5. Why Did Ulster Patients Travel to Scottish Asylums for Mental Health Care, c.1840-1900?

By Michael Kinsella, Ulster University

Scotland’s nineteenth-century chartered asylums had philanthropic roots and developed very differently from the Irish district asylum system. They were not designated as pauper institutions and due to their charitable foundations were profoundly influenced by their relationship with the ‘urban Scottish middle class’.[1] They were also progressive by the standards of Victorian era public institutions in Britain and Ireland. From the 1860s, the Scottish system began to adopt an ‘open doors’ care model thus signalling a retreat from custodial practices and a move towards hospitalisation.[2] Most innovatively, in the aftermath of the 1857 Lunacy (Scotland) Act, the Scottish lunacy commissioners became keen advocates of boarding-out non-dangerous patients into the care of relatives or other private individuals.[3] Ireland’s district asylums were, by contrast, designated pauper institutions under the control of the state.

Although not widespread during the nineteenth century, the practice of sending a relative from Ireland to a Scottish Chartered asylum was not uncommon either, particularly from Ulster. Between 1840 and 1900 an average of 2.8 Irish fee-paying patients were admitted to the Crichton, Edinburgh and Gartnavel Asylums each year. Between 1860 and 1900, admission rates to Irish private asylums, where the person admitted was experiencing a ‘first attack’, averaged 137.3 per year. Therefore admissions to Crichton, Edinburgh and Gartnavel accounted for two percent of all Irish private patient first admissions during this period. If this pattern were repeated across all eight of the Scottish chartered asylums then the Scottish institutions would account for around six percent of all Irish private admissions per year, not including ‘relapses’.[4]

Ulster’s private asylums admitted an average of 14.2 private patients annually. The 126 patients from Ulster made up 76 percent of the 166 Irish fee-paying patients who were admitted to Crichton, Edinburgh and Gartnavel between 1840 and 1900. Therefore this cohort of private patients from Ulster equated to 14.8 percent of the numbers admitted to Ulster’s own private asylums during this period, suggesting that these three Scottish asylums were an important provider of asylum care for Ireland’s northern counties.[5] Both Gartnavel and Edinburgh received the great majority of their Irish private patients from Ulster, representing 59 of Gartnavel’s 69 Irish fee-paying patients and 60 of Edinburgh’s 74 Irish fee-paying patients (85 and 81 percent respectively).[6] 

Image: Dr David Yellowlees. Wellcome Collection.

The Migrating ‘Mad’

Irish families committed their relatives to Scottish asylums for a variety of reasons. Several patients already had relatives in their asylum of choice. These included Marion Ferguson and Rachel Canning, an aunt and niece from County Antrim, who each spent more than thirty years in Gartnavel. They were resident together for a decade from 1890 until Marion’s death in 1900 during which time they worked together daily in the laundry. Rachel was brought to Gartnavel in person by her mother and her initial casebook entry noted that ‘her aunt has been in Gartnavel asylum for many years’.[7]

Edinburgh itself was a distinguished site of psychiatry during this period and a number of Gartnavel’s physicians had trained there including David Yellowlees who was physician-superintendent from 1874 until 1901. Those seeking a cure may have known this whilst others were acting on the recommendation of a doctor. Thomas Adair, a barrister’s son from Dublin who was admitted to Gartnavel voluntarily, knew from the Irish newspapers that Dr William Hutcheson, the institution’s first physician-superintendent, had been called as an expert witness at the trial of Daniel McNaughton for the attempted assassination of the British prime minister, Robert Peel in 1843. Upon arrival at Gartnavel, Thomas asked for Hutcheson by name having read ‘his evidence on the McNaughton case from which he saw that he was a good person to treat a man of weak mind’.[8] William Neville, an eminent Dublin doctor himself, arrived at Edinburgh in ‘the hopes of a cure’ with a letter of recommendation from a physician of the Richmond asylum in Dublin.[9] In total, seven Irish doctors were patients at Crichton, Edinburgh and Gartnavel, including Henry Crolly, who was ‘depressed’ having ‘lost the Professorship of Surgery’ in the Royal College of Surgeons in Dublin.[10]

Privacy and Confidentiality

A number of prominent families were probably seeking privacy and confidentiality when they committed relatives to Edinburgh and Gartnavel. These institutions were in a different jurisdiction from Ireland and some distance from home. One such case involved Charlotte Baird, a 34 year old unmarried “imbecile” from Derry, who was committed to Gartnavel in 1861 by her father, Daniel Baird.[11] Daniel was a wealthy merchant and shipbuilder who rose to be Mayor of Derry in 1846 and later High Sheriff of County Tyrone in 1854. He died in 1862 and so Charlotte never saw her father again. Daniel had endured the premature loss of several children and his primary motive may have been to secure Charlotte’s long term care in a well-regarded institution.[12] However, stigma and shame were not uncommon motives for asylum committals in the nineteenth century and conflicting emotions may have ultimately coalesced in shaping his decision. Charlotte died in Gartnavel in August 1870.

