SSHM and RMA conferences

Over the summer I’ve had the privilege of sharing my early research at a number of conferences. In July I travelled to Canterbury to the Society for the Social History of Medicine, a large conference with an international flavour. It was great to be part of a session on asylums – in Venice, Sydney and North India as well as my own contribution on Norfolk.

conference programme:

The Royal Musical Association Annual Conference in September provided a very different context, with a session on music therapy at which I was the only historical scholar. It’s fascinating to find, though, that there is still plenty of debate about the overall aims of music therapy and the different roles music can play, whether as a means to an end or a goal in itself.

conference programme:

York Retreat

The York Retreat asylum represents a very different institution from the county-run pauper asylums I have previously visited. York also had a county asylum, and it was the unfortunate death of a young Quaker woman there in 1790 that prompted the local Society of Friends to set up a private charitable institution, run on Quaker principles, and intended to provide individual care to a small number of patients. The Retreat is most famous for its dedication to ‘moral treatment’, under the influence of the Tuke family, who were instrumental in its foundation and throughout the nineteenth century. From the mid-nineteenth century it came to resemble more closely the practice of the County asylums, though catered for a combination of Quakers of all social classes, and middle class private patients from non-Quaker backgrounds.

York Retreat Main Building
York Retreat Main Building

Due to the Quaker principles and the small initial size of the asylum, music does not feature in early records. However, as more affluent and non-Quaker patients were admitted, pianos and musical entertainments became more common.


The West Riding Pauper Lunatic Asylum in Wakefield was set up in 1818, and became well-known for its advocacy of non-restraint on a large scale. The asylum made use of the model provided locally by the York Retreat, a much smaller and private institution, using the advice and experience of the Tuke family (who ran the Retreat) but implementing its principles on a much larger scale. As other public lunatic asylums were founded, they often made use of Wakefield as a model.

The main asylum buildings at Wakefield
The main asylum buildings at Wakefield

Work therapy was a central part of asylum management from the outset, and within a few years of its foundation almost all patients were able to participate in some kind of labour, whether outside in the cultivated gardens, or inside, helping with maintenance, cleaning and mending. The Asylum management recognised the importance of work for occupying the minds of the patients and providing a distraction from the melancholy and distress which characterised many patients.

Entertainments and recreations were much less quick to become part of moral treatment. In this case, the management were clear that ‘frivolous’ entertainment was usually not suitable for pauper patients. Not only would such activity provide only temporary relief from the trials of mental health problems (in contrast to the longer-lasting effects of regular employment), it was also morally problematic, given the low status and restricted means of pauper patients. In this case, re-creating life outside the asylum meant only careful use of music and other entertainments.

The recreation hall at Wakefield
The recreation hall at Wakefield

Music became more prominent under the medical director between 1866 and 1876, James Crichton Browne. As well as developing new approaches to the medical treatment of mental disorder, Brown encouraged music and theatre. A large detached hall was built for a variety of purposes, initially as a dining hall, but soon played host to visiting musicians and theatre companies as well as successful in-house groups.

Asylum life

Life in the asylum was, by modern standards, pretty unpleasant. Even by contemporary standards the regime of a large institution meant strict rules, lack of privacy, little independence and an uninspiring diet. The dangers of fire and disease were always close, with threats from poor sanitary conditions, unreliable supplies of water, cheap food, buildings in poor condition, and other patients. Enormous stigma was attached to insanity, so younger patients were often not admitted until they could no longer be kept at home. On the other hand, asylums were often used for elderly patients whose maintenance was beyond the means of friends and families. Paupers and charitable cases were maintained at the cost of their parish or subscribers, so conditions were kept as basic as possible.
Notwithstanding financial constraints, however, asylum officers took pains to make their wards as comfortable as possible. Regular work and recreation were seen as key parts of the therapeutic process. For paupers, occupation not only offered a connection to their lives in the outside world, and an opportunity for meaningful engagement, but also helped to defray the expenses of the asylum. In many asylums, large farms were cultivated, and patients contributed to all aspects of asylum life: laundry, cooking, baking and brewing, making furniture, clothes and shoes, maintenance and, for the convalescent, tending to other patients or administrative roles.
In the early part of the nineteenth century recreational activities were provided as an equivalent for wealthy, private patients: also providing continuity with ‘home’ life. Gradually this was extended to all patients, and wards and day rooms were provided with books, newspapers and games, with organised activities such as dances, walks and sport. Wards were decorated with pictures, plants and paint.
The chapel was another important feature of the asylum, with regular services as well as individual attention; some Chaplains took their roles as carers for spiritual and mental needs of the patients very seriously. For some patients, religion was an essential part of recovery, while for others it provided a diversion, opportunity for change in company or self-expression.


While the Norwich asylum catered exclusively for paupers, the County Asylum in Gloucester was set up to receive both paupers and paying patients of higher social classes. Music formed an important part of the asylum’s programme of recreations for these patients from the 1840s, and it seems that the pauper patients were gradually included in these activities.
One of the innovations at Gloucester was the introduction of singing classes for patients of all classes in 1842. It’s not clear from records how long the classes lasted. However, the Asylum’s Visitors recorded a number of benefits from musical participation. Music was an important entertainment and brought great pleasure to the patients. Learning the music and practising for a concert gave the patients plenty to do with themselves: filling time in a structured way was one of the key challenges facing asylum management. Participating in music also made the patients ‘kindlier’ and more likely to think of others.

The Crescent at Gloucester main site

Musical activities later in the century are similar to those found at Norwich. A band was formed in the 1860s, again to play for dances and other recreational activities, and the chapel boasted an organ and choir. Despite the early involvement in patients in music, it seems that from the middle of the century most musical activity was carried out by the attendants, with the patients either listening or participating in dance. When a second complex of asylum facilities was founded in Barnwood in 1883, it was the weekly dances that were established as a mainstay of entertainment at both sites.

The Clock Tower at Barnwood site
The Clock Tower at Barnwood site


My first archive visit was to the archives of the County Asylum in Norwich. This is a particularly rich collection. In his book on the asylum, Steven Cherry mentions the band that was set up in the 1860s, and in 2006 Radio 4 broadcast a programme looking more closely at some of the music that has survived.


The archives yielded a lot of information about the musical activities in the asylum from the second half of the nineteenth century. In addition to the band, which played for dances and special occasions, the asylum chapel held an organ and a choir was formed to lead services. It seems music was an important part of the recreational activities on offer to the patients, primarily to alleviate the boredom of asylum life. Along with other forms of recreation, and employment for many patients, music formed part of the general ‘moral’ therapy aimed to restore order to an inmate’s life. Unfortunately the asylum’s officers wrote little about the specifically therapeutic effects of music, and it doesn’t seem as if it was used to treat particular disorders or patients. Musical activity was primarily passive: the band was formed of attendants, and only on occasion are there references to patients actually taking part in musical activity.


We are fortunate that a large amount of music from the Norwich asylum survives, rescued as the asylum was being closed down and currently in the possession of David Juritz, a professional violinist who had presented the Radio 4 programme. I was grateful to be able to take a look at just a small proportion of the collection, which mainly stems from the early twentieth century and comprises music suitable for dances and light concerts: arrangements of popular opera and operetta, waltzes, marches and foxtrots. The band clearly had an extensive repertoire and a reasonable amount of skill.