The Origins of Mental Health Care in New Zealand and Wellington

The F-Ward (where the Porirua Hospital Museum and Resource Centre is housed) was built in 1909 as part of the Porirua Hospital campus. Mental health services in New Zealand were first signalled in 1844 when an advertisement appeared in the New Zealand Gazette and Wellington Spectator:

To carpenters etc. –tenders for building temporary wooden building for insane at Wellington, New Zealand.

This signaled the building of a pauper “lunatic” asylum attached to the Wellington jail. Care was strictly custodial under the care of jailers who found their care a very difficult task and wanted them removed from the jail. There was a growing awareness that “lunatics” were a group needing special attention and that their care was not appropriate for a penal institution, and there developed a public demand that they be housed separately in an asylum, as a place of refuge, separate from jails and ordinary hospitals.

Legislation

The Lunatics Ordinance, 1846, was the first legislation concerned with the mentally ill in New Zealand. It provide that after certification a mentally ill person could be sent to a jail, house of correction, or public hospital; or alternatively to a public colonial asylum, although no such institution existed at that time. This represented a step forward in the development of special services for the mentally ill in that it envisaged state provision of services from the public purse and available to every person in the community. (Note: – in those days they did not distinguish between people with what we would now call ‘mental illness’ and those with intellectual disability, or organic brain deterioration (secondary to injury, infection, alcoholism, or dementia). The common factors were deterioration in mental state and a need for care).

In 1852 the Constitution Act placed the responsibility for health services on the Provincial Governments, and between 1854 and 1872, a network of provincial asylums was established throughout the country. Public demand was that within these separate institutions, the mentally ill should be treated “properly”; that is without mechanical restraint and with appropriate regimes. This was interpreted to be a system of moral management and non-restraint whereby the moral example set by staff plus the quiet routines and ordered programs of asylum life were part of an integrated programme to restore their mental order.

This programme changed the nature of mechanical restraint. Straight jackets and irons were replaced where necessary by the use of padded rooms and seclusion. An activation programme was developed consisting of manual work in the garden around the asylum; church services were held regularly; and recreation programmes such as concerts and dances were held for the patients. These new programmes were provided in the hope that asylums were effective institutions providing time and a good moral environment for nature to do the healing. (We now know that does work for a number of mental illnesses.)

Reorgnisation

Following the abolition of the Provincial Government in 1876, the social services of the colony were reorganized and the Lunacy Department was formed as a department of state. It was the lack of public interest as well as law and order consideration which brought the asylums under central control. The general hospitals and charitable institutions, which had more public confidence, passed to local control with local funding. This gave them the power to pass by-laws which they used to deny admission to the mentally ill. All these people were committed to the asylums which had no choice but to admit them. By the mid 1870’s the clientele of the asylums changed from admitting acute and recoverable cases to mostly long term chronic cases. The country was entering a depression, there was no social welfare, and the social consequences of an aging immigrant bachelor population were being felt. Men suffering from the effects of drink or syphilis with no relatives to care for them had nowhere else to go. This situation was to grow worse later in the 19th century and asylums became more and more overcrowded with people who would never leave. Public reaction to asylums changed from one of sympathy to one of fear and withdrawal and a demand for tighter security at local asylums. Treatment was being forced back to the days of mechanical restraint and of custodial care.

Overcrowding

The public had expected that with medical control of the asylums more patients would recover. But the conflict caused by the fact that asylums were terminal institutions for the incurable as well as therapeutic places for the acutely ill had not been resolved. Because all mental illness was treated only within asylums this led to overcrowding and institutionalization. Standards dropped and care became custodial. Poor public relations as asylums became defensive of their care, led to ignorance and antagonism in the community, and to a lack of government funding. When the overcrowding forced the building of a new generation of larger asylums they were located in rural areas away from the areas of population they were meant to serve. In this way Seacliff (1878), Porirua (1887), and Tokanui (1912) were built in areas newly opened up by the railway, where they became self sufficient and closed concerns.

Permanent Buildings

Much larger than early asylums, these new asylums were built in permanent materials rather than wood, which made them slow and costly to build or extend. When they in turn became crowded with the aged, infirm, and incurable, classification and the standard of care deteriorated to a custodial level and the rural location thus came not to protect the patients but tended rather to protect the asylum itself from embarrassment over its declining conditions.

The theme of classification of mental illness and the need to provide separate care for those patients who were chronically ill ran through the development of psychiatric services from the 1850’s to the establishment of Tokanui in 1912. As early as 1858 a select committee had recommended a single central asylum as a national hospital for the chronic and incurable, leaving the acute or recoverable to be cared for more locally near their friends and homes.

The Karori Asylum 1854 – 1873

The first of these new provincial lunatic asylums to care for the mentally ill opened on 1 January 1854 on the site of the present Karori Normal Primary School in Wellington. It is not known for certain whether the asylum moved into a building already present on the site, or was purpose built but probably the former as within 3 years a Select Committee reported that the “old building” be put into proper repair, and by 1867 the buildings were described as “decayed and worm eaten”. The asylum was on the fringe of Wellington, allowing for potential community interaction, but at the same time providing an environment described as spacious and rustic, allowing for manual work such as farming and gardening.

In September 1871, a group of doctors who were also politicians and who were dissatisfied with the high incurability rate in the asylums and lack of medical input, secured a parliamentary inquiry into the lunatic asylums of the colony. The inquiry was chaired by Dr Andrew Buchanan. The inquiry concluded that a new site was required, with enlarged buildings, more attendants, exercise for the women, baths, and a means of warming the isolation rooms. The findings of the Committee of Inquiry laid the foundation for the future development of mental health services in New Zealand.

The Wellington Lunatic Asylum: Mount View 1873 – 1910

The Mt. View Asylum was proclaimed on 22 May 1873 with Dr Charles France as Medical Officer. Henry and Charlotte Seager as Keeper and Matron were appointed from Karori Asylum. The asylum was built on that portion of the Town Belt now partly occupied by Government House. Between 1873 and 1875 the grounds were leveled and an approach built from Adelaide Road by prisoners from the Wellington jail who had been sentenced to hard labour. The building was designed by the architect Christian Julius Toxward who was later to design Wellington Public Hospital at Newtown. The original two-story structure became the central portion of the building when it was later enlarged by the addition of two wings.

By 1905 the number of patients reached 250. For variable periods it was closed to new admissions which were all sent to Porirua Hospital. In May 1910 the remaining patients were transferred, the bulk of them to Porirua, but also to Christchurch and Seacliff asylums following the site being chosen as the location for the new Government House.