From "Pauper Lunatics" to "Rate-Aided Patients": Removing the Stigma of Mental Health Care? 1888-1938

Though the debate surrounding the extent to which pessimism dominated in the late nine-teenth century asylum is extensive, the same debate in the twentieth century remains un-der-explored. Relatively few academics have offered a cross-century analysis that goes beyond the beginning of the First World War to analyse the twentieth century and none of these studies have explored how changes were implemented in the institutions in the West Riding of Yorkshire. This thesis attempts to redress this imbalance by offering an original analysis of a selection of developments and innovations that were carried out in the West Riding of Yorkshire between the years 1888-1938. Consideration is given to four specific innovations and an analysis is made of how successful these new develop-ments were with relation to the eradication of the stigmas of pauperism and certification. Innovations relating to how to segregate mentally deficient children and adults and ser-vice patients will be assessed, along with the establishment of outpatient departments and the local implementation of the 1930 Mental Treatment Act. By offering an analysis of these developments this thesis contributes to our understanding of how successful these social and legal changes were in the administration of mental health care throughout these years.
Primarily this thesis is concerned with an analysis of these different innovations and an observation of the impact that these attempts at change had on the patients. Wherever possible close attention is given to the voices of the patients and their families in order to assess their roles in accessing the services provided. This thesis argues that these innova-tions represent significant legal and social changes in the administration and admission of the mentally ill over the years covered. Despite this however, this thesis identifies that these changes were all beset with many inherent problems, usually linked to a lack of fi-nance and overcrowded institutions, which meant that they were all significantly limited in their capacity to change the system for all but a small minority of sufferers of mental illness and learning disability.