilling, speaking, dancing, religious truths and moral sentiments. Lessons are between 40 and 45 minutes; 3 are given in each class morning and afternoon. “Between the lessons pupils are collected in one room and sing exercises, combining information such as the multiplication and money tables etc and at the same time move the head, arms or legs to the time of the music”.
Of the 144 now in school 15 can read with fluency in the Gospel of St John, 11 can read slowly in the Gospel, 18 can read slowly from lesson boards, 17 know all the letters, 43 know a few letters, 40 know none of the letters. 21 can write sentences, 23 can write words, 14 can write easy words. 11 can do sums, 22 can do sums collectively and count above 100, 10 can count above 50, 22 can count above 25, 48 can count a little, 31 cannot count at all.
Keeping shop is considered play but is very instructive. 28 know all the coins and weights. 8 can tell the time to a minute. The pupils take an interest in the Bible class.
The schoolmistress teaches 102 girls and 28 (infant) boys. She reports that 60 attend the Bible class and the Sunday evening lecture, 54 regularly attend morning and evening prayers. 13 can read the Bible, 17 can write, 30 can do “plain work” well. “Their greatest delight is in writing letters. They appear fond of school… One will sometimes assume my name and functions, and they will keep school among themselves.”
William Millard, lay superintendent of Park House, published “A Manual for the Classification, Training and Education of the Feeble-minded, Imbecile & Idiotic.”
Earlswood is full, but there are 216 candidates. Only 30 will be elected. Additionally 60 payment cases at various rates await admission. A resident assistant medical officer has been appointed. The “Earlswood railway station” is to be opened, and the land between the station and Earlswood has been acquired. Up to now the nearest station was a mile and a half away. Completion of the workshop block will free room up to accommodate another 100 patients.
Since last June there have been 40 admissions and 26 discharges, of whom 6 were healed.
The summer fete was again attended by a large number of subscribers. A meeting was held in Oxford. A letter was sent to every clergyman and to most of the non-conformist ministers of the kingdom asking for a sermon on behalf of the charity. 28 sermons were preached. The Lord Mayor presided at the annual festival. Gifts include a bassoon, hundreds of plants, rhododendrons, albums and toys. James Pullen’s model ship won a bronze medal in the 1867 World Exhibition in Paris.
The Commissioners in Lunacy were satisfied, reporting that personal cleanliness prevailed and only 5 were in bed. For dinner there was “a liberal share of meat and pudding for everyone.”
Langdon Down reports that there is an awakening in the land about the needs of the feeble minded “to establish local charities of a similar nature to our own, and by the attention which is being directed to the wants of the pauper imbecile in the metropolis and elsewhere.”. Specimens of work have been sent to the Paris Exhibition. Down published “A Treatise on Lunacy and its Cognate Affections.” He also held, with Fletcher Beach of Darenth, William Ireland and George Shuttleworth (Down’s assistant at Earlswood) the first medical conference on idiocy in Belfast.
The metropolis had a cholera outbreak; In Earlswood cholera was averted by control of water supplies but the situation needs improvement. But there have been measles and whooping cough epidemics.
276 attend school. 109 speak fairly, 41 read fairly, 29 can write sentences, 10 can work sums, 4 can drawn crayon and pencil, with shading, 28 know all the coins, 10 can tell the time to a minute, 7 can hem and sew neatly, 208 can dress, 216 can use knife and fork (26 can’t feed themselves at all).
Amusements not only interest the patients but are beneficial to the staff. Non-participation is used as punishment. Corporal punishment was strictly forbidden, as was denial of food.
The making and storing of gas needs attention. Gas is made at a lower cost than can be obtained in the neighbourhood.
Despite the general depression of commerce, and the disastrous calamities which have fallen on many” there has been an increase in contributions. There are now 455 inmates. The “most unbounded enjoyment was manifest” at the summer fete; Schweppe & Co provided the lemonade, ginger beer and soda water. “The schools and workshops have been removed to the additional buildings, and te rooms formerly occupied by these are now appropriated as sleeping and day rooms for fresh inmates.”
The Commissioners in Lunacy reported that “a congenital imbecile has recovered his intellect and is now self supporting and well conducted. The deaths were all from ordinary causes. The sanitary condition if the Institution is very good.” They approved “the condition and management of the Institution” and the “comfort, cheerfulness and contentment” of the inmates.
The Medical Superintendant (Langdon Down) reported he organised “new time tables in which the combination of manual with intellectual instruction is more carried out than formerly.” A bronze medal was awarded at the Paris Exposition for the industrial and artistic work of the inmates. “The gymnasia both for the boys and girls require entire renovation.”
