lunacy
lunacy. A term describing insanity, once considered to have been due to changes of the moon, now used legally and colloquially but not by clinicians. In the middle ages, the symptoms and behaviour of those with mental disorders or defects were often ascribed to demonology or witchcraft, and some sufferers were cared for by monastic orders: Bedlam hospital, first used for ‘distracted’ persons 1377, was attached to the priory of St Mary Bethlehem. Many were allowed their liberty if not dangerous, but increasingly they were deliberately segregated, often in company with vagabonds and malefactors, undergoing callous or barbarous treatment (ducking, whipping, chaining to the wall), and becoming a public spectacle for entertainment.
It was not until the latter half of the 18th cent. that a more enlightened approach was adopted (York Retreat, 1796) and the mid-19th cent. that an extensive programme of mental hospital construction was undertaken. Lord Shaftesbury, long interested in the problem and appointed a lunacy commissioner in 1828, secured passage of the Lunacy Act (1845) which distinguished through medical certification ‘persons of unsound mind’ from social rejects. Optimism about curability was misplaced despite the emerging science of psychiatry, and hospital crowding led to a lapse to custodianship again. Subsequent psychotherapeutic, physical, and pharmacological approaches, if sometimes controversial, have generally proved beneficial, but de-institutionalization of patients and their return to the community in the second half of the 20th cent. was not without problems. At law, lunacy is regarded as mental unsoundness that relieves a person of criminal responsibility for their conduct, but all legal tests for insanity put forward have attracted criticism, and many think the issue of responsibility less important than identification and treatment of the disturbed.
It was not until the latter half of the 18th cent. that a more enlightened approach was adopted (York Retreat, 1796) and the mid-19th cent. that an extensive programme of mental hospital construction was undertaken. Lord Shaftesbury, long interested in the problem and appointed a lunacy commissioner in 1828, secured passage of the Lunacy Act (1845) which distinguished through medical certification ‘persons of unsound mind’ from social rejects. Optimism about curability was misplaced despite the emerging science of psychiatry, and hospital crowding led to a lapse to custodianship again. Subsequent psychotherapeutic, physical, and pharmacological approaches, if sometimes controversial, have generally proved beneficial, but de-institutionalization of patients and their return to the community in the second half of the 20th cent. was not without problems. At law, lunacy is regarded as mental unsoundness that relieves a person of criminal responsibility for their conduct, but all legal tests for insanity put forward have attracted criticism, and many think the issue of responsibility less important than identification and treatment of the disturbed.
A. S. Hargreaves
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