Psychiatric Aftercare and the Cottage Home

Cottage homes for convalescing psychiatric patients first appeared in England in the 1880s. Convalescent homes for the somatically sick had developed during the mid-nineteenth century, often located at the seaside or in the country, where they took patients for a time-limited interval after active treatment. Cottage homes provided similarly temporary residential care and recuperation for patients recently discharged from acute treatment within asylums. Although the homes discussed in this chapter were specifically reserved for the convalescent mentally ill, the term ‘cottage home’ had been applied to other institutions from the late nineteenth century. John Adams has described workhouse infirmary wards reserved for children as ‘cottage homes’. Similarly, Edward Shorter has found the term applied to turn-of-the-century sanatoria for nervous and mental disorders in North America. Its usage is also associated with Barnardo's homes for ‘rescued’ girls (though not boys) in the 1870s. The definition of ‘cottage home’ was, therefore, somewhat elastic. Nevertheless, in early twentieth-century British psychiatry it referred more specifically to a type of lay-managed institution for the temporary convalescence of psychiatric post-acute patients. This chapter explores how these homes influenced patients' experience of discharge, identity and belonging through residential psychiatric aftercare.

Access to the cottage homes was regulated through the Mental After-Care Association (MACA).