• historical analysis;
  • mental health/psychiatry;
  • nursing

Background.  Nursing staff in lunatic asylums provided the day-to-day care and containment of patients and were the direct occupational ancestors of today's mental health nurses.

Aim.  This study explores (1) How was asylum nursing seen by asylum nurses themselves and by others, particularly other healthcare workers? (2) What were the demographic characteristics of those who became asylum nurses and what were their patterns of employment?

Methods.  Information regarding contemporary views of asylum nursing were gathered through searching a range of contemporary journals and other publications. Statistical information regarding patterns of employment was gathered from asylum records and census data.

Findings.  During the period from 1890 to 1910 the image of asylum nursing was poor. Allegations of brutality continued to effect its image, despite claims by asylum nurses and medical superintendents that such generalizations were unfair and that asylum nursing was at least as valuable as any other from of nursing. The middle class leadership of voluntary hospital general nursing was particularly critical. At the Three Counties Asylum in Southern England, the majority of asylum nurses came from unskilled or semi-skilled backgrounds. 43% were recruited locally; 43% of nursing staff left after less than a year, and less than a quarter remained after 3 years. Even those individuals thought to be suitable by prior experience, such as ex-servicemen, often did not stay long. Dismissals were common, especially amongst male staff (22%). The discipline was hard, hours long and the work often unpleasant.

Conclusions.  For asylum nurses conditions were poor, the work difficult and their public image negative. The reality was that people from working class backgrounds entered asylum nursing at a relatively young age, often travelling some distance to do so, and then many only stayed for short periods. However, some women were able to take advantage of the possibilities offered by asylum work to develop a career for themselves in the absence of other opportunities.