08/10/2026
It wasn’t until 1885 that structured guidance for the training of staff working at asylums was started.
In the early days, the mid 1800s, “attendants” in the asylum learned on the job guided by colleagues, rule books and inspirational leaders such as Robert Boyd at the Somerset and Bath County Pauper Lunatic Asylum.
In 1891 the Medico Psychological Association, now the Royal College of Psychiatrists, set up the first formal training for attendants complete with lectures and exams.
In 1898 the Annual Report records that “Nine female attendants have passed their exam in mental nursing as set by the Medico Psychological Association” they gained a £2 a year increase in pay. In 1900 four male attendants and six female attendants also passed the exam and six other members of staff passed the St Johns Ambulance Certificate.
It wasn’t until 1919 that mental health nurses gained official recognition for their work. That was just over 100 years ago.
From Handbook for the Instruction of Attendants on the Insane. 1891
“Attendants shall be examples of propriety of conduct, order, personal neatness and perfect truthfulness. They are enjoined to do their utmost to occupy and amuse every patient no matter what the mental condition may be. They shall treat all with impartial consideration and are expected to exercise such tact as will comfort the depressed, soothe the excited and check the impulsive, irritable and destructive.
Any act of neglect, harshness or cruelty towards patients will be punished with the utmost rigour in accordance with the lunacy acts. An attendant must immediately report any ill treatment and attendants are warned against mimicry, deception or irritation of patients. A respectful demeanour towards them must be maintained.
They must always remember that their position is one of great trust and responsibility and that they have the care of those who, through affliction, cannot care for themselves and that upon them the recovery, comfort, happiness and safety of the patients, in great measure, depend.”
Phptographs: Wells & Mendip Museum