Madhouses Act 1774

The Madhouses Act 1774 (14 Geo. 3. c. 49) was an Act of the Parliament of Great Britain, which set out a legal framework for regulating "madhouses" (insane asylums).

Background
By the mid-eighteenth century, the common methods in the United Kingdom for dealing with the insane were either to keep them in the family home, or to put them in a "madhouse", which was simply a private house whose proprietor was paid to detain their residents, and ran it as a commercial concern with little or no medical involvement. This led to two forms of abuse: the first was the keeping of "legitimately" insane people in atrocious conditions, and the second the detention of those who were falsely claimed to be insane – in effect, private imprisonment.

At this stage, there was no legislation to regulate the incarceration of anyone other than a Chancery lunatic or a pauper; there was only a vaguely defined common law power to "confine a person disordered in mind, who seems disposed to do mischief to himself, or another person".

In a case in the mid-1750s, a woman came to suspect that her son-in-law had committed his wife to a madhouse in Hoxton; with the aid of a justice of the peace, she secured the release of her daughter after obtaining a confession from the husband. A similar case in 1762 saw a man trying to obtain the release of an acquaintance, one Mrs Hawley, who he suspected had been confined in a madhouse. His initial application to Lord Mansfield for a writ of habeas corpus was rejected because he was not a relative and so had no standing, but the judge arranged for a doctor to visit the house and speak to the woman. On his report, a writ was granted; she was brought before the court, and discharged.

A Select Committee of the House of Commons, chaired by Thomas Townshend, was set up in 1763 to study the problem of unlawful detention in private madhouses and focused on the Hawley case. It found that she had been committed to the house solely on the word of her husband, who paid two guineas (two pounds and two shillings) a month for her board, and that she was unable to leave the house or communicate with anybody outside it. The inmates were treated as insane, but the agent who arranged their entry freely admitted that he had not committed a single insane person to the house in the past six years. No-one who would pay was turned away, no physicians attended the inmates, and no register was kept of their names. This was, the committee stated, a common situation; they noted that a number of similar cases could have been studied, and they recommended that some form of legislative intervention was needed. The Commons ordered the committee to prepare a bill, but it appears this was never brought in.

The issue was next addressed in 1773 when Townshend's son, also named Thomas Townshend, sponsored a bill to regulate private madhouses; within seven miles of London, this would be the responsibility of the Royal College of Physicians; and outside that, magistrates in county towns. The bill passed the Commons but was rejected by the Lords.

Legislative history
In 1774, Thomas Townshend again reintroduced the Madhouses Bill. The Bill was presented to the Commons for its first reading on 2 March, and was amended in committee on 23 March. The Lords voted on it on 21 April, and made two amendments (the addition of s.19 and s.31) on 6 May, before the bill returned to the Commons on 10 May. The bill received royal assent on 20 May.

Provisions
The Act required that all madhouses be licensed by a committee of the Royal College of Physicians. This license would permit the holder to maintain a single house for accommodating lunatics, and would have to be renewed each year. All houses were to be inspected at least once per year by the committee, who would also keep a central register of all the confined lunatics in order that people could locate them; outside London, the task of inspecting them would fall to the local quarter sessions.

The penalty for "concealing or confining" more than one insane person without a license was set at £500, and every keeper of such a house who took in a patient without an order from a doctor was liable to a fine of £100.

Implementation
The Act took effect on 20 November 1774, six months after receiving royal assent, and was originally stated to remain in force for five years and then until the end of the next parliamentary session. It was continued for a further seven years by the Madhouse Continuation Act 1779 (19 Geo. 3. c. 15), and then continued indefinitely by the Madhouse Law Perpetuation Act 1786 (26 Geo. 3. c. 91); it remained in force until repealed by the Madhouses Act 1828.