The history of mental illness and asylums has long been of interest not just to historians, but to the general public. I think we are both horrified and fascinated by the brutal conditions and treatment of those historically designated as lunatics.

I just read an article, “Madness in the Archives: Anonymity, Ethics, and Mental Health History Research” by David Wright and Renee Saucier in the Journal of the Canadian Historical Association / Revue de la Societe historique du Canada, volume 23, number 2, 2012. (The article is available for no charge at the moment. To download, click on the article link above and then click “Text integral PDF (223 ko)” on the left side of the page.)

"The New Asylum For Idiots" Royal Earlswood Hospital engraving by Edmund Evans (1826 – 1905), via Wikimedia Commons.

“The New Asylum For Idiots” Royal Earlswood Hospital engraving by Edmund Evans (1826 – 1905), via Wikimedia Commons.

This is not an article about the asylums or the patients, but about how historians use available records for research purposes. When historians use original medical records as primary source research materials, they generally try to protect the original doctor-patient confidentiality. There are laws that govern the use of medical records, but they vary from country to country and also depend upon whether the institution was public or private.

The authors lay out the reasons for anonymizing original names, but also make the case for what we lose when we strip the names from the rest of the data.

  • Historically and currently, there is a stigma attached to mental illness. Some historians have made the case that anonymizing the names actually perpetuates that stigma.
  • In order to verify the accuracy of research, we need to be able to check the original source used by the researcher. This is very difficult to do if the names have been changed.
  • Sometimes information about mental illness is available in primary sources other than medical records. If someone suffered from mental illness, that is often reflected in other records, such as household records, family journals and court records. In those cases, changing the names from the medical records does not provide complete protection.

And what happens when these records are digitized for preservation? Do we redact all the names and lose them forever?

I’m struggling with this one. I wouldn’t be embarrassed if my great-great-great grandmother was in an asylum or if my great-great-great grandfather had syphilis. I don’t feel that it reflects badly on me and that people are suddenly going to be wary in my presence. Am I the odd one out and most people feel differently?

Please let me know what you think. Do you think real names should be disguised? Do you feel the value of the historical research outweighs any possible embarrassment to descendants who are still living?