In the two centuries before the end of the Napoleonic Wars in 1815, Britain experienced a special period of great significance in terms of economy, society, politics, history and culture. During this period, there were great changes and everything was renewed. In the 17th and early 18th centuries, with the increasing expansion of international trade and the emerging development of the North American colonies, Britain made significant progress in trade. However, this progress was based on the trafficking and enslavement of African people. above. Brand-new financial institutions such as the Bank of England and the London Stock Exchange came into being to support economic development. Political conflicts were further exacerbated by religious conflicts, triggering the Civil War from 1642 to 1651. The 1688 constitution provided a long-term solution, ensuring that the hereditary monarchy and the elected parliamentary system could work together to maintain political stability and provide a good environment for long-term economic development. Starting from the mid-18th century, Britain experienced a great industrial revolution , which was marked by technological innovation, mechanization, factory production and the emergence of the industrial working class. During this period, a growing urban middle class, along with the previous landowning and merchant classes, established the local infrastructure and public institutions that were vital to modern society.
It is impossible to assess the extent to which a continuously changing society will affect the incidence of mental illness. Indeed, social and environmental stressors are often considered etiologically as precipitating factors in mental illness. It is obvious, however, that the more sophisticated and well-informed the patient is before the onset of the illness, the easier it is for the symptoms and manifestations of madness to be detected, and the sooner measures can be taken to prevent loss of control and help the patient. This will help his family and others involved. More importantly, the potential and significant cultural and intellectual changes brought about by the Enlightenment Movement have caused a gradual change in the way people understand and manage mental illness. The old belief that manifestations of mental illness were attributed to witchcraft and spiritual possession was abandoned, replaced by the view that madness was a form of illness that could be related to bodily systems or the brain itself. In this era of enlightenment and awakening, madness began to be seen as a lack of rationality, and the goal of its treatment and management was to promote the restoration of rationality.
The 18th century was a critical period for the development of psychiatry practice in the UK. Traditional medical treatments for mental disorders were integrated into an increasingly complex medical system that included psychologically oriented "management" techniques that came to be known as "moral therapy." The overriding philosophy that most practitioners of madness, whether medically trained or not, adhere to in practice is that effective treatment is to isolate the patient from the environment and triggers that may make him crazy and to place him in a place where the risk can be eliminated. Minimize and treat effectively in professional institutions. Most agree that these institutions exhibit some manifestations of severe mental disturbance (mental disturbance), including violent and suicidal behavior, delusions, and severe mood disorders. This article examines the three main institutions that emerged in Britain during this period, which were philanthropic, private, and government-led in nature. Of course, the first thing to emphasize is that these fields are not independent, but there are many levels of interaction between them.
1. Lunatic Hospitals (Lunatic Hospitals)
As early as 1600 in London, specialized institutions serving mentally ill patients funded by charitable donations had existed for a long time. The founding of Bethlem Hospital dates back to the 15th century. The popular appellation "Bedlam," which sounds similar to "Bethlem," reflected the common perception that it was a place of mystery, chaos, and squalor. The hospital itself was relatively small, with room for only about 30 patients in 1630. Due to its remote location in the city, its possibilities to expand and improve the crowded, poor and slovenly environment are greatly limited. The patients at Bethlehem Hospital were mainly from the poorer classes. However, a subset of patients from the wealthy classes were housed separately, paying extra for a more comfortable environment and better food.The practice became more common after Dr. Helkiah Crooke was appointed "superintendent" of Bethlehem Hospital in 1619. His enrichment led to public distrust and he was dismissed in 1634. Nonetheless, he set a precedent for a dual approach to public and private affairs that was later widely accepted.
In 1676, the old Bethlehem Hospital was replaced by a magnificent building located in the Moorfields area. The appearance of a magnificent palace made it one of the famous buildings in London at that time. The significance of “New Bethlehem” is extraordinary. It is a remarkable display of public charity, symbolizing the virtue of London's upper-class citizens providing good homes for the ill in unfortunate circumstances, and the dominance of an enlightened attitude towards mental illness and the ways in which madness can be explained. Confirmation of the perception that hospitals are controlled and managed by their high walls. Despite internal deficiencies, limited therapeutic effectiveness, and mismanagement that became increasingly apparent in the 18th century, Bethlehem Hospital was long regarded as an outstanding institution for psychiatric care. It was not until a public inquiry in 1815 that the true story was revealed that this reputation ended.
