Categories of Patients

Pauper Lunatics maintained at the expense of Poor Law Unions (Guardians’ Committees from 1930). In some cases, the patient had been an inmate at a workhouse, whether briefly or long-term, before being transferred to the asylum. The Reception Order for admission of a pauper lunatic had to be signed by a Justice of the Peace, and was accompanied by a Medical Certificate signed by a medical practitioner. This category of patient disappeared with the creation of the National Health Service in 1948.

Private Patients or Boarders (Voluntary Boarders from 1890), paying for their upkeep, could be found in institutions such as the Lawn, which were not pauper asylums. The Lunacy Act, 1890, allowed County asylums to build wards for private patients. This category became Informal Patients in 1959. In contrast to other categories of patients, these were not certified or otherwise compulsorily detained.

Criminal Lunatics was a classification, first introduced by the Criminal Lunatics Act 1800, which enabled prisoners with mental health problems to be detained indefinitely in asylums rather than prisons. Many fell under the remit of the Home Office.

Service Patients. This category, publicly funded, but treated as private patients, was introduced in 1916 at the height of the Great War, to deal with the large number of military personnel with mental health issues caused by the stress of combat, including “Shell Shock”.

As well as the mentally ill, the asylums used to house patients with mental disabilities. The Mental Deficiency Act, 1913, divided these patients into four categories: Idiots, Imbeciles, Feeble-minded People and Moral Defectives. In the 20th Century their distinct needs began to be recognised, and another set of institutions was created in the county, including Caistor Hospital (1931), Harmston Hall Hospital (1935), and St Peter’s Hospital in Bourne (1930) and Holbeach Hospital. These were later replaced by more community based services.