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institutional deaths
Historic deaths, difficult questions

People with learning disabilities are more likely to die prematurely while in residential units, as
was the case 100 years ago. Jan Walmsley and Pamela dale ask if past institutional deaths, often
recorded as ‘natural’, can shed light on today’s tragedies and the attitudes that can cause them

or more than 30 years, a key goal for Bristol; 2013; 2018), we have to ask difficult
both of us as historians has been to questions. Were any of the historic deaths
Fget closer to the lived experiences of we identified preventable? If they were,
people living with learning disabilities. why were they assumed to be natural and
This fits with the increasingly person- not investigated as potentially suspicious?
centred services that gradually emerged Is it possible that serious care failings
from the closure of the long-stay were concealed? Were opportunities to
institutions. protect other patients missed?
However, by concentrating on patients’ It was questions like these that
lives (Atkinson et al, 1997), we have underpinned the long campaign by Sara
perhaps missed the opportunity to Ryan to reveal the truth about the death Memorial to Norfolk Lunatic Asylum: details
consider their deaths and what they can in 2013 of her 18-year-old son Connor about residents’ deaths were recorded and
tell us about care in the past. Our work Sparrowhawk (Ryan, 2017). A number of have since been analysed by historians
exploring this topic was initially developed other disturbing cases were identified
as a response to studies of deaths in and, in a climate of heightened concern sense of inevitability when people with a
19th century mental health facilities. New following events at Winterbourne View, learning disability or mental illness die
research questions have been prompted the Care Quality Commission (CQC) early is too common” (CQC, 2016b: 2).
by more recent events. decided to take the whole sector to task. Just as service providers show
The campaigns described in the last two Two landmark CQC reports (2016a; reluctance to probe into either the nature
issues of Community Living (“Forgotten 2016b) present premature deaths as both or scale of premature deaths, so
lives commemorated”, autumn 2018, page an indictment against complacent service historians have been guilty of maintaining
26; “Ignored and forgotten – in death as in providers and an important source of a strange silence on the subject.
life”, summer 2018, page 16) show that learning points for transforming care While the past lives of people with
proper respect for the people buried in standards. This work provided a reference learning disabilities are increasingly well
institutional graveyards is important. The point for government-commissioned documented, we still know surprisingly little
way people are treated in death is often a investigations into premature mortality about their deaths. This is not accidental.
vital clue to understanding the way they conducted by the University of Bristol It reflects the orientation of the more
were treated (or mistreated) in life. (2013; 2018). This official interest seems influential institutional studies (Gladstone,
There is also a more sinister possibility promising, although an apparent lack of 1996; Thomson, 1998; Wright 2001) and a
we need to explore. With evidence that urgency over implementation at a local or reluctance on the part of institutional
people using learning disability services national level is a major concern. survivors to discuss a painful subject.
today experience serious health inequalities When evaluating services, historians as While historians have correctly identified
and are at significant risk of premature well as practitioners need to be aware of the significant gap between the ideals of
death (Mencap, 2007; Michael, 2008; the CQC’s worrying conclusion that “we people who founded various Victorian and
Emerson and Baines, 2010; University of found that the level of acceptance and Edwardian asylums and the care provided,
they have not pursued this discrepancy to
consider questions of abuse and
premature (and even sinister) deaths.
Historians of 20th century care have
talked about resource scarcity and
pressures on the institutions. However,
there has been no appetite to dwell on
specific abuses or even recount details
about known scandals. Difficult issues have
been minimised, with historians noting the
checks and balances within the system that
apparently protected UK patients from
the types of sterilisation and euthanasia
programmes operated by the Nazi regime
in the 1930s and 1940s (Thomson, 1998).
Historical interest in the governance of
institutions and the wider social,
Historians have been silent on institutional deaths. Studies such as that into Earlswood Asylum economic and political context in which
(above in 1854) have examined how people with learning disabilities lived, not how they died they operated has generally excluded
26 Vol 32 No 2 | Winter 2018 Community Living www.cl-initiatives.co.uk