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Bethlem Royal Hospital, also known as St Mary Bethlehem, Bethlehem Hospital and Bedlam, is a
psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative ...
in
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
. Its famous history has inspired several horror books, films and TV series, most notably '' Bedlam'', a 1946 film with
Boris Karloff William Henry Pratt (23 November 1887 – 2 February 1969), better known by his stage name Boris Karloff (), was an English actor. His portrayal of Frankenstein's monster in the horror film ''Frankenstein'' (1931) (his 82nd film) established h ...
. The hospital is closely associated with
King's College London King's College London (informally King's or KCL) is a public research university located in London, England. King's was established by royal charter in 1829 under the patronage of King George IV and the Duke of Wellington. In 1836, King's ...
and, in partnership with the
Institute of Psychiatry, Psychology and Neuroscience The Institute of Psychiatry, Psychology and Neuroscience (IoPPN) is a research institution dedicated to discovering what causes mental illness and diseases of the brain. In addition, its aim is to help identify new treatments for them and way ...
, is a major centre for psychiatric research. It is part of the
King's Health Partners King's Health Partners is an academic health science centre located in London, United Kingdom. It comprises King's College London, Guy's and St Thomas' NHS Foundation Trust, King's College Hospital NHS Foundation Trust and South London and Ma ...
academic health science centre An academic medical centre (AMC), variously also known as academic health science centre, academic health science system, or academic health science partnership, is an educational and healthcare institute formed by the grouping of a health profess ...
and the
National Institute for Health and Care Research The National Institute for Health and Care Research (NIHR) is the British government’s major funder of clinical, public health, social care and translational research. With a budget of over £1.2 billion in 2020–21, its mission is to "impr ...
(NIHR) Biomedical Research Centre for Mental Health. Founded in 1247, the hospital was originally near
Bishopsgate Bishopsgate was one of the eastern gates in London's former defensive wall. The gate gave its name to the Bishopsgate Ward of the City of London. The ward is traditionally divided into ''Bishopsgate Within'', inside the line wall, and ''Bishop ...
just outside the
walls Walls may refer to: *The plural of wall, a structure * Walls (surname), a list of notable people with the surname Places * Walls, Louisiana, United States *Walls, Mississippi, United States * Walls, Ontario, neighborhood in Perry, Ontario, C ...
of the
City of London The City of London is a city, ceremonial county and local government district that contains the historic centre and constitutes, alongside Canary Wharf, the primary central business district (CBD) of London. It constituted most of London fr ...
. It moved a short distance to
Moorfields Moorfields was an open space, partly in the City of London, lying adjacent to – and outside – its northern wall, near the eponymous Moorgate. It was known for its marshy conditions, the result of the defensive wall acting like a dam, i ...
in 1676, and then to
St George's Fields St George's Fields was an area of Southwark in south London, England. History Originally the area was an undifferentiated part of the south side of the Thames, which was low-lying marshland unsuitable even for agricultural purposes. There ...
in Southwark in 1815, before moving to its current location in
Monks Orchard Monks Orchard is a suburb on the edge of the London Borough of Croydon, in the ceremonial county of Greater London, England, priot to 1965 it was located in the historical county of Surrey. It is situated about 10 miles (16.1 km) south ...
in 1930. The word " bedlam", meaning uproar and confusion, is derived from the hospital's nickname. Although the hospital became a modern psychiatric facility, historically it was representative of the worst excesses of asylums in the era of lunacy reform.


1247–1633


Foundation

The hospital was founded in 1247 as the Priory of the New Order of our Lady of Bethlehem in the
city of London The City of London is a city, ceremonial county and local government district that contains the historic centre and constitutes, alongside Canary Wharf, the primary central business district (CBD) of London. It constituted most of London fr ...
during the reign of Henry III. It was established by the Bishop-elect of Bethlehem, the Italian Goffredo de Prefetti, following a donation of personal property by the London
alderman An alderman is a member of a Municipal government, municipal assembly or council in many Jurisdiction, jurisdictions founded upon English law. The term may be titular, denoting a high-ranking member of a borough or county council, a council membe ...
and former sheriff, Simon FitzMary. The original location was in the parish of St Botolph,
Bishopsgate Bishopsgate was one of the eastern gates in London's former defensive wall. The gate gave its name to the Bishopsgate Ward of the City of London. The ward is traditionally divided into ''Bishopsgate Within'', inside the line wall, and ''Bishop ...
's ward, just beyond London's wall and where the south-east corner of
Liverpool Street Station Liverpool Street station, also known as London Liverpool Street, is a central London railway terminus and connected London Underground station in the north-eastern corner of the City of London, in the ward of Bishopsgate Without. It is the t ...
now stands. Bethlem was not initially intended as a hospital, in the clinical sense, much less as a specialist institution for the insane, but as a centre for the collection of
alms Alms (, ) are money, food, or other material goods donated to people living in poverty. Providing alms is often considered an act of virtue or Charity (practice), charity. The act of providing alms is called almsgiving, and it is a widespread p ...
to support the Crusader Church and to link England to the
Holy Land The Holy Land; Arabic: or is an area roughly located between the Mediterranean Sea and the Eastern Bank of the Jordan River, traditionally synonymous both with the biblical Land of Israel and with the region of Palestine. The term "Holy ...
. De Prefetti's need to generate income for the Crusader Church and restore the financial fortunes of his
see See or SEE may refer to: * Sight - seeing Arts, entertainment, and media * Music: ** ''See'' (album), studio album by rock band The Rascals *** "See", song by The Rascals, on the album ''See'' ** "See" (Tycho song), song by Tycho * Television * ...
had been occasioned by two misfortunes: his
bishopric In church governance, a diocese or bishopric is the ecclesiastical district under the jurisdiction of a bishop. History In the later organization of the Roman Empire, the increasingly subdivided provinces were administratively associate ...
had suffered significant losses following the destructive conquest of Bethlehem by the
Khwarazmian Turks The name Khwarazmian (also Khwarezmian, Khwarizmim, Khorezmian, Chorasmian, Carizmian, and others) may refer to: Places and peoples * Khwarazm, a large oasis region on the Amu Darya river delta in western Central Asia **Khwarazmshah, the title of v ...
in 1244, and his immediate predecessor had further impoverished his cathedral chapter through the alienation of a considerable amount of its property. The
priory A priory is a monastery of men or women under religious vows that is headed by a prior or prioress. Priories may be houses of mendicant friars or nuns (such as the Dominicans, Augustinians, Franciscans, and Carmelites), or monasteries of mon ...
, obedient to the Church of Bethlehem, would also house the poor and, if they visited, provide hospitality to the bishop, canons and
brothers A brother is a man or boy who shares one or more parents with another; a male sibling. The female counterpart is a sister. Although the term typically refers to a familial relationship, it is sometimes used endearingly to refer to non-familia ...
of Bethlehem. Thus, Bethlem became a ''
hospital A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
'', in medieval usage, "an institution supported by charity or taxes for the care of the needy". The subordination of the priory's religious order to the bishops of Bethlehem was further underlined in the foundational charter, which stipulated that the prior, canons and inmates were to wear a star upon their cloaks and capes to symbolise their obedience to the church of Bethlehem.


