Michael Robinson

Introduction

Using Rainhill Asylum records from 1899 as a case study, this chapter aims to help students who are engaged in studies of mental health, mental health institutions, as well as other aspects of the history of medicine. Asylum records offer insight into a vast array of historical topics, and this chapter will focus on broad research questions that these sources can help us to answer. In particular, this essay will look at three research resources: annual reports, admission and discharge registers, and individual casebook records. These files provide clear and concise insight into the infrastructure of these medical facilities and the staff and patients who worked and lived within them. While these documents are rich with detail, they remain inherently flawed as primary sources. As will be discussed, their shortcomings can be overcome via a triangulation of sources.

Rainhill District Lunatic Asylum (latterly known as Rainhill Mental Hospital) was a psychiatric hospital located a few miles outside St Helens, Merseyside. It opened in 1851 accommodating around 300 patients. By 1887, it treated over 1,000 patients who were diagnosed as insane. It was closed in 1991. The facility should not be viewed in isolation. Instead, it was one institution within a network of district facilities throughout Britain and Ireland. The records of the institution are currently held at the Liverpool Record Office located within Liverpool Central Library. Operating for over a century, it is unsurprising to find that the collection is incredibly vast. Resources available include admission papers, discharge and death papers, medical journals and report books of officers and nurses, committee minute books, chaplain reports, visitor’s books, architectural plans, casebooks, annual reports, and registers. Thus, this chapter is only an introduction to the material available within the collection.

Overview

The asylum records of the Rainhill District Asylum, including admission and discharge registers and asylum casebooks, are a product of the 1845 Lunacy Act. This legislation made it compulsory for asylum staff to keep detailed records of institutions and its patients including regular casebook entries describing the patient’s condition. Before this, asylum staff rarely recorded more than a few sentences per patient which rarely went beyond admission. Also, official external reports were produced to aid the running and progress of mental health treatment within institutions. It was during the eighteenth century that medical publications became more concerned with the treatment of mental illness. The records under scrutiny in this chapter reflected this emergence of scientific medical research and investigation into mental illness (Andrews, 1998).

Government inspectors, in the form of Commissioners in Lunacy [A], inspected asylums to check upon asylum conditions and the treatment and condition of patients. These annual reports also include the annual summative account of the Report of the Resident Medical Superintendent [B]. Their two reports provide a vast array of qualitative material. They include a description of asylum conditions, the behaviour of patients, treatment employed, and how patients were disciplined and entertained. In the latter half of these reports, an assortment of asylum staff helped to offer statistical data on patients and the administration of the asylum (see also Andrews, 1998; Risse and Warner, 1992).

Studying mental health for historical research can prove challenging for a variety of reasons. The availability of relevant source material is unpredictable. For instance, because it was rare for poorer members of society to write letters or produce individual records that commented upon their condition, their private experience remains a hidden history (Scull, 2011). Also, mental ill health has long carried a stigma which would have silenced those ashamed to articulate their suffering. Unsurprisingly, in light of these shortcomings, the historiography of mental illness has had a heavy focus on case studies of individual institutions which catered for people diagnosed as mentally ill. These studies are essential to our understanding of district asylums because they provide a critical overview of the asylum’s administration, infrastructure, and treatment methods. However, these publications leave many fundamental questions and considerations untouched. They offer little insight into the profile of patients or staff or their experience while living and working at the treatment facility. This is a feature of earlier historiographies of both medicine and disability (Bredberg, 1999).

While historians have utilised these sources to produce works on individual asylums, this institutional focus was challenged in 1985. In the influential article ‘Doing Medical History From Below’, Roy Porter argued for a social history of medicine with a fuller appreciation of the perspective of the patient (Porter, 1985). When studying the asylum, Porter’s methodology encourages us to consider the insane patient and their experience of treatment; they are equally as important as the medical staff who treated them and the institution in which they were held. As a result of this research, historians have moved beyond exclusively analysing the asylum as an impersonal institution, and a more complex but altogether more convincing picture of the asylum has emerged. For example, Louise Hide’s masterful study of life for patients and staff in two London Asylums between 1890 and 1914 sheds insight into the lives of patients and staff living and working within these institutions (Hide, 2014).

