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RESTRAINT TO RECOVERY – ASYLUM TO ACCEPTANCE




                                              FROM
                                      WILLOWBURN LUNATIC
                                             ASYLUM
                                               TO
                                       BAILLIE HENDERSON
                                            HOSPITAL
                                           1890 – 2010




       Prepared by Roger Hawcroft – May 2012
First records of the notion of ‘lunacy’.


 The notion of lunacy (mental disease or illness) seems to have
  first surfaced in about the 12th Century

 The Catholic Encyclopaedia gives a date of around 1100 for “an
  asylum exclusively for sufferers from mental diseases at Mets”
  (Metz, Northern France)

 King Henry II established Newgate Prison in 1188 into which
  both criminals and ‘lunatics’ were incarcerated
Notions of lunacy - continued


 1284 – Al-Mansuri Hospital opened in Cairo and had music
  therapy for its mental patients.

 1292 – “A lunatic who had burned a man’s house down was
  convicted by the justice but released on their authority.”

 1295 – A legal case linked “the instigation of the devil” and being
  “frantic” and “mad”.
14th Century – Establishment of asylums


 1310 – A German ‘madhouse’ is mentioned at Elbing, near
 Danzig.

 1377 – St Mary of Bethlehem priory was confiscated by King
 Edward III and used for lunatics from 1377.

 1405 – A Royal Commission investigates the state of lunatics
 confined at Bethlem Hospital, London.
Spain – ‘the cradle of humane psychiatry’


 1409 – Spain – Asylums at Valencia, Sargossa, Seville,
 Valladolid, Palma Mallorca, Toledo and Granada. These
 institutions removed chains and used games, occupation,
 entertainment, diet and hygiene to treat inmates

 – As a result, Spain has been described as the cradle of humane
 psychiatry.
16th Century – ‘psychiatric revolution’

 Several writers refer to the Sixteenth Century as a time of
  “the first psychiatric revolution”
  - The reasoning behind this seems to be based on the
  work of several 16th Century writers who offered a natural
  alternative to ideas of demonic possession.
 1567 – Paracelsus published a small book whose title in
  English translation is “Diseases which lead to a loss of
  reason”. The introduction makes it clear that these are
  not caused by spirits but are natural diseases.
Bedlam

 1559 – Bedlam is shown on the earliest surviving map of
  London – a copper plate engraving of Moorfields,
  discovered in 1962 and now in the London Museum.
- The map was probably drawn in 1558 by the Dutch artist
  Anthonis van den Wyngaerrde and engraved by
  Franciscus Hogenberg in 1559
- 1592 – An account of a trial for conspiracy to kill the King
  contains discussion and definitions of terms applying to
  the various ‘degrees’ of insanity, such as ‘furor’, ‘delirium’
  and ‘dementia’.
17th Century - Incarceration


 Michael Foucault suggests that the ‘magnificent developments
 of psychiatry’ made in the 16th Century were largely replaced in
 the 17th Century by absolutist governments that resolved social
 crisis by incarcerating the poor.

 1598 & 1601 – The Elizabethan ‘Poor Law’ Act required every
 parish to appoint overseers of the poor and set up work-houses
 for those who could not support themselves
Life in the 17th Century Asylum


 1628 - Robert Burton’s: The Anatomy of melancholy. What is its,,
 with all the kinds, causes, symptoms and prognostics and
 several cures of it .. Philosophically, Medicinally, Historically
 opened and cut up. was published.

 The book contained a ten picture engraving which was explained
 in a verse in the 1632 edition. The verse for the engraving of the
 maniac is:
Robert Burton’s “The maniac”


But see the Madman range downright
     With furious looks, a ghastly sight
Naked In chains bound doth he lie,
     And roars amain, he knows not why.
Observe him; for as in a glass,
     Thine angry portraiture it was.
His picture keep still in thy presence;
     ‘Twixt him and thee, there’s no difference.
Religion and lunacy

 1611 – The Authorised (King James) Version of the Bible had
  been published.