New Bethlehem Hospital in London opened in 1676
As a national institution, Bethlehem Hospital received patients from all over the country. However, patients mainly come from London and surrounding counties. During the 18th century, the need for related services became increasingly apparent in other parts of the country. In the eastern city of Norwich, Mary Chapman, the wealthy widow of an Anglican clergyman, founded and funded Bethel Hospital, which opened in 1713. After her death in 1724, the hospital continued as a public charity. It initially operated on a small scale, with only 20-30 resident patients in the 1840s, and this number increased to 50 in 1760. The hospital continued to operate into the 20th century.
The most significant development achievement of the 18th century was St Luke's Hospital for Lunaticks established in London in 1751. The direct reason for the establishment of the hospital was the inability of Bethlehem Hospital to meet the needs of the growing number of insane poor. It followed a model that was actually similar to a series of voluntary general hospitals established in London and other towns since 1720. The hospital is funded by private donations and annual pledges, and major donors and pledgers can become administrators of the charity, who have the authority to participate in decision-making and recommend patients for admission. St. Luke's Hospital was originally located in the Moorfields area, adjacent to Bethlehem Hospital, but the two operations were very different. The hospital's first physician, Dr. William Battie, became famous for his treatment methods and especially his concept of "management" of patients. Initially, St. Luke's Hospital housed 50 patients, who were considered "poor and crazy." Although the hospital later expanded, it struggled to keep up with demand and the damage was severe. In 1787, a spectacular new building opened in Old Street, large enough to accommodate 300 patients, and for many years it was the largest institution for the mentally ill in the country. The architectural design of the new St. Luke's Hospital was so influential that it influenced the architecture of public lunatic asylums for more than 25 years.
St Luke's Hospital in London opened in 1787
The success of the voluntary hospital movement and the operation of St Luke's Hospital prompted various local groups to adopt donations and public subscriptions to establish their own mental hospitals. In the case of northern cities, the practical difficulties of being away from London and local access to Bethlehem Hospital or St. Luke's Hospital served as a powerful incentive for local groups to take action. The first local voluntary institution, the Newcastle Lunatic Hospital (Newcastle Lunatic Hospital), which was converted from an old building, opened in 1764 and moved to a new site in 1767, which could accommodate more than 30 patients. In Manchester, hospital administrators decided to build a unique mental hospital to provide "middle-class" relatives with a practical and affordable alternative to "line the pockets of the operators of private lunatic asylums". The Manchester Asylum for the Insane opened in 1766 next to the original hospital.After a rather slow start, the number of patients reached nearly 100 in 1805. The head of York Lunatic Asylum has taken a further step in his campaign to eradicate the ill effects of private asylums. The asylum was a large building, originally designed to accommodate 54 patients, and was quickly expanded to accommodate more patients. In 1813, it accommodated nearly 200 patients. Several other voluntary mental hospitals were established soon after, at Liverpool (1792), Leicester (1794) and Exeter (1801). These voluntary agencies mainly cater to the needs of the poorer sections of society.
Another important institution, York Retreat, was built adjacent to York Lunatic Asylum in 1796 through charitable donations. The institution was founded out of concern for a fellow member who had been tortured to death in York Asylum. York Ashram was designed to strictly adhere to Christian principles and practice "moral therapy" based on love, humanity and respect. Unlike other mental hospital locations (close to the crowded center of the city), York Ashram was intentionally designed in a peaceful semi-rural area with excellent views and site, where patients can exercise and have fun. pastime. Although initially small, with room for only 30 patients in 1800, York Abbey and its treatment system had a profound impact on the subsequent development of mental health institutions in Britain and other countries.
A retreat house near York Lunatic Asylum, opened in 1796
The 18th-century voluntary asylum proved to be a key element of Britain's mental health system, and its impressive success paved the way for the establishment of public asylums in the early 19th century. has laid the foundation, but its limitations cannot be ignored. Except for large institutions like Bethlehem Hospital and St. Luke's Hospital, which have sufficient financial support, other mental hospitals generally suffer from lack of funds and find it difficult to achieve their charitable goals. The result is that they have to charge charity patients weekly out of necessity. What's more, in order to ensure financial stability, they accept wealthy patients who can afford higher costs. Thus, local public mental hospitals unwittingly came into direct competition with private lunatic asylums. Risks arise when a public body or its directors are involved in commercial activities with conflicts of interest, as was the case with York Lunatic Asylum, where malfeasance and scandal became publicized during the Inquiry of 1815.