Despite this appreciation of the ‘patient’s view’, attempts to achieve an equally authentic reflection of the patient’s experience has proven problematic (Armstrong, 1984). The voices of patients, who vastly outweighed the staff who treated them, or the lawmakers who helped to categorise them, remain under-represented in comparison (Kelly, 2015). Perhaps this imbalance is unavoidable. As a result of the Data Protection Act (1998), it is hard to access asylum records less than 100 years old owing to the sensitive personal health information contained in the files. This statutory protection explains why analysis into the patient’s treatment within the nineteenth-century asylum is covered so well in the historiography but why so little work has been produced discussing the twentieth century. Similarly, Hide’s study into life within two London Asylums, published in 2014, does not extend beyond 1914.

Even older patient records not protected by statutory legislation remain awkward to research. Asylum records are rarely digitised and are often only accessible through personal visits to the archive where the material is stored. Sometimes even the luxury of an archive is not afforded to researchers. For example, historians have had to access disorganised asylum material in an abandoned cotton mill (Barham, 2004). Such trips can be time-consuming and expensive. Records which are not stored locally are particularly inconvenient when return trips are necessary to clarify, explore, or extend research enquiries.

The history of research resources can often reflect the historiography (Evans, 1997). This relationship is very much evident in the biography of asylum records. Due to the mammoth size of asylum records, and the lack of appreciation of their historical value before Porter’s rallying call, many asylum records have not been preserved (Risse and Warner, 1992). Records that have survived are often heavily compromised in their quality and rarely available to read in their entirety, having been held in unsuitable conditions for decades. Nevertheless, the increased accessibility of asylum records is a reflection of developments within the historical discipline of mental health research. Over the past thirty years, archivists have made a concerted effort to organise better and make available the historical records of asylums. The Rainhill records were transferred to Liverpool Central Library via the National Museums and Galleries of Merseyside in 1985, the same year as Porter’s seminal article, with further accessions arriving in 1989 (via the National Museums and Galleries of Merseyside) and 1991 (from the Medical Records Officer, Rainhill Hospital). A final deposit was made in 2001 by Lancashire Record Office.

This restoration is not unique to Rainhill. The records of the largest asylum in Ireland, Richmond District Lunatic Asylum, were previously located on the site of the Grangegorman Community Museum, Dublin. The resources were unorganised and barely cited despite providing over twenty tonnes of records dating back to the asylum’s opening in 1815. In 2013, after an investment of £200,000 from the Wellcome Trust, the documents were placed in The National Archives of Ireland having been fully restored and catalogued for researchers to access. This work was laborious, with scholars being unable to access the records during the two-year conversion process. Thus, the ability to access fully restored and appropriately catalogued records in a nearby location is a huge benefit to researchers interested in studying the Rainhill Asylum collection.

The study of asylum care is a constantly evolving area of research. Asylum records offer exciting opportunities for synergetic collaboration with new emerging disciplines such as Trauma Studies and the History of Emotions. For example, Birkbeck University recently established a centre for the Study of the History of Trauma in Science and Medicine which includes a heavy research focus on institutions such as the insane asylum. A variety of sources can be utilised to examine a history of medicine and a history of mental health. Indeed, potentially relevant sources have been discussed elsewhere in this collection including parliamentary debates, newspaper articles, photographs, political cartoons, and oral interviews. A discussion of how to utilise all of these sources is beyond the scope of this chapter. Instead, owing to their frequency within the historiography, and the locality of relevant material, this chapter will focus on the three aforementioned records of the Rainhill Asylum. These documents were not produced for the benefit of future historians. Nevertheless, we can still study this material ‘against the grain’ by utilising the information for historical research rather than for the intention of which they were originally produced. As will now be discussed, we must tread carefully when accessing these records for historical purposes.