The high profile barrister Richard Armstrong, born in Armagh and a former MP for Sligo Borough, was probably seeking sanctuary outside of Ireland when he was admitted to Edinburgh in 1878. He was in a suicidal state having successfully prosecuted a case against another QC, William J. Sidney in 1877. The case greatly troubled him and a contemporary newspaper report is attached to his Edinburgh case notes in which the ‘Sidney scandal’ is described as having ‘convulsed all Dublin last year’.[13] Armstrong recovered relatively quickly and returned home to Ireland within a year.

Geographical proximity also played a role in the decision to commit a relative to a Scottish asylum. Some 126 or 76 percent of the Irish patients admitted to Crichton, Edinburgh and Gartnavel between 1840 and 1900 were from Ulster and 67 of these were from Belfast and the north-eastern counties of Armagh and Down.[14] By comparison, Ticehurst private asylum in Sussex received only three patients from Ireland between 1845 and 1885.[15] Private asylum provision in Ulster was exiguous between 1840 and 1900 with only about 14 admissions taking place each year. Although both County Cork and County Laois contained a private asylum, most private and voluntary asylum provision was in County Dublin.[16] Therefore middle and upper-class families residing in Ulster would often have had little choice but to look much further afield for asylum provision.

Image: The Crichton Royal Institution, Dumfries, Scotland. Transfer lithograph by Fr. Schenck, c.1840-43). Wellcome Collection.

Patients as a Lucrative Source of Income

The Irish private patients were a lucrative source of income for Edinburgh and Gartnavel. Gartnavel’s sixty Irish private patients collectively paid around £26428 in boarding fees between 1840 and 1899 equating to approximately £3.2 million today.[17] This was very significant income for Gartnavel. It seems clear then that the differences in mental health legislation which existed between Scotland and Ireland during the Victorian period created a small but important trade in lunacy between the two jurisdictions and that the Irish private patients who migrated to Scotland were not just patients but also customers.

The Irish private patients who were admitted to Crichton, Edinburgh and Gartnavel between 1840 and 1900 were likely to remain longer than their counterparts in Irish voluntary and private asylums with a quarter incarcerated for more than 10 years.[18] Alice Mauger has found that between 1868 and 1900 only 11.1 percent of Irish voluntary asylum patients and 9.6 percent of Irish private asylum patients stayed for more than a decade.[19] The Irish male patients were particularly vulnerable to long term incarceration once they had arrived in Scotland with almost a third remaining for more than 10 years. Three of the Irish patients experienced the jeopardy of being admitted to more than one of the Scottish asylums studied. William Cox Neville, a Dublin gynaecologist, was a patient at Edinburgh in 1888, Crichton in 1890 and Gartnavel in 1891.[20] George Augustus Workman, a retired gentleman, was initially transferred from Gartnavel to Crichton in 1882 as ‘relieved’ before being discharged to the care of his brother in Belfast in 1884[21] John Wyllie, the treasurer of Queens College, was a patient of Gartnavel in 1896 and later Crichton where he died in 1905.[22]

Many of the Irish private patients were reportedly insane for many years before entering a Scottish asylum. Perhaps the fact that so many of this group were already chronically ill upon admission is a reason for their relatively long periods of incarceration.  Indeed, excluding those whose previous care history is unknown, only 39 percent of the Irish private patients had never previously been under treatment. Not only does this suggest that many of the Irish private patients were already chronically unwell upon admission but also that the decision to travel to a Scottish asylum may have been a final roll of the dice in their pursuit of a cure or relief from their mental disorder.

