The present position of the insane poor under private care in Scotland / by T. W. L. Spence.

  • Spence, T. W. L. (Thomas William Leisk), 1845-1923.
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: The present position of the insane poor under private care in Scotland / by T. W. L. Spence. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    Most patients resided formerly with Relatives and were of the Imbecile type : The majority now reside with Strangers and suffer from Acquired Insanity. This change was associated with two other changes which arose from it. In i858, when the Board entered on its functions, three-fourths of the insane poor were under the care of relatives and only one-fourth were placed with unrelated guardians. Further, of all the insane poor then on the Board's register, it was estimated that about two-thirds were suffering from imbecility or idiocy, and one-third from various forms of acquired insanity. Twenty 3'ears afterwards, when the system of removing suitable patients from asylums to private care began to be developed, the condi- tions above referred to were reversed. At the present time the number of the insane poor boarded with strangers far exceeds the number boarded with relatives, while the patients in private dwellings labouring under acquired insanity are now probably more numerous than imbeciles and idiots. Misunderstanding of term « Boarded-out n : Board's Rules and Requirements alike for all Insane Poor, whether removed from Asylums or otherwise. The increased prominence given in more recent years to the removal of pauper lunatics from asylums to private care has led to the system followed in Scotland, of giving relief to the insane poor in private dwellings being sometimes spoken as a system of « boarding out i>, the word « out » conveying the impression that the essence of the method lies in removing patients from asylums. This however never was and is not now the essential feature of the method, which does not concern itself with the question of whether a patient has been removed from an asylum, or has never been an inmate of an asylum, further than to make a record of the fact as part of the patient's history. What the system aims at and attains is that no insane person in Scotland who receives parochial relief while under private care shall receive such relief unless under conditions prescribed by the State through the Board, and under governmental inspection ensuring the fulfilment of these conditions. It is the broad sweep of this principle, which is a fully applicable to the wealthiest and most populous and busy centres of life in Scotland as to the poorest and most remote parts, which really distinguishes the Scottish method from that followed in other countries. Condition of Insane Poor in Scotland prior to Establishment of Board : Sir Arthur Mitchell's « Insane in Private Dwellings ». Before going further on this subject, it will be advisable to touch briefly upon the history of the system as now consolidated in Scotland.