VPRS 7487 Asylum Records

Full description

Casebooks
From at least 1845 and the proclamation of An Act for the Regulation of the Care and Treatment of Lunatics (8 & 9 Vic c.100), each asylum was required to maintain a Casebook of patients. The book was to be kept in such form as the Governor in Council was from time to time to direct. As soon as possible after the admission of any patient and periodically thereafter, the following details were to be entered into the Casebook:

the mental state and bodily condition of every patient on admission
the history of his/her case recorded from time to time while he/she continued to be a patient in the asylum
a correct description of the medicine and other remedies prescribed for the treatment of his/her disorder
and in the case of death an exact account of the autopsy (if any) of the patient.

Information recorded in the case histories included:

Personal Details

- date of admission
- admission number
- name and address of nearest relative
- by whom brought to the asylum
- previous residence
- age and sex of patient
- whether married, widowed or single
- if any family
- occupation
- habits of life

Medical Details

- form of insanity
- duration of present attack
- if disordered before/if disorder hereditary
- specific signs of insanity
- if suicidal
- if dangerous and destructive
- a brief description of bodily condition
- the history of his/her case recorded from time to time while he/she continued to be a patient in the asylum
- a description of the medicine and other remedies prescribed for the treatment of his/her disorder.

The casebooks usually record whether a patient was transferred elsewhere, discharged or died in custody. A copy of the post-mortem report was sometimes included in cases of death.

These books were to be regularly inspected by an Inspector or other officer appointed under the provisions of the prevailing legislation. It was expected that a full account of the mental and physical condition of the patient would be entered in the casebook on admission of the patient with a further note to be made at the end of each month at least for the first six months and subsequently a full note every six months. However such thorough and accurate notes were not always maintained.

In later years the format of the casebooks was altered slightly. Reference was made to the admission number of the patient and a photograph of the patient on admission was often included. Additional information such as extracts from the required medical certificates and a copy of the Medical Superintendent's report on the mental and physical condition of the patient were often incorporated and additional space was provided for recording the history of each patient.

In 1912 the format of case histories was changed from bound casebooks to loose-leaf folio format. The new format facilitated the transfer of case histories with the patients when they were sent to other institutions.

There is an index by patient surname at the front of both volumes. The volume(s) recording the medical case history of those patients admitted between 1909 and 1912, have not been recovered.

Register of Patients
From at least 1845 and the proclamation of An Act for the Regulation of the Care and Treatment of Lunatics (8 & 9 Vic c.100), public asylums and licensed houses were required to maintain a Register of Patients. Initially the register maintained by licensed houses was officially known as the Book of Admissions. In some institutions the Register was also known as an Admissions Register or as an Admission and Discharge Register and these terms were sometimes stamped on the volumes.

Immediately upon the admission of a person to an asylum, the clerk of the asylum was required to make an entry in the Register of Patients. Details recorded included:

patient's name
date of admission
admission number
date of last previous admission
age
marital status
occupation
previous place of abode
religion, and
once examined by a medical officer, the form of mental disorder and state of physical health.

Further details were entered in the register on the death, transfer or discharge of a patient. Institutions were also required to maintain a separate Register of Discharges, Removals and Deaths, usually known as a Discharge Register.

The format of the Register of Patients which was specified in a schedule to the Lunacy Statute and succeeding legislation, changed little until the proclamation of the Mental Health Act 1959 in 1962.

The record then became officially known as the Register of Patients and Discharge Register and included information about the types of admission. The following five types of admission were specified under sections 41 to 49 of the Mental Health Act 1959.

- Voluntary Boarders (V) were those who entered the hospital at their own request or, if under the age of 16 at the request of a parent or guardian and on the opinion of a medical practitioner.

- Recommended (R) and Approved (A) Patients. A person could be admitted upon the recommendation set out in a prescribed form, of a medical practitioner who had examined the person. As soon as possible after admission the superintendent of the hospital was required to examine the patient and either approve the recommended admission or discharge the patient.

- Judicial Admissions (J). Upon information provided on oath before a justice that a mentally ill person was not receiving proper care, or could not support himself/herself or had committed an offence, and after examination by two medical practitioners, an order could be made for the person to be admitted to or detained in a mental hospital.

- Security Patients (S) were those who had been detained in a gaol but were transferred to a mental hospital upon being determined to be mentally ill.

The post 1962 Registers of Patients also included information previously recorded in a separate Discharge Register, e.g., institution to which the patient was transferred; assigned cause of death where applicable. However some institutions continued to maintain a separate Discharge Register.

These volumes do not have an index.

Discharge Register
Within twenty-four hours after the discharge, removal or escape of any patient the clerk of the asylum was to make and sign an entry to record this occurrence in the Discharge Register also known as the Register of Discharges, Removals and Deaths. This was required under the provisions of section 23 of the Lunacy Statute 1867. Subsequent legislation included similar provisions. An entry was also to be made in the Register of Patients and a written notice was to be sent to the Chief Secretary.

The format of the Discharge Register was specified in the seventeenth schedule of the 1867 Act and in schedules to subsequent legislation. Details recorded included date of death, discharge or removal, date of last admission, number in Register of Patients, name at length, name of hospital to which patient removed (if applicable), condition on discharge, cause of death (if applicable) and age at death. The entries are arranged chronologically by date of discharge.

The Function/Content of the Medical Journal, Staff Register and Annual Examination of Patients Register and Register of Voluntary Boarders were included in the description of how to use the records above.