A "work in progress" presentation relating to the Baillie Henderson Hospital from 1890 to the present day in the context of understanding of mental illness, its historical origins and social factors surrounding it.

1. RESTRAINT TO RECOVERY – ASYLUM TO ACCEPTANCE
FROM
WILLOWBURN LUNATIC
ASYLUM
TO
BAILLIE HENDERSON
HOSPITAL
1890 – 2010
Prepared by Roger Hawcroft – May 2012

2. First records of the notion of ‘lunacy’.
 The notion of lunacy (mental disease or illness) seems to have
first surfaced in about the 12th Century
 The Catholic Encyclopaedia gives a date of around 1100 for “an
asylum exclusively for sufferers from mental diseases at Mets”
(Metz, Northern France)
 King Henry II established Newgate Prison in 1188 into which
both criminals and ‘lunatics’ were incarcerated

3. Notions of lunacy - continued
 1284 – Al-Mansuri Hospital opened in Cairo and had music
therapy for its mental patients.
 1292 – “A lunatic who had burned a man’s house down was
convicted by the justice but released on their authority.”
 1295 – A legal case linked “the instigation of the devil” and being
“frantic” and “mad”.

4. 14th Century – Establishment of asylums
 1310 – A German ‘madhouse’ is mentioned at Elbing, near
Danzig.
 1377 – St Mary of Bethlehem priory was confiscated by King
Edward III and used for lunatics from 1377.
 1405 – A Royal Commission investigates the state of lunatics
confined at Bethlem Hospital, London.

5. Spain – ‘the cradle of humane psychiatry’
 1409 – Spain – Asylums at Valencia, Sargossa, Seville,
Valladolid, Palma Mallorca, Toledo and Granada. These
institutions removed chains and used games, occupation,
entertainment, diet and hygiene to treat inmates
– As a result, Spain has been described as the cradle of humane
psychiatry.

6. 16th Century – ‘psychiatric revolution’
 Several writers refer to the Sixteenth Century as a time of
“the first psychiatric revolution”
- The reasoning behind this seems to be based on the
work of several 16th Century writers who offered a natural
alternative to ideas of demonic possession.
 1567 – Paracelsus published a small book whose title in
English translation is “Diseases which lead to a loss of
reason”. The introduction makes it clear that these are
not caused by spirits but are natural diseases.

7. Bedlam
 1559 – Bedlam is shown on the earliest surviving map of
London – a copper plate engraving of Moorfields,
discovered in 1962 and now in the London Museum.
- The map was probably drawn in 1558 by the Dutch artist
Anthonis van den Wyngaerrde and engraved by
Franciscus Hogenberg in 1559
- 1592 – An account of a trial for conspiracy to kill the King
contains discussion and definitions of terms applying to
the various ‘degrees’ of insanity, such as ‘furor’, ‘delirium’
and ‘dementia’.

8. 17th Century - Incarceration
 Michael Foucault suggests that the ‘magnificent developments
of psychiatry’ made in the 16th Century were largely replaced in
the 17th Century by absolutist governments that resolved social
crisis by incarcerating the poor.
 1598 & 1601 – The Elizabethan ‘Poor Law’ Act required every
parish to appoint overseers of the poor and set up work-houses
for those who could not support themselves

9. Life in the 17th Century Asylum
 1628 - Robert Burton’s: The Anatomy of melancholy. What is its,,
with all the kinds, causes, symptoms and prognostics and
several cures of it .. Philosophically, Medicinally, Historically
opened and cut up. was published.
 The book contained a ten picture engraving which was explained
in a verse in the 1632 edition. The verse for the engraving of the
maniac is:

10. Robert Burton’s “The maniac”
But see the Madman range downright
With furious looks, a ghastly sight
Naked In chains bound doth he lie,
And roars amain, he knows not why.
Observe him; for as in a glass,
Thine angry portraiture it was.
His picture keep still in thy presence;
‘Twixt him and thee, there’s no difference.

11. Religion and lunacy
 1611 – The Authorised (King James) Version of the Bible had
been published.
 The Bible was a major source and influence on ideas of just
about everything in the 17th Century. On the basis of the Bible it
was possible to calculate that something spectacular was likely
to happen in the 1650’s, eg. It was could be calculated that the
great flood took place 1656 years after creation – so 1656 years
after the birth of Christ might be equally significant. Creation
was then put at 4004 and the flood in 2349. 4004-2349 =1656

12. Religion and lunacy - continued
 The execution of the English king in 1649 was therefore woven
into speculation that Christ was due to return and establish his
kingdom.
 This sort of thinking was behind the rapture of the Quakers and
the armed uprising (to bring about his kingdom) of the 5th
Monarchy Men in 1661
 In October 1656, James Nayler (a Quaker) entered Bristol on a
donkey claiming to be Jesus Christ. He was imprisoned until
1659.
 Such conflict as this was to continue for around a century.

