“worried, dull and anxious, not quite up to the battle of life.” Widowed female, 45-54 yrs, Dull and backward

Melancholia, 1830 by William Bartholomew, EU1394, Copyright: Edinburgh University Art Collection

As the second world war was coming to an end a psychiatrist and a psychiatric social worker based at the Crichton Royal Hospital in Dumfries embarked upon the largest survey of a population’s mental health ever undertaken in Scotland. They collated information on over 5000 individuals from 40 rural communities, using hospital and out patient records but also by seeking the opinions of those in positions of authority – ministers, local doctors, teachers, nurses, police constables and public assistance officers – with regards local residents living in their communities, the majority of which had never received treatment. The result is a fascinating, poignant and at times disturbing collection of vignettes of rural life: A mother smoking and reading rather than completing her household chores; an adolescent girl singing too loudly on the bus; a grieving husband drinking before midday; a young boy who mixes up his letters truanting from school; a widow huddling with her cats in a roofless house.

“a helpless creature but has a tongue that “wad cut cloots” Married female, 54-64 yrs, Schizophrenia

On the basis of the collected information, each individual was assigned one of 25 diagnoses. The survey makes no distinction between physical disablities such as deafness or paralysis, learning difficulties, issues such as anxiety and addictions, conditions such as schizophrenia, personality disorders such as psychopathy, or cognitive and neurological disorders such as dementia or epilepsy. In the absence of any interaction between the individuals and a medical professional, these diagnoses were assigned mainly on behaviour, personality and/or looks. Someone may well have been included for being opinionated, humourless, quiet, too thin, overweight, giggly or serious.

“husband a decent fellow, a Communist. She is really in love with someone else – met her first love again recently which upset her” Married female, 25-34 yrs, Manic depressive

Mental health issues were attributed to a number of causes – traumatic births or accidents, home environments, genetics. Illegitimacy is always recorded but it is unclear if this was thought to be a cause of mental disturbances or a symptom. It is certainly implied that this was an indication of moral weakness or that family relations were “inharmonious”, both possibly leading mental health issues.

“Increasing depression and an overwhelming hatred of work in the pits. He has the spectacle of his invalid father always before him and feels a similar fate is awaiting him” Single male, 15-24 yrs, Manic depressive

Work related anxiety appears fairly frequently. One farmer in his 60s was admitted to the Crichton Royal and diagnosed with melancholia following a period of depression and restlessness: “Patient used to out at nights to see his neighbours, but gave this up. The depression gradually got worse until patient became very restless, pacing up and down the floor during the day and not sleeping well at nights. Has a delusion that he has mis-managed the farm, that he is ruined and will be put out ot starve or put in jail. Actually there is no cause for worry, the farm work is all right and no debts”.

Miners in particular suffered because of their working environment, some were claustrophobic, others had had family members who had been injured or killed and for some, the sounds and conditions triggered traumatic memories of serving in the war.

“This boy is good with his hands but backward, “a wee bit dour”. Doesn’t like school. Will probably be quite a good farm hand” Single male, 14 yrs and under, Dull and backward

Imbecility, 1830 by William Bartholomew, EU1384, copyright: Edinburgh University Art Collection

Rural areas at this time were facing an exodus and it would appear that an underlying motivation for the survey was to establish if Dumfriesshire had a viable workforce. The survey entries make repeated references to whether or not individuals are capable of steady work and, if so, what type of employment they are or will be suited to. We therefore get a considerable idea of the common occupations in the area at this time which range from mole catchers, music teachers and mason’s labourers, to railway workers, domestic servants and, of course, farmers. There are also the roles that all towns and villages require – postmasters and mistresses, grocers, tailors, and bakers – and evidence of the major industries and employers in the area: Textiles, forestry, estate work and ICI which arrived in the area at the start of the Second World War.

The language used in the survey is frequently shocking and it would most certainly have been offensive even at the time it was written. It is necessary, however, to distinguish between accepted medical terms which have now fallen out of usage such as “defective”, “idiocy”, “imbecile” and colloquial language entirely inappropriate for inclusion in a formal survey. Scots words appear often: “glaikit”, “dour”, “besom”, “trachle”.  The language is a clear indication of the attitudes of authority figures, not just to those with mental health difficulties, but also to women, children and those with disabilities. The vocabulary used is often infantilising, “soft”, “dopey”, or has criminal connotations, “pirate”, “wrong-un”. There is also evidence of the evolution of language, for example “queer”, “bent” and “gay” are used in this instanace to imply otherness and/or irresponsibility. It is interesting that these particular words would later be transferred to the LGBT community, another marginalised and discriminated against group.

“Blousy, drinks, loose habits, went about with Poles, a bad besom” Married female, 35-44 yrs, Psychopathic personality, Alcoholism

Women are judged particlarly harshly by the survey and domestic violence is frequently condoned by the authorities. There is a very narrow window in which women are allowed to be sexually active; if girls are sexually active too young they are a problem and if women are sexually active too old they are also a problem. Women over the age of 40 are repeatedly protrayed as hysterical or man mad. Women can be inlcuded in the survey for having a messy or dirty house but equally can be included if they are thought to be too preoccupied by cleanliness. Some women talk too much, some talk too little, some do not discipline their children enough, while some are deemed too strict.

The survey does, however, include some interesting references to women’s health including menstrual disorders and the menopause:

“This woman is menopausal, just sat and wept and wept, would not go out or talk to anybody”

“This woman is going through the climacteric, has heart symptoms; anxiety”

“Diagnosed as melancholia associated with the climacteric. She wished to go out naked, tore her hair, tortured her children. Ideas of guilt and ruin”

“Confuses g and c. His writing book made most peculiar reading. Quite good verbally” Single male, 14 yrs and under, Maladjusted child

Children too are dismissed very early on if they display difficulties at school. Some of the difficulties and behaviours recorded can easily be recognised today as dyslexia or autism. Although clinically recognized since the late 19th century it was not until the 1980s when dyslexia was recognized as a neurological disorder rather than a consequence of education.

While the survey does undoubtedly include people suffering with very real and frightening mental health difficulties some of the reasons given for inclusion range from the sublime to the ridiculous:

It is difficult to ascertain if those included in the survey would share the attitudes expressed in the survey or if it is a reflection of the establishment’s adherence to a very narrow definition of “normal”.  For, in general, the survey paints a picture of ordinary people getting on with their lives, despite the obvious hardships, surviving in a world with no safety net, coping with both physical and environmental handicaps, and accepting of the diversity of their families and communities. It should also not be forgotten that these communities were still recovering from the war and in many instances the scars of the first world war are also evident, with older men presenting with issues stemming from shell shock experienced some 20 years previously. In the main, the individuals in the survey seem to be very much up to the battle of life.