Scotland's Asylums: From Montrose to the Open Door, 1781–2001

established claims rest on institutional histories, the records of the Commissioners in Lunacy and hospital archives such as those held by the Lothian Health Services Archive and the University of Dundee. shared claims involve interpretation of motives and outcomes. traditional claims are repeated but not documented.

The weak points are these. Sources give 1779, 1781 and 1782 for Montrose, reflecting the dates of fundraising, building and the first admission. The Dingleton "first open door" claim is widely repeated but rests on institutional accounts, and the exact date varies between 1948 and 1949. Opening dates for some asylums depend on whether a founding charter or the first admission is counted.

Before the asylum

shared The historian Helen Dingwall argues that for centuries madness was seen as a state of being rather than an illness. Most people with mental illness or learning disability lived with their families, and treatment, when given, was much the same as for bodily illness. Those thought dangerous could be chained in tolbooths or kept in workhouse cells. Edinburgh's Charity Workhouse, opened in 1743, held nineteen "lunatics" by 1749, and private madhouses took paying patients. In 1774 the poet Robert Fergusson died in the city's bedlam, and Andrew Duncan's distress at his treatment is said to have spurred his later campaign for a public asylum.

The royal asylums

established Montrose was first. Susan Carnegie, a local landowner, led the campaign for an asylum run on humane principles rather than as a prison, and it admitted its first patients in 1781–82. Aberdeen followed in 1800, Edinburgh's Morningside asylum in 1813, Glasgow's in 1814, Dundee's in 1820, Perth's in 1827 and the Crichton in Dumfries in 1839. They were funded by subscription and fees and became known as the royal asylums as they received charters. Glasgow's building, designed by William Stark on a radial plan so that staff could watch every wing, was copied widely. The historian Dingwall notes that fees varied steeply by social class: by 1820 Dundee had six classes of patient, paying from 7 to 63 shillings a week.

established The Crichton showed what reformers hoped for. James Crichton had left about £100,000, and his widow Elizabeth, prevented from founding a university in Dumfries, used it for an asylum. She appointed W. A. F. Browne, whose Montrose lectures had been published in 1837 as What Asylums Were, Are, and Ought to Be. At the Crichton from 1838 to 1857 Browne practised "moral treatment": occupation, education, entertainment and minimal restraint. Patients worked, read, put on plays and produced art, much of which Browne collected.

The 1857 Act and boarding out

established Reform did not reach everyone. Paupers were often kept in poorhouses or private madhouses, and in the 1850s the American campaigner Dorothea Dix publicised conditions in Scotland. A royal commission reported in 1857 that supervision was "at best variable and at worst simply inadequate". The Lunacy (Scotland) Act of that year created a General Board of Commissioners in Lunacy to inspect and license, and district boards to build publicly funded asylums for patients who could not pay. Argyll District Asylum at Lochgilphead, opened in 1863, was the first, and others followed across the country.

established The Commissioners also backed boarding out. Chronic patients judged harmless were placed with guardians, often in rural households, under official supervision. Up to a quarter of registered patients were cared for this way. Doctors from abroad came to study the system, and it lasted in changed form into the twentieth century. It was criticised too, and the quality of care depended heavily on the guardian.

Life inside the Victorian asylum

shared The asylums grew steadily. Studies of the Fife and Kinross District Asylum between 1874 and 1899 found admissions rising, roughly equal numbers of men and women, and patients who were mostly poor but had been in work, not destitute vagrants. Thomas Clouston at the Royal Edinburgh Asylum described treatment as a fight against "morbid, unsocial ways" through employment, amusement, good food, fresh air and exercise. His patients also received electrical treatments, blistering of the head, and drugs including bromides, paraldehyde, hyoscine and cannabis. Dingwall concludes that as asylums filled, tolerance declined and regimes became harsher, and that the word "asylum", meaning a place of safety, fitted less and less.

The open door and the end of the asylum

established Change began after the First World War, which brought shell-shocked soldiers into psychiatric care, and Scotland's first chair of psychiatry followed at the end of the war. The Mental Deficiency and Lunacy (Scotland) Act 1913 made voluntary admission easier. At Dingleton Hospital in Melrose, the superintendent George Bell removed the locks from every ward door soon after the NHS took over in 1948, a step often described as a world first. In the 1960s his successor Maxwell Jones turned Dingleton into a "therapeutic community". The Mental Health (Scotland) Act 1960 made voluntary admission the norm, and from the 1980s care in the community emptied the large institutions. Dingleton closed in 2001 and Sunnyside, the successor to Montrose, in 2011.

• Glasgow's 1814 asylum, designed by William Stark on a radial plan, became a model for asylums elsewhere.
• W. A. F. Browne collected art made by his patients at the Crichton, one of the earliest such collections.
• At its peak, boarding out placed up to a quarter of Scotland's registered patients with families rather than in institutions.
• Argyll and Bute Hospital at Lochgilphead, opened in 1863 as the first district asylum, was still in use as a psychiatric hospital in the 2010s.

• Disputed: the asylums were simple medical progress. Helen Dingwall argues the move into asylums owed as much to a growing wish to remove "embarrassing" people from polite society as to medical progress. She also concludes that as asylums filled, tolerance declined and regimes became harsher.
• Disputed: when the Montrose asylum opened. Sources give 1779, 1781 and 1782, reflecting the dates of fundraising, building and the first admission. The first patients were admitted in 1781–82.
• Disputed: Dingleton was the first psychiatric hospital in the world to unlock all its wards. It is often described that way, around 1948 or 1949. The claim rests on institutional accounts and is widely accepted, but it has not been independently checked.