 The Bible was a major source and influence on ideas of just
  about everything in the 17th Century. On the basis of the Bible it
  was possible to calculate that something spectacular was likely
  to happen in the 1650’s, eg. It was could be calculated that the
  great flood took place 1656 years after creation – so 1656 years
  after the birth of Christ might be equally significant. Creation
  was then put at 4004 and the flood in 2349. 4004-2349 =1656
Religion and lunacy - continued

 The execution of the English king in 1649 was therefore woven
  into speculation that Christ was due to return and establish his
  kingdom.
 This sort of thinking was behind the rapture of the Quakers and
  the armed uprising (to bring about his kingdom) of the 5th
  Monarchy Men in 1661
 In October 1656, James Nayler (a Quaker) entered Bristol on a
  donkey claiming to be Jesus Christ. He was imprisoned until
  1659.
 Such conflict as this was to continue for around a century.
Pay to view insanity

 1665 – The Great Plague caused more than 1000 Londoners a
  week to die and it also reached many provincial towns.

 1666 – The Great Fire of London raged for 5 days.


 1676 – After the Great Fire, a new Bethlem Hospital was built
  and opened in Moorfields. In 1705 it held 130 patients. – The
  new Bethlem was built as a place of display and tourists could
  pay to see the humans who were incarcerated in the place, often
  naked and in distress.
Late 17th Century

 The earliest records of private madhouses in England stem from
 1670.

 1679 – Habeas Corpus Act was passed


 1696 – Bristol Poor Act established a workhouse for 100 boys.
 The addition of “infants, the aged, infirm, and lunatics” around
 1700, changed its character and it became St Peter’s Hospital.
 In the 18th Century ir had lunatic wards, in the 19th it became an
 asylum
18th Century – Psychiatry as Science

 It is argued that psychiatry became an independent science in
 the 18th Century – not because of developments in medicine but
 rather due to the philosophy of enlightenment which existed at
 the time.

 Reason was seen as the highest good for philosophers and so
 “possession of evil spirits” was regarded as superstition and it
 and the connection with religion was replaced by the argument
 that the mentally ill had “lost their reason”.
18th Century - Asylums

 The first asylums were small and run privately. The best known
  and largest was Bedlam (Bethlem) in London. It had 130
  patients in 1704

 1714 – Vagrancy Act is thought to hae been the first English
  statute to specifically provide for the detention of lunatics

 1723 – Guys Hospital opened lunatic wards


 Charitable asylums were opened in the 18th Century in 8 English
  towns.
Regulation

 1744 – Vagrancy Act – Several naval hospitals were built,
  including those at Gosport (Haslar), Plymouth and Chatham.
  Haslar became the main lunatic asylum for the navy.

 1774 Madhouse Act – based on a recommendation that, “the
  present state of private madhouses in this kingdom requires the
  interposition of the legislature.

 After 1774, private madhouses had to have a licence and
  inspection was introduced
18th to 19th Century Influences

 1777 – York Asylum opened


 1789 – The French Revolution – Resulted in inmates of
 madhouses being examined and either set at liberty or “cared for
 in hospitals indicated for that purpose”.

 By 1800 there were around 40 private madhouses in England.
19th Century

 1800 – Criminal Lunatics Act – aimed at the safe custody of
  criminal lunatics, especially any that had threatened the king

 1808 – County Asylums Act – this was triggered by fear
  generated by the long term detention of lunatics after the 1800
  Act following John Hadfield’s attempt to shoot George III

 1847 - John Connolly published: The Construction and
  Government of Lunatic Asylums which was to become a
  standard for asylum building in the 19th Century
The British Colonial Influence


 In Britain in 1888 asylums became the responsibility of County
 and County Borough Councils and many improvements resulted

 The British 1890 Lunacy Act was a major consolidating Act that
 remained the core of English and Welsh Lunacy Legislation until
 it was repealed by the 1959 Mental Health Act

 With emigration of doctors and humanitarians from Britain, new
 ideas, attitudes and manner of treatment were brought to
 Australia
1890


 Social Climate – At the end of the 19th Century the failure of
  asylum therapy had convinced people that insanity was largely
  (though not entirely) incurable.

 In the 19th Century nearly 10% of patients died within 3 months
  of admission from advanced symptoms of cerebral disease
  causing mental symptoms initially.

 By the end of the 19th Century there were 74000 people in public
  asylums in England
Baillie Henderson Highlight Events

 1887 - James Renwick began construction of the ‘Lunatic
 Asylum’. The contract price was £28,775.

