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“With Tact, Intelligence and a Special Acquaintance with the Insane”

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“With Tact, Intelligence and a Special Acquaintance with the Insane” “With tact, intelligence and a special acquaintance with the insane” A history of the development of mental health care (nursing) in New South Wales, Australia, Colonisation to Federation, 1788 – 1901 Terrence Gordon Smith Doctor of Philosophy School of Nursing, Family and Community Health, College of Social and Health Sciences. UNIVERSITY OF WESTERN SYDNEY 2005 Candidate’s Declaration I certify that this thesis has not already been submitted for any degree and is not being submitted as part of candidature for any other degree. I also certify that this thesis has been written by me and any help received in preparing this thesis, and all sources used, have been acknowledged. …………………………………………. …………………………………………. Pro matre mea Una E. Smith R.N. 1937 – 1996. When, in November 1976, I told my mother I had been accepted into the mental health nurse training course at the then Parramatta Psychiatric Centre (Cumberland Hospital), I did not anticipate her reaction. “Why the hell for? – you should have spoken to me first!” I then discovered something about my mother I had not known before; she had commenced nurse training at the same institution (then the Parramatta Mental Hospital) in the early 1950s, about five years before I was born. She told me she had left before completing her training to join the army, because it was such a bad job having to look after “mad people.” She related stories of the strict discipline of the senior sisters and matron and how she and her fellow nurses would find ways to circumvent the rules – especially those concerning curfews imposed on junior nurses. Whilst Mum had memories of some good times on the wards, she also told some horror stories concerning the behaviour of patients. She predicted that I would not last a month in the job. To her surprise I stayed and, over the next three years of training, I was able to tell her that the work was not nearly as bad as she had told me. So much seemed to have changed and although there were similarities, it was quite different to the stories she had told me. During my second year of working as a registered nurse, to my surprise, Mum announced that she wanted a change in her life and intended to undertake the nurse training course. However, she did not possess the minimum educational requirements for admission to the course. Not to be thwarted, Mum undertook a College of Technical and Further Education certificate course in first line management, to prove that she was capable of further study, and passed with flying colours. Mum was accepted into nursing and undertook the very last full three year hospital course being offered at Cumberland Hospital (before basic nurse education moved to higher education institutions) and she became a registered nurse in 1986. On becoming a nurse, Mum really did experience the change in her life that she had wanted. After nearly 25 years of being a working mother and raising three children (all of whom began careers of their own), she suddenly had a professional and social life which she relished and enjoyed to the full. There are still many mutual colleagues, who remember Mum with much affection. Whilst I moved onward and upward, obtaining a series of clinical qualifications and promotions which evoked from Mum, genuine pride, she was content to remain and enjoy being, a registered nurse clinician (for which I could not have been prouder and something I have returned to since). Sadly, less than two years from her anticipated retirement, Mum was diagnosed with a terminal illness, which she bore with a dignity that I still think back on with amazement. During the final three months of her life, I spent as much time as possible with her. During this period Mum related much about her life that I would not have ever known otherwise. I recall that one conversation concerned her initial horror at the thought that I intended to become a mental health nurse, and the irony of Mum following me back into the profession. Just hours before she died, Mum told me that she had hoped to see me commence doctoral studies and, should the opportunity arise, I should undertake it. Mum, this is for you. Acknowledgements. This work would never have been possible without the patience, support and tolerance of family, friends and colleagues. Special thanks go to my (very tolerant) friends, Marion Johnson, Catherine Quince, Bob Walsh, Ron McClelland, Raylene West and Enid Chalker. Also friend and at times helper, Olga Tatrai of the Parramatta Historical Society. In particular I wish to mention Jacqui Ristau and Sandra Dayao of Cumberland Hospital’s Library – both of whom helped me to track down articles and books regarding the history of mental health care and treatment and articles from 19th and early 20th century journals. The staff of the Mitchell