13. Pay to view insanity
 1665 – The Great Plague caused more than 1000 Londoners a
week to die and it also reached many provincial towns.
 1666 – The Great Fire of London raged for 5 days.
 1676 – After the Great Fire, a new Bethlem Hospital was built
and opened in Moorfields. In 1705 it held 130 patients. – The
new Bethlem was built as a place of display and tourists could
pay to see the humans who were incarcerated in the place, often
naked and in distress.

14. Late 17th Century
 The earliest records of private madhouses in England stem from
1670.
 1679 – Habeas Corpus Act was passed
 1696 – Bristol Poor Act established a workhouse for 100 boys.
The addition of “infants, the aged, infirm, and lunatics” around
1700, changed its character and it became St Peter’s Hospital.
In the 18th Century ir had lunatic wards, in the 19th it became an
asylum

15. 18th Century – Psychiatry as Science
 It is argued that psychiatry became an independent science in
the 18th Century – not because of developments in medicine but
rather due to the philosophy of enlightenment which existed at
the time.
 Reason was seen as the highest good for philosophers and so
“possession of evil spirits” was regarded as superstition and it
and the connection with religion was replaced by the argument
that the mentally ill had “lost their reason”.

16. 18th Century - Asylums
 The first asylums were small and run privately. The best known
and largest was Bedlam (Bethlem) in London. It had 130
patients in 1704
 1714 – Vagrancy Act is thought to hae been the first English
statute to specifically provide for the detention of lunatics
 1723 – Guys Hospital opened lunatic wards
 Charitable asylums were opened in the 18th Century in 8 English
towns.

17. Regulation
 1744 – Vagrancy Act – Several naval hospitals were built,
including those at Gosport (Haslar), Plymouth and Chatham.
Haslar became the main lunatic asylum for the navy.
 1774 Madhouse Act – based on a recommendation that, “the
present state of private madhouses in this kingdom requires the
interposition of the legislature.
 After 1774, private madhouses had to have a licence and
inspection was introduced

18. 18th to 19th Century Influences
 1777 – York Asylum opened
 1789 – The French Revolution – Resulted in inmates of
madhouses being examined and either set at liberty or “cared for
in hospitals indicated for that purpose”.
 By 1800 there were around 40 private madhouses in England.

19. 19th Century
 1800 – Criminal Lunatics Act – aimed at the safe custody of
criminal lunatics, especially any that had threatened the king
 1808 – County Asylums Act – this was triggered by fear
generated by the long term detention of lunatics after the 1800
Act following John Hadfield’s attempt to shoot George III
 1847 - John Connolly published: The Construction and
Government of Lunatic Asylums which was to become a
standard for asylum building in the 19th Century

20. The British Colonial Influence
 In Britain in 1888 asylums became the responsibility of County
and County Borough Councils and many improvements resulted
 The British 1890 Lunacy Act was a major consolidating Act that
remained the core of English and Welsh Lunacy Legislation until
it was repealed by the 1959 Mental Health Act
 With emigration of doctors and humanitarians from Britain, new
ideas, attitudes and manner of treatment were brought to
Australia

21. 1890
 Social Climate – At the end of the 19th Century the failure of
asylum therapy had convinced people that insanity was largely
(though not entirely) incurable.
 In the 19th Century nearly 10% of patients died within 3 months
of admission from advanced symptoms of cerebral disease
causing mental symptoms initially.
 By the end of the 19th Century there were 74000 people in public
asylums in England

22. Baillie Henderson Highlight Events
 1887 - James Renwick began construction of the ‘Lunatic
Asylum’. The contract price was £28,775.
 1890 - First patients arrived from Woogaroo to what was then
the Willowburn Lunatic Asylum – 10 women on 17 May 1890
 1902 - 4 Wards in operation
 1909 - Golf course built after Home Secretary gives permission

23. 1910 – 1940 Major Expansion
 1910 - Compulsory nurse training introduced
 1910 – 1920 - Expansion with building of Ray House Ward 1;
Jofre House Ward A; Rush House Ward B; New pump house;
Tredgold; James House; Hill House; and various residences
 1930 - Nurses quarters built
 1932 – 1944 - Various residences and boiler house built

