Archive centreCarlisle
ReferenceTHOS 8
TitleGarlands Mental Hospital, Carlisle
DescriptionIncluding: Management and Administration; Finance; Staff; Patients
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ContextThe 1828 County Asylums Act (9 Geo IV c. 40) had given powers to the Quarter Sessions to appoint Visitors to inspect asylums. At least three Justices of the Peace, with at least one medical practitioner, were to make up the Committee (see CQAL 7, CC4/10)
The 1845 Asylums Act (8 & 9 Vic c. 126) required that every county provide adequate asylums for the care of pauper lunatics, idiots and others of unsound mind. It created a full-time national inspectorate - Commissioners in Lunacy - and it prescribed that records should be kept and that these should be inspected. This led to the creation of Cumberland and Westmorland Joint Luncacy Committee (see CC1/24 and CC14/10).
As counties were slow to provide local asylums, the 1853 Lunacy Act (16 & 17 Vic c. 97) was passed, providing that compulsory measures should be taken against any authority that was neglecting to provide asylums. Until this Act was passed, patients in Cumberland and Westmorland were provided for either in local workhouses, at home, in private homes or sent to asylums outside the county, for example, Dunston Lodge, Gateshead (see DX 305).
The 1853 Act ensured that action was taken locally and county finance was raised in 1854 and 1856 towards providing an asylum (see QAL 2 and CF 9). Various locations were considered (see DHUD 1/37/4 and CC1/24) before articles of agreement were signed to purchase the Garlands Estate at Carleton, near Carlisle, with a house and 108 acres, with at least 50 acres specified for the building of an asylum. Construction began in 1858 and the first Medical Superintendent was appointed in 1861. The hospital opened for patients on 2 January 1862. The hospital was initially built to accommodate 200 patients with two thirds coming from Cumberland and one third from Westmorland. When the estate was purchased it included a farm. This continued to be an integral part of the hospital's activities. It was used as a form of occupational therapy and provided food and income for the hospital. A market garden was also developed.
Almost immediately, it was realised that the hospital would need to expand to meet needs. From then on, the extension and alteration of the hospital would be ongoing; as early as 1864 plans wre drawn up that would double the size of the hospital. In 1866 a new block to house female patients was opened and a new block for male patients in 1868.
In 1867, it was decided that the hospital should be able to accept private patients, who would be charged at a higher rate than that paid by Poor Law Union funded patients. It would also be possible to take patients from outside the two counties. The funds generated by these patients were put into a specific Building and Repair Fund. This was initially used for building a separate chapel, which opened in 1876.
In the 1870s due to overcrowding, the boarding out system of local patients had to be reintroduced. An 1877 report found the wards were inadequate, as were the laundry, kitchen and workshop. There were also problems with the sewage system.
The Medical Superintendent reported annually to the Committee of Visitors appointed by the Quarter Sessions until 1888 when responsibility was transferred to county and borough councils. The Committee of Visitors published annual reports and recommendations and the Commissioners in Lunacy also inspected and reported annually.
The 1890 Lunacy Act (53 Vic c. 5) specified the documents that should be created and their design. A reception order was used for non-pauper patients; they lasted for a year but were renewable (see THOS 8/4/1). A system for monitoring mechanical restraint was introduced (see THOS 8/4/29). The inspections now covered administration and record keeping, as well as the medical care, treatment and buildings. Any patient who escaped and stayed free for 14 days was considered to be free.
Later, photographs were taken of patients and placed in case books, alongside case notes for the patients.
Cumberland House was opened in 1896 for 12 private patients and Westmorland House in 1900 for 24 female private patients.
In 1929 the hospital changed from case books (see THOS 8/4/38-40) to loose leaf patient records. Regulations introduced by the Health Service circular HC89(20) recommended that clinical records of individual patients were not normally preserved other than by way of samples
The 1927 Mental Deficiency Act led to the creation of the Cumberland, Westmorland and Carlisle Joint Committee (see CAC1/13/1-5)
All deaths at the hospital from whatever cause were subject to inquests and post mortem. There is also a record of interments; there was no burial ground on the Hospital site.
The 1930 Mental Treatment Act (20 Geo 5 c. 23) changed the terminology used. It abolished 'lunatic' and replaced with 'patient' or 'person of unsound mind' and replaced 'asylum' with 'mental hospital.' It created 3 categories of patient; 'voluntary' were those who submitted themselves of their own free will for treatment; 'temporary' were those who it was thought would benefit from treatment but were not capable of voluntarily admitting themselves for short-term treatment; 'certified' were covered by the 1890 Act. The initial duration order of six months could be extended for two further periods of three months but could not exceed twelve months. The distinction between private and pauper patients was abolished.
Under the terms of the National Health Service Act of 1946, the Hospital was transferred to the Ministry of Health from 1 July 1946 and with the Regional Hospital Board (in Newcastle-upon-Tyne) being responsible for its administration.
The 1959 Mental Health Act (7 & 8 Eliz 2 c. 72) placed new emphasis on community based services and began the reduction of long-stay accommodation.
Local Government reorganisation in 1974 led to the creation of Regional Health Authorities with Area Health Authorities at county level. District Health Authorities replaced both levels in 1982.
The Community Care Act 1990 led to a purchase/provider distinction.
The old building was closed on 30 March 1999 and succeeded by the Carleton Clinic.
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