Selecting and interpreting sources

Annual reports

The vast size of asylums has led them to be described as ‘miniature towns’, with many having a chaplain, bakery, mortuary, graveyard, water, and gas resources, and even police officers and firefighters (Scull, 2011). Annual reports provide the best overview of an asylum’s infrastructure. They contain in-depth and detailed information on patients. This includes a host of quantifiable data including admission, discharge, and death statistics, the number of patients who had been previously admitted, the average length of residencies, the marital status of patients, their occupation, nationality, religion, as well as information on staff salaries and wages, and the condition of the asylum facilities and cost of upkeep and repairs. These detailed records are remarkably consistent and transparent making it easy to cross-reference themes across a chosen period. The leading authorities at these institutions, such as the Resident Medical Superintendent, are also consistently referenced. Thus, follow-up research is possible by utilising the online archive of publications such as The Lancet or The British Medical Journal, which can trace the papers or obituaries of these officials. Through this record-linkage, it then becomes possible to relate the clinician’s conduct within the asylum to their education, ideas, and writings not available within the collection (Risse and Warner, 1992).

While providing an essential insight into the operation of the district lunatic asylum, it is important to consider the intended audience of such reports. Dealing with the administration and running of institutions, these reports mostly forfeit any consideration of individual patients or subordinate staff employed within the asylum. Represented as statistical data, the insight and experience of employees and patients remain obscured. Secondly, as summative accounts, these records may purposefully or accidently misrepresent asylum conditions or omit relevant information which would be crucial to your research. As public records to be scrutinised by external officials, it is entirely plausible that these reports could downplay difficulties and disagreement to present a united front. An analysis of these issues would perhaps be better served by looking at other records within the collection such as the minutes of committee meetings. These files provide far more detailed accounts of asylum infrastructure and administration than those presented in annual reports. Even external reports by the inspectorate cannot be accepted as being entirely representative of daily asylum life. These inspections usually lasted less than forty-eight hours with little consideration of the patients’ opinion undertaken.

Admission and Discharge Register

Despite their absence in annual reports, patients are traceable within the Rainhill collection. One way in which this is achievable is via an analysis of the Register of Patients [C]. Demographic data within the records were entered as a result of a general questionnaire and medical examination of patients on their admission (Armstrong, 1984). Asylum registers include a wealth of information including the name of patients, their age, previous entries, gender, age, marital status, occupation, last place of residence, diagnosis, supposed cause of insanity, their bodily and mental condition, the duration of their mental attack, as well as information regarding their discharge, recovery, or death.

Depending on the aims of the researcher, these data sets can offer a host of revealing contrasts and trends. For example, they can help us to trace clinical patterns with medical diagnoses appearing and disappearing in accordance to the medical discourse of the time. Such prosopographic methodologies are not just restricted to diagnoses. Patient biographies can be produced with regards to issues such as age, marital status, gender, employment, the length of treatment, and discharge details. An astute and confident understanding of programmes such as Microsoft Excel or SPSS provides potential for quantitative research via a production of patient biographies (Kelly, 2015).

Despite these benefits, registers remain imperfect as a research resource. They provide negligible insight into the patient’s day-to-day experience as no information is given on their medical condition and daily conduct is provided beyond their admission. The absence of any data sandwiched in between their entry and exit into the asylum is especially problematic when remembering that many patients remained in the asylum for decades at a time. This creates the necessity of navigating through the available sources to gain insight into the patient’s experience of treatment. Fortunately, registers are incredibly well-indexed and, as a result, their individual medical records are easily traceable within the casebook.