Langdon Down resigned after some disagreements with the Board, and left in April. Dr Grabham was appointed in June.
The Schoolmaster reports that he has 154 pupils divided into 6 classes by attainment. 70 can speak, 27 read, 26 write and 10 do sums. 10 can tell the time and 23 know all the coins and weights in the shop lesson. During fine weather the band plays twice a week and the pupils play Aunt Sally, croquet etc or walk round the grounds . There have been 3 balloon ascents and a firework display. The Bible Class is attended by 109 boys, and nearly all the inmates attend the Sunday evening services and morning and evening prayers.
One of the boys admitted in 1865 “could not speak, or very little, knew 3 letters, counted to ten, knew no coins etc. He is very much improved in speaking, knows nearly all the letters, counts to 49, knows 19 of the writing letters, knows 6 coins and 6 colours.”
The schoolmistress reports that 128 girls and infants attend, of whom 8 are altogether incapable of improvement and 5 have died. 43 can speak, 7 can read, 6 write, 2 do easy sums, 9 can hem and sew; 18 need to be fed. The patients, “at their various employments after they have done with school…are apt, obliging and industrious workers, some displaying more intelligence than could ever have been expected.”
There are 478 inmates, and 35 will be elected. 21 (whose term of 5 years has expired) will leave, though most are candidates for re-election for another 5 years or for life. “Obedience, attention and order are only to be attained by the long and repeated efforts of kind and experienced instructors and attendants.”
The Commissioners in Lunacy reported that since the appointment of Dr Grabham there has been only one case of restraint, and the just for one hour. They say the number of females employed is too small. The basement has been refloored and will be used for exercise in wet weather. The playground is improved, a drinking fountain provided, a new mortuary and new linen room provided. Water for drinking and culinary purposes will be provided by the Caterham Water Company (the well water is too saline). The hall is too small.
There are 10 officers and 126 staff of whom 34 men and 25 women are attendants. Salaries of officers and masters are £1703, wages of attendants, masters of trade and servants are £1448.
More land (to prevent objectionable building) and an Inn adjoining the grounds have been purchased. The Inn “has been for a long time a source of great annoyance and anxiety. This is now converted into a dwelling for the Steward, whose rooms in the main building will be devoted to the reception of fresh inmates.”
The Medical Superintendant (now Geoffrey Wallington Grabham MD) reports that the highest number of inmates was 502, the average 472. Health has been good, with none of “epidemic character”, but a detached infirmary is necessary for isolating patients, and accommodation for the sick is already too limited. “The erection of the proposed new block of buildings will relieve the urgent pressure in the female division and provide the additional space so much needed in the dining hall.” (The new buildings will include a kitchen, scullery and bakehouse.) A dishonest night watchman was detected by the use of electric communication between the Superintendant’s house and outer and store doors. 53 more boys are employed in the workshops. “It is a more difficult matter to find occupation suited to the female pupils”. 28 do household work and 9 needlework. Wages have been increased “to secure a better class of persons than formerly; and to retain their services for a longer period.” There were the usual entertainments, trip, fete and bazaar and “The New Year’s Dramatic Entertainment was carried out with great spirit by the officers and servants.” About 60 staff take part along with one or two patients.
The Schoolmaster reports that 146 attend school, 129 of them in the morning or afternoon; 17 attend both. In the past year 53 have left the school, some discharged, several died, the remainder in a useful occupation.
The Schoolmistress has had 8 discharged (term having expired), 2 gone to household work, 7 transferred to the boys school and 7 died. The total of pupils is 145 including 18 male infants, 68 are present morning and afternoon, 77 in the morning only. 66 can use knife and fork, 11 hem and sew well. 48 speak fairly, 16 read very fairly, 13 write, 6 work simple sums. A large proportion are very affectionate. “An approving smile from their teacher accomplishes much. The Monday evening amusements (which are eagerly anticipated throughout the week) afford extreme pleasure to one and all.”
A printing press, toys, dolls, scrapbooks, engravings and 3 cases of oranges were donated. George Shuttleworth left Earlswood for a post in Lancaster.
1881 – 36th Report of the Commissioners in Lunacy
391 men, 170 females. Few in bed, good diet, adequate exercise in the “airing-courts”. Kindness shown by staff to new patients. 208 males and 94 females are “usefully employed”, many of the former in trades, and 19 on the land. 34 are in the tailor’s shop. “The industrial occupation of the girls is, of course, in-doors; none are found fit for laundry work, but they assist the nurses, do domestic work, and a few act as monitors.” Wards are comfortable, clean, and well ventilated. 200 epileptics, with night supervision. Entertainments. 150-200 annually go on a leave of absence. Attendance in chapel on Sundays is 400-500. 30-40 of “the best behaved” go to parish church.
