Introduction

In this revealing passage from a 1911 annual report, William Graham, the medical superintendent of Purdysburn public asylum for the insane near Belfast (known as Purdysburn Villa Colony), offered a veiled apology for the high level of provision made for the insane poor in a facility which was, after all, financed by the ratepayers and for whose managers and administrators economy was a guiding principle. Graham contrasted the ‘hygienic efficiency’ of the new buildings with the slums of Britain and Ireland while making an exhortation to ‘level up’ society, to bring the poor up to the living standards of the better off. At first glance, this passage seems to be little more than a justification for the expense of providing comfortable living conditions for the mentally ill but the dichotomy that is set up here between the ‘degraded and unlovely’ slums and the ‘hygienic efficiency’ of the asylum expresses a distinctively Victorian/Edwardian spatial classification, and hints at a cultural context in which the mental, the physical and the moral were closely bound together. This chapter will tease apart some of the resonances of Graham's statement and will begin by setting the public health context in Belfast c.1900 before moving to wider discourses which cast ‘the city’, and particularly urban slums, as centres of disease and infection to which the rural/agricultural and rural/suburban spaces of the asylum provided a healthful counterpoint. This will be followed by an analysis of the writings of medical superintendent William Graham which will set out the connections he makes between poverty, environment and mental health.