Leavesden Hospital

Founding and Setting Up

The Metropolitan Asylums Board was set up in 1867 to provide care in London for “insane paupers” currently living in workhouses. These people were also described as “quiet, harmless imbeciles”. There was a category of “moral imbeciles” – people who could not control their bad impulses and for whom punishment had no deterrent effect. This could include unmarried mothers, petty thieves and homosexuals.

There was a commitment to provide dignified, solid institutions, but there should not be extravagances. They should be mostly of brick with only essential stonework, such as thresholds, and no fancy circular tops to doors and windows. Tall rooms and windows which could provide plenty of ventilation were advised and the rooms were heated by open fires. There were always complaints about it being bitterly cold. There was no heating in the communal bathrooms. Surfaces were painted light green or grey.

Two identical asylums were built, one in Caterham and the other in Leavesden, both designed by architect John Giles. A site north of Watford was purchased for £7,600.  Altogether the buildings and furnishings cost £145,000.

As there was no mains water supply, a huge well. more than 60 feet deep and very wide was dug in the chalk ground with many horizontal underground channels. This could provide 100 gallons of water per minute as it was pumped out. The hospital had its own gas works.

Staff  were advertised for: attendants, nurses, laundry maids, cooks and various supervisors and experts in a particular jobs. Salaries were from £13 to £25 per year for the most lowly workers and from £40 to £500 for supervisors. The applicants must be able to read and write. One Workmistress was required to supervise needlework and also play the organ in the chapel. About 80 capable patients would be expected to work in the laundry.

Most staff would live on the premises but if they lived in their own homes they would receive an allowance for rent, coal, gas, milk and potatoes

An initial stock of bedding and clothing was made by patients at an already existing asylum. Prisoners at Coldbath Fields Prison made the male attendants’ uniforms and baskets, mats and tables.

The kitchen was huge and could supply meals for 2000 people at a time.

Both institutions were opened on 9 October 1870. Each was named the Metropolitan District Asylum for Chronic Imbeciles.

Some events in the hospital’s history

At first there were 860 females in 6 blocks (there were a number of small buildings on the site) and 700 males in 5 blocks. The cost per head for food and clothes was 7p per day. The initial cost per bed, including the buildings was £89.4s.10p

75 were children and the selected paupers had other disabilities, for example 325 were epileptics and some were deaf, dumb or blind.  By allotting more staff to the epileptics and putting them in separate wards, the number of dangerous fits was reduced.

Both patients and staff were segregated by sex, occupying separate rooms and sitting separately at meals, entertainments  and worship. Discipline was extremely strict. Male and female staff  were not allowed to talk to each other when off duty even over a fence in the grounds. This was a sacking offence. Even the Medical Superintendent and Matron were reprimanded for visiting each others’ quarters.

A head gardener was appointed at a wage of 25s weekly. He and the farmers were helped by about 60 patients. The male staff wore smart uniforms and had to show respect to their superiors by saluting. They were allowed one day’s leave every 4 weeks

1873 The children were sent to the renovated Hampstead Smallpox Hospital.

The hospital soon became overcrowded and more ward blocks were built. Patients were continually being moved to other institutions. Store-rooms became wards.

1881  The census shows 1638 patients and 447 staff. The patients are described by their category of mental disability and many of them also by their jobs, such as seamstress or carpenter. One named man is listed as Blind Imbecile – Cigar Maker.

A recreation hall, also two training schools for nurses and a nurses’ home were built. Luxuries such as a Turkish bath and an electricity supply, driven by a steam generator were added. Many patients suffered from TB and a special ward was set up. Wards for infectious diseases were built on the north side of the main buildings so the prevailing south-west winds would blow any pollution away from the well-ventilated work rooms and dormitories.

1913 A new Mental Deficiency Act instituted regular inspections to see that patients were legally detained and properly cared for,  and moneys and other properties owned by them were not being misused or stolen.

By 1914 there were 2195 beds. A new ward was added for people with the eye infection, trachoma, but soon afterwards, because the first World War had begun, wards were taken over for wounded soldiers. Many of the staff were called up and 22 died fighting. In the meantime the patients were sleeping in the corridors and chapel and the staffing was at a very low level.

There were reports from the wounded soldiers about how they had got on well with their “strange companions”.

1921  Things were getting back to normal and there were 2209 beds. Patients began to receive pay for their work. Apart from hard work, occupational therapy was introduced. The hospital had been renamed the Leavesden Mental Hospital.

There were various rehabilitation schemes. Patients were taught life skills such as shopping, dealing with money, using the telephone and generally looking after themselves. They moved to a halfway house hostel onsite and were encouraged to look for work and eventually live independently. Over the years, either through education and training or natural recovery, about a quarter of the patients left the institution. Perhaps some of them should never have been committed in the first place.

1930 The hospital was transferred to the London County Council. Major improvements were carried out   A large school building opposite was bought and converted into wards.

1939 In the second World War this extra building was taken over for use as a military hospital.

After the war, in 1948, when the National Health Service had been established, it took over the hospital, by this time very full, 3,000 patients. Proper training schemes for staff were introduced. The farm was rundown. Children were again admitted and a school set up. The number of residents slowly decreased after the 1970s.

