The National Council For Lunacy Reform and Montagu Lomax.

(A review of the NCLR minute books 1920-22)

The Minerva Cafe in London’s Holborn district had acquired a whiff of dissent at the beginning of the twentieth century. It had strong associations with the women’s suffrage movement, the British Socialist Party and Sylvia Pankhurst’s Communist Workers Party. On 29th April 1920, the cafe hosted the first of two private meetings for a group of men and women  who were determined to improve care for the mentally ill. Montagu Lomax was not amongst them, and indeed his name would have been entirely unknown to these people. At the second meeting, held on 19th May 1920, a provisional committee was appointed and a new campaigning society was formed and named ‘The National Council For Lunacy Reform’ (NCLR).

The first official  meeting of the NCLR took place the following week on 28th May 1920. Minutes were hand-written in a blue exercise book, with members names and addresses inscribed randomly on the left hand pages, sometimes upside down 1. Whilst the appearance of the notebook is slightly ‘village fete’, the NCLR was in fact highly organised, and effective. It played a crucial role in the events unleashed by Dr Lomax’s 1921 book ‘Experiences of an Asylum Doctor’, and was instrumental in the campaign for a Royal Commission on Lunacy and Mental Disorder, and the subsequent 1930 Mental Treatment Act. The NCLR created the wave of publicity which Lomax subsequently rode, and the story of the Council’s formation is fascinating.

In 1920, the members of the newly formed NCLR committee were an extraordinary group of individuals. As far as I can tell, their connection seems to have been through the socialist movement including the Labour Party and Independent Labour Party. Some were theosophists, some anti-vivisectionists and many had also been active in the agitation for women’s suffrage prior to the first world war. J. Ernest Parley, an erstwhile asylum attendant and author of ‘Life In A Madhouse’ (1920), was a founder member but he was highly unlikely to have had the background  required  to attract his fellow committee members. It is not clear from the available records who was first to suggest the NCLR, but many of the 14 men and women of the first executive committee and its 5 co-opted members would have been well known to the British public of the time. The following are just a few of the names from the minute book:

  • Harold Baillie-Weaverwas a barrister. He was a strong supporter of feminism and was a theosophist and humanitarian. With his wife Gertrude, he had campaigned against vivisection.
  • Lizzie Lind-af-Hageby. A wealthy member of Swedish nobility, she trained as a medical student in order to expose the cruelty of vivisection. She was famous for the ‘brown dog affair’ of 1903 and the brown dog riots. Worth reading about. She was also a feminist, suffragist  and a theosophist.
  • Leisa Katharina Schartau. A Swedish school friend of Lizzie Lind, and also antivivisectionist, animal rights and environmental rights campaigner in the UK.
  • Mrs. H.W. Nevinsonwas a J.P.. She was married to Henry Nevinson, a war correspondent on The Daily Chronicle and The Manchester Guardian. (His son by his first marriage was Christopher Nevinson, the celebrated first world war artist). 
  • (Alice) Honora Enfieldprominent advocate of women’s rights and founder of The International Women’s Co-operative Guild.
  • Daphne Oliviercoming  from a Fabian background, she studied at Cambridge University where she mixed with Rupert Brooke and John Maynard Keynes. She  later became interested in the educational methods of Rudolph Steiner and established the first Steiner school in the UK. 
  • Dorothea Sanger –  aristocracy from the Pease family, married Charles Percy Sanger, a barrister and part of Lady Ottoline Morrell’s Bloomsbury set.
  • Lord Henry Cavendish-Bentinckfrom an old aristocratic family and Member of Parliament

There were a number medical doctors, including  Dr Hector Munro, founder of the Munro Flying Ambulance Corps in the first world war and  a director of the London Medico-Psychological Clinic. He was a socialist, vegetarian, suffragette and nudist2

So the NCLR founder members were well connected to the aristocracy; the literary ‘glitterati’ of the day; economists; journalists; the legal and medical professions; the Labour and Conservative parties, and MPs. Many founder members were veteran campaigners. Their previous experience and their contacts were to prove crucial in the success of the NCLR.

The First Two Years of the NCLR:

Conditions for patients within lunatic asylums had long been an issue of public concern. Dorothea Dix started an asylum reform movement in the United States around 1840, yet by the turn of the century, treatment of the mentally ill was still inhumane as described by Clifford Beers in his 1908 book ‘A Mind That Found Itself’. In Britain, the Alleged Lunatics Friend Society was started by ex-patients in the mid 19th Century to campaign for improvement in the mental health services. Historian, Nicholas Hervey considered that the Society played an important role in raising public consciousness of the threat psychiatric practices raised to civil liberties, and that it acted as an alter ego to the Lunacy Commission 3. Richard Paternoster, the founder of the Alleged Lunatics Friend Society followed Jeremy Bentham’s aphorism that “Publicity is the very soul of justice”. This principle was very much at the heart of the NCLR.