2. Private lunatic asylums
Private lunatic asylums played an important role in the history of the development of the British mental health service system, which can be fully demonstrated in the important work of William Parry-Jones published in 1972. His research was later culminated by Roy Porter and other scholars, who however underestimated the influence of the asylums before 1700. In fact, there is evidence that private practitioners were providing residential care and treatment to the mentally ill as early as 1600. Practitioners' private incarceration of people whose behavior is dangerous or who are difficult to care for at home is in fact a response to their families' need for services that are more personal, diverse, and financially affordable than public institutions such as Bethlehem Hospital. By 1700, private lunatic asylums had become a fixture of the market for health-related services, with some in London and others scattered throughout the UK. Relevant operators (proprietors) in medical commercialization exploration activities can essentially be called medical industry practitioners. Many asylums were adapted from larger family homes and were limited in size.
An earlier case was the lunatic asylum run by Dr. Carter in the Holborn area of London. Around 1606, a girl named Dionys Fitzherbert was imprisoned. She suffered from mental illness. Seriously abnormal. Dionis suffered frightening delusions and fantasies, convinced that he was a heinous sinner, and feared that he would be burned to death. She remained for several weeks in Dr. Carter's lunatic asylum, where she was cared for by the doctor, his family, and her "caretakers." The treatment was successful and Dionis made a full recovery and returned to his family.Another early case occurred in 1630 and involved Edmund Franklin, a deranged member of a Bedfordshire landowning family who was extremely violent and aggressive towards his family and others, destroying property in churches. and caused riots. He was imprisoned in Dr. Helkiah Crook's private lunatic asylum at Bethlehem Hospital. His family agreed to pay a whopping £200 a year for his meals and treatment, just to match his status as a "gentleman."
In the 17th century, the Hoxton area of London was famous for its private lunatic asylum. Antiquarian and diplomat William Le Neve, who fought for the Crown in the English Civil War, was stripped of all his property and became "mad and ill-tempered in mind". In 1658 he was taken to the private asylum in Hoxton and "shut up", where he died in 1661. There were also several private lunatic asylums in northeast London. In the 1670s, Edward Trevor (the son of a prominent politician) was imprisoned for several years at Mrs Woodford's madhouse in Moorfields; on the floor and brutally abused. James Newton's asylum at Clerkenwell is also famous. In a promotional poster printed in the mid-1670s, he claimed to be "reliable and expert" in treating patients suffering from "distracted or melancholy" and had cured numerous patients. He insists his motivations are humanitarian and not just financial, and cites several cases of successful cures. It is obvious that Newton's clientele was not limited to private patients but also included some paupers who were paid by parish officials. Other asylum founders were also admitting the poor during this period, including Robert Roden of Moorfields and John Smith of Hackney.
There is also evidence that lunatic asylums were operating in places outside London. The Reverend John Ashburne of Suffolk kept patients at a private estate in Norton until the 1650s, including Edmund Mascoe who stayed there in October 1656 Edmond Muskett, who was "haunted by madness and rage in his mind." Five years later, Ashbourne was attacked and killed by a recovering patient who had been allowed to leave. The eulogy written for him in the report at the time said that he was "famous throughout Britain" for his "superior medical skills in curing the mad". In his autobiography, Reverend George Trosse describes a lunatic asylum at Glastonbury in Somerset during this period. As a young man, he lived a life of drinking, gambling, and dissipation until 1656 when he suffered from "outragious madness" characterized by violence, frightening delusions, and brilliant fantasies. He was committed to an asylum run by a man "highly respected in the industry for his skill and rejuvenation," where he underwent three separate sessions before fully recovering. Tross describes in detail the treatment he received, especially the caring and compassionate advice given by Mrs Gollop, the "grande dame of the asylum." A few miles away from Glastonbury in a village called Wedmore, the insane asylum founded in 1680 by the surgeon John Westover became the wider whole Components of medical practice. A surviving medical record and diary records that Westover admitted at least 30 patients between 1686 and 1700. Most of them only stayed for a few days or months, and only two people were hospitalized for as long as several years. His patients came from the west of England and even included some poor people whose fees were paid by parish officials.