24. 1948 - 1968
 1948 - Sewing room (Bootmaker’s workshop) built
 1949 - 8 hour working day introduced
 1950 - Patient numbers reach 1400
 1953 – Name changed to Toowoomba Mental Hospital
 1961 - Gowrie Hall complex built
 1966 -1968 - Laundry built

25. Name change – Baillie Henderson Hospital
 1968 (August 27th) - Hospital renamed as Baillie Henderson
Hospital
 1968 – 1970 - Canteen built
 1970 - Rockville Training Centre transferred to Baillie Henderson
 1972 - Nursing administration cafeteria built
 1973 - Outpatient clinic established at Toowoomba Base
Hospital

26. De-institutionalisation Beginnings
 1974 - Digby, Connolly & Tuke built
 1976 - Rockville Training Centre closed
 1980 - Outreach community psychiatric services began
 1982 - Whishaw Day Centre commenced
 1984 - Recreation complex built

27. From Institution to Community
 1986 - Medical orientated outpatients clinic for dischargees
opened at Gowrie Hall
 1992 - Ridley opened and patients transferred there from Gowrie
 1993 - Final intake into 3 year psychiatric nursing course
 1996 - 38 hour week introduced

28. Integration Beginnings
 1999 - Browne House closed
 2000 - Baillie Henderson Hospital & Toowoomba Base Hospital
become part of Toowoomba Health Service District
Laundry refurbished to cater for district
District achieves Accreditation
Cafeteria closed
 2001 - AMHU opens at Toowoomba Base – Hill house residents
moved there

29. Decade of Restructuring
 2007 - Mental Health Review by Gerry Fitzgerald
 2008 - Toowoomba and Ipswich Health Service Districts
amalgamated to become Darling Downs – West Moreton Health
Service District
 2010 - De-amalgamation – Darling Downs Health Service
District formed including Toowoomba & Baillie Henderson
Hospitals
 2011 - Government announces demise of Queensland Health &
establishment of Local Health Networks from July 2012

30. The Superintendents
1888 – 1898 : DR JAMES BALLANTYNE HOGG
1898 – 1928 : DR JAMES NICHOLL
1928 – 1945 : DR JAMES MCDONALD
1946 – 1949 : DR CLIVE BOYCE
1950 – 1968 : DR JOHN BAILLIE HENDERSON
1969 – 1976 : DR MICHAEL DE GROOT
1977 – 1984 : DR JOAN RIDLEY
1986 – 2006: DR JEFFERY THOMPSON

31. DR James Ballantyne Hogg
 1888 - 1898 (Recalled to Goodna)
First Medical Superintendent of
what was then Willowburn
Lunatic Asylum.
Dr Hogg emigrated from
Edinburgh. He was well
educated and a sympathetic
custodial carer. He was one of
the earliest doctors in Australia to
insist on disinfectant for treating
wounds during operations.

32. Dr James Nicholl
 1898 - 1928
Dr Nicholl’s focus was on
discipline, safety & cleanliness,
and the provision of available
treatments.
He introduced recreation
activities including football,
cricket, tennis, dances & visits by
musicians.
He also purchased more land
around the hospital and lowered
some of the high fences

33. Dr James McDonald
 1928 - 1945
Dr McDonald took over in a time of
increasing knowledge about
schizophrenia and research into
medication for mental conditions.
During his term of office, new
terms were introduced, such as
“mentally sick” rather than “lunatic”
and “mental hospital” rather than
“lunatic asylum”.
At this time the hospital was a
working farm.

34. Dr Clive Boyce
 1946 - 1950
Dr Boyce had an enlightened
attitude to treatment – referred
to as his ‘open-house’ concept.
He insisted that patients be
treated humanely, even during
episodes of violence.
The model of care at this time
was still based on activity and
custodial care.

35. Dr John Baillie Henderson
 1950 - 1968
When Dr Henderson took over there
were 1400 patients, both adults and
children.
Dr Henderson aimed to make life
easier for patients and introduced
new treatments, increased the
numbers of staff and improved
working conditions. He also
appointed the first psychologist, in
1951 an Occupational Therapist in
1957 and a social worker in 1966.