One of the first tasks of the committee was to devise a list of ‘Objects’ to define the Council’s raison d’être. This included the promotion of research into the nature and causes of insanity; investigation of the present system for the care and treatment of the mentally unsound; securing more effective measures for the recovery of mental health with attractive hostels (‘rest homes’);  safeguarding the liberty of the subject; reducing the burden of asylum expenditure; and finally to educating public opinion on the whole subject of the nature and treatment of mental disorder. The initial ‘Objects’ lacked a clear focus, although perhaps the broad scope of the mandate was deliberate. The committee set about publicising their existence from the outset. A letter was sent to the Ministry of Health to introduce the council, and the hunt for ‘persons of influence’ to endorse the work of the Council was set in motion. By the second committee meeting, 23 persons of influence had agreed to give their names, and further letters of invitation were sent out with these 23 names attached – an early version of celebrity endorsement.

The national press was provided with publicity leaflets outlining the work of the Council from an early stage. On 1st  November 1920, most of the national papers for England, Scotland and Wales carried a notice identical to that found on page 10 of The Scotsman:

Notices of response appeared the following week in a number of papers, commenting anonymously that the formation of the NCLR was ‘greatly welcomed’ and attaching the names of several members of the Council including the Bishop of Kensington, Lord Henry Bentinck and Sir Sydney Olivier, a prominent Fabian and father of committee member Daphne Olivier. During the committee meeting of November 18th 1920, the secretary reported that a good number of letters had been received from those interested in lunacy reform.

The initial objective of the Council was the provision of rest homes for early mental cases which would not come under the lunacy laws. It is interesting that Dr Helen Boyle had been providing exactly this facility for impoverished women  in Brighton since 1905 where she steadfastly refused to cooperate with the lunacy law commissioners. The committee decided to petition Parliament on the matter. This seems to be where previous campaigning experience confirmed that going to the very top was an effective first move.  Honora Enfield clearly knew her way around the various consultative committees in Parliament. She was aware that the Ministry of Health were trying to get a Miscellaneous Provisions Bill through which contained sections bearing on Lunacy. A deputation to the Minister of Health was proposed and a subcommittee established to work on proposals to present to the Minister.

The committee knew that co-operation with other pressure groups was vital to produce maximum leverage. The Ex-Services Welfare Society (ESWS) was also campaigning for rest homes for members of the military suffering from neurasthenia. The appalling treatment of some soldiers detained within lunatic asylums had shocked the British public, so as campaigning partners go, the ESWS was a good choice. Representatives from the NCLR and ESWS attended each other’s committee meetings, from time to time shared platforms in public meetings. The ESWS was later mired in controversy over misappropriation of funds at which point the partnership with the NCLR was terminated. The committee made great efforts to educate the public on all aspects of lunacy reform. They contacted adult schools, sending information leaflets for their members, and offering to supply speakers. Public meetings were proposed but hiring suitable venues meant that appeals for funds became necessary. It soon became clear that considerable amounts of money would be required to cover not only hall hire but also printing costs, and speakers’ expenses.

The drive to raise sufficient funds required an intensive campaign to bring the whole subject of lunacy reform to the public attention, again through adverts and articles placed in national  newspapers. The committee members were urged to use any contacts they had within the national press who might be able to further the campaign.  ‘Asylum Sunday’ was introduced by Miss Maude Royden who preached on lunacy at the London Guild house when literature was distributed and a collection taken. Several vicars were inspired to take the  ‘Asylum Sunday’ format back to their own churches. Drawing Room Meetings were set in motion. This seemed to be a recognised method of raising large donations from the wealthy members of the community. A ‘person of influence’ offered the use of their drawing room for an afternoon or evening, their friends were invited, the NSLR supplied a speaker for the occasion and a collection was taken. Drawing room meetings sometimes attracted in excess of 70 folk, so this was a lucrative source of funding. Many of the drawing room meetings were hosted by titled men and women in aid of the NCLR over the next few years. Lord Henry Cavendish Bentinck was involved in this manner and later became honorary treasurer for the Society. Finances began to improve slowly such that the  first public meeting of the Society could be held in London at the King’s Weigh House in June 1921.  Ernest Parley described his experiences as an asylum attendant, and Lizzie Lind-af-Hageby, an articulate public speaker, discussed the aims and objectives of the NCLR.

