The 1857 Lunacy (Scotland) Act required all areas to build a District Asylum for its 'pauper lunatics'. The need for more diverse classification of the patients and the better management of different types of psychiatric conditions in the late 19th century led to a wider variety of building types and plans for hospitals built during this period. Hartwood was a purpose-built asylum on an isolated site for exclusion.
In the early 1890’s, a site was identified for The Lanarkshire Lunatic Asylum and in 1895, the Lanarkshire (Hartwood) Asylum was opened. This Baronial building stood at the top of a small hill within acres of “pleasure grounds”.
The Lanarkshire County Lunatic Asylum opened its doors in 1895 in Hartwood near Shotts, described as a self-sufficient and secure hospital for the 'mentally deficient'.
The first patients that arrived here were from workhouses; these poor people had been kept for too long in a completely unsuitable environment and most arrived in a very poor state of physical health.
Patients ranged from age 10 to 80 and included people who were mentally handicapped as well as those with mental health issues such as melancholy and hysteria. Dr Clark, the Asylum's first physician, took a very different stance to care than was common at the time - rather than punish and deprive those that were unable, he prescribed fresh air, clean surroundings, nourishing food, mental stimulation and, of course, acts of what was considered kindness.
The hospital blocks were constructed in a diversified plan to accommodate increasing specialisation in the care of psychiatric patients with a main building block with central towers and side wings.
The industrialisation of the surrounding area boosted the local population and resident numbers rose accordingly, reaching 960 by 1913. The expansion required more building and another local architect, James Lochhead, was commissioned to build more wards and other buildings: a sanatorium in 1904, a new reception block in 1916 and a male staff hostel in 1936. The largest, and only remaining, one of these was the Nurses Home accommodation built from 1926 and opened in 1931.
Most of the buildings were linked by glazed enclosed external walkways to control the movement of the patients around the site. By the mid-1950s, Hartwood Hospital was a fully independent site which had created a hospital "village" with a variety of facilities including a bowling green, an arcade of shops and a dance hall. The hospital had its own cemetery in which 1,255 former patients were interred. The village system of patient care, exemplified by the Alt-Scherbitz hospital near Leipzig in Germany in the 1870s, encouraged psychiatric patients to be cared for within their own community setting. Hartwood was the largest asylum in Europe, housing 2,500 residents. The introduction of the 1990 Community Care Act resulted in psychiatric care moving to the community and the subsequent redundancy of the Hartwood Hospital buildings.
For most of its history until the formation of the NHS in 1948, the hospital housed mainly pauper patients, where the Parochial Boards paid for their upkeep, varying from the pauper rate of £58+ a year, depending on the accommodation, care and service required for each individual.
Hartwood Hospital had its own library, surgery, dispensary, butchery, dairy, bakery, shop and workshops and there was also agricultural land used for growing produce. There was a ballroom for musical entertainment - now a residents' lounge and underground vaults.
Patients lived in either the female or the male wards and worked on the farm or in the kitchen and laundry. The complex had its own spring-fed reservoir to provide a water supply. The site was connected to the nearby Shotts railway line to Glasgow, but the private sidings were eventually closed a few years later.
1255 paupers are buried in a graveyard near to the railway.
There has been controversy over various treatments given to patients at the asylum during its history, including the administration of shock therapy without anaesthetic. In the asylum's early years, before mental illness was considered treatable, inmates would simply be restrained and left in rooms, many of them until their deaths.
Hartwood evolved into an NHS psychiatric hospital, but it eventually became unsuitable for mental health treatment so the wards shut in the mid-1990's and its services became what we now know as care in the community. The building itself became a teaching college, but finally closed its doors in 1998 .
We are slowly building a glossary of words and phrases which can be seen in the records from 1895 onwards. Thankfully, many of these words have been wiped from our vocabulary as they are no longer acceptable, but they allow us to paint the picture of the conditions, treatment and how people viewed the poor, the disabled and the sick.
To allow us to move forward, we must not forget our past.
A theory propounded by eugenicists in the late 19th and 20th centuries that breeding by people who have disabilities, mentally ill people or people who are seen as 'feckless' or 'idle', particularly those from the poorer classes, will cause general racial deterioration in a society.
This was one of the main reasons that those who found themselves in poorhouses and asylums were not allowed to mix and had separate living spaces, nothing to do with ‘Victorian moral’ views, but more to stop them having children.
Around the mid 1920’s, the terminology changed: “hospital” replaced “asylum”, “nurse” replaced “attendant” and “lunatics” were now “patients”.
Diagnoses and Therapy
During the early years, patients were admitted from the local area and were paid for by the parochial county boards. Patients were admitted with a range of diagnoses - including psychosis, depression and anxiety disorders - terms that were still evolving in clinical language. Like many hospitals of this era, it also housed people with long-term learning disabilities and elderly people with dementia.
Fresh air therapy was just one of a range of holistic treatments used, The optimism of this modern era was clear in the efforts devoted to holistic treatments and occupational health. From its opening, a hospital farm was established in the grounds to provide open-air activity for patients in their recovery stages, and to supply the kitchens. Arts and crafts were encouraged, and many homes still to this day house the wee woven stools made by the patients.
The modernising of mental hospitals affected not just medical treatment, but encouraged greater focus on occupation and entertainment. By the mid-1930s, mental hospitals across Scotland had cinemas, hosted dances and sports clubs as part of an effort to make entertainment and occupation a central part of recovery and rehabilitation and Hartwood was no exception.
At the centre of Hartwood Hospital was the large hall, located on the first floor, an ornate and formal entertainment space which could accommodate 1200 people for musical performances, and dances.
Mental hospitals appear to us today in a state of ghostly dereliction, after years of neglect and a generation of bad press. But behind these images lies a history that is rich in everyday efforts to make institutional life more liveable. In the early years of operation, each ward had fresh flowers and a supply of books that was changed every fortnight. It was not unusual for mental hospitals during this era to have their own sports teams, education departments and art and music classes. With mental health continuing to receive more attention than ever before, perhaps Hartwood’s history of care and community can help guide future treatments.
Removing the Stigma
Looking at the bricks and mortar doesn’t really tell us what life was like for individuals living in these institutions and everyone’s story and experiences are different.
The stigma that many people still feel surrounds mental health issues may in part be due to the way people have been treated in the past, from being chained up in prison-like conditions, to being held in remote, out-of-town asylums – out of sight, out of mind and then many buried in remote unmarked graves like the 1255 in our cemetery.
So, for this reason, we must remember them all, raise awareness of mental health and improve everyone’s wellbeing.