Casebooks

Casebook records provide information on individual patients unavailable in any other resource. This includes admission details [E], which provide detailed explanations as to why the patient was certified as insane. This crucial testimony was often provided by a family member of the patient. Information on the previous condition and life of a patient is of particular importance for social research as it allows us to formulate a clearer picture of the everyday life of the patient before admission (Risse and Warner, 1992). Lengthy updates on their behaviour and condition while receiving treatment are also included, as is their interaction with staff and fellow patients, and even quotations from the patient during conversations with staff could be transcribed. Even a photograph of the individual on admission and discharge [F] is included. Despite the incredible detail included within these immensely readable accounts, historians must remain cautious when utilising these records.

While a patient’s testimony is often included in these reports, due to the very nature of the doctor and patient relationship, the process of transcribing clinical records rested primarily on the physician’s perspective. There is no indication of how consistent and professional the doctor’s enquiries were at the time of interaction and examination. Also, they are often summarised or paraphrased by asylum staff. The patient’s tone and what they were responding to also remains absent. Rarely is the patient’s statement allowed ‘to speak for itself’ (Andrews, 1998). David Armstrong similarly recognised that ‘the patient’s view’ is likely to be largely bypassed as any historical analysis can only assess ‘what is heard, not what is said’ (Armstrong, 1984).

Rather than providing updates on the patient’s life within the asylum, a focus on ‘scientific’ clinical enquiries, which broadly describe physical and mental symptoms, remain the focus of attention. Large asylums accommodating many chronic patients would also have had enormous difficulty in keeping accurate, in-depth and up-to-date records on its numerous patients. Thus, descriptions such as ‘No Change’ and ‘Continues in the same condition’ to depict the status of patients over lengthy periods of treatment are extremely limited to a researcher interested in charting the daily life of patients (Rambaut, 1903). Ideally, two casebooks – one kept by a patient explaining her interpretation of her condition, and her experience within the asylum, and one held by a medical professional – would exist to offer a fairer reflection of the doctor’s opinion alongside the ‘patient’s view’. Of course, such records do not exist (Leese, 2014). One way in which historians have attempted to work around this is via analysis of correspondence sent from patients to family members. This material has allowed previous works to comprehend the patient’s viewpoint regarding their mental condition and their experience of patienthood (Beveridge, 1998). Unfortunately, the survival rate for such material is inconsistent, with no evidence of such records existing within the Rainhill collection.

Despite these problems, the inclusion of a patient’s testimony, despite being highly mediated by the dominant figure of the document’s author, does, at the very least, provide the viewpoint of an individual who would otherwise have remained totally obscured. So far, this chapter has introduced three research resources held within the Rainhill collection, and discussed the benefits and drawbacks inherent in this material. We will now finish by tackling problems with the source material, while attempting to highlight their usefulness for historical research.

Practical advice

The Annual Report of the Rainhill Asylum [A] will be analysed first. The first section of the report includes the annual report of the lunacy inspectorate, an external body who scrutinised asylum conditions and its administration, and the Resident Superintendent, an internal official employed within the asylum. It could be potentially illuminating to analyse how the two reports ‘speak’ to one another, while also identifying similarities and differences between the reports. Did the annual visits from external officials influence medical policy or asylum conditions? Was the Resident Superintendent able to remain autonomous and ignore recommendations and complaints? Indeed, an analysis of the Lunacy Inspectorate, and their influence on asylum policy has received scant attention in the historiography (Mellet, 1981). Common trends and fluctuations between the two reports over a given period may provide essential detail as to the power structure within institutions, wider mental health policy, and how progressive these institutions were as medical facilities.

The second half of the record contains a vast array of statistical data. This includes information regarding admissions, discharges and deaths, financial reports, diagnostic categories, and a host of other quantifiable data. The impeccable organisation of these data provide researchers with the opportunity to use programs such as Microsoft Excel or SPSS to produce quantifiable data. A vast array of approaches is possible to suit your research purpose best. For example, the records allow a calculation of recovery and discharge rates. This would help answer a research query as to whether Rainhill Asylum matched its aspiration as a treatment facility (Risse and Warner, 1992).