“Dangerous conditions in the Kitchen and at the Workshop Block” – walls needing immediate repair. But the whole of the main building has now been restored, except the central rear block, which comprises te Dining Hall, Kitchen and Female Epileptic portion.” An extensive list of repairs ad maintenance were carried out.
“To celebrate the Coronation of His Majesty King George V, the patron of this institution, the Board decided to admit all those candidates on the Ordinary List, who had been applying for admission at three or more elections, and twelve were received for a period of seven years.”
“At the asylum, a Coronation Picnic was given to the patients…wit games, races, music and dancing on the lawns- a happy and thoroughly enjoyable day for all.”
“Unfortunately, a slight outbreak of Scarlatina prevented the happy gathering of the patients to receive, at the hands of the lady friends of the Members of the Board, the toys and presents which are distributed on the occasion known as the New Years Entertainment.”
The Commissioners in Lunacy report that over the last 8 months 36 patients were admitted, 13 discharged or removed, and 10 died. There are now 356 males (including 15 at Walton) and 143 females (499 in total). 305 are election cases (44 for life, 136 gratuitously for 7 years, 125 for payments below cost.) There are many others received for payments less than cost.
There is 1 day staff member for every 7 patients; 7 are employed for night duty. 57% have been at the asylum for 5 years.
Patients were “well cared for, happy and contented. The health of those we saw is generally good….A good dinner, consisting of beef and potatoes, followed by pudding, was served in the Hall during our visit, and evidently gave satisfaction. No use of mechanical restraint or seclusion has been reported.” 50% attended Sunday Services, 63% the associated entertainments and 59% were usefully employed.
The Earlswood seaside home in Walton on the Naze is a convalescent home with 15 male patients, many of whom work in the garden and sheds. The house was very clean and tidy, the beds and bedding in good condition, dress and personal appearance quite satisfactory. “They all seemed very happy and contented. Their physical health was good, nobody being in bed.”
“The earnestly desired legislation for the Care and Control of the feeble-minded …is being prepared by the Home Secretary. Hitherto, the want of some properly constituted power to detain and provide suitable Homes for the class now known as the Feeble-minded, has led to calamities which threaten the moral and physical degeneration of the race.” This will be less expensive than provision for them “temporarily, as criminals (in prisons and reformatories), and as the irresponsible “ins and outs” in our Workhouses, or to allow them, fully knowing them to be degenerates, to swell the number of unemployables. When at large, all of these multiply rapidly, and to an alarming extent, as those having knowledge of these evils can demonstrate.”
This will require considerable expenditure. “Fortunately, this charity has a well defined sphere of usefulness, in supplying the needs of the middle and professional classes, many of whom, in special circumstances, require help.”
Of the 55 cases admitted, 52 were admitted for the first time. “Of the new cases, 5 were Mongolian, 3 Cretinous, 1 Hydrocephalic, and 8 Epileptic, and the probable cause for their affliction were as follows: shock, fright and trouble during childbirth 17, injuries to head and spine 5, convulsions 10, alcoholism 2, consanguinity 1, pthisis 3 and there was a history of heredity in 9.” 2 of the 28 discharges wee due to the amount of improvement.
Of 14 deaths 6 were from TB, 3 Heart disease, 2 Nervous diseases and 1 each for pneumonia, senile decay and Asthenia. After an absence of 13 years, 14 patients and 1 nurse had Scarlet Fever. Strict isolation has been enforced. The fractured arm and leg hav healed, but a knee injury “will, I fear, lead to disorganisation, and permanent crippling of the joint.” 54 patients have had 3,046 fits, males having an average of 63 pa and females 43. There were 1486 by day, 1560 at night.
The 39 patients elected for life have an average age of 59.5; the 33 patients paid for for life have an average of 50.75. Of those resident 91 have been in the institution for over 30 years, 56 for over 40, 22 for over 50 and 2 for over 60 years. “It becomes more difficult to obtain our patients at an early age, owing to the desire to keep children in the special schools up to 16 years, rather than send them to Institutions or Colonies, and the chief drawback to this system is… Defective children are brought into contact with normal children, from whom they learn bad language, bad habits, and much that is not desirable.”
