Alleged Lunatics' Friend Society
Encyclopedia
The Alleged Lunatics' Friend Society (ALFS) was a pressure group started by ex-patients in 19th century Britain
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 that campaigned for the human rights
Human rights
Human rights are "commonly understood as inalienable fundamental rights to which a person is inherently entitled simply because she or he is a human being." Human rights are thus conceived as universal and egalitarian . These rights may exist as natural rights or as legal rights, in both national...

 of people alleged to have mental disorders (who were known then as lunatics). ALFS is recognized today as a pioneer of peer support
Peer support
Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters, and can take a number of forms such as peer mentoring, listening, or counseling...

 and the psychiatric survivors movement
Psychiatric survivors movement
The psychiatric survivors movement is a diverse association of individuals who are either currently clients of mental health services , or who consider themselves survivors of interventions by psychiatry, or who identify themselves as ex-patients of mental health services...

.

Background

There was increasing concern in the 19th century in the United Kingdom at the ease with which a growing number of people were being confined to the system of private and public madhouses, also known as asylums or psychiatric hospital
Psychiatric hospital
Psychiatric hospitals, also known as mental hospitals, are hospitals specializing in the treatment of serious mental disorders. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialise only in short-term or outpatient therapy for low-risk patients...

, often leading to reports and literary accounts of abuse and illegal confinement
Involuntary commitment
Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a hospital or in the community ....

. There was also concern that physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s were undermining personhood by arguing that mental disorder was physical and hereditary. Civil liberty
Civil liberties
Civil liberties are rights and freedoms that provide an individual specific rights such as the freedom from slavery and forced labour, freedom from torture and death, the right to liberty and security, right to a fair trial, the right to defend one's self, the right to own and bear arms, the right...

 advocates were in favor of granting more self-determination
Self-Determination Theory
Self-determination theory is a macro theory of human motivation and personality, concerning people's inherent growth tendencies and their innate psychological needs. It is concerned with the motivation behind the choices that people make without any external influence and interference...

 and responsibility to the insane
Insanity
Insanity, craziness or madness is a spectrum of behaviors characterized by certain abnormal mental or behavioral patterns. Insanity may manifest as violations of societal norms, including becoming a danger to themselves and others, though not all such acts are considered insanity...

, and increasingly concerned with the assumption that custody was the appropriate way to deal with people labeled as lunatics. A process of certification was introduced for detaining people, but there were protests at the ease with which certain behaviours
Human behavior
Human behavior refers to the range of behaviors exhibited by humans and which are influenced by culture, attitudes, emotions, values, ethics, authority, rapport, hypnosis, persuasion, coercion and/or genetics....

 were being defined as sufficiently disturbed to justify detention, and suspicion of the motives behind the expansion of asylums and of the financial incentives for recruitment of patients. The boundaries of diagnoses
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...

 seemed to be expanding beyond insanity, to include issues of morality
Morality
Morality is the differentiation among intentions, decisions, and actions between those that are good and bad . A moral code is a system of morality and a moral is any one practice or teaching within a moral code...

, eccentricity
Eccentricity (behavior)
In popular usage, eccentricity refers to unusual or odd behavior on the part of an individual. This behavior would typically be perceived as unusual or unnecessary, without being demonstrably maladaptive...

 and criminality, with doctors increasingly claiming the expertise to distinguish the mad from the sane.

In 1838, Richard Paternoster
Richard Paternoster
Richard Paternoster was an English civil servant in the East India Company, barrister and founder of the Alleged Lunatics' Friend Society, an organisation that exposed abuses in lunatic asylums and campaigned for the reform of the lunacy laws.-Early life and career:Paternoster was born in 1802 in...

 was discharged after 41 days in a London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

 madhouse (Dr. Finch's madhouse at Kensington
Kensington
Kensington is a district of west and central London, England within the Royal Borough of Kensington and Chelsea. An affluent and densely-populated area, its commercial heart is Kensington High Street, and it contains the well-known museum district of South Kensington.To the north, Kensington is...

