Victorian-era England saw little (if any) distinction between jails and mental-health hospitals, often referred to as lunatic asylums. Any person considered unfit for society was isolated in either facility, sometimes for life.

Lunatic asylums first appeared in the mid-119th century in Britain; most of them no longer exist today or have been redesigned for other purposes.

Historical records of the doctors, patients, and treatment-related activities are not available in any one file repository; much did not survive.

The remaining few documents, mainly about patients, are stored in local archives. Lunatic asylums came across as a form of improvement in mental health care, but the treatments were horrendous inside.

One of the most notorious lunatic asylums was the Bethlem Hospital, established in 1247 and rebuilt in 1676. Now known as the Bethlem Royal Hospital, it is the world’s oldest mental-health facility.

Despite the grandeur façade, the asylum was understaffed, largely unmaintained, and grossly overpopulated.

Instead of providing a safe place for the mentally ill, it was a dumping ground for the psychologically unwell to be exposed to some questionable therapies.

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10 /10 An Iconic Symbol

When the Bethlem Hospital was reconstructed in 1676, it became one of the most iconic symbols of London. It was a significant landmark and attraction as famous as the London Zoo and Westminster Abbey.

The facility and what it represented would inspire dramas, poems, and countless works of art. At that time, the Bethlem was the most ostentatious mental-health facility globally.

The façade was so opulent that people began to compare the hospital and the Palace of Versailles. On the inside, however, it was a different story altogether.

Museum Of The Mind

9 /10 Chaos And Madness

More popularly known as Bedlam, Bethlem Hospital was the first health facility to specialize in mental disorders. The patients were often referred to as either “lunatic” or “mad.”

The nickname itself means chaos, uproar, or extreme confusion. It became quite a generic term because most mental hospitals began to be called Bedlam.

Much more than just a home for madness, the hospital was the most sophisticated representation of its kind at the time. Some people say metaphorically that the world is an excellent bedlam with all its turmoil, noises, and howls of protest.


8 /10 A Religious Origin

Like most hospitals before the 19th century, the Bedlam started as part of a religious order, and it had been a monastery for St. Mary of Bethlehem before it was repurposed.

By 1400, the abbey had changed into a medieval hospital to provide care for the ill and a refuge for anyone in need.

Homeless and strangers would turn up at the door for shelter and food. Over time, it shifted focus to specialize in treatments for the mentally disturbed, especially those labeled by society as “mad.”

Public Domain

7 /10 In (Sanity)

Bedlam was pretty much a byword for lunacy by the 17th century. The name appeared in various Jacobean ballads and dramas and in Shakespeare’s plays like Macbeth and Hamlet.

In many cases, Bedlam was used to symbolize the permeability between sanity and insanity, sensibility and lunacy.

The dramas, plays, and ballads often satirized or talked about how easy it was to slip from one side to the other. Bethlem Hospitals’ architectural design could be described as a frenzy.


6 /10 Another Palace In London

Robert Hooke, a natural philosopher and city surveyor, was the designer of the reconstruction project in 1676. Every inch of its 165m façade was inspired by the Tuileries, an imperial palace in Paris.

It created an impression of a wealthy estate, not of a mental hospital from the outside. The appearance was of a court, alright, but it didn’t change that it was home to lunatics.

John Thomas Smith wrote in 1815 that for many years the Bethlem Hospital was the only building in London that looked like a proper palace.


5 /10 Civic Pride

One of the main objectives of the reconstruction was to transform the idea of London from being a city of old timber warren into a place of modernity and sophistication.

The designer achieved the goal with flying colors. The splendid architecture ignited a civic pride and projected a sense of charitable mission because the treatments available inside would make London a more livable city for everybody.

Following the reconstruction, private asylums began to appear everywhere in the city. None of those capitalism-backed facilities triumphed in the grandeur Bedlam asylum.


4 /10 Lunatic Building

The Bedlam was becoming an actual lunatic building on a second look. The fancy exterior turned out to be so heavy that the walls at the back couldn’t provide sufficient support; it almost immediately cracked.

Water seeped through the walls on a rainy day. Moreover, it didn’t even have a proper foundation as the building was constructed on rubble.

As soon as all those problems became public knowledge, people realized it was a beautiful face to conceal a chaotic London. It was splendor on its way to an abrupt collapse from the very beginning.

Museum Of The Mind

3 /10 The Grim Inside

The problems were not limited to the structure alone. Many of the patients’ treatments and general living conditions were as grim as the cracks.

Starting from the late 1590s or early 1600s, Bedlam was open to the public, and friends and relatives would bring food and supplies for the patients.

Bear in mind that everyone was welcome to visit, whether or not they had a connection with any patient. Bethlem sustained operations thanks to charitable contributions and visitors’ donations.

Visiting Bedlam and seeing the grim conditions inside were meant to remind people to keep their sanity in check.


2 /10 Horrific Treatments

Many accounts share the horrors of Bethlem Hospital, more specifically about how the patients were subjected to some questionable treatment methods.

One of the most famous examples was rotational therapy, in which a patient was seated in a chair suspended by ropes. The chair was rotated up to 40 times in one direction and released to spin independently.

Such a treatment was said to help induce sleep and evacuate the bowels. Prescription medicine to induce vomiting and bleeding also was not uncommon; it was believed that purging would remove the mental problem.


1 /10 Confused London

The contradictory conditions between the façade and interior established an interpretation of a confused London. Like the patients treated in Bedlam, the city failed to exercise sound judgment when designing the facility.

Finally, in 1815, the Bethlem Hospital was demolished; the opulent home for the lunatics was gone, and with it the horrible conditions and treatments inside.

Bethlem moved to Beckenham, Kent, in 1930 and has been operating as an NHS hospital since 1948.

Despite the modern reconstruction and significant overhaul of treatment methods, the idea of Bedlam as chaos and madness remains.

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