The number of private lunatic asylums increased steadily in England during the 18th century. Remarkably, in London in 1724, the eloquent writer Daniel Defoe claimed that 15 of the lunatic asylums were in the city.Half of them can be confirmed from scattered records including newspaper advertisements. Some operators are medical professionals, while others do not have medical licenses. In their promotional materials, they tend to exaggerate their abilities and the number of patients they successfully cure. In 1715, Robert Norris, a pharmacist who ran a lunatic asylum in Holborn, claimed to have 30 years of medical experience in "effectively treating madness" and boasted that his "curative effect (without side effects)" had never been achieved so far. Beyond, and his success has become well-known in Britain, "far and abroad". In 1729, Mr Dalton, who also ran a lunatic asylum in Holborn, claimed that "under the blessing of God he has successfully cured every type of mental illness at a fair price". In 1732, he claimed that he had "cured several patients who were declared incurable by other doctors" and that his medicines were "effective and infallible in the treatment of insanity, hysteria, and anxiety."
In the 1750s, lunatic asylum operations became increasingly concentrated in specific areas of London. In the Chelsea area of the west, the several houses of Michael Duffield and his family received patients almost all from the distinguished class; in the northeast, the Hoxton area had John Miles ( Nearby in the east, Matthew Wright opened his first asylum at Bethnal Green in 1727, housing private clients and paupers from various London parishes. After Wright's death in 1744, his wife Eleanor took over his business. In the second half of the 18th century, the business of housing the poor gradually expanded and was concentrated in several large lunatic asylums in Bethnal Green and Hoxton.
London's two leading "mad-doctors" also became private lunatic asylum operators in the 1750s. In 1754, Dr. William Batty of St. Luke's took over the asylum in Wood's Close, Clerkenwell, which had previously belonged to James Newton and his son of the same name. Barty's reputation allowed him to attract wealthy and respectable clients. At the time of his death in 1776, all proceeds from the asylum were substantial. In 1758, Dr. John Monro of Bethlehem Hospital became a co-proprietor of Brooke House in Clapton, a suburb of northern London. After Barty's death, Munro also took over his asylum in Clerkenwell. As a result of his public duties at Bethlehem Hospital, his extensive private practice and his two high-end lunatic asylums, John Monroe achieved a high status in London's "trade in lunacy".
For London's private lunatic asylums, the period from 1775 to 1815 was a period of constant change. Official figures show that in 1775 there were 19 licensed madhouses owned by 14 operators. In 1816, this number rose to 40 lunatic asylums and 26 operators. During this period, several reputable lunatic asylums ceased operation or changed hands several times, while new ones sprang up in large numbers. Some have established themselves in the competition, while others have disappeared after a few years. Two men worth mentioning are Sir Jonathan Miles and Thomas Warburton who consolidated their roots and established their business empires in the Hoxton and Bethnal Green areas respectively. . Their asylum housed 1,200 patients in 1815, most of whom were poor lunatics housed at low prices by the parish authorities. At the same time, they also served private clients who could afford the high prices, and these people were often the main clients of other lunatic asylums in London. Most of these organizers in
London are businessmen and women, and they do not have formal medical certification. This situation differs from the situation elsewhere, where operators are primarily medically certified physicians or surgeons. On the other hand, the development speed of various places is also slower than that of London. Credible sources indicate that only a handful of lunatic asylums were in operation between 1700 and 1750, most of them in the west, south and central regions of England.One of the asylums near Bristol was founded in 1740 by Joseph Mason, who had been working as an assistant in his late father's asylum. He claimed to have had great success in treating " hysteria, , madness and attention disorders". In the 1860s, he admitted more than 40 patients and moved into a larger house. After Mason's death in 1779, his daughter continued to run the asylum until 1788, when it was taken over by his grandson, Dr. Joseph Mason Cox. Under the control of Cox, the asylum admitted 65 patients in July 1815, becoming a famous local asylum at the time.
From 1760 onwards, the number of newly established local lunatic asylums increased steadily. Several were founded by members of the medical profession, including the first lunatic asylum founded in 1760 by Dr. Francis Willis in the Dunston area of Lincolnshire. He moved to Greatford in 1776 and later became famous for his successful treatment of King George III. Some physicians working in public mental hospitals also began to accept private clients, such as Dr. John Beevor of Bethel Hospital in Norwich in 1765, who was on the outskirts of the city for "all patients suffering from violent moods". Mr. and Mrs." founded his "Private Lunatic House." Dr. John Hall of the Newcastle Lunatic Hospital also opened his own "Private House For Lunatics" in 1767. Dr. Thomas Arnold ran a large private insane asylum for 30 years before becoming the superintendent of the Leicester City Asylum in 1794. Several surgeons also entered the profession, such as William Perfect who established his own lunatic asylum in West Malling, Kent in 1766 and ran it for 40 years. From 1790 to 1815, a large number of lunatic asylums were built. Official Returns in 1815 show that there were at least 38 lunatic asylums operating outside London. They were widely distributed throughout Britain, although their concentration was more pronounced in lunatic asylums in the western and central counties. Further afield, two private lunatic asylums for Europeans only appeared in India, one in Madras before 1787 and the other in Calcutta in 1793. .
