“The inmates are ghosts whose dreams have been murdered” Jill Johnston, U.S. journalist after she observed “patients” in New York’s mental ward at Bellevue Hospital.

Throughout medieval times in Western civilization, people who displayed any sign of mental illness were treated with fear, revulsion and often times, violence. The “treatment” of such people frequently consisted of simply locking them up in a dungeon and ignoring them. They were considered possessed by demons or the devil. Many were murdered or burned at the stake, victims of a misdirected religious fervor that claimed thousands of victims, especially during the Inquisition in 13th century Europe. Organized crusades against so-called “heretics” were formed by the Roman Papacy to persecute those of lesser faith. Soon, the Inquisition was used to severely punish political enemies, criminals and the mentally ill. In England, pressures on the ruling classes, forced them to deal with those who appeared “different” than others. A place was needed to treat and house the mentally retarded and others with mental afflictions that could not be explained. As a result, the Priory of St. Mary of Bethlehem Hospital in London opened its doors in 1247 Encarta 2000.

Sketch of Bedlam Mental Hospital (TIMEPIX)

The hospital became the first institution for the mentally ill in the Western world when it began to house the insane exclusively in the early 1400s and it soon gained a reputation as a place of suffering and misery. The living conditions for the patients were horrendous. They were often chained to the wall and tortured under the premise that it was for their own good. There were no guidelines or procedures on how to deal with the mentally ill at that time. Sanitary measures were unknown. For the most part, patients were left screaming in the darkness alone, sometimes doused in cold water or spun around in rotating chairs. Soon, members of the London upper class began to tour the hospital for entertainment. They were charged a fee to enter inside the institution and stare at the unfortunate souls who acted so much different than themselves. The hospital, if it can be called that, later became notorious under its better-known name, Bedlam; a word in the English language that has become synonymous with chaos and confusion. During the 19th century when its popularity was at its highest, Bedlam entertained more tourists than Westminster Abbey and the Tower of London.

The insanity defense has its roots firmly embedded in centuries of legal tradition. As early as the 13th Century, the English Lord Bracton established the principle of mental deficiency in human behavior.  He said that some people simply do not know what they are doing and act in a manner “as to be not far removed from the brute” (Menninger, 1968, p. 112). From that concept, “insanity” came to mean that a person lacks the awareness of what he or she is doing and therefore cannot form an intent to do wrong.  Since there was no malice in the intent of his or her actions, then there could be no technical guilt. The standard for insanity in the courts was determined to be  such that a “man  must be totally deprived of his understanding and memory so as not to know what he is doing, no more than an infant, brute or a wild beast” (Melton, 1997, p. 190). This “wild beast” standard was the insanity requirement of England’s courts for over a hundred years and any defendant who attempted to use the defense had to prove he or she lacked the minimum understanding of a wild animal or infant. It wasn’t until 1843, when a man named Daniel M’Naghten committed a murder that would alter forever the history of jurisprudence in the Western world.