Views & Reviews Review of the Week

A giddy dance

BMJ 2008; 337 doi: (Published 24 October 2008) Cite this as: BMJ 2008;337:a2127
  1. Wendy Moore, journalist, London
  1. wendymoore{at}

    The history of Europe’s oldest psychiatric institution is a familiar tale of recurring neglect and reform, finds Wendy Moore

    Rambling through the centuries of Bethlem Hospital’s long history can have a dizzying effect. Rather than a steady, sedate march towards progress, the story of Europe’s oldest psychiatric institution is a giddy dance of scandals, investigations, and promised reforms in an ever repeating pattern, reminiscent of the history of mental health care as a whole.

    Founded in a fit of philanthropic fervour in London in 1247, Bethlem began treating mental illness in the 14th century. The first allegations of mistreatment were swift to follow. Stories of neglect, abuse, and corruption prompted a first royal commission in 1403, which led to parliamentary proposals for reform in 1411—setting in motion a cycle that would become wearily familiar down the years.

    As the horror stories continued, it was little wonder that by the 16th century the hospital’s nickname of “Bedlam” had become synonymous with chaos or that, from the 17th century, …

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