Royal Edinburgh
Details
Previous Names: Edinburgh Lunatic Asylum, Royal Edinburgh Lunatic Asylum, Royal Edinburgh Hospital for Mental and Nervous Disorders
Location: Morningside Place, Edinburgh
Principal Architect: Sydney Mitchell
Layout: Single Building with later Pavillion Extensions
Status: Remains Open
Opened: 1813
History
The story of the Royal Edinburgh Hospital begins with Dr. Andrew Duncan (1744–1828), a prominent Scottish physician and professor at the University of Edinburgh. He was deeply concerned about the lack of proper facilities for treating mental illness in Edinburgh, which led him to advocate for a dedicated asylum for over 30 years.
In 1806, Duncan founded the “Society for the Provision of a Lunatic Asylum in Edinburgh and its Environs.” His vision finally materialised in 1813, with the opening of the Edinburgh Lunatic Asylum on Morningside Estate. The institution was funded through public subscription and aimed to provide humane treatment for mentally ill patients, a progressive idea at the time. Early treatments focused on rest, diet, and physical activity, aligned with the principles of “moral treatment” gaining popularity in Europe.
In the decades following its opening, the hospital faced increasing demand for its services, prompting expansions. By 1842, it became known as the Royal Edinburgh Asylum, reflecting its growing reputation and royal patronage.
The hospital’s approach evolved significantly during this time, particularly under the influence of prominent figures in psychiatry. Treatments moved away from the punitive methods of earlier centuries and embraced the “moral treatment” model, which emphasised humane care, therapeutic engagement, and the elimination of restraints.
The mid-19th century also saw the addition of separate wings and buildings, catering to patients of different socioeconomic classes. Wealthier patients were housed in private wards, which helped fund the care of less affluent individuals.
Dr. Thomas Smith Clouston, who became the medical superintendent in 1873, was instrumental in transforming the hospital into a leader in psychiatric care. Clouston implemented several reforms, including:
- Expanding facilities to accommodate more patients, including chronic cases.
- Advocating for occupational therapy, which involved engaging patients in activities such as gardening, arts, and crafts to promote mental well-being.
- Introducing education programs for staff to ensure a more professional approach to patient care.
- Clouston was also a prolific writer, publishing works on mental health that influenced psychiatric practice worldwide. During his tenure, the hospital earned an international reputation as a center for excellence in psychiatry.
The Victorian era marked a period of significant architectural and functional growth for the hospital. New buildings were added to the Morningside campus, including the Craig House complex in 1894, designed to house wealthier patients in more comfortable surroundings. These facilities reflected the belief that the environment played a crucial role in mental health, with attention paid to aesthetics, natural light, and ventilation.
Craig House, in particular, became famous for its elegant design, resembling more of a stately home than a hospital. It showcased the hospital’s commitment to providing dignity and respect to all patients, particularly private ones.
By the early 20th century, the institution was officially renamed the Royal Edinburgh Hospital in 1922. The advent of new medical treatments, including electroconvulsive therapy (ECT) and psychotropic drugs, revolutionised the care of mental health patients. The hospital gradually reduced its reliance on long-term institutional care and shifted toward therapies aimed at reintegration into society.
The mid-20th century also saw the rise of the de-institutionalisation movement, which sought to reduce the number of people housed in psychiatric hospitals in favor of outpatient and community-based services. This shift led to changes in the hospital’s operations, with a greater focus on acute care and rehabilitation services.
In the early 21st century, the Royal Edinburgh Hospital underwent significant redevelopment to modernise its facilities while retaining its historical character. The redevelopment project, completed in phases, includes:
- New state-of-the-art wards designed to meet contemporary mental health care standards.
- Integration of community-based services to reduce the need for long-term hospitalisation.
- Preservation of historic buildings, such as Craig House, which has been repurposed for residential use.
Today, the hospital remains at the forefront of mental health care in Scotland, offering a range of services for conditions such as depression, anxiety, bipolar disorder, and schizophrenia. It also serves as a teaching and research hub.