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Review – Attending Madness in the Australian colonial asylum

Lee-Ann Monk, Attending Madness: at work in the Australian colonial asylum, Rudopi, 2008.

In Attending Madness (Rodopi, 2008), Lee-Ann Monk explores the lives and identities of asylum attendants working in Australia in the 1870s, placing their role within a larger international context as well as delving into the daily lives of attendants in Victoria. Monk’s book highlights an area of deficiency in this particular area of scholarship; the narrative about 19th century asylum attendants as simplistic, brutish people with limited qualifications has been widely accepted by students of this era. Attending Madness paints a very different picture, showing how their roles as professionals evolved within the shifting asylum movement of the late 19th century. Far from simply being precursors to psychiatric nurses, asylum attendants had a very specific place.

Popular perception of 19th century asylums often consists of holding facilities where people were stored away from society, for lack of a better place to put them. As Monk points out, a radical shift started to occur in the late 19th century, with a transition from asylums as facilities to lock up people with mental illness to more curative and therapeutic institutions. Monk unfortunately doesn’t devote very much analysis to exploring how and why people were classified with mental illness, as this is not the subject of her work –  her focus on attendants means that readers miss some important contextual discussions, like the use of institutionalisation to silence and isolate women who went against their families.

The shift in attitudes about the social role of asylums carried over into a change in attendant culture. Monk traces the early history of attendants as ‘keepers’ who primarily focused on controlling patients to true attendants responsible for the psychological well-being of their charges. She highlights the role of the anti-restraint movement and the change in asylum culture from a place where violence was an acceptable measure for managing patients to one where inquests could result in firings of violent and abusive attendants.

While life in the asylum was by no means enjoyable, the picture of the relationship between attendants and inmates she paints is more complex than the one commonly accepted. Some inmates also became attendants, for example, and they had a role as caregivers, not just controllers. This reflected a larger social desire to use asylums to provide inmates with support in the hopes of returning them to society, rather than simply as warehouses for unwanted human beings.

Of particular interest is Monk’s discussion of gendering among asylum attendants, especially in terms of masculinity. Both men and women worked as attendants, often as married couples, and the role of asylum attendant had complex gender implications. Attending Madness points to larger social tensions about the role of men in society and the balance between masters and servants, as asylum culture very much positioned attendants as servants to the head warden, rather than as independently skilled care providers. Many resisted this, rebelling against authority and considering themselves akin to artisans and craftspeople, not servants.

The tensions among male attendants as they navigated their masculinity within the framework of a relatively new occupation were reflected in the consistent wage disparities between men and women. Monk points out that women’s wages were deliberately kept low to avoid offending male attendants by suggesting that women were their equals, and that male attendants were afforded more respect for their work than women. She also illustrates the way that attitudes about masculinity intersected with behaviours among attendants; some relied on violence and confrontation, while others took a more humane approach, and asylums began to reward those who interacted with patients as human beings, rather than objects in need of control.  This process lead to a more nuanced perceptions of masculinity.

During this era, asylum attendants began shaping more concrete views of their work as an occupation that required skill and training. Monk’s highlights of job applications and letters of reference show a shift in how people thought about the work in terms of the kinds of traits they emphasized to show their suitability for the work. Applicants discussed things like their humane natures, and in some instances, prior knowledge of the patients, in the case of attendants who had previously worked in the gaol and wished to transfer to the asylum. Applications from former gaolkeepers are particularly fascinating, as they show how the applicants distinguished between their roles as guards and the work of asylum attendants.

Asylums of this era are often thought of as little more than prisons, but the reality was more complex. While patients didn’t enjoy freedom of movement and lived by a rigid schedule, the isolation of people with mental illnesses from the prison population, as well as people with physical illnesses and other disabilities, shows that the asylum had a specific purpose, and that reformers wanted to emphasize a therapeutic role for asylums, not just an isolating one.

Attending Madness provides a fascinating view into a dead occupation, and expands the scholarship on mental institutions during this particular period in history. While Monk’s book focuses on Australia, many of the reforms she discusses were taking place in other regions of the world, particularly England, the nation many Australian reformers looked to when developing proposals for improving the state of the nation’s asylums.

This is not a book that can be read in isolation; it must be placed within the larger context of the history of asylums and cultural attitudes about madness. Reading Attending Madness alone would provide a somewhat skewed view of the role of asylums in the society of this era, but it makes an excellent companion volume for those interested in exploring this topic more deeply.