) having been detained following a disagreement with his father over money. He advertised in The Times
The Times
The Times is a British daily national newspaper, first published in London in 1785 under the title The Daily Universal Register . The Times and its sister paper The Sunday Times are published by Times Newspapers Limited, a subsidiary since 1981 of News International...

newspaper for fellow survivors to join him in a campaign against abuses of the madhouses. He was initially joined by four men, the most noted being John Thomas Perceval
John Thomas Perceval
John Thomas Perceval was a British army officer who was confined in lunatic asylums for three years and spent the rest of his life campaigning for reform of the lunacy laws and for better treatment of asylum inmates. He was one of the founders of the Alleged Lunatics' Friend Society and acted as...

, son of the assassinated prime minister
Prime minister
A prime minister is the most senior minister of cabinet in the executive branch of government in a parliamentary system. In many systems, the prime minister selects and may dismiss other members of the cabinet, and allocates posts to members within the government. In most systems, the prime...

. Even though he had been treated in the most esteemed private asylums (Brislington House in Bristol
Bristol
Bristol is a city, unitary authority area and ceremonial county in South West England, with an estimated population of 433,100 for the unitary authority in 2009, and a surrounding Larger Urban Zone with an estimated 1,070,000 residents in 2007...

, run by Quaker Edward Long Fox
Edward Long Fox
Edward Long Fox was a British psychiatrist. He established an insane asylum at Brislington House, near Bristol, England, and classified the patients according to social class as well as behavioural presentation....

, and Ticehurst Asylum in Sussex
Sussex
Sussex , from the Old English Sūþsēaxe , is an historic county in South East England corresponding roughly in area to the ancient Kingdom of Sussex. It is bounded on the north by Surrey, east by Kent, south by the English Channel, and west by Hampshire, and is divided for local government into West...

) he felt he had not been treated as a gentleman
Gentleman
The term gentleman , in its original and strict signification, denoted a well-educated man of good family and distinction, analogous to the Latin generosus...

 or an individual. The men published their experiences of asylum care, including lack of discussion about treatment, and punishment with solitary confinement, straitjacket
Straitjacket
A straitjacket is a garment shaped like a jacket with overlong sleeves and is typically used to restrain a person who may otherwise cause harm to themselves or others. Once the arms are inserted into the straitjacket's sleeves, they are then crossed across the chest...

s and cold baths. They argued that inspectors were not doing a proper job, and failing to see things for a moment from the perspective of patients. Others who joined the cause were William Bailey (an inventor who had spent five years in madhouses), Captain Richard Saumarez (whose two brothers has been incarcerated in Chancery asylum by his father, and he could not see them or challenge their detention), and Dr. John Parkin, another ex-patient.

Formation

On July 7, 1845, Paternoster, Perceval, and a number of others formed the Alleged Lunatics Friends Society. In the first year it campaigned for changes to lunacy laws to reduce illegal incarceration
Incarceration
Incarceration is the detention of a person in prison, typically as punishment for a crime .People are most commonly incarcerated upon suspicion or conviction of committing a crime, and different jurisdictions have differing laws governing the function of incarceration within a larger system of...

 and improve asylum conditions, to offer help to discharged patients, and to raise awareness of Christian duties and sympathies in this regard. During 1845, the Society had eighteen vice-presidents and seventeen directors. The number of members is not known but as well as ex-patients this included politicians (e.g. Thomas Wakley, Thomas Duncombe, William Sharman Crawford, Benjamin Bond Cabbell, R. A. Christopher) and ten lawyers (including Gilbert Bolden, who helped draw together disparate elements and develop a common set of demands that would have a wider appeal; C. P. Villiers, James Russell). The name reflects the fact that each member of the society was considered to be a friend of those alleged to be insane, whether the member was an ex-patient, family member or other concerned party.