Politics and patronage

During the thirteenth and fourteenth centuries, with its activities underwritten by episcopal and papal
indulgences In the teaching of the Catholic Church, an indulgence (, from , 'permit') is "a way to reduce the amount of punishment one has to undergo for sins". The '' Catechism of the Catholic Church'' describes an indulgence as "a remission before God o ...
, the hospital's role as a centre for alms collection persisted, but its linkage to the Order of Bethlehem increasingly unravelled, putting its purpose and patronage in doubt. In 1346, the
master Master or masters may refer to: Ranks or titles * Ascended master, a term used in the Theosophical religious tradition to refer to spiritually enlightened beings who in past incarnations were ordinary humans *Grandmaster (chess), National Master ...
of Bethlem, a position at that time granted to the most senior of London's Bethlemite brethren, applied to the city authorities seeking protection; thereafter metropolitan office-holders claimed power to oversee the appointment of masters and demanded in return an annual payment of 40 shillings. It is doubtful whether the city really provided substantial protection and much less that the mastership fell within their patronage but, dating from the 1346 petition, it played a role in the management of Bethlem's finances. By this time, the Bethlehemite bishops had relocated to Clamecy, France, under the surety of the
Avignon papacy The Avignon Papacy was the period from 1309 to 1376 during which seven successive popes resided in Avignon – at the time within the Kingdom of Burgundy-Arles, Kingdom of Arles, part of the Holy Roman Empire; now part of France – rather than i ...
. This was significant as, throughout the reign of
Edward III Edward III (13 November 1312 – 21 June 1377), also known as Edward of Windsor before his accession, was King of England and Lord of Ireland from January 1327 until his death in 1377. He is noted for his military success and for restoring r ...
(1327–77), the
English monarchy The monarchy of the United Kingdom, commonly referred to as the British monarchy, is the constitutional form of government by which a hereditary sovereign reigns as the head of state of the United Kingdom, the Crown Dependencies (the Bailiwi ...
had extended its patronage over ecclesiastical positions through the seizure of priories under the control of non-English religious houses. As a dependent house of the Order of Saint Bethlehem in Clamecy, Bethlem was vulnerable to seizure by the crown and this occurred in the 1370s when Edward III took control. The purpose of this appropriation was, in the context of the
Hundred Years' War The Hundred Years' War (; 1337–1453) was a series of armed conflicts between the kingdoms of Kingdom of England, England and Kingdom of France, France during the Late Middle Ages. It originated from disputed claims to the French Crown, ...
between France and England, to prevent funds raised by the hospital from enriching the
French monarchy France was ruled by monarchs from the establishment of the Kingdom of West Francia in 843 until the end of the Second French Empire in 1870, with several interruptions. Classical French historiography usually regards Clovis I () as the firs ...
via the
papal court The papal household or pontifical household (usually not capitalized in the media and other nonofficial use, ), called until 1968 the Papal Court (''Aula Pontificia''), consists of dignitaries who assist the pope in carrying out particular ceremoni ...
. After this event the masters of the hospital, semi-autonomous figures in charge of its day-to-day management, were normally crown appointees and it became an increasingly
secularised In sociology, secularization (or secularisation) is the transformation of a society from close identification with religious values and institutions toward non-religious values and secular institutions. The ''secularization thesis'' expresses the ...
institution. The memory of its foundation became muddied and muddled; in 1381, the royal candidate for the post of master claimed that from its beginnings it had been superintended by an order of knights and he confused its founder, Goffredo de Prefetti, with the
Frankish Frankish may refer to: * Franks, a Germanic tribe and their culture ** Frankish language or its modern descendants, Franconian languages * Francia, a post-Roman state in France and Germany * East Francia, the successor state to Francia in Germany ...
crusader,
Godfrey de Bouillon Godfrey of Bouillon (, , , ; 18 September 1060 – 18 July 1100) was a French nobleman and pre-eminent leader of the First Crusade. First ruler of the Kingdom of Jerusalem from 1099 to 1100, he avoided the title of king, preferring that of princ ...
. The removal of the last symbolic link to the Bethlehemites was confirmed in 1403 when it was reported that master and inmates no longer wore the star of Bethlehem. In 1546, the Lord Mayor of London, Sir John Gresham, petitioned the crown to grant Bethlem to the city. This petition was partially successful and
Henry VIII Henry VIII (28 June 149128 January 1547) was King of England from 22 April 1509 until his death in 1547. Henry is best known for his six marriages, and for his efforts to have his first marriage (to Catherine of Aragon) annulled. His disa ...
reluctantly ceded to the City of London "the custody, order and governance" of the hospital and of its "occupants and revenues". This charter came into effect in 1547. The crown retained possession of the hospital while its administration fell to the city authorities. Following a brief interval when it was placed under the management of the governors of
Christ's Hospital Christ's Hospital is a public school (English independent boarding school for pupils aged 11–18) with a royal charter located to the south of Horsham in West Sussex. The school was founded in 1552 and received its first royal charter in 1553 ...
, from 1557 it was administered by the governors of
Bridewell Bridewell Palace in London was built as a residence of King Henry VIII and was one of his homes early in his reign for eight years. Given to the City of London Corporation by his son King Edward VI for use as an orphanage and place of correc ...
, a prototype
house of correction The house of correction was a type of establishment built after the passing of the Elizabethan Poor Law (1601), places where those who were "unwilling to work", including vagrants and beggars, were set to work. The building of houses of correctio ...
at
Blackfriars Blackfriars, derived from Black Friars, a common name for the Dominican Order of friars, may refer to: England * Blackfriars, Bristol, a former priory in Bristol * Blackfriars, Canterbury, a former monastery in Kent * Blackfriars, Gloucester, a f ...
. Having been thus one of the few metropolitan hospitals to have survived the dissolution of the monasteries physically intact, this joint administration continued, not without interference by both the crown and city, until incorporation into the
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
in 1948.; .


From Bethlem to Bedlam

It is unknown when Bethlem, or Bedlam, began to specialise in the care and control of the insane, but it has been frequently asserted that Bethlem was first used for the insane from 1377. This date is derived from the unsubstantiated conjecture of the Reverend Edward Geoffrey O'Donoghue, chaplain to the hospital, who published a
monograph A monograph is a specialist work of writing (in contrast to reference works) or exhibition on a single subject or an aspect of a subject, often by a single author or artist, and usually on a scholarly subject. In library cataloging, ''monograph ...
on its history in 1914. While it is possible that Bethlem was receiving the insane during the late fourteenth century, the first definitive record of their presence in the hospital is in the details of a visitation of the Charity Commissioners in 1403. This recorded that amongst other patients there were six male inmates who were "''mente capti''", a Latin term indicating insanity. The report of the visitation also noted the presence of four pairs of
manacles Handcuffs are restraint devices designed to secure an individual's wrists in proximity to each other. They comprise two parts, linked together by a chain, a hinge, or rigid bar. Each cuff has a rotating arm which engages with a ratchet that ...
, 11 chains, six locks and two pairs of
stocks Stocks are feet restraining devices that were used as a form of corporal punishment and public humiliation. The use of stocks is seen as early as Ancient Greece, where they are described as being in use in Solon's law code. The law describing ...
but it is not clear if any or all of these items were for the restraint of the inmates. While mechanical restraint and
solitary confinement Solitary confinement is a form of imprisonment in which the inmate lives in a single cell with little or no meaningful contact with other people. A prison may enforce stricter measures to control contraband on a solitary prisoner and use additi ...
are likely to have been used for those regarded as dangerous, little else is known of the actual treatment of the insane for much of the
medieval period In the history of Europe, the Middle Ages or medieval period lasted approximately from the late 5th to the late 15th centuries, similar to the post-classical period of global history. It began with the fall of the Western Roman Empire a ...
. The presence of a small number of insane patients in 1403 marks Bethlem's gradual transition from a diminutive general hospital into a specialist institution for the confinement of the insane. This process was largely completed by 1460. From the fourteenth century, Bethlem had been referred to colloquially as "Bedleheem", "Bedleem" or "Bedlam". Initially "Bedlam" was an informal name but from approximately the
Jacobean era The Jacobean era was the period in English and Scottish history that coincides with the reign of James VI of Scotland who also inherited the crown of England in 1603 as James I. The Jacobean era succeeds the Elizabethan era and precedes the Ca ...
the word entered everyday speech to signify a state of madness, chaos, and the irrational nature of the world. This development was partly due to Bedlam's staging in several plays of the Jacobean and Caroline periods, including '' The Honest Whore, Part I'' (1604); ''
Northward Ho ''Northward Ho'' (or ''Ho!'', or ''Hoe'') is an early Jacobean era stage play, a satire and city comedy written by Thomas Dekker and John Webster, and first published in 1607. ''Northward Ho'' was a response to ''Eastward Ho'' (1605) by Ben Jon ...
'' (1607); ''
The Duchess of Malfi ''The Duchess of Malfi'' (originally published as ''The Tragedy of the Dutchesse of Malfy'') is a Jacobean revenge tragedy written by English dramatist John Webster in 1612–1613. It was first performed privately at the Blackfriars Theatre, ...
'' (1612); '' The Pilgrim'' (); and '' The Changeling'' (1622). This dramatic interest in Bedlam is also evident in references to it in early seventeenth-century plays such as '' Epicœne, or The Silent Woman'' (1609), ''
Bartholomew Fair The Bartholomew Fair was one of London's pre-eminent summer charter fairs. A charter for the fair was granted to Rahere by Henry I to fund the Priory of St Bartholomew; and from 1133 to 1855 it took place each year on 24 August within the preci ...
'' (1614), and ''
A New Way to Pay Old Debts ''A New Way to Pay Old Debts'' (c. 1625, printed 1633) is an English Renaissance theatre, English Renaissance drama, the most popular play by Philip Massinger. Its central character, Sir Giles Over-reach, became one of the more popular villains ...
'' (). The appropriation of Bedlam as a theatrical locale for the depiction of madness probably owes no little debt to the establishment in 1576 in nearby
Moorfields Moorfields was an open space, partly in the City of London, lying adjacent to – and outside – its northern wall, near the eponymous Moorgate. It was known for its marshy conditions, the result of the defensive wall acting like a dam, i ...
of The Curtain and
The Theatre The Theatre was an Elizabethan playhouse in Shoreditch (in Curtain Road, part of the modern London Borough of Hackney), just outside the City of London. It was the first permanent theatre ever built in England. It was built in 1576 after th ...
, two of the main London playhouses; it may also have been coincident with that other theatricalisation of madness as charitable object, the commencement of public visiting at Bethlem.