 1890 - First patients arrived from Woogaroo to what was then
 the Willowburn Lunatic Asylum – 10 women on 17 May 1890

 1902 - 4 Wards in operation


 1909 - Golf course built after Home Secretary gives permission
1910 – 1940 Major Expansion

 1910 - Compulsory nurse training introduced


 1910 – 1920 - Expansion with building of Ray House Ward 1;
  Jofre House Ward A; Rush House Ward B; New pump house;
  Tredgold; James House; Hill House; and various residences

 1930 - Nurses quarters built


 1932 – 1944 - Various residences and boiler house built
1948 - 1968

 1948 - Sewing room (Bootmaker’s workshop) built


 1949 - 8 hour working day introduced


 1950 - Patient numbers reach 1400


 1953 – Name changed to Toowoomba Mental Hospital


 1961 - Gowrie Hall complex built


 1966 -1968 - Laundry built
Name change – Baillie Henderson Hospital

 1968 (August 27th) - Hospital renamed as Baillie Henderson
  Hospital

 1968 – 1970 - Canteen built


 1970 - Rockville Training Centre transferred to Baillie Henderson


 1972 - Nursing administration cafeteria built


 1973 - Outpatient clinic established at Toowoomba Base
  Hospital
De-institutionalisation Beginnings

 1974 - Digby, Connolly & Tuke built


 1976 - Rockville Training Centre closed


 1980 - Outreach community psychiatric services began


 1982 - Whishaw Day Centre commenced


 1984 - Recreation complex built
From Institution to Community

 1986 - Medical orientated outpatients clinic for dischargees
  opened at Gowrie Hall

 1992 - Ridley opened and patients transferred there from Gowrie


 1993 - Final intake into 3 year psychiatric nursing course


 1996 - 38 hour week introduced
Integration Beginnings

 1999 - Browne House closed


 2000 - Baillie Henderson Hospital & Toowoomba Base Hospital
 become part of Toowoomba Health Service District
          Laundry refurbished to cater for district
          District achieves Accreditation
          Cafeteria closed

 2001 - AMHU opens at Toowoomba Base – Hill house residents
 moved there
Decade of Restructuring
 2007 - Mental Health Review by Gerry Fitzgerald


 2008 - Toowoomba and Ipswich Health Service Districts
 amalgamated to become Darling Downs – West Moreton Health
 Service District

 2010 - De-amalgamation – Darling Downs Health Service
 District formed including Toowoomba & Baillie Henderson
 Hospitals

 2011 - Government announces demise of Queensland Health &
 establishment of Local Health Networks from July 2012
The Superintendents


1888 – 1898 : DR JAMES BALLANTYNE HOGG
1898 – 1928 : DR JAMES NICHOLL
1928 – 1945 : DR JAMES MCDONALD
1946 – 1949 : DR CLIVE BOYCE
1950 – 1968 : DR JOHN BAILLIE HENDERSON
1969 – 1976 : DR MICHAEL DE GROOT
1977 – 1984 : DR JOAN RIDLEY
1986 – 2006: DR JEFFERY THOMPSON
DR James Ballantyne Hogg

 1888 - 1898 (Recalled to Goodna)

                              First Medical Superintendent of
                              what was then Willowburn
                              Lunatic Asylum.
                              Dr Hogg emigrated from
                              Edinburgh. He was well
                              educated and a sympathetic
                              custodial carer. He was one of
                              the earliest doctors in Australia to
                              insist on disinfectant for treating
                              wounds during operations.
Dr James Nicholl

 1898 - 1928
                       Dr Nicholl’s focus was on
                       discipline, safety & cleanliness,
                       and the provision of available
                       treatments.
                       He introduced recreation
                       activities including football,
                       cricket, tennis, dances & visits by
                       musicians.
                       He also purchased more land
                       around the hospital and lowered
                       some of the high fences
Dr James McDonald

 1928 - 1945
                       Dr McDonald took over in a time of
                       increasing knowledge about
                       schizophrenia and research into
                       medication for mental conditions.
                       During his term of office, new
                       terms were introduced, such as
                       “mentally sick” rather than “lunatic”
                       and “mental hospital” rather than
                       “lunatic asylum”.
                       At this time the hospital was a
                       working farm.
Dr Clive Boyce

 1946 - 1950

                     Dr Boyce had an enlightened
                     attitude to treatment – referred
                     to as his ‘open-house’ concept.
                     He insisted that patients be
                     treated humanely, even during
                     episodes of violence.
                     The model of care at this time
                     was still based on activity and
                     custodial care.
Dr John Baillie Henderson