It is, however, important to recognise regionalism when discussing asylum care. Regardless of your research aim, the annual reports of Rainhill Asylum will not be entirely representative of national trends. This can be addressed by extending the number of institutions considered in your research. The Rainhill collection hosts the regional annual reports which address asylums throughout the northwest of England. While providing less information than annual reports dedicated to single facilities, the annual inspectorate reports of the national district asylum network are accessible online via digitised parliamentary papers. The records of the Rainhill Asylum can, therefore, be useful as a micro study, but it is also possible to contextualise your Rainhill research within a larger a regional or national context. The more annual reports you can analyse, and the longer the period you can assess, the stronger your argument will become. But, remain realistic. It will be impossible to cover every aspect of asylum care in every asylum from their establishment to their closure. From the outset, it is important to establish a manageable research project by the time and resources available.

Despite the detailed quantitative data available in annual reports, very little information is provided on individual patients. Reliance on official records to uncover the everyday realities of disabled and ill people have been rightly criticised as ‘inevitably one-sided in their account of the disabled people, presenting them as depersonalised objects of institutional action’ (Bredberg, 1999). To better understand the patient, and subsequently ‘study medical history from below’, we must consider more patient-focused records. Asylum registers [C] can help achieve this. They include a wider variety of data on individual patients from admission to their discharge from or death within the asylum. These records therefore provide the potential to undertake a life-course analysis of patients, and information within these records might become the subject of intricate prosopographic research. Once manually entering such data into Excel or SPSS it becomes possible to compare specific data for research questions and discover trends and dissimilarities which would not be possible, or much harder to decipher, by relying solely on annual reports.

An analysis of these trends can help us understand a clinician’s thought process and their contemporary understanding of mental illness. It is even possible to discover patterns between individuals and treatment experience. For example, was there a correlation between the gender/diagnosis/occupation/age of a patient and the likelihood of them being discharged recovered or remaining in the asylum until their death? There is a host of pre-established debates within the historiography which you can engage with using the register as a case study. For example, how did gender impact on the diagnosis of admitted patients? Previous research has argued that females were diagnosed differently to men and were more likely to be diagnosed with ‘Hysteria’ (Showalter, 1987).

The depth of potential comparisons offers massive scope to fit your research needs. Once again, as the breadth and depth of the material are so vast, it is important to be clear as to what you are looking to assess before analysing the data. The mammoth size of these records also makes it impossible to cover every aspect of one register. Depending on your research query, it may not be necessary to detail every piece of data in a patient’s individual record. Ask yourself how much data should be collected, or how you might identify representative information.

The process of obtaining information, entering them electronically and coding the data to match your research aims also requires an understanding of the software being used to undertake statistical research. Thus, it may be beneficial to read guides on research methods regarding statistics or programs such as Excel or CPSS. This learning process will improve your skill as a historian and improve the quality of your research. They also permit the study of patients outside of asylum walls. As patients are named with an accompanying age and address, it is possible to track down the lives of patients and their families in civil society before their admission or after their discharge via online catalogues such as Ancestry. A life-course analysis helps to demonstrate that individuals referenced within institutional records should not only be defined by their patient-hood; this methodology offers a potential new branch of ‘medical history from below’.

Summative annual reports and admission and discharge registers are incredibly detailed, but not the most beneficial if attempting to analyse the lived experience of those within the asylum. An analysis of individual casebook records allows us to address this omission. Casebooks include information on patients not mentioned in an admission register or annual report. For example, an explanation for their admittance, usually provided by a friend or family, is included, as is detailed information on their family history of insanity, their personal history, and a detailed physical and mental description of the patient on admission. These descriptive accounts can help us to understand better why these men and women were admitted. In particular, it is possible to focus on certain descriptions or criteria included in these individual accounts to decipher why certain diagnostic categories were utilised by medical staff.