Invitation to a Drawing Room meeting at the house of Dr Octavia Lewin

Lomax’s book ‘Experiences of an Asylum Doctor’ was published in June 1921. The NCLR voted unanimously to admit him to the organisation. He  was soon speaking  at many public meetings around the country on their behalf.

Miss Margaret Cameron was appointed as an experienced fund raiser to cover the London area and was paid £3 per week. Miss Gabrielle Bell was engaged as a professional fundraiser for the north of England in February 1922. She had been one of the most successful organisers for the Save The Children Fund. Miss Bell was to act for the ESWS as well, and it was agreed that she should be paid 5% of the funds raised. By March 1922, Miss Bell had set about forming local fundraising committees in the north of England and arranging a lecture tour for Dr Lomax. An arrangement was made with George Alan and Unwin that they would supply ‘Experiences’ to the Council for 2/4d per copy which they could sell on at 3/6d. Lomax wrote to his publisher describing his lecture  in Leeds where he had sold a number of his books 4, so this was a lucrative source of income..

Publicity and the fund-raising drive quickly raised the public profile of the NCLR. Prominent figures such as G.K.Chesterton and H.G.Wells endorsed the Council as did a number of titled ladies and gentlemen from the aristocracy. Prominent psychiatrists joined the council – Dr Helen Boyle in May 1921, and Dr Lionel Weatherly in November 1921. Sir Frederick Milner, a retired MP, offered to chair the Council.  In November 1921, the Labour Party Public Health Advisory Committee asked for input from the NCLR to their programme of lunacy reforms to be incorporated into their official legislation programme. The NCLR was also invited to attend the Board of Control Conference in January 1922, and sent Dr Octavia Lewin as its representative. The Board of Control was the semi-autonomous authority within the Ministry of Health with responsibility for regulating the mental hospitals and other institutions concerned with mental illness and mental “deficiency’. Slowly gaining in credibility and with reasonable  financial reserves, the NCLR was beginning to make its mark.

In September 1921, the NCLR secretary expressed his belief that the time had come to transform the NCLR into a more active organisation with a wider scope and more vigorous propaganda. He suggested taking on a professional administrator and recommended Mrs Barbara Ayrton-Gould, who he said had ‘so successfully worked with other reform movements and raised money for propagandist causes’. Barbara Ayrton-Gould was an excellent choice but came with a high price tag of £500 per annum to cover her salary and office expenses. Ayrton-Gould set out her aim for a ‘Royal Commission Of Enquiries’ (into lunacy reform) and from this point onward, the original object  of ‘rest homes’ was quietly sidelined from the NCLR’s objectives,  and obtaining a Royal Commission became its main focus.

The NCLR and the Ministry of Heath Inquiry

The Board of Control’s response to the publication of Lomax’s experiences was to set up  an internal inquiry into the truth of his allegations about Prestwich Asylum. This was clearly an attempt to whitewash the problem, but by the time the internal report was presented to the Ministry of Health, it was clear that the public reaction to the book demanded a more robust response. The MOH commissioned a more thorough inquiry under the chairmanship of Sir Cyril Cobb, which sat in February 1922, less than 8 months after the book was published.

Barbara Ayrton-Gould visited Lomax at home in early January 1922. He had been ill and had asked initially that the Cobb Inquiry be postponed until he recovered. However, by the time of Mrs Ayrton-Gould’s visit, he had decided that the whole inquiry was valueless and that he would rather save his own evidence and witnesses for a Royal Commission. The National Asylum Workers Union was of the same mind and had declared that they would have nothing to do with Cobb. Ayrton-Gould thought that the Cobb Inquiry would generate considerable public interest, so it was crucial that the NCLR should call as much evidence as possible on the question of asylum conditions and administration. She also suggested that the membership of the Cobb committee was biased so should be criticised publicly, and that questions should be put to the Minister of Health in Parliament. NCLR representatives including Dr Helen Boyle attended the Cobb Inquiry. They reported to the NCLR committee meeting of 21/2/22 that the Cobb inquiry ‘appeared to be quite farcical’.  Dr Hubert Bond from the Board of Control had visited the Prestwich Asylum and found everything in order and claimed that Lomax’s allegations were groundless. The Cobb Committee report  was thus generally considered to be another  ‘whitewash’.. Lomax wrote a long rebuttal of its findings, published by the NCLR 5.

