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Michael Kinsella, Alice Mauger, The Cost of Insanity in Nineteenth Century Ireland: Public Voluntary and Private Asylum Care, Social History of Medicine, Volume 35, Issue 3, August 2022, Pages 1035–1036, https://doi.org/10.1093/shm/hkac034
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The Cost of Insanity in Nineteenth-Century Ireland: Public, Voluntary and Private Asylum Care by Alice Mauger is an original and important contribution to the literature of asylum history in Britain and Ireland. Whilst the history of the pauper insane and the public asylums which accommodated them has been the focus of much assiduous scholarly research and wider public interest, the social and economic organisation of asylum care for nineteenth-century middle and upper-class patients has attracted much less attention, particularly in the Irish and Scottish contexts. In this comparative analysis of Ireland's different asylum sectors, Mauger argues that the political, social and economic structures of Ireland and Britain diverged in several significant respects leading to the creation ‘of a uniquely Irish institutional framework’ (p. 2). This provides a novel contribution to historians' attempts to understand the asylum system in nineteenth-century Ireland which, as Mauger explains with great clarity, was composed of a large and populous network of district (or pauper asylums), four voluntary asylums and a private asylum sector catering for only a few hundred patients of the most affluent social class. Mauger also examines the interface between the families of paying patients and asylum managers, arguing that these families were often able to choose which type of asylum their relatives would enter. This helps underpin a key theme of the book in which Mauger successfully outlines the development of ‘an institutional marketplace’ within which the families of fee-paying patients, particularly the most affluent, were able to influence the standard of accommodation and care provided by the voluntary and private asylums which they chose. Indeed, Mauger provides evidence that by the end of the nineteenth century this had led to competition between the voluntary and private sectors.