Although the Irish private patients were at greater risk of a lengthy stay in a Scottish asylum their risk of dying there was not significantly greater than if they had been in an Irish voluntary or private asylum. The mortality rate for this group of patients was 30.4 percent (excluding those for whom an outcome was not recorded) as opposed to 30 percent for Irish voluntary asylums and 28.1 percent for Irish private asylums.[23] Although the Irish patients experienced a comparable mortality rate to their peers in Irish asylums, they were more likely to recover when compared with their counterparts in Irish district and voluntary asylums. The ‘cure’ rate amongst the Irish private patients at Crichton, Edinburgh and Gartnavel was 41.2 percent with a further 22 percent described as ‘relieved’ upon discharge.[24] The comparative figures for Irish voluntary asylums, which were the most comparable in terms of ethos and structure, were 32.4 percent and 24.7 percent.[25] However, given the chronic nature of illness in so many of the Irish patients who were  admitted to Crichton, Edinburgh and Gartnavel, coupled with their dislocation from family and community, the discharge and recovery rates appear impressively high.

Image: Framed Drawing of Glasgow Lunatic Asylum (built 1809) by David M. Walker. Wellcome Collection. Attribution 4.0 International (CC BY 4.0).

Better Prospects of Cure and Care

The literature on British and Irish nineteenth-century private asylums remains relatively small and therefore comparisons between different jurisdictions are necessarily tentative. However, the Irish private patients of Crichton, Edinburgh and Gartnavel enjoyed better prospects than those incarcerated in Ticehurst private asylum in Sussex. In her study of Ticehurst, Charlotte MacKenzie found that from 1845 patients could expect to be resident for a median period of approximately 25 years and an astonishing 60 to 80 per cent died in the institution.[26] Conversely in his study of Hook Norton and Witney private asylums in Oxfordshire, William Parry-Jones found an average mean stay of 18.2 and 20.9 months respectively, much shorter than the patients of Ticehurst but still longer than the Irish private patients of Gartnavel.[27] To some degree these divergent outcomes may simply reflect the lack of standardised care and treatment approaches practised by nineteenth-century asylums. Nevertheless, the empirical data does appear to support Andrew Scull’s argument that wealth was no guarantee of a cure. However, his assertion that families were essentially purchasing a form of luxurious detention for their relatives is more questionable.[28] The senior physicians at Edinburgh and, to a lesser degree, Gartnavel, were a driving force in nineteenth century attempts to establish psychiatry as a discrete branch of medical science. Their reports were widely read and the reputations of their asylums to some degree reflected upon the middle-class laymen who were integral to their management. It is fallacious to believe that the middle and upper class Irish families who availed of their services, 61 percent of whom had seen their relatives undergo some other form of previous treatment, were settling for a gilded cage rather than the expectation of improvement or recovery. Although the Irish lunacy inspectors took a dim view of the motivations  of middle and upper-class Irish families who incarcerated their mentally disordered relations, the casebooks of the Crichton, Edinburgh and Gartnavel asylums and the correspondence they received from patients’ families suggests those families often held powerful and conflicting emotions about the decision they had taken.

© The Author(s) 2021. Published by the Epidemic Belfast team on behalf of Ulster University. Any unauthorised broadcasting, public performance, copying or re-recording will constitute an infringement of copyright.


[1] Gayle Davis, ‘The Cruel Madness of Love’: Sex, Syphilis and Psychiatry in Scotland, 1880-1930 (Amsterdam: Rodopi, 2008), pp. 43-44.

[2] Jonathan Andrews, They’re in the Trade…of Lunacy: Scottish Lunacy Commissioners and Lunacy Reform in Nineteenth-Century Scotland (London: Wellcome Trust, 1988), pp. 19-20.

[3] Davis, ‘The Cruel Madness of Love’, p. 48.

[4] Compiled from Reports of the Inspectors of Lunatics Ireland (1843, 1850, 1860, 1870, 1880 and 1893) and ‘Glasgow Royal Asylum’,Greater Glasgow and Clyde Archive Register of Private Patients GGHB13/6; ‘Glasgow Royal Asylum’,Case Notes GGCA HB13/5; ‘Royal Edinburgh Asylum’, Case Books, Lothian Health Service Archive HB7/51/19-72 1868-1898; ‘Royal Edinburgh Asylum’, General Register of Patients, LHB7/35/3-8, 1868-1898; ‘Crichton Royal Institution’, Greater Glasgow and Clyde Archive Patient Records DGH/1/5/2/1-10

[5] Tenth Report on the District, Criminal and Private Lunatic asylums in Ireland; Nineteenth Report on the District, Criminal and Private Lunatic Asylums in Ireland; Twenty-Ninth  Report on the District, Criminal and Private Lunatic Asylums in Ireland; Forty-Second Report on the District, Criminal and Private Lunatic Asylums in Ireland.