 1950 - 1968
                          When Dr Henderson took over there
                          were 1400 patients, both adults and
                          children.
                          Dr Henderson aimed to make life
                          easier for patients and introduced
                          new treatments, increased the
                          numbers of staff and improved
                          working conditions. He also
                          appointed the first psychologist, in
                          1951 an Occupational Therapist in
                          1957 and a social worker in 1966.
Dr Michael de Groot

 1969 – 1976

                       Dr Groot instigated the integration
                       of the male and female sides of the
                       hospital.
                       He placed great emphasis on staff
                       training, appointed 3 nurse
                       educators, broadened the
                       curriculum & upgraded the library.
                       In 1976 there were 770 patients
                       remaining in the hospital
Dr Joan Ridley

 1977 - 1984   Dr Ridley brought a new emphasis on
                deinstitutionalisation and the development
                of community services.
                She established the first Community Liaison
                Nursing Service, the forerunner of today’s
                Community Mental Health Teams. She
                was an advocate for staff development and
                education and had a focus on social skill
                programs for patients.
                Dr Ridley saw the hospital as just one
                component of an integrated mental health
                service
Dr Jeffery Thompson

 1986 - 1996      Dr Thompson had been Dr Ridley’s
                   assistant and continued her work by
                   further developing rehabilitation and
                   community services.
                   Notably, Dr Thompson reorganised the
                   structure of the hospital to focus on 5
                   extended care patient groups, put simply:
                   •Elderly demented & disturbed
                   •Mentally retarded
                   •Brain damaged
                   •Psychotic & assaultative
                   •Chronically schizophrenic
The Administrative Era

The new millennium brought about an increasing shift from
local to centralised control and the era of administration as
opposed to clinically orientated decision making.

The era has been one of constant changes at executive level
and much instability. An unfortunate consequence of this
has been a lessening of the links between the hospital and
the local community.

At the same time, this period has seen a rapid acceleration
in the need for mental health services, ever increasing
costs, and some considerable uncertainty about the future.
2010 and Beyond


 In 2011 the State Government announced that it would split
 up Queensland Health and establish local Hospital and
 Heath Networks.

 These networks will, once again, put more control in the
 hands of local communities through the establishment of
 local Boards to oversee hospital management.

 There will still be centralised support and supervision but
 more decision-making will rest at the local level.
The Museum

For the centenary celebrations of 1990, a museum was
established in one of the original buildings of the hospital.

Unfortunately, since that time there has been little attention
given to either the building (which is now in an extremely
poor state of repair) or to the artefacts held within it.

In 2010 attempts were started to revitalise the museum with
a hope that much can be preserved and eventually used for
public display once more. This work is ongoing.
Confinement & Containment


 In the early days, psychiatry was in its infancy – Freud was
 postulating about dreams (1900) and psychology didn’t
 exist.

 There were no medications as we know them today and
 little understanding of the range of mental illnesses, their
 symptoms and manifestations

 Treatment was about confinement, work, and discipline
Sterility of the pre-medical era

Women’s admission ward
Window Treatments


         Windows were generally
         barred on the outside and
         provided virtually the only
         ventilation in the wards.
         However, the high-ceiling
         design of the wards was
         specifically intended to create
         a minimum area of air space
         for each patient.
Straitjacket



    In the early years there were
    not the medications that we
    have today.
    In many cases, physical
    controls were the only resort of
    the carers where patients were
    violent and intent on harming
    themselves or others.
Hand Muffs
Peaceful sleep?
Dr Whishaw’s demise

Fire nozzle
                        On 7th December 1908 Dr.
                        Reginald Robert Whishaw
                        was hit over the head with a
                        fire nozzle wielded by one of
                        the patients. Dr Whishaw
                        died the following day of a
                        fractured skull
Self sufficiency – work as therapy

                 For many years the clothes
                 used in the hospital were made
                 by patients.
                 Shoes and other items were
                 also made within the hospital.
                 As activity was the main
                 therapy, patients were put to
                 work – women mainly in sewing
                 and men in the fields.
                 For two years the sale of
                 produce actually covered the
                 cost of running the hospital!
Commode Room


     A small room – one on each
     floor of the building – was
     the only internal toilet
     facility available to patients.
The ‘Facilities’
Shower Stalls
Dinner is served!
Recipe Book
Nurse Registration
Nurse in uniform
Nurse’s bedroom
Female ward dining room 1913
Early wheel-chairs
Medicine bottles
General view of hospital - 1915
Steinway Grand Piano
Don Featherstone – Resident Artist
Art as therapy
Communion Table



                  Religion was a
                  significant element
                  for many patients
                  who often saw their
                  conditions as some
                  sort of punishment
                  for wrong doing
Bread slicer and butterer
Dentistry
Ground Floor
First Floor Ward
Gardening par excellence


                  Many trophies were
                  won by the hospital for
                  its gardens.
                  The hospital floats took
                  out several first prizes
                  in the annual Carnival
                  of the Flowers in
                  Toowoomba
The Museum Building Today
THANK YOU!



