Was insanity increasing? A response to Edward Hare.

One of the central paradoxes of the Victorian reforms in the treatment of the mentally ill was the curious fact that the “scientific” discovery of mental illness and the adoption of a more rational approach based on this discovery—an approach which aimed at treating and curing the lunatic, rather than neglecting him or incarcerating him in a gaol or workhouse—were associated with an explosive growth in the number of insane people. Edward Hare's recent Maudsley Lecture raises again the interesting question of whether or not this reflects a true increase in the incidence of mental illness in nineteenth century England. As he correctly notes, the aggregate data collected at the time do not allow a “decisive answer”, but I am pleased that his reassessment of the probabilities led him to endorse my prior conclusion that its incidence was indeed increasing. (Scull, 1979).