A typical casebook page [D] provides updates on the condition and conduct of patients from their admission to their death or discharge provides a host of information on their daily life within the asylum walls. The patient’s participation in recreational and entertainment activities are regularly included as is the conditional access to such privileges. This information not only provides information on individual patients but provides insight into institutional policy not-fully-explained in annual reports (Risse and Warner, 1992). It is no surprise that those involved in the medical humanities have begun to rely heavily on these files. One prominent historian involved in the study of asylums even went so far as to attest: ‘[they] may provide the surest basis we have for understanding the changing nature of the experience of the insane in asylums since 1800’ (Andrews, 1998).

It is imperative to remember that the narrator of such records is not the patient under treatment. An asylum staff member transcribed information following an interaction between doctor and patient. We must be wary of blindly accepting their opinion. It is impossible to verify the accuracy or context in which an examination took place (Kelly, 2015). From boredom to a stressful work environment, a range of human factors could have influenced the transcribing records which are impossible to detect within the record itself. Despite the aforementioned methodological problems raised as a result of the narrator’s dominance in these accounts, even these highly mediated inclusions can prove useful to a historian. As their descriptions range from sympathy to condescension to outright hostility, a dismissal or suspicion of a patient or a sympathetic understanding can help us understand better the ethos of medical treatment within such facilities, the personality of asylum staff, and how they viewed the patients under their care (Risse and Warner, 1992).

These internal records are not summative accounts nor were they produced for the benefit of external scrutiny. For this very reason, they can offer insight into a facility which medical staff may have been reluctant to demonstrate to the outside world. For example, previous research into the Rainhill collection has verified that widely held derogatory opinions of the Irish migrant in civil society influenced the clinician’s description of the Irish-born patient (Cox, Marland and York, 2013). Despite the influence such opinions may have had in the treatment of patients, racist descriptions of Irish patients were unlikely to feature within the official annual reports available to outsiders. With such evidence in mind, the usefulness of these records as research resources comes to fruition.

However, without an understanding of the wider social and medical discourse, such examples from casebooks provide descriptions and not a historical argument. If, for example, you are looking to investigate the treatment of Irish-born patients further, it is important to understand the casebook material within the existing literature on Irish migration into Britain, and perceptions of the Irish migrant amongst Britons, during your chosen period. If analysing a specific category of the patient population, whether it be female prostitutes, unmarried mothers, criminal lunatics, or alcoholics, an understanding of how these people were perceived and treated in wider society and outside of asylum walls, is essential. This engagement with the broader literature will allow your institutional case study to not only further our understanding of an individual asylum, but it will allow your work to intersect with much broader themes.

As Richard Evans argues: ‘The gaps in a document, what it does not mention, are often just as interesting as what it contains’ (Evans, 1997). It is, therefore, important to consider the silences contained within casebook records. Previous research has argued that wealthy, professional, literate patients received more descriptive entries and attention from asylum staff within transcribed medical notes. Also, those who demonstrated more extroverted behaviour also received more attention in comparison to more depressed and insular individuals (Andrews, 1998). The casebook allows a historian to explore these arguments. Did patients of wealthier and professional backgrounds receive more attention than pauper lunatics? Did patients diagnosed with an illness such as ‘mania’ or ‘delusional insanity’ receive more attention than those diagnosed with ‘melancholia’? It is not uncommon for updates on a patient to become irregular and less detailed the longer they were residents within the asylum. What does this tell us about patient care? Was little thought or hope of treatment afforded a patient over a specified time limit? The answers to these questions could help formulate evidence not only on the history of institutional care but could also offer potential insight into the relationship between socio-economic influences and perceptions of certain mental illnesses that are still relevant today.