THANK YOU FOR YOUR ATTENDANCE

           Roger Hawcroft
  Manager, Clinical Library Services
 Darling Downs Health Service District
  roger_hawcroft@health.qld.gov.au

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Restraint to Recovery: Asylum to Acceptance

  • 1. RESTRAINT TO RECOVERY – ASYLUM TO ACCEPTANCE FROM WILLOWBURN LUNATIC ASYLUM TO BAILLIE HENDERSON HOSPITAL 1890 – 2010 Prepared by Roger Hawcroft – May 2012
  • 2. First records of the notion of ‘lunacy’.  The notion of lunacy (mental disease or illness) seems to have first surfaced in about the 12th Century  The Catholic Encyclopaedia gives a date of around 1100 for “an asylum exclusively for sufferers from mental diseases at Mets” (Metz, Northern France)  King Henry II established Newgate Prison in 1188 into which both criminals and ‘lunatics’ were incarcerated
  • 3. Notions of lunacy - continued  1284 – Al-Mansuri Hospital opened in Cairo and had music therapy for its mental patients.  1292 – “A lunatic who had burned a man’s house down was convicted by the justice but released on their authority.”  1295 – A legal case linked “the instigation of the devil” and being “frantic” and “mad”.
  • 4. 14th Century – Establishment of asylums  1310 – A German ‘madhouse’ is mentioned at Elbing, near Danzig.  1377 – St Mary of Bethlehem priory was confiscated by King Edward III and used for lunatics from 1377.  1405 – A Royal Commission investigates the state of lunatics confined at Bethlem Hospital, London.
  • 5. Spain – ‘the cradle of humane psychiatry’  1409 – Spain – Asylums at Valencia, Sargossa, Seville, Valladolid, Palma Mallorca, Toledo and Granada. These institutions removed chains and used games, occupation, entertainment, diet and hygiene to treat inmates – As a result, Spain has been described as the cradle of humane psychiatry.
  • 6. 16th Century – ‘psychiatric revolution’  Several writers refer to the Sixteenth Century as a time of “the first psychiatric revolution” - The reasoning behind this seems to be based on the work of several 16th Century writers who offered a natural alternative to ideas of demonic possession.  1567 – Paracelsus published a small book whose title in English translation is “Diseases which lead to a loss of reason”. The introduction makes it clear that these are not caused by spirits but are natural diseases.
  • 7. Bedlam  1559 – Bedlam is shown on the earliest surviving map of London – a copper plate engraving of Moorfields, discovered in 1962 and now in the London Museum. - The map was probably drawn in 1558 by the Dutch artist Anthonis van den Wyngaerrde and engraved by Franciscus Hogenberg in 1559 - 1592 – An account of a trial for conspiracy to kill the King contains discussion and definitions of terms applying to the various ‘degrees’ of insanity, such as ‘furor’, ‘delirium’ and ‘dementia’.
  • 8. 17th Century - Incarceration  Michael Foucault suggests that the ‘magnificent developments of psychiatry’ made in the 16th Century were largely replaced in the 17th Century by absolutist governments that resolved social crisis by incarcerating the poor.  1598 & 1601 – The Elizabethan ‘Poor Law’ Act required every parish to appoint overseers of the poor and set up work-houses for those who could not support themselves
  • 9. Life in the 17th Century Asylum  1628 - Robert Burton’s: The Anatomy of melancholy. What is its,, with all the kinds, causes, symptoms and prognostics and several cures of it .. Philosophically, Medicinally, Historically opened and cut up. was published.  The book contained a ten picture engraving which was explained in a verse in the 1632 edition. The verse for the engraving of the maniac is:
  • 10. Robert Burton’s “The maniac” But see the Madman range downright With furious looks, a ghastly sight Naked In chains bound doth he lie, And roars amain, he knows not why. Observe him; for as in a glass, Thine angry portraiture it was. His picture keep still in thy presence; ‘Twixt him and thee, there’s no difference.
  • 11. Religion and lunacy  1611 – The Authorised (King James) Version of the Bible had been published.  The Bible was a major source and influence on ideas of just about everything in the 17th Century. On the basis of the Bible it was possible to calculate that something spectacular was likely to happen in the 1650’s, eg. It was could be calculated that the great flood took place 1656 years after creation – so 1656 years after the birth of Christ might be equally significant. Creation was then put at 4004 and the flood in 2349. 4004-2349 =1656
