Mental Ill Health

Our mental health has many dimensions: medical, psychological, social, spiritual and environmental. While boundaries between what is deemed as sanity or insanity remain elastic and widely debated, we find, or are given our place on the spectrum: perhaps with a diagnosis, a treatment a lifestyle change or a place of safety. Excerpt from the guide to the Bedlam exhibition at the Wellcome Collection 2016

This book that accompanied the Wellcome Collection exhibition explores mental illness through the successive incarnations of the institution that defined it: the madhouse. The text is brought to life with many photos and illustrations from across Europe and the US. It’s an excellent resource for teaching.


I like discovering resources in Oxfam, this book by Christopher Payne with an accompanying essay by Oliver Sacks is a wonderful collection of photos of derelict old asylums. They have a nostalgic quality to them reminding me that asylums were built with good intentions but often became places of horror and abuse. When I was at medical school in the 1980s I completed a psychiatry placement in large Victorian mental hospital. A few years later all the patients were discharged to ‘care in the community’ and the buildings were converted into luxury housing.

Look at the pictures and explore your thoughts about the role of the asylum in mental health care.

Patient poem on wall at Augusta State Hospital
Unclaimed copper cremation urns, Oregon Hospital
Patient Tooth Brushes
Patient Bath Tubs Oregon
Straight Jackets
Danvers State Hospital
Patient Cafe Harlem Valley State Hospital
Buy the book it's a great resource

What do you think about Hogarth’s famous painting of Bedlam Hospital? The asylum doors were opened so the public could become voyeurs of the distress and suffering of the mentally ill.

The sculptural installation Schering Chess (2015) by Javier Tellez was created to represent a mental hospital. Figures representing different mental illnesses, labelled with the corresponding 1970’s Schering treatment are displayed on a board resembling hospital lino with the pawn pieces taking the form of fragile eggs. The oppositional chess pieces, one side comprised of red earth, the other rendered in pristinely artificial, are held in a display case, facing each other off in a controlled environment.

You can see more of Tellez work online.

Photo of book by Sebastian Barry

Sebastian Faulks is renowned for his stories about the impact of war on human relationships, his recent Trilogy Human Traces, Engleby and Snow Country explore his fascination with psychiatry and the instability of the human mind. They are great books to discuss in a reading group.

The definition of mental illness varies depending on which country of the world you live in.

Times change and thinking evolves. Can you think of issues that are attributed to mental illness in some countries but are accepted as normal in others.

Sebastian Barry’s novel The Secret Scripture tells the story of Rose, an elderly lady who was incarcerated in a mental asylum in Ireland as a young adult purely because her behaviour was not felt to be acceptable by the Catholic Church. It’s a thought-provoking story to discuss in a reading group, especially the influence of religious belief on behaviour and the power of the local Catholic Priest.

The Extraction of the Stone of Madness BOSCH, HIERONYMUS Copyright ©Museo Nacional del Prado Reproduced under educational license

Apart from committing people to the asylum are there other psychiatric treatments that have fallen from fashion?

Take a look at this famous picture by Bosch.

What is the doctor doing?

In the 15th Century it was not uncommon for individuals suffering from psychosis to have their skull trephined to allow the evil spirit to leave the body. The practice was barbaric and usually resulted in the patient’s death. Bosch painted this picture as an allegory. He is making fun of the doctor by depicting him wearing a funnel, implying that it is the doctor and not the patient who is mad, and that the doctor is only motivated by money, hence the large purse on his waist cord. What sense do you make of the woman balancing the book on her head and the priest?

What other explanations for mental ill health that you have encountered?



Inside Out Pixar Film

The Pixar animation film Inside Out (2015) is a useful teaching resource to explore emotions and links well with the work of Brene Brown. 

Look at these pages for more specific resources

Suppose you want to look at issues that impact specifically on clinicians’ mental well-being. In that case, Caroline Elton’s book Also Human – The inner lives of doctors is relevant and thought-provoking. I think this book is so important that I am going to keep recommending it until everyone I know has read it!

Created Jan 2023