Management

The position of master was a
sinecure A sinecure ( or ; from the Latin , 'without', and , 'care') is an office, carrying a salary or otherwise generating income, that requires or involves little or no responsibility, labour, or active service. The term originated in the medieval chu ...
largely regarded by its occupants as means of profiting at the expense of the poor in their charge. The appointment of the masters, later known as keepers, had lain within the patronage of the crown until 1547. Thereafter the city, through the
Court of Aldermen The Court of Aldermen forms part of the senior governance of the City of London Corporation. It comprises twenty-five aldermen of the City of London, presided over by the Lord Mayor (becoming senior alderman during his year of office). The Cou ...
, took control and, as with the King's appointees, the office was used to reward loyal servants and friends. Compared to the masters placed by the monarch, those who gained the position through the city were of much more modest status. In 1561, the Lord Mayor succeeded in having his former porter, Richard Munnes, a draper by trade, appointed to the position. The sole qualification of his successor in 1565, a man by the name of Edward Rest, appears to have been his occupation as a grocer. Rest died in 1571, at which point the keepership passed on to John Mell in 1576, known for his abuse of "the governors, those who gave money to the poor, and the poor themselves." The Bridewell Governors largely interpreted the role of keeper as that of a house manager and this is clearly reflected in the occupations of most appointees as they tended to be inn-keepers, victualers or brewers and the like. When patients were sent to Bethlem by the Governors of the Bridewell the keeper was paid from hospital funds. For the remainder, keepers were paid either by the families and friends of inmates or by the parish authorities. It is possible that keepers negotiated their fees for these latter categories of patients. John Mell's death in 1579 left the keepership open for the long-term keeper Roland Sleford, a London cloth-maker, who left his post in 1598, apparently of his own volition, after a 19-year tenure. Two months later, the Bridewell Governors, who had until then shown little interest in the management of Bethlem beyond the appointment of keepers, conducted an inspection of the hospital and a census of its inhabitants for the first time in over 40 years. Their purpose was "to view and p rse the defaultes and want of rep rc ns". They found that during the period of Sleford's keepership the hospital buildings had fallen into a deplorable condition with the roof caving in and the kitchen sink blocked, and reported that "...it is not fitt for anye man to dwell in wch was left by the Keeper for that it is so loathsomly filthely kept not fit for any man to come into the house". The committee of inspection found 21 inmates with only two having been admitted during the previous 12 months. Of the remainder, six at least had been resident for a minimum of eight years and one inmate had been there for around 25 years. Three were from outside London, six were charitable cases paid for out of the hospital's resources, one was supported by a parochial authority, and the rest were provided for by family, friends, benefactors or, in one instance, out of their own funds. The reason for the Governors' new-found interest in Bethlem is unknown but it may have been connected to the increased scrutiny the hospital was coming under with the passing of
poor law In English and British history, poor relief refers to government and ecclesiastical action to relieve poverty. Over the centuries, various authorities have needed to decide whose poverty deserves relief and also who should bear the cost of hel ...
legislation in 1598 and to the decision by the Governors to increase hospital revenues by opening it up to general visitors as a spectacle. After this inspection, the Governors initiated some repairs and visited the hospital at more frequent intervals. During one such visit in 1607 they ordered the purchase of clothing and eating vessels for the inmates, presumably indicating the lack of such basic items.


Helkiah Crooke

At the bidding of
James VI and I James VI and I (James Charles Stuart; 19 June 1566 – 27 March 1625) was King of Scotland as James VI from 24 July 1567 and King of England and Ireland as James I from the union of the Scottish and English crowns on 24 March 1603 until ...
,
Helkiah Crooke Helkiah Crooke (1576 – 1648) was Court physician to King James I of England. He is best remembered for his textbook on anatomy, ''Mikrokosmographia, a Description of the Body of Man''. He was the first qualified doctor to be appointed Keeper ...
(1576–1648) was appointed keeper-physician in 1619. As a
Cambridge Cambridge ( ) is a university city and the county town in Cambridgeshire, England. It is located on the River Cam approximately north of London. As of the 2021 United Kingdom census, the population of Cambridge was 145,700. Cambridge bec ...
graduate, the author of an enormously successful English language book of
anatomy Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its ...
entitled ''Microcosmographia: a Description of the Body of Man'' (1615) and a member of the medical department of the royal household, he was clearly of higher social status than his city-appointed predecessors (his father was a noted preacher, and his elder brother Thomas was created a
baronet A baronet ( or ; abbreviated Bart or Bt) or the female equivalent, a baronetess (, , or ; abbreviation Btss), is the holder of a baronetcy, a hereditary title awarded by the British Crown. The title of baronet is mentioned as early as the 14th ...
). Crooke had successfully ousted the previous keeper, the
layman In religious organizations, the laity () consists of all members who are not part of the clergy, usually including any non-ordained members of religious orders, e.g. a nun or a lay brother. In both religious and wider secular usage, a layperson ...
Thomas Jenner, after a campaign in which he had castigated his rival for being "unskilful in the practice of medicine". While this may appear to provide evidence of the early recognition by the Governors that the inmates of Bethlem required medical care, the formal conditions of Crooke's appointment did not detail any required medical duties. Indeed, the Board of Governors continued to refer to the inmates as "the poore" or "prisoners" and their first designation as patients appears to have been by the
Privy Council A privy council is a body that advises the head of state of a state, typically, but not always, in the context of a monarchic government. The word "privy" means "private" or "secret"; thus, a privy council was originally a committee of the mon ...
in 1630. From 1619, Crooke unsuccessfully campaigned through petition to the king for Bethlem to become an independent institution from the Bridewell, a move that while likely meant to serve both monarchial and personal interest would bring him into conflict with the Bridewell Governors. Following a pattern of management laid down by early office-holders, his tenure as keeper was distinguished by his irregular attendance at the hospital and the avid appropriation of its funds as his own. Such were the depredations of his regime that an inspection by the Governors in 1631 reported that the patients were "likely to starve". Charges against his conduct were brought before the Governors in 1632. Crooke's royal favour having dissolved with the death of James I,
Charles I Charles I may refer to: Kings and emperors * Charlemagne (742–814), numbered Charles I in the lists of Holy Roman Emperors and French kings * Charles I of Anjou (1226–1285), also king of Albania, Jerusalem, Naples and Sicily * Charles I of ...
instigated an investigation against him in the same year. This established his absenteeism and embezzlement of hospital resources and charged him with failing to pursue "any endeavour for the curing of the distracted persons". It also revealed that charitable goods and hospital-purchased foodstuffs intended for patients had been typically misappropriated by the hospital steward, either for his own use or to be sold to the inmates. If patients lacked resources to trade with the steward they often went hungry. These findings resulted in the dismissal in disgrace of Crooke, the last of the old-style keepers, along with his steward on 24 May 1633.


Conditions

In 1632 it was recorded that the old house of Bethlem had "below stairs a parlour, a kitchen, two larders, a long entry throughout the house, and 21 rooms wherein the poor distracted people lie, and above the stairs eight rooms more for servants and the poor to lie in". It is likely that this arrangement was not significantly different in the sixteenth century. Although inmates, if deemed dangerous or disturbing, were chained or locked up, Bethlem was an otherwise open building with its inhabitants at liberty to roam around its confines and possibly the local neighbourhood. The neighbouring inhabitants would have been quite familiar with the condition of the hospital as in the 1560s, and probably for some considerable time before that, those who lacked a lavatory in their own homes had to walk through "the west end of the long house of Bethlem" to access the rear of the hospital and reach the "common Jacques". Typically the hospital appears to have been a receptacle for the very disturbed and troublesome and this fact lends some credence to accounts such as that provided by Donald Lupton in the 1630s who described the "cryings, screechings, roarings, brawlings, shaking of chaines, swearings, frettings, chaffings" that he observed. Bethlem had been built over a sewer that served both the hospital and its precinct. This common drain regularly blocked, resulting in overflows of waste at the entrance of the hospital. The 1598 visitation by the Governors had observed that the hospital was "filthely kept", but the Governors rarely made any reference to the need for staff to clean the hospital. The level of hygiene reflected the inadequate water supply, which, until its replacement in 1657, consisted of a single wooden
cistern A cistern (Middle English ', from Latin ', from ', "box", from Greek ', "basket") is a waterproof receptacle for holding liquids, usually water. Cisterns are often built to catch and store rainwater. Cisterns are distinguished from wells by t ...
in the back yard from which water had to be laboriously transported by bucket. In the same yard since at least the early seventeenth century there was a "washhouse" to clean patients' clothes and bedclothes and in 1669 a drying room for clothes was added. Patients, if capable, were permitted to use the "house of easement", of which there were two at most, but more frequently "piss-pots" were used in their cells. Unsurprisingly, inmates left to brood in their cells with their own excreta were, on occasion, liable to throw such "filth & Excrem n" into the hospital yard or onto staff and visitors. Lack of facilities combined with patient incontinence and prevalent conceptions of the mad as animalistic and dirty, fit to be kept on a bed of straw, appear to have promoted an acceptance of hospital squalor. However, this was an age with very different standards of public and personal hygiene when people typically were quite willing to urinate or defecate in the street or even in their own fireplaces. For much of the seventeenth century the dietary provision for patients appears to have been inadequate. This was especially so during Crooke's regime, when inspection found several patients suffering from starvation. Corrupt staff practices were evidently a significant factor in patient malnourishment and similar abuses were noted in the 1650s and 1670s. The Governors failed to manage the supply of
victuals Food is any substance consumed by an organism for nutritional support. Food is usually of plant, animal, or fungal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals. The substance is ing ...
, relying on "gifts in kind" for basic provisions, and the resources available to the steward to purchase foodstuffs was dependent upon the goodwill of the keeper. Patients were fed twice a day on a "lowering diet" (an intentionally reduced and plain diet) consisting of bread, meat, oatmeal, butter, cheese and generous amounts of beer. It is likely that daily meals alternated between meat and dairy products, almost entirely lacking in fruit or vegetables. That the portions appear to have been inadequate also likely reflected contemporary
humoral theory Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers. Humorism began to fall out of favor in the 1850s ...
that justified rationing the diet of the mad, the avoidance of rich foods, and a therapeutics of depletion and purgation to restore the body to balance and restrain the spirits.