36. Dr Michael de Groot
 1969 – 1976
Dr Groot instigated the integration
of the male and female sides of the
hospital.
He placed great emphasis on staff
training, appointed 3 nurse
educators, broadened the
curriculum & upgraded the library.
In 1976 there were 770 patients
remaining in the hospital

37. Dr Joan Ridley
 1977 - 1984 Dr Ridley brought a new emphasis on
deinstitutionalisation and the development
of community services.
She established the first Community Liaison
Nursing Service, the forerunner of today’s
Community Mental Health Teams. She
was an advocate for staff development and
education and had a focus on social skill
programs for patients.
Dr Ridley saw the hospital as just one
component of an integrated mental health
service

38. Dr Jeffery Thompson
 1986 - 1996 Dr Thompson had been Dr Ridley’s
assistant and continued her work by
further developing rehabilitation and
community services.
Notably, Dr Thompson reorganised the
structure of the hospital to focus on 5
extended care patient groups, put simply:
•Elderly demented & disturbed
•Mentally retarded
•Brain damaged
•Psychotic & assaultative
•Chronically schizophrenic

39. The Administrative Era
The new millennium brought about an increasing shift from
local to centralised control and the era of administration as
opposed to clinically orientated decision making.
The era has been one of constant changes at executive level
and much instability. An unfortunate consequence of this
has been a lessening of the links between the hospital and
the local community.
At the same time, this period has seen a rapid acceleration
in the need for mental health services, ever increasing
costs, and some considerable uncertainty about the future.

40. 2010 and Beyond
 In 2011 the State Government announced that it would split
up Queensland Health and establish local Hospital and
Heath Networks.
 These networks will, once again, put more control in the
hands of local communities through the establishment of
local Boards to oversee hospital management.
 There will still be centralised support and supervision but
more decision-making will rest at the local level.

41. The Museum
For the centenary celebrations of 1990, a museum was
established in one of the original buildings of the hospital.
Unfortunately, since that time there has been little attention
given to either the building (which is now in an extremely
poor state of repair) or to the artefacts held within it.
In 2010 attempts were started to revitalise the museum with
a hope that much can be preserved and eventually used for
public display once more. This work is ongoing.

42. Confinement & Containment
 In the early days, psychiatry was in its infancy – Freud was
postulating about dreams (1900) and psychology didn’t
exist.
 There were no medications as we know them today and
little understanding of the range of mental illnesses, their
symptoms and manifestations
 Treatment was about confinement, work, and discipline

43. Sterility of the pre-medical era
Women’s admission ward

44. Window Treatments
Windows were generally
barred on the outside and
provided virtually the only
ventilation in the wards.
However, the high-ceiling
design of the wards was
specifically intended to create
a minimum area of air space
for each patient.

45. Straitjacket
In the early years there were
not the medications that we
have today.
In many cases, physical
controls were the only resort of
the carers where patients were
violent and intent on harming
themselves or others.

46. Hand Muffs

47. Peaceful sleep?

48. Dr Whishaw’s demise
Fire nozzle
On 7th December 1908 Dr.
Reginald Robert Whishaw
was hit over the head with a
fire nozzle wielded by one of
the patients. Dr Whishaw
died the following day of a
fractured skull

49. Self sufficiency – work as therapy
For many years the clothes
used in the hospital were made
by patients.
Shoes and other items were
also made within the hospital.
As activity was the main
therapy, patients were put to
work – women mainly in sewing
and men in the fields.
For two years the sale of
produce actually covered the
cost of running the hospital!

50. Commode Room
A small room – one on each
floor of the building – was
the only internal toilet
facility available to patients.

51. The ‘Facilities’

52. Shower Stalls

53. Dinner is served!

54. Recipe Book

55. Nurse Registration

56. Nurse in uniform

57. Nurse’s bedroom

58. Female ward dining room 1913

59. Early wheel-chairs

60. Medicine bottles

61. General view of hospital - 1915

62. Steinway Grand Piano

63. Don Featherstone – Resident Artist

64. Art as therapy

65. Communion Table
Religion was a
significant element
for many patients
who often saw their
conditions as some
sort of punishment
for wrong doing

66. Bread slicer and butterer

67. Dentistry

68. Ground Floor

69. First Floor Ward

70. Gardening par excellence
Many trophies were
won by the hospital for
its gardens.
The hospital floats took
out several first prizes
in the annual Carnival
of the Flowers in
Toowoomba

71. The Museum Building Today

72. THANK YOU!
THANK YOU FOR YOUR ATTENDANCE
Roger Hawcroft
Manager, Clinical Library Services
Darling Downs Health Service District
roger_hawcroft@health.qld.gov.au