  • 12. Religion and lunacy - continued  The execution of the English king in 1649 was therefore woven into speculation that Christ was due to return and establish his kingdom.  This sort of thinking was behind the rapture of the Quakers and the armed uprising (to bring about his kingdom) of the 5th Monarchy Men in 1661  In October 1656, James Nayler (a Quaker) entered Bristol on a donkey claiming to be Jesus Christ. He was imprisoned until 1659.  Such conflict as this was to continue for around a century.
  • 13. Pay to view insanity  1665 – The Great Plague caused more than 1000 Londoners a week to die and it also reached many provincial towns.  1666 – The Great Fire of London raged for 5 days.  1676 – After the Great Fire, a new Bethlem Hospital was built and opened in Moorfields. In 1705 it held 130 patients. – The new Bethlem was built as a place of display and tourists could pay to see the humans who were incarcerated in the place, often naked and in distress.
  • 14. Late 17th Century  The earliest records of private madhouses in England stem from 1670.  1679 – Habeas Corpus Act was passed  1696 – Bristol Poor Act established a workhouse for 100 boys. The addition of “infants, the aged, infirm, and lunatics” around 1700, changed its character and it became St Peter’s Hospital. In the 18th Century ir had lunatic wards, in the 19th it became an asylum
  • 15. 18th Century – Psychiatry as Science  It is argued that psychiatry became an independent science in the 18th Century – not because of developments in medicine but rather due to the philosophy of enlightenment which existed at the time.  Reason was seen as the highest good for philosophers and so “possession of evil spirits” was regarded as superstition and it and the connection with religion was replaced by the argument that the mentally ill had “lost their reason”.
  • 16. 18th Century - Asylums  The first asylums were small and run privately. The best known and largest was Bedlam (Bethlem) in London. It had 130 patients in 1704  1714 – Vagrancy Act is thought to hae been the first English statute to specifically provide for the detention of lunatics  1723 – Guys Hospital opened lunatic wards  Charitable asylums were opened in the 18th Century in 8 English towns.
  • 17. Regulation  1744 – Vagrancy Act – Several naval hospitals were built, including those at Gosport (Haslar), Plymouth and Chatham. Haslar became the main lunatic asylum for the navy.  1774 Madhouse Act – based on a recommendation that, “the present state of private madhouses in this kingdom requires the interposition of the legislature.  After 1774, private madhouses had to have a licence and inspection was introduced
  • 18. 18th to 19th Century Influences  1777 – York Asylum opened  1789 – The French Revolution – Resulted in inmates of madhouses being examined and either set at liberty or “cared for in hospitals indicated for that purpose”.  By 1800 there were around 40 private madhouses in England.
  • 19. 19th Century  1800 – Criminal Lunatics Act – aimed at the safe custody of criminal lunatics, especially any that had threatened the king  1808 – County Asylums Act – this was triggered by fear generated by the long term detention of lunatics after the 1800 Act following John Hadfield’s attempt to shoot George III  1847 - John Connolly published: The Construction and Government of Lunatic Asylums which was to become a standard for asylum building in the 19th Century
  • 20. The British Colonial Influence  In Britain in 1888 asylums became the responsibility of County and County Borough Councils and many improvements resulted  The British 1890 Lunacy Act was a major consolidating Act that remained the core of English and Welsh Lunacy Legislation until it was repealed by the 1959 Mental Health Act  With emigration of doctors and humanitarians from Britain, new ideas, attitudes and manner of treatment were brought to Australia
  • 21. 1890  Social Climate – At the end of the 19th Century the failure of asylum therapy had convinced people that insanity was largely (though not entirely) incurable.  In the 19th Century nearly 10% of patients died within 3 months of admission from advanced symptoms of cerebral disease causing mental symptoms initially.  By the end of the 19th Century there were 74000 people in public asylums in England
  • 22. Baillie Henderson Highlight Events  1887 - James Renwick began construction of the ‘Lunatic Asylum’. The contract price was £28,775.  1890 - First patients arrived from Woogaroo to what was then the Willowburn Lunatic Asylum – 10 women on 17 May 1890  1902 - 4 Wards in operation  1909 - Golf course built after Home Secretary gives permission