1634–1791


Medical regime

The year 1634 is typically interpreted as denoting the divide between the mediaeval and early modern administration of Bethlem. It marked the end of the day-to-day management by an old-style keeper-physician and its replacement by a three-tiered medical regime composed of a non-resident physician, a visiting surgeon and an
apothecary ''Apothecary'' () is a mostly archaic term for a medical professional who formulates and dispenses '' materia medica'' (medicine) to physicians, surgeons, and patients. The modern chemist (British English) or pharmacist (British and North Ameri ...
, a model adopted from the royal hospitals. The medical staff were elected by the Court of Governors and, in a bid to prevent profiteering at the expense of patients that had reached its apogee in Crooke's era, they were all eventually salaried with limited responsibility for the financial affairs of the hospital. Personal connections, interests and occasionally royal favour were pivotal factors in the appointment of physicians, but by the measure of the times appointees were well qualified as almost all were Oxford or Cambridge graduates and a significant number were candidates for or fellows of the
Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
. Although the posts were strongly contested, nepotistic appointment practices played a significant role. The election of
James Monro James Monro (1838 – 28 January 1920) was a lawyer who became the first Assistant Commissioner (Crime) of the London Metropolitan Police and also served as Commissioner of Police of the Metropolis from 1888 to 1890. Early career Monro was ...
as physician in 1728 marked the beginning of a 125-year Monro family dynasty extending through four generations of fathers and sons. Family influence was also significant in the appointment of surgeons but absent in that of apothecaries. The office of physician was largely an honorary and charitable one with only a nominal salary. As with most hospital posts, attendance was required only intermittently and the greater portion of the income was derived from private practice. Bethlem physicians, maximising their association with the hospital, typically earned their coin in the lucrative " trade in lunacy" with many acting as visiting physicians to, presiding over, or even, as with the Monros and their predecessor Thomas Allen, establishing their own mad-houses. Initially both surgeons and apothecaries were also without salary and their hospital income was solely dependent upon their presentation of bills for attendance to the Court of Governors. This system was frequently abused and the bills presented were often deemed exorbitant by the Board of Governors. The problem of financial exploitation was partly rectified in 1676, when surgeons received a salary, and from the mid-eighteenth century elected apothecaries were likewise salaried and normally resident within the hospital. Dating from this latter change, the vast majority of medical responsibilities within the institution were undertaken by the sole resident medical officer, the apothecary, owing to the relatively irregular attendance of the physician and surgeon. The medical regime, being married to a depletive or
antiphlogistic Anti-inflammatory is the property of a substance or treatment that reduces inflammation or swelling. Anti-inflammatory drugs, also called anti-inflammatories, make up about half of analgesics. These drugs remedy pain by reducing inflammation as op ...
physic until the early nineteenth century, had a reputation for conservatism that was neither unearned nor, given the questionable benefit of some therapeutic innovations, necessarily ill-conceived in every instance. Bathing was introduced in the 1680s at a time when
hydrotherapy Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine (particularly naturopathy), occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term ...
was enjoying a recrudescence in popularity. "Cold bathing", opined John Monro, Bethlem physician for 40 years from 1751, "has in general an excellent effect";Quoted in and remained much in vogue as a treatment throughout the eighteenth century. By the early nineteenth century, bathing was routine for all patients of sufficient hardiness from summer "to the setting-in of the cold weather". Spring signalled recourse to the traditional armamentarium; from then until the end of summer Bethlem's "Mad ''Physick''" reigned supreme as all patients, barring those deemed incurable, could expect to be bled and blistered and then dosed with emetics and purgatives. Indiscriminately applied, these curative measures were administered with the most cursory physical examination, if any, and with sufficient excess to risk not only health but also life. Such was the violence of the standard medical course, "involving voiding of the bowels, vomiting, scarification, sores and bruises," that patients were regularly discharged or refused admission if they were deemed unfit to survive the physical onslaught. The reigning medical ethos was the subject of public debate in the mid-eighteenth century when the Paper War of 1752–1753 erupted between John Monro and his rival
William Battie William Battie (sometimes spelt Batty;) 1 September 1703 – 13 June 1776) was an English physician who published in 1758 the first lengthy book on the treatment of mental illness, ''A Treatise on Madness'', and by extending methods of treatment ...
, physician to the reformist St Luke's Asylum of London, founded in 1751. The Bethlem Governors, who had presided over the only public asylum in Britain until the early eighteenth century, looked upon St Luke's as an upstart institution and Battie, formerly a Governor at Bethlem, as traitorous. In 1758 Battie published his ''Treatise on Madness'' which castigated Bethlem as archaic and outmoded, uncaring of its patients and founded upon a despairing medical system whose therapeutic transactions were both injudicious and unnecessarily violent. In contrast, Battie presented St Luke's as a progressive and innovative hospital, oriented towards the possibility of cure and scientific in approach. Monro responded promptly, publishing ''Remarks on Dr. Battie's Treatise on Madness'' in the same year.


Bethlem rebuilt at Moorfields

Although Bethlem had been enlarged by 1667 to accommodate 59 patients, the Court of Governors of Bethlem and Bridewell observed at the start of 1674 that "the Hospitall House of Bethlem is very olde, weake & ruinous and to small and streight for keepeing the greater numb of lunaticks therein att p eent". With the increasing demand for admission and the inadequate and dilapidated state of the building it was decided to rebuild the hospital in
Moorfields Moorfields was an open space, partly in the City of London, lying adjacent to – and outside – its northern wall, near the eponymous Moorgate. It was known for its marshy conditions, the result of the defensive wall acting like a dam, i ...
, just north of the city proper and one of the largest open spaces in London. The architect chosen for the new hospital, which was built rapidly and at great expense between 1675 and 1676, was the
natural philosopher Natural philosophy or philosophy of nature (from Latin ''philosophia naturalis'') is the philosophical study of physics Physics is the natural science that studies matter, its fundamental constituents, its motion and behavior throu ...
and City Surveyor
Robert Hooke Robert Hooke FRS (; 18 July 16353 March 1703) was an English polymath active as a scientist, natural philosopher and architect, who is credited to be one of two scientists to discover microorganisms in 1665 using a compound microscope that ...
. He constructed an edifice that was monumental in scale at over wide and some deep. The surrounding walls were some long and deep while the south face at the rear was effectively screened by a 714-foot (218 m) stretch of London's ancient wall projecting westward from nearby
Moorgate Moorgate was one of the City of London's northern gates in its defensive wall, the last to be built. The gate took its name from the Moorfields, an area of marshy land that lay immediately north of the wall. The gate was demolished in 1762, b ...
. At the rear and containing the courtyards where patients exercised and took the air, the walls rose to high. The front walls were only high but this was deemed sufficient as it was determined that "Lunatikes... are not to epermitted to walk in the yard to be situate betweene the said intended new Building and the Wall aforesaid." It was also hoped that by keeping these walls relatively low the splendour of the new building would not be overly obscured. This concern to maximise the building's visibility led to the addition of six gated openings wide which punctuated the front wall at regular intervals, enabling views of the facade. Functioning as both advertisement and warning of what lay within, the stone pillars enclosing the entrance gates were capped by the figures of "Melancholy" and "Raving Madness" carved in Portland stone by the Danish-born sculptor
Caius Gabriel Cibber Caius Gabriel Cibber (1630–1700) was a Danish sculptor, who enjoyed great success in England, and was the father of the actor, author and poet laureate Colley Cibber. He was appointed "carver to the king's closet" by William III. Biograph ...
. At the instigation of the Bridewell Governors and to make a grander architectural statement of "charitable munificence", the hospital was designed as a single- rather than double-pile building, accommodating initially 120 patients. Having cells and chambers on only one side of the building facilitated the dimensions of the great galleries, essentially long and capacious corridors, high and wide, which ran the length of both floors to a total span of . Such was their scale that
Roger L'Estrange Sir Roger L'Estrange (17 December 1616 – 11 December 1704) was an English pamphleteer, author, courtier, and press censor. Throughout his life L'Estrange was frequently mired in controversy and acted as a staunch ideological defender of Kin ...
remarked in a 1676 text eulogising the new Bethlem that their "''Vast'' Length ... wearies the travelling eyes' of ''Strangers''". The galleries were constructed more for public display than for the care of patients as, at least initially, inmates were prohibited from them lest "such persons that come to see the said Lunatickes may goe in Danger of their Lives". The architectural design of the new Bethlem was primarily intended to project an image of the hospital and its governors consonant with contemporary notions of
charity Charity may refer to: Giving * Charitable organization or charity, a non-profit organization whose primary objectives are philanthropy and social well-being of persons * Charity (practice), the practice of being benevolent, giving and sharing * Ch ...
and benevolence. In an era prior to the state funding of hospitals and with patient fees covering only a portion of costs, such self-advertisement was necessary to win the donations, subscriptions and
patronage Patronage is the support, encouragement, privilege, or financial aid that an organization or individual bestows on another. In the history of art, arts patronage refers to the support that kings, popes, and the wealthy have provided to artists su ...
essential for the institution's survival. This was particularly the case in raising funds to pay for major projects of expansion such as the rebuilding project at Moorfields or the addition of the Incurables Division in 1725–39 with accommodation for more than 100 patients. These highly visible acts of civic commitment could also serve to advance the claims to social status or political advantage of its Governors and supporters. However, while consideration of patients' needs may have been distinctly secondary, they were not absent. For instance, both the placement of the hospital in the open space of Moorfields and the form of the building with its large cells and well-lit galleries had been chosen to provide "health and Aire" in accordance with the miasmatic theory of disease causation. It was London's first major charitable building since the
Savoy Hospital The Savoy Palace, considered the grandest nobleman's townhouse of medieval London, was the residence of prince John of Gaunt until it was destroyed during rioting in the Peasants' Revolt of 1381. The palace was on the site of an estate given t ...
(1505–17) and one of only a handful of public buildings then constructed in the aftermath of the
Great Fire of London The Great Fire of London was a major conflagration that swept through central London from Sunday 2 September to Thursday 6 September 1666, gutting the medieval City of London inside the old Roman city wall, while also extending past the ...
(1666). It would be regarded, during this period at least, as one of the "Prime Ornaments of the City ... and a noble Monument to Charity". Not least due to the increase in visitor numbers that the new building allowed, the hospital's fame and latterly infamy grew and this magnificently expanded Bethlem shaped English and international depictions of madness and its treatment.


