Workhouses are commonly town institutions; their locality often objectionable; their structure indifferent and dull; their site and their courts for exercise confined and small, and their means of recreation and of occupation, especially out of doors, very limited. Petty officers of Unions so often figure before the world, and have been so admirably portrayed by Dickens and other delineators of character, on account of their peculiarities of manner and practice, that no sketch from us is needed to exhibit their unfitness as guardians and attendants upon the insane. As to workhouse nurses, little certainly can be expected from them, seeing that they are only pauper inmates pressed into the service; if aged, feeble and inefficient; if young, not unlikely depraved or weak-minded; always ignorant, and it may be often cruel; without remuneration or training, and chosen with little or no regard to their qualifications and fitness.
However satisfactory the structure of the ward and its supervision might be rendered, its connexion with a Union Workhouse will be disadvantageous to the good government and order of the establishment, as above noticed, and detrimental to the welfare of the insane confined in it. Thus it must be remembered that very many of the lunatic inmates have been reduced to seek parochial aid solely on account of the distressing affliction which has overtaken them; before its occurrence, they may have occupied an honourable and respectable position in society, and, consequently, where consciousness is not too much blunted, their position among paupers--too often the subjects of moral degradation--must chafe and pain the disordered mind and frustrate more or less all attempts at its restoration. To many patients, therefore, the detention in a workhouse is a punishment superadded to the many miseries their mental disorder inflicts upon them; and consequently, when viewed only in this light, ought not to be tolerated.
Of all cases of lunacy, the wards of a workhouse are least adapted to recent ones, for they are deficient of satisfactory means of treatment, whether medical or moral, and the only result of detention in them to be anticipated, must be to render the malady chronic and incurable. Yet although every asylum superintendent has reported against the folly and injury of the proceeding, and notwithstanding the distinct and strong condemnation of it by the Commissioners in Lunacy, the latter, in their Report for 1857, have to lament an increasing disposition, on the part of Union officers, to receive and keep recent cases in workhouses. Moral treatment we hold to be impossible in an establishment where there are no opportunities of classification, no proper supervision and attendance, and no means for the amusement and employment of the mind; but where, on the contrary, the place and organization are directly opposed to it, and the prospects of medical treatment are scarcely less unfavourable. An underpaid and overworked medical officer, in his hasty visits through the wards of the workhouse daily, or perhaps only three or four times a week, very frequently without any actual experience among the insane, cannot be expected to give any special attention to the Pauper Lunatics, who are mostly regarded as a nuisance in the establishment, to be meddled with as little as possible, and of whose condition only unskilled, possibly old and unfeeling pauper nurses, can give any account. Indeed, unless reported to be sick, it scarcely falls into the routine of the Union medical officer regularly to examine into the state and condition of the pauper lunatics. These remarks are confirmed by the statement of the Lunacy Commissioners, in their 'Further Report,' 1847 (p. 276), that pauper inmates, "in their character of lunatics merely, are rarely the objects of any special medical attention and care," and that it "was never found (except perhaps in a few cases) that the medical officer had taken upon himself to apply remedies specially directed to the alleviation or cure of the mental disorder. Nor was this indeed to be expected, as the workhouse never can be a proper place for the systematic treatment of insanity."