  • 23. 1910 – 1940 Major Expansion  1910 - Compulsory nurse training introduced  1910 – 1920 - Expansion with building of Ray House Ward 1; Jofre House Ward A; Rush House Ward B; New pump house; Tredgold; James House; Hill House; and various residences  1930 - Nurses quarters built  1932 – 1944 - Various residences and boiler house built
  • 24. 1948 - 1968  1948 - Sewing room (Bootmaker’s workshop) built  1949 - 8 hour working day introduced  1950 - Patient numbers reach 1400  1953 – Name changed to Toowoomba Mental Hospital  1961 - Gowrie Hall complex built  1966 -1968 - Laundry built
  • 25. Name change – Baillie Henderson Hospital  1968 (August 27th) - Hospital renamed as Baillie Henderson Hospital  1968 – 1970 - Canteen built  1970 - Rockville Training Centre transferred to Baillie Henderson  1972 - Nursing administration cafeteria built  1973 - Outpatient clinic established at Toowoomba Base Hospital
  • 26. De-institutionalisation Beginnings  1974 - Digby, Connolly & Tuke built  1976 - Rockville Training Centre closed  1980 - Outreach community psychiatric services began  1982 - Whishaw Day Centre commenced  1984 - Recreation complex built
  • 27. From Institution to Community  1986 - Medical orientated outpatients clinic for dischargees opened at Gowrie Hall  1992 - Ridley opened and patients transferred there from Gowrie  1993 - Final intake into 3 year psychiatric nursing course  1996 - 38 hour week introduced
  • 28. Integration Beginnings  1999 - Browne House closed  2000 - Baillie Henderson Hospital & Toowoomba Base Hospital become part of Toowoomba Health Service District Laundry refurbished to cater for district District achieves Accreditation Cafeteria closed  2001 - AMHU opens at Toowoomba Base – Hill house residents moved there
  • 29. Decade of Restructuring  2007 - Mental Health Review by Gerry Fitzgerald  2008 - Toowoomba and Ipswich Health Service Districts amalgamated to become Darling Downs – West Moreton Health Service District  2010 - De-amalgamation – Darling Downs Health Service District formed including Toowoomba & Baillie Henderson Hospitals  2011 - Government announces demise of Queensland Health & establishment of Local Health Networks from July 2012
  • 30. The Superintendents 1888 – 1898 : DR JAMES BALLANTYNE HOGG 1898 – 1928 : DR JAMES NICHOLL 1928 – 1945 : DR JAMES MCDONALD 1946 – 1949 : DR CLIVE BOYCE 1950 – 1968 : DR JOHN BAILLIE HENDERSON 1969 – 1976 : DR MICHAEL DE GROOT 1977 – 1984 : DR JOAN RIDLEY 1986 – 2006: DR JEFFERY THOMPSON
  • 31. DR James Ballantyne Hogg  1888 - 1898 (Recalled to Goodna) First Medical Superintendent of what was then Willowburn Lunatic Asylum. Dr Hogg emigrated from Edinburgh. He was well educated and a sympathetic custodial carer. He was one of the earliest doctors in Australia to insist on disinfectant for treating wounds during operations.
  • 32. Dr James Nicholl  1898 - 1928 Dr Nicholl’s focus was on discipline, safety & cleanliness, and the provision of available treatments. He introduced recreation activities including football, cricket, tennis, dances & visits by musicians. He also purchased more land around the hospital and lowered some of the high fences
  • 33. Dr James McDonald  1928 - 1945 Dr McDonald took over in a time of increasing knowledge about schizophrenia and research into medication for mental conditions. During his term of office, new terms were introduced, such as “mentally sick” rather than “lunatic” and “mental hospital” rather than “lunatic asylum”. At this time the hospital was a working farm.
  • 34. Dr Clive Boyce  1946 - 1950 Dr Boyce had an enlightened attitude to treatment – referred to as his ‘open-house’ concept. He insisted that patients be treated humanely, even during episodes of violence. The model of care at this time was still based on activity and custodial care.
  • 35. Dr John Baillie Henderson  1950 - 1968 When Dr Henderson took over there were 1400 patients, both adults and children. Dr Henderson aimed to make life easier for patients and introduced new treatments, increased the numbers of staff and improved working conditions. He also appointed the first psychologist, in 1951 an Occupational Therapist in 1957 and a social worker in 1966.
  • 36. Dr Michael de Groot  1969 – 1976 Dr Groot instigated the integration of the male and female sides of the hospital. He placed great emphasis on staff training, appointed 3 nurse educators, broadened the curriculum & upgraded the library. In 1976 there were 770 patients remaining in the hospital