Library Sydney and Archives Authority of New South Wales also deserves a special mention for their efforts in locating primary sources. Professor Colin Holmes is especially thanked, for encouraging me to commence the work and for supervising its early stages and, Associate Professor Carol Liston who also provided early supervision and later advice and encouragement. Special thanks to Dr Sarah Mott who graciously agreed to act as my Associate Supervisor at an extremely late stage of the work. Extra special thanks is offered to my Principal Supervisor, Dr Rene Geanellos, whose patience, support and practical help went well beyond what one might have reasonably expected. When serious health problems left me wondering if I should continue, Rene also became “therapist” and it is no exaggeration to say that without her kindness and encouragement, this work would never have been produced. Last but never least, to my partner Michael Cleary, whose endless love, care and concern – often in the face of extreme self-absorption and at times irritability on my part, can never be repaid; I offer my deepest love and gratitude. Table of Contents Page List of Abbreviations. v Abstract. vi Chapter 1. Introduction. 1 1.1 The origins of the need and purpose for this work 1 1.2 Limiting the scope of the project 4 1.3 The geographical limits of the project 5 1.4 Aim of the work 6 1.5 Review of the literature 7 1.5.1 Brief prelude to modern mental health nursing 7 1.5.2 Advent of modern mental health nursing 18 1.5.3 History of mental health care and nursing in New South 29 Wales 1.6 History – what it is and what it is not 34 1.7 Discussion of the position informing this work 37 1.8 Accessing the sources 42 1.9 A brief overview of the work and thesis 43 1.10 Overview of chapters 45 1.11 A note on nomenclature 49 Chapter 2. The convict era. 50 2.1 The establishment of the penal colony of New South Wales 50 2.2 Governor Phillip’s responsibilities towards the mentally ill 52 2.3 Incidence of mental illness in the new colony 56 2.4 Australia’s first lunatic asylum at Castle Hill 70 2.5 The Liverpool Asylum 82 2.6 The life of lunatics not admitted to the asylum 87 2.7 Lunacy and the benevolent asylums 94 i Chapter 3. The advent of Joseph and Susannah Digby. 98 3.1 The establishment of Tarban Creek Asylum 98 3.2 Expertise from abroad – the appointment of the Digbys 99 3.3 Possible reasons for Bourke’s request for well qualified 101 mental health carers of the insane from England 3.4 Background of the Digbys’ tradition of care 106 3.5 The Digbys’ appointment publicly attacked 113 3.6 The Digbys take up their appointment 116 3.7 Staffing difficulties at the Tarban Creek Asylum 118 3.8 The duties of the keepers 122 3.9 Procedures for admission to the lunatic asylum 126 3.10 The ‘Cabbage Tree Mob’ fiasco 128 3.11 Aftermath - the colony’s first Lunacy Act 131 3.12 Overcrowding - the Governor’s improvised solution 135 Chapter 4. The genesis of medical ascendancy over mental 138 health care in New South Wales. 4.1 The malice of ΙΑΤΡΟΣ. 138 4.2 The Select Committee on the Lunatic Asylum Tarban Creek 150 1846 4.3 The Select Committee’s recommendations 171 4.4 Sequela of the Select Committee’s report 175 4.5 Further trouble for the Digbys 179 4.6 The medical profession’s coup d’état 181 4.7 Dr Francis Campbell takes control 182 4.8 Regulations for the Guidance of Attendants, 1848 184 4.9 The events leading to Joseph Digby’s dismissal 189 4.10 A short postscript 195 ii Chapter 5. The more things change – the more they stay the 196 same: 1850-1868. 5.1 The establishment of the Parramatta Lunatic Asylum 196 5.2 Paradise lost – the Tarban Creek Asylum 203 5.3 The Commission of Enquiry Report of 1855 207 5.4 Staff loyalty to the medical superintendent 215 5.5 A labour crisis: all that glitters ... 216 5.6 Yet another Inquiry: The Select Committee on Lunatic 225 Asylums, 1863 – 64 5.7 Restraint verses non-restraint in New South Wales asylums 231 5.8 The end of the old guard superintendents 237 Chapter 6. Though this be madness, yet there be method in it. 243 6.1 Enter Dr Frederic Norton Manning 243 6.2 Manning’s report on lunatic asylums 245 6.3 Recommendations concerning attendants of the insane 247 6.4 Dr Manning’s ten year medical superintendency of Tarban 250 Creek Asylum 6.5 Sex, lies and murder - The Select Committee Inquiry into 255 Parramatta Lunatic Asylum 1876 6.6 A system corrupt – the allegations against the asylum 258 officials 6.7 In the wake of the Select Committee Inquiry 263 6.8 The attendants’ culture of silence 265 6.9 The problem of government administration of lunacy in the 269 late 19th century 6.10 The appointment of an Inspector General of the Insane; the 271 first step in developing a comprehensive mental health service 6.11 Regulation of nursing services for the insane 274 6.12 The Moral Treatment of patients in the work of attendants 283 and nurses 6.13 The science of insanity in late 19th century New South 286 Wales iii Chapter 7.
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