You should not attempt to introduce your medical opinion. Utilising the Diagnostic and Statistical Manual of Mental Disorders, just four symptoms are needed for a diagnosis to be offered. Even today, however, attempts to define mental illness remains difficult even for medical professionals. X-ray and scans can objectively assess physical symptoms, but the same luxury to categorise someone as sane or mad remains difficult (Scull, 2011). Quite simply, we do not know enough about a patient’s backstory and individual experience to pathologise the individual. As those who have previously engaged with casebook records point out, it is almost ‘ahistorical’ to diagnose patients retrospectively (Hide, 2014).

Studied individually, asylum records can offer insight into your chosen subject. However, it can be a mistake to over-privilege one source. In their most basic function, annual reports provide insight into the operation of the asylum; registers provide collective biographies of patients, and individual casebooks provide unique and personal insight into this larger population. Therefore, a triangulation of these sources can prove incredibly rewarding. If, for instance, your chosen research theme was dedicated to female patients diagnosed with ‘Melancholia’, then annual reports, admission and discharge registers, and individual casebook files can allow us to undertake a methodologically sound approach to the subject.

Firstly, the annual reports can help us calculate how many female patients were diagnosed with ‘Melancholia’, and how their presence compared with other diagnostic categories. They also provide insight into the general condition and infrastructure of the asylum shared by this patient population. Secondly, a chosen data set of female ‘Melancholic’ patients within the admission and discharge register allows us to produce a group biography of these women, enabling us to study a variety of trends within the patient population such as socio-economic backgrounds, age profiles, marital status, and the probability of recovery. Finally, while recognising that a small sample of individual records cannot be adequately represented in your entire data set, nor is it always possible to provide relevant casebook examples in their entirety, the individual casebook file of Winifred Tilson [D] can provide a detailed individual microstudy into the experience of female melancholics who underwent treatment in Rainhill Asylum. This example is just one of a host of variables that a researcher can explore.

Finally, this chapter wishes to urge two notes of caution with regards to practical issues. Judgements of psychiatric irregularity are intrinsically linked to broader socio-political trends and constantly shift and evolve over time. For example, the Rainhill records will describe some sections of its patient population as mentally ill but whose reception in modern-day society would be very different. These diagnoses could, for example, incorporate patients with learning difficulties, epileptics, and homosexuals. Categorising these people as mentally ill would be inaccurate and offensive today. Even the name of the institution does not remain static. The Rainhill District Lunatic Asylum was relabelled as the Rainhill Mental Hospital in the 1920s, which coincided with attempts to reform the practice and image of these facilities. Thus, when including medical terms in your research project, be sure to understand any diagnostic category or medical term in its contemporary setting, and clarify your understanding of the terminology, and how these terms are defined in your work, from the outset of your submitted work.

Legal issues also ensure that a researcher must be clear what material is available to access from the outset and adjust their methodology accordingly. For example, during World War II an annexed building on Rainhill’s grounds was utilised as a military institution to accommodate servicemen suffering from neuropsychiatric symptoms. Access to the relevant material to research these men will be impossible for another two decades. In contrast, official reports, fundamental to the study of institutions, but which offer little in the way of individual perspectives, are freely available to researchers as they rarely include personal information on individual patients. These issues must be considered when thinking about how to use these sources best. Such restrictions should not always be viewed negatively. Owing to the 100-year rule, a new selection of records becomes available on a yearly basis. This newly available material provides students with the perfect opportunity to access primary documents which have received negligible consideration.

Conclusion

This chapter has considered a small range of asylum records currently held within the wider Rainhill collection located in Liverpool Central Library. The depth and detail involved in these records offer a host of research possibilities to the historian utilising the records. An institutional case study is possible as is situating the material within broader treatment, medical, and social contexts. Regardless of the type of document utilised, as with all records discussed in this collection, a student using the Rainhill records must think critically and write honestly about the limitations inherent within these research resources. These imperfections should not deter a historian from engaging with the subject. With an honest appraisal of their flaws, utilising these records provides the potential for exciting and progressive academic research. A study of the Rainhill Asylum offers the opportunity to partake in a fascinating and ever-expanding discipline.

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