Public visiting

Visits by friends and relatives were allowed and it was expected that the family and friends of poor inmates would bring food and other essentials for their survival. Bethlem was and is best known for the fact that it also allowed public and casual visitors with no connection to the inmates. This display of madness as public show has often been considered the most scandalous feature of the historical Bedlam. On the basis of circumstantial evidence, it is speculated that the Bridewell Governors may have decided as early as 1598 to allow public visitors as means of raising hospital income. The only other reference to visiting in the sixteenth-century is provided in a comment in
Thomas More Sir Thomas More (7 February 1478 – 6 July 1535), venerated in the Catholic Church as Saint Thomas More, was an English lawyer, judge, social philosopher, author, statesman, and noted Renaissance humanist. He also served Henry VIII as Lord ...
's 1522 treatise ''The Four Last Things'', where he observed that "thou shalt in Bedleem see one laugh at the knocking of his head against a post". As More occupied a variety of official positions that might have occasioned his calling to the hospital and as he lived nearby, his visit provides no compelling evidence that public visitation was widespread during the sixteenth century. The first apparently definitive documentation of public visiting derives from a 1610 record which details Lord Percy's payment of 10
shilling The shilling is a historical coin, and the name of a unit of modern currencies formerly used in the United Kingdom, Australia, New Zealand, other British Commonwealth countries and Ireland, where they were generally equivalent to 12 pence o ...
s for the privilege of rambling through the hospital to view its deranged denizens. It was also at this time, and perhaps not coincidentally, that Bedlam was first used as a stage setting with the publication of ''The Honest Whore, Part I'', in 1604. Evidence that the number of visitors rose following the move to Moorfields is provided in the observation by the Bridewell Governors in 1681 of "the greate quantity of persons that come daily to see the said Lunatickes". Eight years later the English merchant and author,
Thomas Tryon Thomas Tryon (6 September 1634 – 21 August 1703) was an English sugar merchant, author of popular self-help books, and early advocate of animal rights and vegetarianism. Life Born in 1634 in Bibury near Cirencester, Gloucestershire, England, ...
, remarked disapprovingly of the "Swarms of People" that descended upon Bethlem during public holidays. In the mid-eighteenth-century a journalist of a topical periodical noted that at one time during
Easter Week The Octave of Easter is the eight-day period, or octave, that begins on Easter Sunday and ends with the following Sunday. In Christian churches that celebrate it, it marks the beginning of Eastertide. The first seven of these eight days are als ...
"one hundred people at least" were to be found visiting Bethlem's inmates. Evidently Bethlem was a popular attraction, yet there is no credible basis to calculate the annual number of visitors. The claim, still sometimes made, that Bethlem received 96,000 visitors annually is speculative in the extreme. Nevertheless, it has been established that the pattern of visiting was highly seasonal and concentrated around holiday periods. As Sunday visiting was severely curtailed in 1650 and banned seven years later, the peak periods became Christmas, Easter and
Whitsun Whitsun (also Whitsunday or Whit Sunday) is the name used in Britain, and other countries among Anglicans and Methodists, for the Christian High Holy Day of Pentecost. It is the seventh Sunday after Easter, which commemorates the descent of the Ho ...
. The Governors actively sought out "people of note and quallitie" – the educated, wealthy and well-bred – as visitors. The limited evidence would suggest that the Governors enjoyed some success in attracting such visitors of "quality". In this elite and idealised model of charity and moral benevolence the necessity of spectacle, the showing of the mad so as to excite
compassion Compassion motivates people to go out of their way to relieve the physical, mental or emotional pains of others and themselves. Compassion is often regarded as being sensitive to the emotional aspects of the suffering of others. When based on n ...
, was a central component in the elicitation of donations, benefactions and legacies. Nor was the practice of showing the poor and unfortunate to potential donators exclusive to Bethlem as similar spectacles of misfortune were performed for public visitors to the
Foundling Hospital The Foundling Hospital in London, England, was founded in 1739 by the philanthropic sea captain Thomas Coram. It was a children's home established for the "education and maintenance of exposed and deserted young children." The word "hospital" w ...
and
Magdalen Hospital Magdalene asylums, also known as Magdalene laundries, were initially Protestant but later mostly Roman Catholic institutions that operated from the 18th to the late 20th centuries, ostensibly to house "fallen women". The term referred to femal ...
for Penitent Prostitutes. The donations expected of visitors to Bethlem – there never was an ''official'' fee – probably grew out of the monastic custom of alms giving to the poor. While a substantial proportion of such monies undoubtedly found their way into the hands of staff rather than the hospital poors' box, Bethlem profited considerably from such charity, collecting on average between £300 and £350 annually from the 1720s until the curtailment of visiting in 1770. Thereafter the poors' box monies declined to about £20 or £30 per year. Aside from its fund-raising function, the spectacle of Bethlem offered moral instruction for visiting strangers. For the "educated" observer Bedlam's theatre of the disturbed might operate as a cautionary tale providing a deterrent example of the dangers of immorality and vice. The mad on display functioned as a moral exemplum of what might happen if the passions and appetites were allowed to dethrone reason. As one mid-eighteenth-century correspondent commented: " here is nobetter lesson obe taught us in any part of the globe than in this school of misery. Here we may see the mighty reasoners of the earth, below even the insects that crawl upon it; and from so humbling a sight we may learn to moderate our pride, and to keep those passions within bounds, which if too much indulged, would drive reason from her seat, and level us with the wretches of this unhappy mansion". Whether "persons of quality" or not, the primary allure for visiting strangers was neither moral edification nor the duty of charity but its entertainment value. In
Roy Porter Roy Sydney Porter, FBA (31 December 1946 – 3 March 2002) was a British historian known for his work on the history of medicine. He retired in 2001 from the director of the Wellcome Institute for the History of Medicine at University College L ...
's memorable phrase, what drew them "was the ''frisson'' of the freakshow", where Bethlem was "a rare Diversion" to cheer and amuse. It became one of a series of destinations on the London tourist trail which included such sights as the
Tower A tower is a tall Nonbuilding structure, structure, taller than it is wide, often by a significant factor. Towers are distinguished from guyed mast, masts by their lack of guy-wires and are therefore, along with tall buildings, self-supporting ...
, the
Zoo A zoo (short for zoological garden; also called an animal park or menagerie) is a facility in which animals are kept within enclosures for public exhibition and often bred for Conservation biology, conservation purposes. The term ''zoological g ...
,
Bartholomew Fair The Bartholomew Fair was one of London's pre-eminent summer charter fairs. A charter for the fair was granted to Rahere by Henry I to fund the Priory of St Bartholomew; and from 1133 to 1855 it took place each year on 24 August within the preci ...
,
London Bridge Several bridges named London Bridge have spanned the River Thames between the City of London and Southwark, in central London. The current crossing, which opened to traffic in 1973, is a box girder bridge built from concrete and steel. It r ...
and
Whitehall Whitehall is a road and area in the City of Westminster, Central London. The road forms the first part of the A roads in Zone 3 of the Great Britain numbering scheme, A3212 road from Trafalgar Square to Chelsea, London, Chelsea. It is the main ...
. Curiosity about Bethlem's attractions, its "remarkable characters", including figures such as
Nathaniel Lee Nathaniel Lee (c. 1653 – 6 May 1692) was an England, English dramatist. He was the son of Dr Richard Lee, a Presbyterian clergyman who was rector of Hatfield and held many preferments under the Commonwealth of England, Commonwealth; Dr Lee was ...
, the dramatist, and
Oliver Cromwell Oliver Cromwell (25 April 15993 September 1658) was an English politician and military officer who is widely regarded as one of the most important statesmen in English history. He came to prominence during the 1639 to 1651 Wars of the Three Ki ...
's porter, Daniel, was, at least until the end of the eighteenth-century, quite a respectable motive for visiting. From 1770 free public access ended with the introduction of a system whereby visitors required a ticket signed by a Governor. Visiting subjected Bethlem's patients to many abuses, including being poked with sticks by visitors or otherwise taunted, given drinks and physically assaulted or sexually harassed, but its curtailment removed an important element of public oversight. In the period thereafter, with staff practices less open to public scrutiny, the worst patient abuses occurred.