In February 1922, the NCLR committee reported that the press campaign continued to push the topic of lunacy reform. The NCLR had had three long letters published in the Times, with two leaders devoted to the subject of lunacy reform. These had drawn replies in the Press from Sir Alfred Mond  (Minister of Health) and Sir Frederick Willis (chairman of the Board of Control). Interviews with Dr Lomax and Mrs Ayrton-Gould had also appeared in the Herald. Mr Bennet, the editor of Truth magazine had been approached by the committee and was very willing to cooperate. (Truth magazine subsequently played an important  role in the campaign for a Royal Commission). Dr Lionel Weatherly had received a personal letter from Sir Alfred Mond, the Minister for Health, in which he acknowledged that there ‘was a need for a properly constituted Public Enquiry’. The NCLR sent a deputation to Mond on 16th March 1922, and felt that the Minister acknowledged the NCLR’s concerns and admitted the urgent need of reform. Mrs Ayrton-Gould, who lead the deputation, felt that this was very encouraging ‘since it was obvious that the authorities were trying to placate the council’.

In May 1922, the BMJ carried an article on the formation of the National Council for Mental Hygiene (NCMH) 6. The members list reads like a Who’s Who for the celebrated psychiatrists and physicians of its day – Henry Head; Frederick Mott; Maurice Craig; W.H.H. Rivers; Bedford Pierce; George Robertson; Humphrey Rolleston to name but a few. Dr Helen Boyle was also a member as was the aforementioned Hubert Bond from the Board of Control who was then the president of the Medico-Psychological Association. Many of the objectives of the new council were similar to those of the NCLR, and indeed overlapped with some of the recommendations that Lomax had made in ‘Experiences’ in 1921, particularly the need for outpatient clinics for treatment of early cases of mental disorders. The NCLR was quick to ally itself with the new NCMH and wrote to the Press to confirm its proposed partnership with the great and good of the medical world. The inaugural meeting of the NCMH was attended by Dr Lomax and Dr Sara White along with Mrs Ayrton-Gould.

After a prolonged and difficult campaign, Barbara Ayrton-Gould’s declared goal of a Royal Commission was finally achieved and the Royal Commission on Lunacy and Mental Disorder was established in 1924, reporting in July 1926. The focus of the NCLR then changed to ensuring that the recommendations of the Royal Commission were enshrined in law. This particular battle was long and hard. The NCLR minute books contain several newspaper cuttings commenting on the lack of action in Parliament. In 1928, the NCLR changed its name to The National Society For Lunacy Law Reform, to reflect the need to drive through the recommendations of the Royal Commission. Eventually the Mental Treatment Act of 1930 was passed through Parliament, a decade after the formation of the NCLR and nine years after Lomax’s book was published. 

Summary:

Lomax wrote: ‘ When in the summer of 1921 I published my book of ‘Asylum Experiences” I was quite unprepared for the immense amount of public interest it immediately excited……..The fact that a book written by an obscure and hitherto unknown medical man, and having no pretensions to do more than skim the surface of the matter dealt with, should have such a striking and immediate effect proved at least two things: that the subject was recognised to be of pressing importance and appealed to public interest, and that I had quite unexpectedly struck the ‘psychological moment’ for its discussion’ 5.It seems from review of the NCLR minute books that Lomax’s book was indeed well-timed, launched just as the highly organised NCLR campaign for lunacy reform was gathering momentum. The NCLR was able to provide professional campaign support for Lomax, lobbying members of parliament;  funding public meetings, managing the national Press interest, publishing supporting literature and giving  Lomax influential contacts with the political, literary and medical movers and shakers of the day. Lomax in turn, provided the NCLR with an articulate witness of the horrors of the lunacy system, who wrote clear, well-argued articles which could be understood by the layman, and was prepared to take every opportunity to campaign for reform. Certainly the synergy between Lomax and the NCLR was a significant factor in the success of the lunacy reform campaign, and the subsequent 1930 Mental Treatment Act. 

Acknowledgements:

With many thanks to Dr Claire Hilton, historian in residence at the RCPsych, for her input and editing skills.

References:

1)  National Council for Lunacy Reform Minute Books, 1920-1922 Welcome Collection. SA/MIN/1/1-3

2) Elsie and Marie Go to War. (Extracts) Diane Atkinson (https://www.dianeatkinson.co.uk/excerpt_EandM.html)

3) Hervey, N. (1986). Advocacy or folly: The Alleged Lunatics’ Friend Society, 1845–63. Medical

History, 30(3), 245-275. doi:10.1017/S0025727300045701 p252

4)  Letters to and from Montagu Lomax: correspondence between publishers George Allen and 

     Unwin and Montagu Lomax. University of Reading, Special Collections, AUC 8/17. 1923-24.

5) A Reply to the ‘Report of the Committee on the Administration of Mental Hospitals’ 1922 by 

    Montagu Lomax. Welcome Collection 

6) National Council for Mental Hygiene, BMJ May 13th 1922 p766

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