Maudsley Hospital

The Maudsley Hospital is a familiar site on Denmark Hill, built from red brick with neo classical influences, white columns and a cupola. Since the original building was completed in 1916, the site of the hospital, including The Institute of Psychiatry, the hospital’s teaching and research arm, has been extended as newer facilities have been built and old houses bought to cover most of the block bordered by Denmark Hill, Windsor Walk, Grove Vale and De Crespigny Park. The hospital’s origins lie in the vision and generosity of Dr Henry Maudsley.

After mixed beginnings in the medical profession, Dr Maudsley was, at the age of 24, appointed Medical Superintendent at the Royal Manchester Lunatic Asylum. It was the making of him as, after returning to London three years later, his life was then spent "in getting such practice in lunacy as I could, which increased gradually, and in writing the books which I published in succession."

In February 1908, after a long and successful career both in practice and teaching, Dr Maudsley at the age of 73, wrote to the London County Council offering £30,000 “for the establishment in London of a fitly equipped hospital for mental diseases.” This would be under the following conditions: the hospital was to be for early and acute cases only; it was to have an outpatient department; it was to be equipped for 75 to 100 patients, 50 to 75 pauper patients, and the remainder paying patients; and it was to be in a central position, within three to four miles of Trafalgar Square. Provision was to be made for research and teaching to be recognised by and affiliated to the University of London. The LCC was to have entire charge, control, maintenance and upkeep of the hospital except for appointing medical officers and in matters relating to education and research.

It was Dr Maudsley’s belief “that many cases of acute insanity where recovery usually occurred within a few weeks or under three months would be cured, and the persons thus saved from much of the prejudice which is sometimes a lasting injury to them when they have been sent to an asylum; and it is hoped that in a small institution, with several medical and other attendants, the patient and apt application of individual treatment, mental and medical, would bring about recoveries which might not take place in large asylums in which multitudes are congregated and such individual treatment is almost impracticable.”

Interviewed by a newspaper regarding his offer, Dr Maudsley stated “The main reason why I offered the money to the council is because there is at present no such hospital in London for the poor of the metropolis. There are only two or three hospitals for mental cases altogether, and they are for paying patients. Bethlehem of course is one of the best known. The poor of London who cannot afford to pay for treatment are sent to the infirmary wards for a fortnight or so, and then, if no improvement has taken place, they are forwarded on to an asylum. My idea is to give these people a chance of being cured by proper treatment in a thoroughly equipped hospital devoted exclusively to mental cases.” (The Standard, 19 February 1908)

All admissions were to be made on a voluntary basis with patients free to leave after giving 24 hours notice. No certified patients were to be admitted and no patient was to be certified in the hospital. This stipulation by Maudsley required a change in the law by Act of Parliament.

The London County Council accepted Dr Maudsley’s offer and a year later an estimate approved for the project. It was not until two years later that it was announced that a suitable site had been found, the delay explained by the vendor of another site they believed to be suitable changing his mind about selling. The site of 107 and 109 Denmark Hill was then proposed, consisting of two residential houses with land totalling four and a half acres. It was at a cost of £10,000 which with the building works and fitting out estimated at £40,000 put the total cost at £50,000 which later rose to just under £70,000. Dr Maudsley later increased his donation by a further £10,000.

The hospital build was slow to start, not commencing until 1913. Then it was held up by a builders’ strike and then by the outbreak of World War I in 1914. The hospital was completed in 1915 but immediately requisitioned by the War Office and became a Neurological Clearing Centre for neurological casualties of the First World War, including those suffering from the new condition known as ‘shell shock’. Some patients received controversial treatments including electric shock treatment whilst the majority were just given the opportunity to rest and recuperate and were encouraged into occupational therapies such as carpentry and gardening to restore basic functioning. Patients were the subject of comprehensive research and many patients made sufficient recovery to return to light duties but many never recovered. The more serious cases were transferred to other hospitals or asylums.

In 1917, the hospital accommodated 185 soldiers and 18 officers, many accommodated in “tented wards” where the sides could be opened up in good weather and allow a thorough airing. Houses in Champion Hill were taken over to house officer patients and to provide nurses’ accommodation.

The hospital demobilised after the war but then taken over by the Ministry of Pensions to treat former soldiers still suffering. The hospital was not open for admissions from the general public until February 1923 when the Minister of Health, Sir Arthur Griffith-Boscawen, declared the hospital open and is reported to have said on the occasion that “the opening of the hospital was the inauguration of a new era in mental treatment which was going to save a great deal of suffering. An attempt was to be made to deal with recoverable cases, thereby rendering them curable. There was also a keen desire for exact research into the causes of mental disorder, and to see that the proper clinic instruction of students was carried out.”

Dr Maudsley died in 1918 and sadly unable to witness the opening of the hospital he had envisaged for the treatment of curable mental disorders in the general public.

The Maudsley joined forced with the Bethlem Royal Hospital when the National Health Service was created to form a postgraduate psychiatric teaching hospital. The Maudsley’s medical school and research arm became the Institute of Psychiatry.

The South London and Maudsley NHS Trust was created in 1999 and merged was formed from the merger of three organisations: Bethlem and Maudsley, Lambeth Healthcare and Lewisham and Guy's NHS Trusts to serve the London Boroughs of Croydon, Lambeth, Lewisham and Southwark.

Sources:

Patricia H Allbridge, Historical Notes on the Bethlem Royal Hospital and the Maudsley Hospital, 1971

Maudsley Hospital website

BBC website, ‘World War One at home’