1791–1900

Despite its palatial pretensions, by the end of the eighteenth century Bethlem was physically deteriorating with uneven floors, buckling walls and a leaking roof. It resembled "a crazy carcass with no wall still vertical – a veritable Hogarthian auto-satire". The financial cost of maintaining the Moorfields building was onerous and the capacity of the Governors to meet these demands was stymied by shortfalls in Bethlem's income in the 1780s occasioned by the bankruptcy of its treasurer; further monetary strains were imposed in the following decade by inflationary wage and provision costs in the context of the Revolutionary wars with France. In 1791, Bethlem's Surveyor, Henry Holland, presented a report to the Governors detailing an extensive list of the building's deficiencies including structural defects and uncleanliness and estimated that repairs would take five years to complete at a cost of £8,660: only a fraction of this sum was allocated and by the end of the decade it was clear that the problem had been largely unaddressed. Holland's successor to the post of Surveyor, James Lewis, was charged in 1799 with compiling a new report on the building's condition. Presenting his findings to the Governors the following year, Lewis declared the building "incurable" and opined that further investment in anything other than essential repairs would be financially imprudent. He was, however, careful to insulate the Governors from any criticism concerning Bethlem's physical dilapidation as, rather than decrying either Hooke's design or the structural impact of additions, he castigated the slipshod nature of its rapid construction. Lewis observed that it had been partly built on land called "the Town Ditch", a receptacle for rubbish, and this provided little support for a building whose span extended to over . He also noted that the brickwork was not on any foundation but laid "on the surface of the soil, a few inches below the present floor", while the walls, overburdened by the weight of the roofs, were "neither sound, upright nor level".


Bethlem rebuilt at St George's Fields

While the logic of Lewis's report was clear, the Court of Governors, facing continuing financial difficulties, only resolved in 1803 behind the project of rebuilding on a new site, and a fund-raising drive was initiated in 1804. In the interim, attempts were made to rehouse patients at local hospitals and admissions to Bethlem, sections of which were deemed uninhabitable, were significantly curtailed such that the patient population fell from 266 in 1800 to 119 in 1814. Financial obstacles to the proposed move remained significant. A national press campaign to solicit donations from the public was launched in 1805. Parliament was successfully lobbied to provide £10,000 for the fund under an agreement whereby the Bethlem Governors would provide permanent accommodation for any lunatic soldiers or sailors of the French Wars. Early interest in relocating the hospital to a site at Gossey Fields had to be abandoned due to financial constraints and stipulations in the lease for Moorfields that precluded its resale. Instead, the Governors engaged in protracted negotiations with the city to swap the Moorfields site for another municipally owned location at St. George's Fields in
Southwark Southwark ( ) is a district of Central London situated on the south bank of the River Thames, forming the north-western part of the wider modern London Borough of Southwark. The district, which is the oldest part of South London, developed ...
, south of the Thames. The swap was concluded in 1810 and provided the Governors with a site in a swamp-like, impoverished, highly populated, and industrialised area where the Dog and Duck tavern and St George's Spa had been. A competition was held to design the new hospital at Southwark in which the noted Bethlem patient James Tilly Matthews was an unsuccessful entrant. The Governors elected to give James Lewis the task. Incorporating the best elements from the three winning competition designs, he produced a building in the neoclassical style that, while drawing heavily on Hooke's original plan, eschewed the ornament of its predecessor. Completed after three years in 1815, it was constructed during the first wave of county asylum building in England under the County Asylum Act ("
Wynn Wynn or wyn (; also spelled wen, ƿynn, and ƿen) is a letter of the Old English alphabet, where it is used to represent the sound . History The letter "W" While the earliest Old English texts represent this phoneme with the digraph , ...
's Act") of 1808. Extending to in length, the new hospital, which ran alongside the
Lambeth Road Lambeth Road is a road in Lambeth (to the west) and Southwark (to the east), London running between Lambeth Bridge over the River Thames at the western end and St George's Circus at the eastern end. The road is designated the A3203. The boro ...
, consisted of a central block with two wings of three storeys on either side. Female patients occupied the west wing and males the east; as at Moorfields, the cells were located off galleries that traversed each wing. Each gallery contained only one toilet, a sink and cold baths. Incontinent patients were kept on beds of straw in cells in the basement gallery; this space also contained rooms with fireplaces for attendants. A wing for the
criminally insane The insanity defense, also known as the mental disorder defense, is an affirmative defense by excuse in a criminal case, arguing that the defendant is not responsible for their actions due to an episodic psychiatric disease at the time of the cr ...
 – a legal category newly minted in the wake of the trial of a
delusion A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some o ...
al James Hadfield for attempted
regicide Regicide is the purposeful killing of a monarch or sovereign of a polity and is often associated with the usurpation of power. A regicide can also be the person responsible for the killing. The word comes from the Latin roots of ''regis'' ...
 – was completed in 1816. This addition, which housed 45 men and 15 women, was wholly financed by the state. The first 122 patients arrived in August 1815 having been transported to their new residence by a convoy of
Hackney coach A hackney or hackney carriage (also called a cab, black cab, hack or London taxi) is a carriage or car for hire. A hackney of a more expensive or high class was called a remise. A symbol of London and Britain, the black taxi is a common ...
es. Problems with the building were soon noted as the steam heating did not function properly, the basement galleries were damp and the windows of the upper storeys were unglazed "so that the sleeping cells were either exposed to the full blast of cold air or were completely darkened". Although glass was placed in the windows in 1816, the Governors initially supported their decision to leave them unglazed on the basis that it provided ventilation and so prevented the build-up of "the disagreable effluvias peculiar to all madhouses". Faced with increased admissions and overcrowding, new buildings, designed by the architect
Sydney Smirke Sydney Smirke (20 December 1797 – 8 December 1877) was a British architect. Smirke who was born in London, England as the fifth son of painter Robert Smirke and his wife, Elizabeth Russell. He was the younger brother of Sir Robert Smirke ...
, were added from the 1830s. The wing for criminal lunatics was increased to accommodate a further 30 men while additions to the east and west wings, extending the building's facade, provided space for an additional 166 inmates and a dome was added to the hospital chapel. At the end of this period of expansion Bethlem had a capacity for 364 patients.


1815–16 Parliamentary Inquiry

The late eighteenth and early nineteenth centuries are typically seen as decisive in the emergence of new attitudes towards the management and treatment of the insane. Increasingly, the emphasis shifted from the external control of the mad through physical restraint and coercion to their
moral management Moral treatment was an approach to mental disorder based on humane psychosocial care or moral discipline that emerged in the 18th century and came to the fore for much of the 19th century, deriving partly from psychiatry or psychology and partly f ...
whereby self-discipline would be inculcated through a system of reward and punishment. For proponents of lunacy reform, the
Quaker Quakers are people who belong to a historically Protestant Christian set of Christian denomination, denominations known formally as the Religious Society of Friends. Members of these movements ("theFriends") are generally united by a belie ...
-run
York Retreat The Retreat, commonly known as the York Retreat, is a place in England for the treatment of people with mental disorders, mental health needs. Located in Lamel Hill in York, it operates as a Non-profit organisation, not for profit Charitable tru ...
, founded in 1796, functioned as an exemplar of this new approach that would seek to re-socialise and re-educate the mad. Bethlem, embroiled in scandal from 1814 over its inmate conditions, would come to symbolise its
antithesis Antithesis (Greek for "setting opposite", from "against" and "placing") is used in writing or speech either as a proposition that contrasts with or reverses some previously mentioned proposition, or when two opposites are introduced together f ...
. Through newspaper reports initially and then evidence given to the 1815 Parliamentary Committee on Madhouses, the state of inmate care in Bethlem was chiefly publicised by Edward Wakefield, a Quaker land agent and leading advocate of lunacy reform. He visited Bethlem several times during the late spring and early summer of 1814. His inspections were of the old hospital at the Moorfields site, which was then in a state of disrepair; much of it was uninhabitable and the patient population had been significantly reduced. Contrary to the tenets of moral treatment, Wakefield found that the patients in the galleries were not classified in any logical manner as both highly disturbed and quiescent patients were mixed together indiscriminately. Later, when reporting on the chained and naked state of many patients, Wakefield sought to describe their conditions in such a way as to maximise the horror of the scene while decrying the apparently bestial treatment of inmates and the thuggish nature of the asylum keepers. Wakefield's account focused on one patient in particular, James Norris, an American marine reported to be 55 years of age who had been detained in Bethlem since 1 February 1800. Housed in the incurable wing of the hospital, Norris had been continuously restrained for about a decade in a harness apparatus which severely restricted his movement. Wakefield stated that: Wakefield's revelations, combined with earlier reports about patient maltreatment at the York Asylum, helped to prompt a renewed campaign for national lunacy reform and the establishment of an 1815
House of Commons The House of Commons is the name for the elected lower house of the bicameral parliaments of the United Kingdom and Canada. In both of these countries, the Commons holds much more legislative power than the nominally upper house of parliament. ...
Select Committee on Madhouses, which examined the conditions under which the insane were confined in county asylums, private madhouses, charitable asylums and in the lunatic wards of Poor-Law workhouses. In June 1816 Thomas Monro, Principal Physician, resigned as a result of scandal when he was accused of 'wanting in humanity' towards his patients. Dr T. B. Hyslop came to the hospital in 1888 and rose to be physician in charge, bringing the hospital into the 20th century and retiring in 1911.