Views and actions

The Society argued that patients should have more of a voice in their confinement and care, and access to legal representation. The predominant moral treatment
Moral treatment
Moral treatment was an approach to mental disorder based on humane psychosocial care or moral discipline that emerged in the 18th century and came to the fore for much of the 19th century, deriving partly from psychiatry or psychology and partly from religious or moral concerns...

 was seen as repression
Psychological repression
Psychological repression, also psychic repression or simply repression, is the psychological attempt by an individual to repel one's own desires and impulses towards pleasurable instincts by excluding the desire from one's consciousness and holding or subduing it in the unconscious...

 achieved by mildness, coaxing and solitary confinement. Its emphasis on reeducation was seen as treating people like children or mental defectives, and lack of chance to exert their own free will
Free will
"To make my own decisions whether I am successful or not due to uncontrollable forces" -Troy MorrisonA pragmatic definition of free willFree will is the ability of agents to make choices free from certain kinds of constraints. The existence of free will and its exact nature and definition have long...

 or judgment was thought to impede recovery. The Society was suspicious of the tranquility admired by asylum inspectors, suggesting patients were simply being crushed and then discharged to live a meek existence in society. They suggested that rules and expected conduct in society created irritations of the will, and many mental problems stemmed from disappointments and rejections in life. They challenged the prevailing practice of cutting people off from associations with their home, and argued that more attention needed to be paid to what patients were saying. They accused people of being hypocritical
Hypocrisy
Hypocrisy is the state of pretending to have virtues, moral or religious beliefs, principles, etc., that one does not actually have. Hypocrisy involves the deception of others and is thus a kind of lie....

 in deeming themselves sane by a servile following of the rules. They advocated on behalf of paupers (the poor) generally. They gave attention to the plight of 'single lunatics' (those confined (often in secret) to their own homes by relatives, or placed in some other isolated place to be forgotten and not cause scandal.) They promoted the use of clergy
Clergy
Clergy is the generic term used to describe the formal religious leadership within a given religion. A clergyman, churchman or cleric is a member of the clergy, especially one who is a priest, preacher, pastor, or other religious professional....

 to visit and protect patient rights, by representing community and connection rather than lock and key. They opposed the enlargement of asylums.

From 1845 to 1863, the Society bombarded the government with literature. Gradually many of its ideas were adopted, often without credit. This included protections added to laws; for example, that diagnoses must be stated on asylum certifications, deaths in asylums must be reported promptly, abused or neglected patients should get a copy of their certification which could result in prosecutions, and patients could get a legal hearing before admission. The Society also argued for patients' legal rights to be displayed in every asylum, and that medical documents should record if an inmate objected, that patient's property should be sealed, and that voluntary halfway house
Halfway house
The purpose of a halfway house, also called a recovery house or sober house, is generally to allow people to begin the process of reintegration with society, while still providing monitoring and support; this is generally believed to reduce the risk of recidivism or relapse when compared to a...

s should be created.

Between 1845 and 1863, the Society took up the cases of at least seventy patients. They monitored particular institutions for years and consistently drew attention to abuses that had escaped the attention of inspectors. They held public meetings and lectures around the United Kingdom that helped uncover abuses, although they were often poorly attended. They obtained a special government investigation (Select Committee) in 1859. They exposed many illegitimate and illegal admissions, including brutality in detention procedures; confinement by relatives in order to avoid to social embarrassment or financial loss (for example when someone might otherwise lose an inheritance, or married a servant, or wanted to give money to a religious sect); irregularities in certification related to financial conflicts of interest; infringements of patients' rights (for example, defrauding a Bedlam
Bedlam
Bedlam may refer to:* Bethlem Royal Hospital, London hospital first to specialise in the mentally ill and origin of the word "bedlam" describing chaos or madness-Places:* Bedlam, North Yorkshire, a village in England...

 patient of his savings; family reducing patient's trust fund while he was inside); family promoting indefinite detention with minimal publicity; postal correspondence being interfered with; physicians relying on physical treatments and neglecting to spend time with patients; hearings being superficially legal but prejudiced in advance and ignoring rules of evidence).

Difficulties

The Society faced a number of difficulties. Throughout its history, ALFS attracted gratuitous abuse from the popular press and medical journal
Medical journal
A public health journal is a scientific journal devoted to the field of public health, including epidemiology, biostatistics, and health care . Public health journals, like most scientific journals, are peer-reviewed...

s. The negative personal accounts of their treatment published by Paternoster and Perceval alienated the medical profession, though at the same time physicians gave it a mixed reception, with some staunchly opposed and many asylum owners refusing to cooperate, while most thought it brought in some beneficial reforms. The Society itself included some physicians, who tended towards concessions and sometimes undermined the Society. Its efforts were continually hampered by the disdainful attitude, narrow views and obstructionist beauraucracy of the government, who often did not give credit to the Society, helped only minimally with documents, and did not adequately protect informant's names. The Society also faced obstruction from asylum owners and generally had to use habeas corpus
Habeas corpus
is a writ, or legal action, through which a prisoner can be released from unlawful detention. The remedy can be sought by the prisoner or by another person coming to his aid. Habeas corpus originated in the English legal system, but it is now available in many nations...

 to bring cases before the courts. They helped discharged patients seek redress for their sufferings in asylums. Although these cases were not often successful, they did cause embarrassment to asylums.

