‘Brain Fever’: Middlewood Hospital and 19th-Century Mental Disability

Updated 15 February 2022

By Lauren Chaloner

Located in the north-western suburb of Sheffield between Middlewood and Wadsley, Middlewood Hospital is a former psychiatric hospital first opened in 1872. Although visitors to the site today would be met with rows of modern family homes, in the early nineteenth century this was quite a different story. The hospital is unique in not only demonstrating its capacity to house patients displaying mental disabilities, but also its later transformation into a physical hospital for wounded soldiers during the First World War.

In 1866, the only other psychiatric hospital was to be found at the West Riding County Asylum in Wakefield. However, having only 1,130 beds available to serve the patients of South Yorkshire, they were suffering with significant overcrowding. With the help of Lord Wharncliffe, the Wharncliffe Estate was identified by surveyors as an appropriate site to build a secondary hospital to support West Riding County Asylum.

The design of the building included kitchens, a communal recreation hall, blocks to be occupied by ‘inmates’ and an administrative section comprised of small offices. The main sections of the hospital were divided into male and female wings, each bearing distinctive gothic-style architecture. Despite being completed three years after it first opened in 1875 at a cost of £6,000, the expansion of the hospital continued through to the twentieth century. 

Looking at the Sheffield Archives, the diversity of the patients and their mental illness is apparent. For example, a 34-year-old housewife’s ‘cause of insanity’ was religion, whilst a 43-year-old male colliery labourer was incarcerated based on his ‘excitement over the election’. The diversity and often unusual reasons for ‘lunacy’ underpins the nineteenth century’s lack of understanding towards mental illness.

The appearance of ‘strokes’, ‘love’, ‘pregnancy’ and ‘grief’ were also being listed as reasons for ‘insanity’ and this demonstrates the absence of treatment for contemporary mental health issues such as postpartum depression. The illnesses that contemporary society treats today were commonly associated in the nineteenth century with ‘madness’.

As J. Lovely has noted, it was not uncommon to witness physical restraint, and in many cases the patients were simply left ‘comfortable’ by being fed and kept warm instead of treated. This was particularly demonstrated in Sarah H. York’s investigations into suicide patients. She argues that for the majority of patients living within asylum settings prevention and protection was the course of action, rather than investigating and treating the cause of suicidal thoughts. 

More modern scholarship - such as the work of Mary O. Johnson - has noted that there was a gender divide in regards to treatment and admissions to asylums. This is indeed highlighted by Middlewood Hospital. Not only were the women in the asylum more likely to be associated with mania (stemming from marital and social expectations), they were also physically segregated from the men. 

But interestingly, the asylums during this period arguably focused less on gender and more on social and economic factors, which influenced the patients’ experiences in the asylums. So despite there being minor differences between the genders, they were not as distinct as in wider Victorian society.

The relatively indiscriminate approach to nineteenth-century mental health, rather than specific, tailored treatment, led to broad labels (such as ‘lunatics’) and generalised lack of treatment. Although after 1905, despite the records demonstrating a shift away from listing the causes of ‘insanity’, there was still rarely the desire to find a cause of illness. This is displayed in the Middlewood Hospital records where most patient illnesses are categorised as having ‘unknown’ causes. Instead, tactics of prevention and isolating them from wider society were favoured. 

The outbreak of the First World War in 1914 shifted the hospital’s focus away from mental patients and towards helping the physically wounded and disabled people. Whilst the adaption of Middlewood Hospital into Middlewood War Hospital was temporary, it highlights the different approaches towards disabled people between the late nineteenth and early twentieth century. The switch to helping soldiers through physical treatment for physical wounds, highlights a shift from the lack of significant treatment within the hospital when it was a mental facility. 

The difficulty in treating mental illness alongside the fact that many patients were either transferred or released when the hospital was converted during the war, demonstrates the prioritising of physical disability over mental illness during this era. This debate continued into the contemporary world. 

In 1920, the hospital was handed back by the military, and it was during this time that the West Riding Asylums Committee had decided to drop the term ‘Asylum’ and Middlewood Hospital became known as Middlewood Mental Hospital. Whilst its use as a hospital for the wounded was again required at the outbreak of the Second World War, its expansion to include educational lecture theatres for staff and official medical facilities such as X-Ray machines, signalled a turn towards the 21st century. 

Although the hospital closed in 1995 and was converted into a private housing development called Wadsley Park Village, the transformation in treatment at Middlewood Hospital not only demonstrates the Victorian attitudes towards mental and physical disability, but its adaptation to prioritise the war signals the importance of economic and social factors in determining the treatment of mental health patients.

This is a debate which has persisted into contemporary society. This is most notably highlighted by the Covid-19 pandemic which resulted in an increased £500 million funding to support mental health as part of the current UK government’s ‘Mental Health Recovery Plan’. The contemporary interest in mental disabilities has therefore made significant shifts since the nineteenth century, but the stigma - and lack of accessibility - surrounding both visible and the unseen disabilities still persists.