1930 to the present

In 1930, the hospital moved to the suburbs of Croydon, on the site of Monks Orchard House between
Eden Park Eden Park is New Zealand's largest sports stadium, with a capacity of 50,000. Located in central Auckland, New Zealand's largest city, it is three kilometres southwest of the CBD, on the boundary between the suburbs of Mount Eden and King ...
,
Beckenham Beckenham () is a town in Greater London, England, within the London Borough of Bromley, in Greater London. Until 1965 it was part of the historic county of Kent. It is located south-east of Charing Cross, situated north of Elmers End and E ...
,
West Wickham West Wickham is an area of South East London, England, mainly within the London Borough of Bromley with some parts lying in the London Borough of Croydon. It lies south of Park Langley and Eden Park, west of Hayes and Coney Hall, north of ...
and
Shirley Shirley may refer to: Arts and entertainment * ''Shirley'' (novel), an 1849 novel by Charlotte Brontë * ''Shirley'' (1922 film), a British silent film * ''Shirley'' (2020 film), an American film * ''Shirley'' (album), a 1961 album by Shirley Bas ...
. The old hospital and its grounds were bought by
Lord Rothermere Viscount Rothermere, of Hemsted in the county of Kent, is a title in the Peerage of the United Kingdom. It was created in 1919 for the press lord Harold Harmsworth, 1st Baron Harmsworth. He had already been created a baronet, of Horsey in th ...
and presented to the
London County Council London County Council (LCC) was the principal local government body for the County of London throughout its existence from 1889 to 1965, and the first London-wide general municipal authority to be directly elected. It covered the area today kno ...
for use as a park; the central part of the building was retained and became home to the
Imperial War Museum Imperial War Museums (IWM) is a British national museum organisation with branches at five locations in England, three of which are in London. Founded as the Imperial War Museum in 1917, the museum was intended to record the civil and military ...
in 1936. The hospital was absorbed into the
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
in 1948.


750th anniversary and "Reclaim Bedlam" campaign

In 1997 the hospital started planning celebrations of its 750th anniversary. The service user's perspective was not to be included, however, and members of the
psychiatric survivors movement The psychiatric survivors movement (more broadly consumer/survivor/ex-patient movement) is a diverse association of individuals who either currently access mental health services (known as consumers or service users), or who are survivors of interv ...
saw nothing to celebrate in either the original Bedlam or in the current practices of mental health professionals towards those in need of care. A campaign called "Reclaim Bedlam" was launched by
Pete Shaughnessy Peter Anthony Shaughnessy (14 September 1962 – 15 December 2002) was a British mental health activist and one of the founders of Mad Pride, a group of mental health activists who reclaimed terms such as "mad" and "nutter" from misuse, and c ...
, supported by hundreds of patients and ex-patients and widely reported in the media. A sit-in was held outside the earlier Bedlam site at the Imperial War Museum. The historian Roy Porter called the Bethlem Hospital "a symbol for man's inhumanity to man, for callousness and cruelty."


Recent developments

In 1997, the Bethlem Gallery was established to showcase the work of artists that have experienced mental distress. In 1999, Bethlem Royal Hospital became part of the
South London and Maudsley NHS Foundation Trust South London and Maudsley NHS Foundation Trust, also known as SLaM, is an NHS foundation trust based in London, England, which specialises in mental health. It comprises four psychiatric hospitals (Bethlem Royal Hospital, Lambeth Hospital and ...
("SLaM"), along with the
Maudsley Hospital The Maudsley Hospital is a British psychiatric hospital in south London. The Maudsley is the largest mental health training institution in the UK. It is part of South London and Maudsley NHS Foundation Trust, and works in partnership with the In ...
in
Camberwell Camberwell () is a district of South London, England, in the London Borough of Southwark, southeast of Charing Cross. Camberwell was first a village associated with the church of St Giles and a common of which Goose Green is a remnant. This e ...
, and the merger of mental health services in Lambeth and Lewisham took place. In 2001, SLaM sought planning permission for an expanded Medium Secure Unit and extensive works to improve security, much of which would be on Metropolitan Open Land. Local residents' groups organised mass meetings to oppose the application, with accusations that it was unfair that most patients could be from inner London areas and were, therefore, not locals and that drug use was rife in and around the hospital. Bromley Council refused the application, with
Croydon Council Croydon London Borough Council is the local authority for the London Borough of Croydon in Greater London, England. It is a London borough council, one of 32 in the United Kingdom capital of London. Croydon is divided into 28 wards, electing 70 co ...
also objecting. However the
Office of the Deputy Prime Minister An office is a space where an organization's employees perform administrative work in order to support and realize objects and goals of the organization. The word "office" may also denote a position within an organization with specific duti ...
overturned the decision in 2003 and development started. The 89-bed, £33.5m unit (River House) opened in February 2008. It is the most significant development on the site since the hospital opened in 1930.


Fatal restraints

Olaseni Lewis (known as Seni; aged 23) died in 2010 at Bethlem Royal Hospital after police subjected him to prolonged restraint of a type known to be dangerous. Neither police nor medical staff intervened when Lewis became unresponsive. At coroner's inquest, the jury found many failures by both police and medical staff which played a part in Lewis's death. They said "The excessive force, pain compliance techniques and multiple mechanical restraints were disproportionate and unreasonable. On the balance of probability, this contributed to the cause of death." Ajibola Lewis, Olaseni Lewis's mother, claimed a nurse at
Maudsley hospital The Maudsley Hospital is a British psychiatric hospital in south London. The Maudsley is the largest mental health training institution in the UK. It is part of South London and Maudsley NHS Foundation Trust, and works in partnership with the In ...
where Lewis had been earlier warned against allowing his transfer to Bethlem. "She said to me, 'Look, don't let him go to the Bethlem, don't let him go there'," his mother said. A doctor later persuaded her to take her son to Bethlem hospital. She was concerned about the conditions there. "It was a mess," she told the court, "It was very confused, a lot of activity, a lot of shouting. I was not happy; I was confused." Police were trained to view Lewis's behaviour as a medical emergency, but the jury found police failed to act on this. The jury found that "The police failed to follow their training, which requires them to place an unresponsive person into the recovery position and if necessary administer life support. On the balance of probability this also contributed to the cause of death." A doctor did not act when Lewis became unresponsive while his heart rate dramatically slowed. The
Independent Police Complaints Commission The Independent Police Complaints Commission (IPCC) was a non-departmental public body in England and Wales responsible for overseeing the system for handling complaints made against police forces in England and Wales. On 8 January 2018, th ...
first cleared officers over the death, but following pressure from the family, they scrapped the conclusions and started a new inquiry. The IPCC was planning disciplinary action against some of the police officers involved. Deborah Coles of the charity
Inquest An inquest is a judicial inquiry in common law jurisdictions, particularly one held to determine the cause of a person's death. Conducted by a judge, jury, or government official, an inquest may or may not require an autopsy carried out by a coro ...
, who has supported the Lewis family throughout their campaign, said the jury had reached the most damning possible conclusions on the actions of police and medics. "This was a most horrific death. Eleven police officers were involved in holding down a terrified young man until his complete collapse, legs and hands bound in limb restraints, while mental health staff stood by. Officers knew the dangers of this restraint but chose to go against clear, unequivocal training. Evidence heard at this inquest begs the question of how racial stereotyping informed Seni's brutal treatment." A disciplinary hearing conducted by the
Metropolitan Police The Metropolitan Police Service (MPS), formerly and still commonly known as the Metropolitan Police (and informally as the Met Police, the Met, Scotland Yard, or the Yard), is the territorial police force responsible for law enforcement and ...
found the officers had not committed misconduct. The hearing was criticised by the family because it was held behind closed doors with neither press nor public scrutiny. In 2014, Chris Brennan (aged 15) died of asphyxiation while at Bethlem hospital after repeated self-harming. The
coroner A coroner is a government or judicial official who is empowered to conduct or order an inquest into Manner of death, the manner or cause of death, and to investigate or confirm the identity of an unknown person who has been found dead within th ...
found lack of proper
risk assessment Broadly speaking, a risk assessment is the combined effort of: # identifying and analyzing potential (future) events that may negatively impact individuals, assets, and/or the environment (i.e. hazard analysis); and # making judgments "on the to ...
and lack of a care plan contributed to his death. The hospital claimed staffing problems and low morale were factors. Lessons were learned and the adolescent unit where Brennan died was assessed as good in 2016. In November 2017, a bill was debated in the
House of Commons The House of Commons is the name for the elected lower house of the bicameral parliaments of the United Kingdom and Canada. In both of these countries, the Commons holds much more legislative power than the nominally upper house of parliament. ...
that would require psychiatric hospitals to give more detailed information about how and when restraints are used. This bill is referred to as "Seni's law". In November 2018, the bill received Royal Assent as the Mental Health Units (Use of Force) Act 2018.


Facilities

The hospital includes specialist services such as the National Psychosis Unit. Other services include the Bethlem Adolescent Unit, which provides care and treatment for young people aged 12–18 from across the UK. The hospital has an
occupational therapy Occupational therapy (OT) is a global healthcare profession. It involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or ''occupations'', of individuals, groups, or communities. The field of ...
department, which has its own art gallery, the Bethlem Gallery, displaying work of current and former patients. The
Bethlem Museum of the Mind Bethlem Museum of the Mind is a museum focusing on the history of Bethlem Royal Hospital, its programme of care, and its patients. Opened in 2015, the museum is housed in an Art Deco building shared with the Bethlem Gallery, which hosts exhibiti ...
features exhibits about the history of Bethlem Royal Hospital and the history of mental healthcare and treatment. It features a permanent collection of art created by some of its patients, as well as changing exhibitions. Every Saturday morning, a
parkrun Parkrun (stylised as parkrun) is a collection of events for walkers, runners and volunteers that take place every Saturday morning at more than 2,000 locations in 23 countries across six continents. Junior Parkrun (stylised as junior parkrun) ...
is held in the grounds of Bethlem Royal Hospital.