The Society had flaws. ALFS often lacked subtlety, inviting rejections and disparagement. In general, the issue of illegal incarceration of the sane gained support, but other suggestions were often derided. Perceval often advocated heavily in favor of church involvement, and the superiority of private madhouses with personal attendants for the better off. In public meetings his extrovert manner sometimes rode roughshod over others or stoked up allegations, and the personal nature of his attacks undermined the sense of the Society's objectivity; he was sometimes venting personal frustrations with society and convention. The Society sometimes alienated potential supporters with a persecutory flavor to its comments. It produced enemies by its exposure of upper class
Upper class
In social science, the "upper class" is the group of people at the top of a social hierarchy. Members of an upper class may have great power over the allocation of resources and governmental policy in their area.- Historical meaning :...

 sensibilities and flaws of the Lunacy Commission, hardline approach to social inclusion of ex-patients, alignment with radical groups, and emphasis on localist rather than centralist supervision of asylums. The government wanted control over the asylums, but was wary of alienting the medical profession by curbing its powers in favor of patients' rights.

Legacy

The Society's activities came to a natural end in the mid 1860s. Saumarez died; Bolden had a young family and in the later 1860's moved to Birmingham. Perceval had lost three brothers between 1856 and 1861, and promotion of his nephew to a position of influence in the government and lunacy commission may have given him some peace of mind.

The Society had continually challenged the boundaries of mental disorder that others were seeking to set down. ALFS questioned the growing faith placed in medical expertise. Although often seeking publicity, it did most of its effective work out of the limelight in exchanges with the government. It has been argued that the Society was held back by myths about mental illness, and deserved more support than it attracted for its achievements. The Society may never have been able to gain more widespread support due to public disinterest or avoidance of the issues, and some of its following has been attributed to the reputation it gained for intrusive and insensitive investigations. However, while it sometimes overstated its case, more often than not very real abuses were uncovered. It kept up continual questioning about the adequacy of long-term care, whether in asylums, workhouses, or private lodgings. ALFS was the only group prepared to bring test cases to court in this area of civil liberties, while most Victorians wanted it kept out of the public eye. It has been said that patients' rights, asylum care, and medical accountability all suffered with its demise in the 1860s. It was a predecessor to other United Kingdom organisations such as the Lunacy Law Reform Association the National Society for Lunacy Reform and the current national charity MIND, and is recognised as a pioneer of advocacy and peer support and the psychiatric survivors movement
Psychiatric survivors movement
The psychiatric survivors movement is a diverse association of individuals who are either currently clients of mental health services , or who consider themselves survivors of interventions by psychiatry, or who identify themselves as ex-patients of mental health services...

.

See also

  • Antipsychiatry
  • Deinstitutionalization
  • MindFreedom International
    MindFreedom International
    MindFreedom International is an international coalition of over one hundred grassroots groups and thousands of individual members from fourteen nations. It was founded in 1990 to advocate against forced medication, medical restraints, and involuntary electroconvulsive therapy. Its stated mission is...

  • Recovery model
    Recovery model
    The Recovery Model as it applies to mental health is an approach to mental disorder or substance dependence that emphasizes and supports each individual's potential for recovery...

  • Treatment Advocacy Center
    Treatment Advocacy Center
    The Treatment Advocacy Center is national U.S. nonprofit organization dedicated to eliminating legal and other barriers to the timely and effective treatment of severe mental illness...

  • World Network of Users and Survivors of Psychiatry
    World Network of Users and Survivors of Psychiatry
    The World Network of Users and Survivors of Psychiatry is an international organisation representing, and led by "survivors of psychiatry". As of 2003, over 70 national organizations were members of WNUSP, based in 30 countries...

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