“The average life of an imbecile has been assumed to be about 30 years, or less” but the reality (with suitable and continued care and supervision) is probably considerably over 50 years. Mr T Small, the religious instructor and Head Schoolmaster, died at the age of 90.
The making of wool rugs in the Boys School has proved to be a further success. A letter read “We have enjoyed having her home, she has been very good, and seems so much happier and contented than she used to be.” Another said “I certainly thnk discipline and a quiet routine of life have improved him greatly”, yet another “we hope to be able to get him some light work.”
Entertainments included Football (patients), Dancing, a staff concert, Bioscope, Pierrot and Variety entertainments, Cricket (patients & staff), Picnics, Bonfire and Fireworks. Patients are being trained in a brass band. There are twice daily prayers and a weekly service and bible class.
“With Feeble-minded pupils greater success can be shown in manual and industrial training than in educational or scholastic work.” This year 6000 repairs were carried out in the Shoe Shop, over 400 pairs of boots made, and 9000 annual reports printed, as well as about 200,000 other items including 104,492 time and duty sheets. 99 items of clothing were repaired and 422 made, including coats, vests, trousers and knickers. 424 brushes, 204 baskets, 113 mattresses, 84 palliases, 110 mats and rugs, 60 pillows were made and 30 items of furniture covered and 86 baskets repaired. 634,186 items were laundered, 99,591 of these for attendants and 16,262 for officers. The farm produced large quantities of beef, mutton, veal, pork, fowls, butter, milk eggs and potatoes. Prizes were won at the Redhill & Reigate Agricultural Show for mangolds, wheat, pigs, potatoes and steers.
191 inmates were employed during 1911, 160 of them males and 31 females. The males were employed in 21 occupations: bakers (2), basket makers(3), boot and shoe cleaners (12), bookbinder (1), brush makers (7), carpenters (12), famers (10), gardeners (20), housework (14), industrial training (5), kitchen helps (7), laundry (9), mat weavers (7), mess rooms (3), plumbers and painters (9), printers and compositors (7), shoemakers (12), store help (1), tailors (14), upholsterers (2) and schoolroom monitors (3). Females were employed as assisting nurses (10), assisting in bedrooms, pantry, wardrobe and workroom (12), laundry (3), linen room (2), sculleries & passages (1) and schoolroom monitors (3).
35 of the boys attend school full time, 23 half time, 2 occasionally. The half time and occasional pupils are employed as tailors etc. During the year 11 have been transferred to full time work.
At the end of the year there were 499 cases resident, 349 males and 141 females. Their ages varied from 5 to over 75 with almost half being teenagers. Two residents had been in the asylum for over 60 years, 20 between 50 and 60 years; but the majority (271) for under 7 years.
During 1911 55 were admitted for the first time, plus 3 others. 28 cases were discharged (relieved) and 14 died of TB (6), meningitis (1), chorea (1), syncope(3), pneumonia (1), asthenia (1) and senility (1); 10 post mortems were carried out.
Probable or assigned causes of imbecility for those admitted in 1911 were heredity – 9; consanguinity – 1; pthisical history – 3; Alcoholism in mother – 1; prolonged labour – 5; shock, fright, trouble or worry to mother during pregnancy – 12; Convulsions in infancy – 10; accident to head in infancy – 4; accident to spine – 1; epileptic on admission – 8; no cause assigned – 8.
From 1847 to 1911, 3855 (2579 males and 1276 females) had been admitted, 21 had recovered, 2033 were relieved and 147 not improved. 1155 had died, the average yearly deaths ranging from 2.5 to 4.1% of those resident.
“The Mental Health Act 1959 became law on 1st November 1960. Almost all the patients are now on an Informal Basis. The term mental deficiency is now obsolete, and the patients are classed as sub-normal or severely sub-normal. I would like to thank all those parents who agreed so readily to discard certification, and to allow the patients too remain informally. Five patients remained certified on 1st November, 1960.”
“We like to think that custodial care is a thing of the past in Earlswood,, and that each patient is trained to lead as full a life as hi capabilities permit. This we try to do by a dynamic psycho-therapeutic approach.”
The Holiday Home in Walton-on-Naze accommodates 21patients (those without relatives) who stay for a fortnight, with 374 having a holiday in the year.
The mixed school caters for 4 to 16 year olds. 4 teachers each supervise a class of 15 children, who are taught sense training, button and lacing frames, simple raffia work, painting, eurythmics and personal hygiene. In one class simple instruction in reading, writing and arithmetic is combined with physical exercises, speech training, country dancing and plasticine modelling; there are sessions with hand bell ringing, raffia designs and puppetry.