1959 the word “mental” was not allowed to be used in a hospital name

A Medium Secure Unit was added for convicted prisoners with behavioural problems, for instance they did not understand that they had done wrong. This was an important innovation and received people from all over the country. It still survives and is named after the psychiatrist who established it, Eric Shepherd.

1974 There were 1356  residents who cost £80 per week each to keep.

Scandals: Aaron Kosminski, a Polish hairdresser was a patient from 1894 until his death in 1919. He was suspected of being Jack the Ripper. This has recently been proved true from DNA evidence. He was a very disturbed and erratic patient. He suffered from auditory hallucinations and had a paranoid fear of being fed by other people. He picked up thrown-away food. He never washed or bathed. He was not considered dangerous. Mentally ill, dangerous people were transferred to the county asylum

Carers in the 70s and 80s reported that pregnant, unmarried girls had been admitted who were mentally normal and also people who had committed minor crimes. A man who had stolen a bicycle had been in there for 45 years.

Strange elderly people wandered about in mismatched clothes.


Unlike the original “residents” at Normansfield, whose relations paid towards their care, the “patients” were paupers who had to provide  90% of the requirements of the institution themselves under the instruction of  craftspeople and teachers. They were:

  • blacksmiths
  • tinsmiths (for kitchen equipment)
  • printers
  • cobblers
  • tailors
  • bookbinders
  • upholsterers
  • bakers
  • clockmakers
  • laundry workers
  • cigar makers
  • farmers
  • gardeners
  • painters
  • cooks
  • seamstresses
  • kitchen maids
  • carpenters

They made the patients’ clothes, the nurses’ uniforms, mats, baskets , bedding and mattresses, shoes, beer, cooked food, worked in the laundry, grew vegetables, and looked after farm animals. Those who were able, but could not learn a trade, did the cleaning.

Men wore corduroy suits and neckerchiefs. Women wore long dresses, shawls and bonnets. In the 1920s they started to receive pay for some of their work.

They could attend chapel services. Epileptic patients went to separate services.

Entertainments: Soon after this institution opened £15 was spent on playing cards and board games. There were pianos and other musical instruments . A band was set up to play music for dancing. Exercise and sports were organised. There was an annual grant to provide library books.

Smoking was encouraged. It was considered “absolutely necessary to the treatment of the insane”

The staff formed a football team that was in the local league.

Towards the end of its existence, under the NHS, many local people worked as volunteers at the hospital and befriended the residents. It is remembered with affection.

Closing down

Leavesden Hospital closed in 1985. By then there were only 189 residents

A new policy had been adopted by the NHS, that people with learning disabilities would be better living in a normal environment. The large buildings and sites of the institutions could be sold for a huge profit and the money used to set up small community homes with varying care support depending on the needs of the residents.

This project was begun in the 1990s by which time the numbers of residents in all intitutions were dwindling considerably. Organisations such as Mencap and local church charities were contracted to find large houses and employ staff to move the residents into communities of around 5-10. There was quite an idealistic feeling about this and the residents blossomed out and enjoyed making choices about furnishings and clothes and what to shop for and eat.

Of course this was very expensive and there needed to be more staff than residents to cover 24 hour care, and take people out to restaurants and entertainments and normal, family-type holidays. Nowadays children with learning disabilities live at home and go to special or ordinary schools. The generation from the institutions would have been over 40 when they left and by now many will have come to the end of their lives. It is to be hoped that the small homely communities are still being set up and older people are not sent to “care homes”.

Some of the former residents of Normansfield still live in this area. However, the interesting work projects, such as the bakery in Mortlake and the Garden Gang that operated from the Avenue Day Centre in Normansfield Avenue seem to have disappeared. There is now only one day centre in the borough.

At Leavesden, the Medium Secure unit for prison offenders survives and also the school, which now caters for 18-25 year-olds with learning disabilities.


Leavesden Hospital History Association

Digby A Wright: From Idiocy to Mental Deficiency

Out of sight Out of mind: website

The Builder 1868 report on architect’s plans

Gwendoline M Ayers: England’s First State Hospitals

Monica Diplock: The History of Leavesden Hospital

Sir Allan Powell: The Metropolitan Asylum Board and its Work

1881 census

Leavesden Hopital is a well-remembered and recorded place. There was a memorial last month for all the people who had lived and worked there.

Founding and setting up

  • Insane paupers currently in workhouses
  • Quiet, harmless imbeciles
  • Moral imbeciles
  • MAB institution
  • Sister to Caterham, North of Watford


  • 1881 1638 patients and 447 staff
  • 1913 New Act – regular inspections
  • 1914 2195 beds – wards used for wounded soldiers, patients slept in corridors
  • Many staff called up, 22 died fighting
  • 1921 Occupational therapy introduced
  • 1959 Secure unit for criminals
  • 1995 Closed


  • Blacksmiths
  • Tinsmiths (for kitchen equipment)
  • Printers
  • Cobblers
  • Bookbinders
  • Upholsterers
  • Bakers
  • Clockmakers
  • Laundry workers
  • Tailors
  • Cigar makers
  • Farmers
  • Gardeners
  • Painters
  • Cooks
  • Seamstresses
  • Kitchen maids
  • Carpenters
  • Cleaners