Jane Austen did not write about disabled people in any of her books, but people with disabilities were just as common in Regency England as they are today. Whether the disability was physical or cognitive, people back then wanted to care for their loved ones who needed extra assistance or intensive support, just as we do now. How did they do it? The story of the York Lunatic Asylum vs the York Retreat gives us some important insight.
Most disabled people were cared for at home or in their home community if at all possible. Keeping the disabled person in a familiar setting and among people who loved them was undoubtedly the best option for families with enough money to do so. But what did society do with those poor unfortunates whose families did not or could not care for their family member, especially a “lunatic” family member? (“Lunatic” might include anyone with a mental disability or disorder, from severe depression to schizophrenia to autism and the like.) Who took care of them?
In Austen’s day there were a number of “asylums” which took in those who could not care for themselves. Sometimes these were funded by the government and sometimes they were run with private funds. Wealthy families occasionally paid for one of their loved ones to be cared for at these institutions, but most inmates were poor, and naturally, the poorer a patient was, the worse their care was likely to be. The common view was that “lunatics” had the minds of animals, and so they should be confined and controlled. There was little hope given for any improvement.
The York Lunatic Asylum was founded in 1777 and typified this approach to the disabled. Fortunate patients from wealthy families were relatively well-treated while poor patients suffered through straightjackets, restraining chains, inadequate food, and little supervision or protection. But all patients, even wealthy ones, were subject to such “treaments” as purges and cold baths. Deaths among the poor patients were common but they were not reported. Since the asylum was private there were no government inspections, and so there was no way to evaluate how well “treatment” was working, or if there was any attempt at treatment at all.
In 1792 a young Quaker woman suffering from what we would now call chronic depression was admitted to the York Lunatic Asylum. Six weeks later, she was dead. Her fellow Quakers investigated her death, and when they discovered the horrifying conditions under which she died, they decided to do something about it. They founded their own asylum called the York Retreat.
At the York Retreat, treatment was based on the idea that “lunatics” had souls. Therefore the Quakers believed that the disabled deserved to be treated like human beings, not dumb beasts. Few restraints were used. Patients were encouraged to participate in outdoor activities, to practice simple arts and crafts, and to do productive work in the community. This basic philosophy, so revolutionary in its day, gradually became the operating philosophy for “lunatic” homes around the world. To this day the York Retreat model drives how we as a society try to treat the mentally disabled.
Meanwhile the Quakers were not done with the York Asylum. They were not content to allow other patients to suffer under the brutal conditions they had found inside the institution. Instead they managed to get a leading Quaker appointed as one of the patrons of the asylum, and in 1814 they were successful in bringing about a parliamentary inquiry into abuses at the hospital.The leadership and staff of the hospital were completely replaced and the asylum began to follow the kinder, gentler practices of the York Retreat. In following decades the asylum name changed to Bootham Park. Gradually it evolved into a modern psychiatric hospital. It closed in 2016.
The York Retreat continues operating today. It specializes in treating those with complex mental disorders like dementia, PTSD, autism, etc..
It’s interesting to think how Darcy and Elizabeth might have reacted to having a child with a disability, and how they would have viewed the rise of institutions like the York Retreat. I’d like to think that they would have made sure that any disabled child of theirs would enjoy a full, integrated life at Pemberley. And I’d love to see a story where Elizabeth champions the rights of the disabled and perhaps becomes a sponsor of the York Retreat.
As the mother of an autistic woman I am fascinated by how far we have progressed in our treatment of those with mental disabilities, and by how much some things have not changed. We still fight for people with disabilities to be looked at as human and worthy of inclusion in society. Perhaps that is a battle that will always have to be fought.
For further reading: A History of Disability