Spring Vale, Staffordshire opened in 1808
Generally speaking, local private lunatic asylums operated on a smaller scale than London lunatic asylums, housing less than 10 patients, and most of the lunatic asylums The number of patients ranges from 20 to 50. In 1784, the largest lunatic asylum was established by Samuel Proud in Bealstown, Staffordshire, housing 72 patients. In 1815, the two largest asylums were William Ricketts' Droitwich Lunatic Asylum and William Finch's Laworth in nearby Salisbury. Laverstock House (Laverstock House), the former housed about 90 patients, the latter housed 120 patients. In all three cases, they took in private clients and paupers. There were significant differences in the standards and conditions under which lunatic asylums were established in London and elsewhere. There are lunatic asylums where the operators provide good accommodation, a pleasant environment, and enlightened treatments, and there are also lunatic asylums where patients are forced to endure filthy conditions, minimal care, and cruel treatment. These changes reflect the important nature of private mental health care services. While some operators realize that their businesses will thrive if they can provide a consistently high level of care for patient recovery, other operators are concerned with making easy profits by confining as many patients as possible, rarely in patients efforts on rehabilitation and discharge.
3. Investigation, control and a new era
The continued growth of charities and private institutions for the mentally ill in the 18th century has raised public concerns about the way in which they operate and the limitations of effective services.A group of people interested in promoting steady reforms gradually united, and their efforts led to a series of important parliamentary inquiries in 1763, 1807 and 1815. More importantly, they promoted the country's early legislative actions, curbed the excesses and abuses that occurred in some lunatic asylums, and promoted the direct participation of local governments and the public sector in the construction of lunatic asylums.
The increasing number of private lunatic asylums, especially in London, aroused special concern, and several rumors began to circulate about them. As early as 1706, the writer and political commentator Daniel Defoe publicized the case of a supposedly sane young woman who was forcibly committed to a London lunatic asylum, where she was shackled by greedy family members seeking to disinherit her. Hands, feet, beatings and forced medication. Defoe continued to make a big fuss on this matter, publishing detailed criticisms of some lunatic asylum operators who did not admit their exploitative behavior, and calling on the government to curb or moderately control it. Through a series of reported lawsuits, pamphlets and newspaper letters, the theme gradually became clear. People were particularly concerned about the "unlawful imprisonment" of normal people in lunatic asylums, who were framed by spouses, relatives and shameless lunatic asylum operators, and then were confined and abused. "Phenomenon. In 1763, in response to these calls, a parliamentary committee was convened to consider the issue. Evidence came from various sources and implicated the famous doctors William Batty and John Monroe. After a brief investigation, the committee concluded that legislation was necessary to prevent abuse, but Parliament stopped there and took no further action.
After more lawsuits and protests, the Regulation of Madhouses Act of 1774 was finally passed. The Act provides for the formal accreditation of private lunatic asylums, regular inspections and conditions for admission of patients supported by medical certificates. Operators of lunatic asylums who did not comply with the Act were subject to heavy fines. However, the bill also has some limitations. For example, the bill does not cover poor patients, and compliance with the bill relies on the efforts of local officials. Historians of psychiatry often underestimate the importance of the 1774 Act. Nonetheless, it does represent a significant government intervention in an area that had previously been absent. At this point, a legal framework has been developed that emphasizes key principles and prevents all types of malfeasance. It marks the state's recognition of its central role in protecting the interests of people with mental illness, ensuring that abuse is curbed and setting industry service standards.
The focus of psychiatric reformers gradually shifted to the plight of poor patients who were ignored or abused in community and parish workhouses. In 1807 Parliament established a special committee to consider these questions. Evidence comes from various sources, but that provided by Gloucestershire Sir George Onisephorus Paul, the governor of Gloucestershire and prison reformer, is the most influential. Paul insists that the voluntary mental hospitals established over the past few decades have brought huge benefits to society, but charity pledgers in other cities have been unable to follow the initiative due to lack of funds. He believed that this hospital model could provide the basis for a nationwide system of public mental hospitals. The select committee adopted his recommendation and made the decision to encourage county officials to allocate funds from local taxes to support the poor in the lunatic asylum.