Media

In 2013, the
South London and Maudsley NHS Foundation Trust South London and Maudsley NHS Foundation Trust, also known as SLaM, is an NHS foundation trust based in London, England, which specialises in mental health. It comprises four psychiatric hospitals (Bethlem Royal Hospital, Lambeth Hospital and ...
(SLaM) took part in a Channel 4 observational documentary, Bedlam. Staff and patients spent two years working with television company The Garden Productions. The four-part series started on 31 October. The first programme, ''Anxiety'', followed patients through the 18-bed Anxiety Disorders Residential Unit. This national unit treats the most anxious people in the country—the top one per cent—and claims a success rate of three in four patients. The next programme was called ''Crisis''; cameras were allowed in
Lambeth Hospital Lambeth Hospital is a mental health facility in Landor Road, South London. It was previously known as the "Landor Road hospital" and is now operated by the South London and Maudsley NHS Foundation Trust and is affiliated with King's College Lo ...
's Triage ward for the first time. In a postcode with the highest rates of psychosis in Europe, this is the Accident and Emergency of mental health, where patients are at their most unwell. The third programme, ''Psychosis'', films a community mental health team.
South London and Maudsley NHS Foundation Trust South London and Maudsley NHS Foundation Trust, also known as SLaM, is an NHS foundation trust based in London, England, which specialises in mental health. It comprises four psychiatric hospitals (Bethlem Royal Hospital, Lambeth Hospital and ...
provides support for more than 35,000 people with mental health problems. The final programme, ''Breakdown'', focuses on older adults, including the inpatient ward for people over 65 with mental health problems at
Maudsley Hospital The Maudsley Hospital is a British psychiatric hospital in south London. The Maudsley is the largest mental health training institution in the UK. It is part of South London and Maudsley NHS Foundation Trust, and works in partnership with the In ...
.


Notable patients

*
Richard Dadd Richard Dadd (1 August 1817 – 7 January 1886) was an English painter of the Victorian era, noted for his depictions of fairies and other supernatural subjects, Orientalism, Orientalist scenes, and enigmatic genre works, genre scenes, rendered w ...
– artist * John Frith – would-be assailant of King
George III George III (George William Frederick; 4 June 173829 January 1820) was King of Great Britain and of Ireland from 25 October 1760 until the union of the two kingdoms on 1 January 1801, after which he was King of the United Kingdom of Great Br ...
*
Mary Frith Mary Frith (c. 1584 – 26 July 1659), alias Moll (or Mal) Cutpurse, was an English notorious pickpocket and fence of the London underworld. Meaning of nicknames Moll, apart from being a nickname for Mary, was a common name in the 16t ...
– also known as "Moll Cutpurse" or "The Roaring Girl", released from Bedlam in 1644 according to Bridewell records * Daniel M'Naghten – catalyst for the creation of the M'Naghten Rules (criteria for the defence of insanity in the British legal system) after the
shooting Shooting is the act or process of discharging a projectile from a ranged weapon (such as a gun, bow, crossbow, slingshot, or blowpipe). Even the acts of launching flame, artillery, darts, harpoons, grenades, rockets, and guided missiles can ...
of Edward Drummond * Jonathan Martin – set fire to
York Minster The Cathedral and Metropolitical Church of Saint Peter in York, commonly known as York Minster, is the cathedral of York, North Yorkshire, England, and is one of the largest of its kind in Northern Europe. The minster is the seat of the Archbis ...
*
William Chester Minor William Chester Minor (also known as W. C. Minor; 22 June 1834 – 26 March 1920), was an American army surgeon, psychiatric-hospital patient, and lexicographical researcher. After serving in the Union Army during the American Civil War, Minor m ...
– surgeon who was committed for murder; best known for being one of the largest contributors to the ''
Oxford English Dictionary The ''Oxford English Dictionary'' (''OED'') is the first and foundational historical dictionary of the English language, published by Oxford University Press (OUP). It traces the historical development of the English language, providing a com ...
'' * James Hadfield – would-be assassin of King
George III George III (George William Frederick; 4 June 173829 January 1820) was King of Great Britain and of Ireland from 25 October 1760 until the union of the two kingdoms on 1 January 1801, after which he was King of the United Kingdom of Great Br ...
*
Margaret Nicholson Margaret Nicholson (c. 1750 – 14 May 1828) was an Englishwoman who assaulted King George III in 1786. Her futile and somewhat half-hearted attempt on the King's life became famous and was featured in one of Shelley's first works: '' Posthumo ...
– would-be assassin of King
George III George III (George William Frederick; 4 June 173829 January 1820) was King of Great Britain and of Ireland from 25 October 1760 until the union of the two kingdoms on 1 January 1801, after which he was King of the United Kingdom of Great Br ...
*
Edward Oxford Edward Oxford (18 April 1822 – 23 April 1900) was the first of seven people who tried to assassinate Queen Victoria. After Oxford was arrested and charged with treason, a jury found that Oxford was not guilty by reason of insanity and he ...
– tried for high treason after the attempted assassination of
Queen Victoria Victoria (Alexandrina Victoria; 24 May 1819 – 22 January 1901) was Queen of the United Kingdom of Great Britain and Ireland from 20 June 1837 until Death and state funeral of Queen Victoria, her death in 1901. Her reign of 63 years and 21 ...
and Prince Albert *
Augustus Welby Northmore Pugin Augustus Welby Northmore Pugin ( ; 1 March 181214 September 1852) was an English architect, designer, artist and critic with French and, ultimately, Swiss origins. He is principally remembered for his pioneering role in the Gothic Revival st ...
(1812–1852) – English architect, best known for his work on the Houses of Parliament as well as many churches; in the last year of his life he had a breakdown, possibly due to
hyperthyroidism Hyperthyroidism is the condition that occurs due to excessive production of thyroid hormones by the thyroid gland. Thyrotoxicosis is the condition that occurs due to excessive thyroid hormone of any cause and therefore includes hyperthyroidism ...
, and was for a short period confined in Bethlem *
Hannah Snell Hannah Snell (23 April 1723 – 8 February 1792) was a British woman who disguised herself as a man and became a soldier. Hannah Snell was mentioned in James Woodforde's diary entry of 21 May 1778 selling buttons, garters, and laces. Biograp ...
(1723–1792) – a woman cross-dressing as a male soldier; spent the last six months of her life in Bethlem * Bannister Truelock – conspirator who plotted to assassinate
George III George III (George William Frederick; 4 June 173829 January 1820) was King of Great Britain and of Ireland from 25 October 1760 until the union of the two kingdoms on 1 January 1801, after which he was King of the United Kingdom of Great Br ...
*
Louis Wain Louis William Wain (5 August 1860 – 4 July 1939) was an English artist best known for his drawings, which consistently featured anthropomorphized large-eyed cats and kittens. Later in life, he was confined to mental institutions and struggle ...
– artist


See also

* Abraham-men *
History of psychiatric institutions The lunatic asylum (or insane asylum) was an early precursor of the modern psychiatric hospital. The fall of the lunatic asylum and its eventual replacement by modern psychiatric hospitals explains the rise of organized, institutional psychiatry ...
* John Cutting (psychiatrist) *
Lists of hospitals These are links to lists of hospitals around the world. According to Cybermetrics Lab, they completed their rankings from over 16,500 hospitals worldwide in 2015. By continent *Lists of hospitals in Africa *Lists of hospitals in Asia *Lists of h ...
*
Tom o' Bedlam "Tom o' Bedlam" is the title of an anonymous poem in the "mad song" genre, written in the voice of a homeless " Bedlamite". The poem was probably composed at the beginning of the 17th century. In ''How to Read and Why'' Harold Bloom called it "the ...
, an anonymous poem c. 1600, about a Bedlamite. *
List of hospitals in England The following is a list of hospitals in England. For NHS trusts, see the list of NHS Trusts. East Midlands * Arnold Lodge, Leicestershire *Babington Hospital – Belper, Derbyshire *Bassetlaw District General Hospital – Worksop, Nottinghams ...
*
King's Health Partners King's Health Partners is an academic health science centre located in London, United Kingdom. It comprises King's College London, Guy's and St Thomas' NHS Foundation Trust, King's College Hospital NHS Foundation Trust and South London and Ma ...
*
Bethlem Museum of the Mind Bethlem Museum of the Mind is a museum focusing on the history of Bethlem Royal Hospital, its programme of care, and its patients. Opened in 2015, the museum is housed in an Art Deco building shared with the Bethlem Gallery, which hosts exhibiti ...


Notes


Footnotes


Sources

Primary sources * * * * Secondary sources :Books * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * :Journals articles and book chapters * * * * * * * * * * * * * * * * * * * * * * :Theses * :Newspapers and news agencies * * * :Webpages * * * * * *


External links

*
Bethlem Royal Hospital on the NHS website

Care Quality Commission inspection reports
*



{{authority control 1247 establishments in England 1330 establishments in England Buildings and structures completed in 1675 Hospital buildings completed in 1814 Hospital buildings completed in 1930 Buildings and structures in the London Borough of Bromley
Bethlehem Hospital Bethlem Royal Hospital, also known as St Mary Bethlehem, Bethlehem Hospital and Bedlam, is a psychiatric hospital in London. Its famous history has inspired several horror books, films and TV series, most notably ''Bedlam'', a 1946 film with Bo ...
Health in the London Borough of Croydon Hospitals established in the 14th century NHS hospitals in London Organisations based in London with royal patronage Psychiatric hospitals in England Social history of London History of the London Borough of Bromley