  • 37. Dr Joan Ridley  1977 - 1984 Dr Ridley brought a new emphasis on deinstitutionalisation and the development of community services. She established the first Community Liaison Nursing Service, the forerunner of today’s Community Mental Health Teams. She was an advocate for staff development and education and had a focus on social skill programs for patients. Dr Ridley saw the hospital as just one component of an integrated mental health service
  • 38. Dr Jeffery Thompson  1986 - 1996 Dr Thompson had been Dr Ridley’s assistant and continued her work by further developing rehabilitation and community services. Notably, Dr Thompson reorganised the structure of the hospital to focus on 5 extended care patient groups, put simply: •Elderly demented & disturbed •Mentally retarded •Brain damaged •Psychotic & assaultative •Chronically schizophrenic
  • 39. The Administrative Era The new millennium brought about an increasing shift from local to centralised control and the era of administration as opposed to clinically orientated decision making. The era has been one of constant changes at executive level and much instability. An unfortunate consequence of this has been a lessening of the links between the hospital and the local community. At the same time, this period has seen a rapid acceleration in the need for mental health services, ever increasing costs, and some considerable uncertainty about the future.
  • 40. 2010 and Beyond  In 2011 the State Government announced that it would split up Queensland Health and establish local Hospital and Heath Networks.  These networks will, once again, put more control in the hands of local communities through the establishment of local Boards to oversee hospital management.  There will still be centralised support and supervision but more decision-making will rest at the local level.
  • 41. The Museum For the centenary celebrations of 1990, a museum was established in one of the original buildings of the hospital. Unfortunately, since that time there has been little attention given to either the building (which is now in an extremely poor state of repair) or to the artefacts held within it. In 2010 attempts were started to revitalise the museum with a hope that much can be preserved and eventually used for public display once more. This work is ongoing.
  • 42. Confinement & Containment  In the early days, psychiatry was in its infancy – Freud was postulating about dreams (1900) and psychology didn’t exist.  There were no medications as we know them today and little understanding of the range of mental illnesses, their symptoms and manifestations  Treatment was about confinement, work, and discipline
  • 43. Sterility of the pre-medical era Women’s admission ward
  • 44. Window Treatments Windows were generally barred on the outside and provided virtually the only ventilation in the wards. However, the high-ceiling design of the wards was specifically intended to create a minimum area of air space for each patient.
  • 45. Straitjacket In the early years there were not the medications that we have today. In many cases, physical controls were the only resort of the carers where patients were violent and intent on harming themselves or others.
  • 48. Dr Whishaw’s demise Fire nozzle On 7th December 1908 Dr. Reginald Robert Whishaw was hit over the head with a fire nozzle wielded by one of the patients. Dr Whishaw died the following day of a fractured skull
  • 49. Self sufficiency – work as therapy For many years the clothes used in the hospital were made by patients. Shoes and other items were also made within the hospital. As activity was the main therapy, patients were put to work – women mainly in sewing and men in the fields. For two years the sale of produce actually covered the cost of running the hospital!
  • 50. Commode Room A small room – one on each floor of the building – was the only internal toilet facility available to patients.
  • 58. Female ward dining room 1913
  • 61. General view of hospital - 1915
  • 63. Don Featherstone – Resident Artist
  • 65. Communion Table Religion was a significant element for many patients who often saw their conditions as some sort of punishment for wrong doing
  • 66. Bread slicer and butterer
  • 70. Gardening par excellence Many trophies were won by the hospital for its gardens. The hospital floats took out several first prizes in the annual Carnival of the Flowers in Toowoomba
  • 72. THANK YOU! THANK YOU FOR YOUR ATTENDANCE Roger Hawcroft Manager, Clinical Library Services Darling Downs Health Service District roger_hawcroft@health.qld.gov.au

Editor's Notes

  1. Baillie Henderson Hospital History
  2. Baillie Henderson Hospital History