[6] ‘Glasgow Royal Asylum’,GGCA Register of Private Patients GGHB13/6; ‘Royal Edinburgh Asylum’, General Register of Patients, LHSA LHB7/35/3-8.

[7] ‘Glasgow Royal Asylum’, New Casebook Series Females vol. 3 p. 287, p. 394; vol. 5 p. 572.

[8] ‘Glasgow Royal Asylum’, House Surgeon’s Notes for Physician: Male GGCA, HB13/5/36/38.

[9] ‘Royal Edinburgh Asylum’, Case Book, Lothian Health Services Archive, LHB7/51/50/737.

[10] ‘Royal Edinburgh Asylum’, Case Book, LHSA LHB7/51/19/654-657.

[11] ‘Glasgow Royal Asylum’, Admission Documents (Male and Female) 1861, GGCA HB13/7/68.

[12] Greater Shantallow Area Partnership, Families of Boomhall Country House  https://www.shantallow.net/families-of-boomhall-country-house. Accessed 13 October 2021

[13] ‘Royal Edinburgh Asylum’, Case Book, Lothian Health Services Archive, LHB7/51/19/153-155.

[14] ‘Glasgow Royal Asylum’,GGCA Register of Private Patients, GGHB13/6; ‘Royal Edinburgh Asylum’, Case Books, Lothian Health Service Archive, HB7/51/19-72 1868-1898; ‘Royal Edinburgh Asylum’, General Register of Patients, LHSA LHB7/35/3-8, 1868-1898; ‘Crichton Royal Institution’, GGCA Patient Records, DGH/1/5/2/1-10

[15] Charlotte Mackenzie, Psychiatry for the Rich A History of Ticehurst Private Asylum, 1792-1917 (Routledge: London and New York, 1992),p. 131.

[16] Compiled from Reports of the Inspectors of Lunatics Ireland (1843, 1850, 1860, 1870, 1880 and 1893).

[17] Bank of England, Inflation Calculator Goods and Services.https://www.bankofengland.co.uk/monetary-policy/inflation/inflation-calculator. Accessed 14 October 2021.

[18] ‘Glasgow Royal Asylum’,GGCA Register of Private Patients, GGHB13/6; ‘Royal Edinburgh Asylum’, Case Books, Lothian Health Service Archive HB7/51/19-72 1868-1898; ‘Royal Edinburgh Asylum’, General Register of Patients, LHSA LHB7/35/3-8, 1868-1898; ‘Crichton Royal Institution’, GGCA Patient Records DGH/1/5/2/1-10

[19] Alice Mauger, The Cost of Insanity in Nineteenth-Century Ireland (Basingstoke: Palgrave Macmillan, 2018),p. 98.

[20] ‘Royal Edinburgh Asylum’, Case Book, LHSA LHB7/51/50/737; ‘Glasgow Royal Asylum’, Admission Documents: Male & Female, GGHB13/7/98.

[21] ‘Glasgow Royal Asylum’, Admission Documents: Male & Female, 13/7/89.

[22] ‘Glasgow Royal Asylum’, Case Notes, New Case Book Series: Males Vol.6, GGCA HB 13/5/128/166.

[23] Mauger, Cost of Insanity, p. 98

[24] ‘Glasgow Royal Asylum’,Greater Glasgow and Clyde Archive Register of Private Patients, GGHB13/6; ‘Glasgow Royal Asylum’,Case Notes, GGCA HB13/5; ‘Royal Edinburgh Asylum’, Case Books, Lothian Health Service Archive, HB7/51/19-72 1868-1898; ‘Royal Edinburgh Asylum’, General Register of Patients, LHB7/35/3-8, 1868-1898; ‘Crichton Royal Institution’, Greater Glasgow and Clyde Archive Patient Records, DGH/1/5/2/1-10

[25] Mauger, The Cost of Insanity, p. 98.

[26] MacKenzie, Psychiatry for the Rich, p. 119.

[27] W.L. Parry-Jones, The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries (London: Routledge and Kegan Paul, 1972), p. 211.

[28] Andrew Scull Museums of Madness: The Social Organisation of Insanity in Nineteenth-Century England (London: Allen Lane, 1979), p. 208.