Bedlam: The story behind the London mental hospital that came to mean hell on earth

The word “Bedlam” conjures up scenes of wild chaos and confusion but, in the 13th century, it was linked to one specific place: The Bethlehem Royal Hospital in London. This was the first asylum in England, founded in 1247, and it cared for the mentally ill free of charge. It still functions as a psychiatric hospital today.

A current exhibition at the Wellcome Collection in London (which will run until Jan. 15, 2017) examines the history of Bedlam and our attitudes to mental health over the centuries. Mike Jay, guest curator of the exhibition, explains that while Bethlehem Royal Hospital refers to a specific factual place, “Bedlam” became it’s popular image, “it’s mythic twin or double.”

“Bedlam becomes this proverbial place of madness because it’s the first and for a long time the only home for people who, at that time, were called ‘mad’ in the country,” he explains. There were ballads and songs written about Bedlam and it became “a theatrical cliché.”

“On stage Bedlam is a looking glass world which reflects our own,” he says. “It’s full of strangeness and ambiguity: The sane are mad and the mad are sane.”

This theme continued throughout the centuries. The 18th century artist William Hogarth made a series of eight paintings, The Rake’s Progress, showing a young bon vivant’s increased depravity, with the last scene showing him languishing at Bedlam. In Hogarth’s depiction of the hospital, he added the emblem of Britannia on a coin, to signal that Bedlam’s madness was a feature of British society, not just confined to the hospital.

“This became a meme, if you like, of the 18th century, that the world is a great Bedlam,” explains Jay.

But despite recognizing the blurred lines of sanity, there was great fear around Bedlam during this era. This was a time when religious fervor was starting to fade, and so Bedlam became a secular image of hell.

“By the time of Hogarth’s painting, the great wars of faith—the civil war and the reformation—are over. It’s a more enlightened world, the age of reason,” says Jay. “And Bedlam is what happens to you if you’ve lost your reason. I think that’s why it becomes very potent at this point.”

But contrary to the notion that Bedlam was a chamber of horrors contrasted with our attitudes today, Jay says there have been examples of humane, enlightened mental health work through the centuries, even alongside instances of poverty, neglect, and cruelty.

“I think that’s the same today,” he says. “There have always been people who are progressive and compassionate and who recognized the support that some people need.”

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