The Metropolitan Asylums Board (MAB)

The Metropolitan Asylums Board (MAB) was set up under the 1867 Metropolitan Poor Act.

Workhouses had contained the insane, mentally defective and those with infectious diseases, and there was a need to put them in separate institutions. Until 1930 the asylums were regarded legally as workhouses. Only London residents were eligible.

Funding was by London ratepayers assisted by means-testing of the patients’ families.

The main asylums for the mentally deficient were:

  • Caterham and Leavesden (near Watford), built as virtual copies of each other and opened in 1870
  • Darenth was opened in 1878 as a school for those aged 5 to 16
  • In 1880 an adult asylum next to it was opened with workshops for the more able
  • Tooting Bec opened in 1903, and was modelled on Caterham and Leavesden
  • Fountain was a fever hospital which in 1911 began to take the lowest grade of children

These asylums tended to work along similar lines, including pay and conditions

During the Edwardian period:

  • Weekly cost per inmate was 9 to 14 shillings
  • There were about 6,600 inmates in all the institutions
  • Staff to patient ratio varied (1905) from 1 : 2.91 (Tooting Bec) to 1 : 6.42 (Caterham and Leavesden), according to attention needed for e.g. children and the senile
  • The Medical Superintendents were paid £600-800 p.a.
  • The doctors (“medical officers”) were paid £150-£300
  • The basic attendant grade were paid £30, hence high turnover


The Metropolitan Asylums Board felt there was a need for a school for mentally deficient children:

A temporary school at Clapton, north London, was opened in 1875

164 acres were purchased at a site at Darenth, near Dartford

In 1878 the new asylum was opened

In 1880 an adult asylum was opened next door for when the children turned 16

Gradually the adult asylum became workshops for the more able

In 1905 the two institutions combined under one Medical Superintendent

Patients in the adult asylum made, under supervision, items for use by the MAB institutions

Site also contained a farm, and patients helped with any building work


Clear that an honest attempt made to provide good care, appropriate to ability level

Much thought was given to how the industrial colony worked

At the same time, a firm hand was used, and there are hints that some patients felt they were prisoners

Everything was done with a view to being economical (6 pence a day per patient in 1911, £50,000 in all)

Fletcher Beach, the first Medical Superintendent, believed in “pruning” strong interests

“It made them more human… by stopping that, his leading shoot, the boy would sprout in the direction of kindliness and cleanliness”

He also believed in measuring skulls, palates and ears to assess the patient … and also in assessing the parents as drunks, depressed, and so on

By the Edwardian period there were 2000 patients, half in the school

Sometimes up to half were epileptics

The genders only mixed in classrooms and in entertainments – even at church they sat on separate sides of the aisle


About 200 staff did their work with poor pay and conditions

There was high turnover (often half the staff had been there less than a year)

Usually there were only five doctors to deal with 2000 patients

Inspector reports often complained about inadequate staff numbers, and unskilled teachers

In 1973 it was agreed to close Darenth, the first big learning disability institution to do so

One thousand residents were resettled to other hospitals, hostels, small group homes and local facilities

Many reports were compiled describing the process

In 1988 the hospital closed

Most buildings were demolished

The site is now Darent Valley Hospital, 300 new houses, and a country park

Board and lodging was also supplied

The Board collected numerous statistics, and its annual reports and minutes at the London Metropolitan Archives are a rich source

The Board claimed to be doing its best on many occasions

It did place much emphasis on economy, and life for the “inmates” (and staff) was often grim

The Board was wound up in 1930 when its responsibilities passed to the London County Council

The asylums carried on and later were named hospitals under the NHS