Mental recovery, citizenship roles, and the Mental After-Care Association, 1879–1928

Abstract

This article argues for the importance of studying life after mental illness. A significant proportion of people who experience mental illness recover, but the experience continues to affect their lives. Historical examination of the birth of mental after-care through the Mental After-Care Association (MACA) highlights the challenges faced by those who were discharged recovered from English and Welsh lunatic asylums between 1879 and 1928. This research demonstrates the relationship between ideas regarding psychiatric recovery and citizenship. Throughout the period, certification of insanity for institutional treatment stripped patients of the status and rights of citizenship. Discharge on account of recovery restored a patient's legal access to citizenship, yet suspicions about their right and ability to particate in society lingered. The MACA designed after-care to facilitate restoration to full citizenship. The MACA was a product of the active citizenship movement, according to which, one's right to identify as a citizen depended on the performance of certain duties to the community. These duties varied according to socio-economic position and sex, meaning that each individual was prescribed a gendered personal citizenship role. MACA personnel saw their endeavours as part of their own citizenship roles, and designed their treatments accordingly. The MACA used a patient's assumption of a citizenship role to indicate recovery, and believed that supporting the performance of that role had mentally healing effects for patients who had been discharged recovered. MACA workers thus imbued the psychiatric innovation of after-care with the liberal political and social values of active citizenship.