The commercialization of care

For nearly thirty years, historians and sociologists have been debating the reasons why institutions for the insane developed on an unprecedented scale in eighteenth- and nineteenth-century Europe. Earlier Whiggish evaluations in terms of medical and humanitarian progress — the realization that insanity is an illness, the rise of the welfare state — gave way in the 1960s–70s to more sceptical appraisals linking the birth of the asylum to a repudiation of the irrational in the age of reason (Foucault), or a quest for social control in newly industrialized societies (Doerner). ¹ Both Foucault and Doerner included England in their broader European analyses, but it remained for Scull to provide a more detailed study of the genesis of English asylums in terms of social control. Scull linked the rise of the asylum to the demands which an industrial-capitalist labour market placed on family resources, arguing that segregation of the dependent insane freed other family members to participate in the market, as well as endorsing the social order by removing the disruptive or deviant. He also emphasized the self-promotion of the medical profession as experts in insanity as the motor of continuous growth of the asylum system throughout the nineteenth century. ²