In 1808, the decree followed. The County Asylums Act authorizes each county authority to establish an asylum for indigent patients at its own expense, jointly with other counties, or voluntary subscriptions, and provides for the reasonable selection of locations, characteristics of residences, and medical care. Basic standards for support, management practices, and types of patients that can be admitted. Although the bill is not mandatory, several counties have taken early steps to implement it. Three county lunatic asylums opened in 1815, two in Bedfordshire and Nottinghamshire in 1812, and one in Norfolk in 1814. Two of these were funded directly by county authorities, while Nottingham Lunatic Asylum was the product of a joint effort between the county and previous voluntary pledges. Over the next few years, several other county lunatic asylums were opened.Although the number of counties where such asylums were initially established was small, their impact was far-reaching. The government, through its local representatives, was directly involved in the cause of institution-building for the insane. In 1845, it became mandatory to "establish lunatic asylums in every county."
Although the 1808 Act became the most important practical achievement of the lunacy reformers, the Parliamentary Select Committee of 1815-1816 was due to the breadth of its inquiry and the amount of information involved in private lunatic asylums, voluntary hospitals and public institutions. It also appears to be equally important as this bill. The committee's report was particularly concerned with mismanagement and abuse at Bethlehem Hospital, the charitable York Lunatic Asylum, the asylum run by Jonathan Myers and Thomas Warburton at Hoxton, and the vast private asylum at Bethnal Green. Behavior. Other local private institutions, particularly in the west of England, have also come under heavy criticism. The vast number of deficiencies and crimes in various institutions were brought to light, proving that the poor were the main victims. However, there is also evidence of enlightened initiatives in some public and private institutions. For example, William Finch at Laverstock, Edward Long Fox at Brislington near Bristol, William Ricketts at Droitwich, Thomas Bakewell at Private lunatic asylums run by places such as Spring Vale near Taford were well received; the new county lunatic asylum in Nottingham set a model for other areas to follow.
Brislington House, located near Bristol, opened in 1806.
Conclusion
In 1815, Britain had gradually formed a diverse and relatively complex professional institutionalized care and treatment system for mentally ill patients. , its core elements are voluntary charity, individual private and later direct participation of government forces. Although their functions are independent, they occasionally interact and overlap with each other. Physicians from some public mental hospitals also devoted themselves to the operation of private lunatic asylums, stealing customers from charitable institutions or taking in patients who could not be cured to make profits. Like William Batty, John Monroe and John Hall of Newcastle and Thomas Arnold of Leicester, positional factors gave them greater control over the local "crazy trade". In fact, there is a lot of overt and covert fighting between different agencies. Families of private patients had the option of admitting the patient to a private lunatic asylum, a voluntary mental hospital, or even a county lunatic asylum where the fees were lower but the accommodations were equally comfortable. Government agencies, such as the parish workhouse authorities, often prioritized the admission of poor patients to Bethlehem Hospital, St. Luke's Hospital, and other mental hospitals, or to county lunatic asylums, but if these institutions could not afford them, they had to be sent to private lunatic asylums. . In summary, although often limited in practice, there are always multiple solutions available in complex markets.
Objectively speaking, the reports of the Parliamentary Committee of 1815-1816 give us a detailed picture of the provision of services to madmen in 1815, and the picture was mixed. Obviously, charities, voluntary agencies and private institutions all have problems that cannot be ignored, and many cases of successful practice also illustrate that no type of institution is full of evil or immune to it. The emerging British healthcare system is based on a "mixed economic system of care", in which both the private and public sectors play their respective roles. Together, they provide a diverse service model to meet the needs of all levels of society and provide adequate care. Regulatory safeguards. Interestingly, after two hundred years of development and turbulence in the mental health service system, the current unstable relationship between public services and private institutions is eerily similar to the situation in 1815. For future researchers, there is still broad research space for a multi-perspective and in-depth examination of the relative importance of individual private, voluntary charity and government actions to the mentally disordered population in Britain in the 19th and 20th centuries. Future research will also delve deeper into the question of how various models of care and treatment continued to spread after 1815 in the British Empire and beyond.