60 adult females have Occupational Therapy. There are three therapists. The work includes needlework, knitting, darning, macrame, making socks, tea cosies and shopping bags. 70 Adult males have OT, 60 of them do industrial work in the morning. Afternoon therapy includes group speech training, simple woodwork and able games. Some send weekly letters home.
8 lower grade girls have play therapy but even those with mental ages of 4 and 5 have done some simple industrial work. 72 boys attend continuation school taking part in industrial work such as assembling cardboard boxes, folding and packing greeting cards, lampshade making, paper bag making, brush making and work on hand looms. 24 adult males work on the farm, market garden and ornamental grounds. 47 patients are employed in the kitchen, laundry, tailor’s shop, upholsterer’s shop, printing office and engineering. (According to the 1962 report work is paid for at rates varying from 5 to 30 shillings a week.)
The PT instructor teaches young children to walk and gives older patients regular sessions of formal physical training. He organises cricket matches and country walks in the summer, which were much enjoyed. In winter the patients had concerts, pictures, whist drives and coach trips at least twice a week. There is a TV in most wards.
There is a new department of speech therapy, addressing dyslalia, stammering and aphasia. The child psychiatry unit is in its 13th year, and works with emotional difficulties and maladjustments. “These ay develop from background insecurity arising from such difficulties as adoption, parental mishandling, neglect or frank rejection. Some children have a weakness of personality which makes their daily contact with their fellows a frightening conflict, and they develop anxiety or other nervous symptoms as a result. Many emotional difficulties lead to the development of physical symptoms, and so such problems as bed-wetting and soiling are ever present.
There have been a number of cases this year in which the prime cause of trouble proved to be the mother’s going out to work. Although this is designed to produce a higher standard of living for the children, they lose so much in security that the apparent benefits are lost.”
The psychology department gives all new admissions a mental test. There was a flu epidemic. Radiography discovered no cases of TB. There is a visiting dentist and an eye specialist.
Earlswood has a milk herd of 60 cows and 180 pigs.
1966 annual report
The Royal Earlswood Hospital Management Committee administers the Royal Earlswood Hospital (675 beds), Forest Hospital in Horsham (328 beds), Farmfield Hospital near Horley (174 beds) and Earlswood Home in Walton-on-Naze (299 beds, totalling 1203 beds at the end of 1965. The Royal Earlswood Group was established under the NHS in 1946, and is under the general direction of the SW Metropolitan Regional Hospital Board, itself responsible to the Ministry of Health.
In Earlswood there were 49 admissions in 1966, 36 discharges and transfers, 13 deaths. Of the 651 patients at the end of 1966 396 were male; 81 of them children (55 male). All ages and both genders of mentally subnormal and severely subnormal patients resident in West Sussex are admitted, with others from the eastern part of Surrey including Croydon and some cases from the Inner London boroughs. Demand for both short term and long stay cases continues to grow and increased accommodation is being built. Better bathing facilities and sanitary annexes have been provided and a large scale washing up machine installed. Accommodation for married staff has been increased. the staff social building will be extended so as to provide a museum.
Volunteers help by running the patients shop, library, trips, visiting lonely patients etc. There is difficulty recruiting staff. The group employs 551 staff: 125 nursing males, 95 nursing females, 190 other males and 123 other females. 181 joined and 163 left during the year. Since 1948 the nurse training school produced 83 state registered nurses qualified to nurse the mentally subnormal. Currently there are 29 student nurses, 22 of them male.
Earlswood board minutes and annual reports: Surrey History Centre
Dr John Langdon Down and Normansfield: O Conor Ward
Mental Disability in Victorian England, the Earlswood Asylum 1847-1901: David Wright
2.30pm Talk: Finding Ivy: From Belonging and alienation and back again
Speakers: Helen Atherton and Florian Schwanninger
The story of one victim of the Aktion T4 programme. Ivy was born in the UK and in 1930 went to live in an institution in Vienna. In the summer of 1940 she was killed at Hartheim castle near Linz. Different historical material has been used to tell Ivy’s story including photographs, church records, census reports and newspapers.
3.30pm Aktion T4: A documentary film
The Aktion T4 Nazi Euthanasia programme was responsible for the murder of approximately 275,000 people with learning disabilities.
In this 30 minute documentary film, Berge Kanikanian who has Down’s syndrome, travels to Poland and Germany to visit the sites of euthanasia centres and speaks to researchers and historians.
Please note this talk and film is not suitable for anyone under 16 years of age.