Where were people with mental health problems cared for in Oxfordshire before 1850?
The first place in England dedicated to the care of ‘lunatics’ was the Bethlem Hospital in London, popularly known as Bedlam, which was founded in 1247. Until the early seventeenth century most people who were regarded as mad, and who were not cared for at home or within their local community, were confined in prisons, or housed in parish workhouses. From the early seventeenth century a number of different types of place for their care then developed. Examples of all of them are to be found in Oxfordshire today.
Private for-profit establishments for the care of lunatics, known as ‘madhouses’, grew in number, responding to demand without any regulation or planning, with most offering different levels of care at different prices. Around 1730 a madhouse was opened at Hook Norton by Sarah Minchin. Successive members of her family continued to be proprietors until it was sold and then closed in 1854. In 1823 a madhouse was opened in Witney by Edward Batt, with further generations of his family running the house until it too closed in 1857. Conditions in madhouses varied enormously. While some houses offered a good standard of care, conditions in some were scandalous.
By the mid-eighteenth century the new prosperity of England led to an era of civic philanthropy. Charitable general infirmaries were established in larger and wealthier cities and towns, and from the 1750s a number of charitable asylums were founded, all of which had their origins in a local infirmary, including the Warneford. From 1812 some governors (all fellows of Oxford Colleges) of the Radcliffe Infirmary, which had opened in 1770, began to plan an asylum. The Radcliffe Asylum opened for patients in 1826, originally with 40 beds, treating mostly private and charity patients, as well as some poorer people (paupers). The Revd. Samuel Warneford made substantial donations to the Asylum, so it was re-named in his honour in 1843, and continues today as the Warneford Hospital.
The Radcliffe Asylum opened for patients in 1826… and continues today as the Warneford Hospital.
By the beginning of the nineteenth century, the combined effects of the industrial revolution and population growth had led to the growth of some urban parishes to tens of thousands, while in small rural parishes, penny-pinching, corruption and inefficiency together led to appalling scandals in parish workhouses. This problem was addressed by the Poor Law Amendment Act of 1834, one of the most significant pieces of British social legislation. It created Poor Law Unions made up from a number of parishes, each Union being required to build a workhouse. Eight Poor Law Unions were created in Oxfordshire market towns, with the Union for the City of Oxford (which had a population of 20,000 in 1831) being the largest.
Paupers who were considered to be lunatics or ‘idiots’ by the Union relieving officers (an early form of social worker) and medical officers and who could not be managed in their homes, were usually sent first to the workhouse. Those who were not dangerous might then remain in the workhouse, so the workhouses were both a major route of access to the asylum, and also contained significant numbers of non-dangerous lunatics.
Nationally levels of provision for mentally disturbed people were inadequate, even though an Act of Parliament in 1808 permitted (but did not require) county and borough authorities to build a lunatic asylum. But these public asylums grew in number only slowly after that Act, so in 1845 the Lunatic Asylums Act required the erection and maintenance of an asylum by all counties and boroughs within five years.
In 1840 J W Henley, the MP for Oxfordshire for 37 years, made a proposal for an asylum for pauper lunatics in Oxfordshire. A site at Littlemore was purchased, and the first inmates were admitted – all from Hook Norton madhouse – to the new Oxfordshire County Asylum in 1846. Initially, the Oxfordshire County Asylum accepted patients from Berkshire, but in 1870 Berkshire created its own facility at Moulsford, which was later known as the Fairmile Hospital.
The Oxfordshire County Asylum opened in 1846… its first inmates all transferred from Hook Norton madhouse.
Early on, individuals could move between institutions, such as Thomas Mallings who was admitted in 1847 to Hook Norton Asylum, having previously been in an asylum in London and in the Warneford Asylum. But by the late 1840s, with the county and borough public asylums growing remorselessly in both number and size, the system was less flexible. It is the public asylums which are remembered most in popular memory, as grim places of containment, and which provided the great majority of mental hospital places until the 1960s, but they were part of a shifting network of institutions, of varying size and standards of care.
Professor John Hall, March 2026
