Hartwood Hospital

The Asylum

The Lanarkshire County Lunatic Asylum opened its doors in 1895 in Hartwood, near Shotts, as a purpose-built, self-sufficient, and secure hospital dedicated to the care of those classified at the time as "mentally deficient." Situated in a remote, tranquil setting, the asylum was designed to provide both safety and treatment, far removed from the overcrowded workhouses and unsuitable environments many patients had previously endured.

The first patients admitted to Hartwood came primarily from local workhouses, where many had been confined for extended periods under harsh conditions. These individuals were often in poor physical health due to neglect, inadequate nutrition, and lack of proper medical care.

The patient population was remarkably diverse, ranging in age from just 10 years old to as old as 100.

They included individuals with intellectual disabilities as well as those suffering from a variety of mental health conditions prevalent at the time, such as melancholy (an early term for depression) and hysteria. The asylum also cared for people with epilepsy, dementia, and other chronic conditions that society struggled to understand or manage.

 

Dr. Archibald Campbell Clark, the asylum’s first physician, took a notably progressive approach to treatment—one that stood in stark contrast to the punitive and neglectful methods common in many institutions during the Victorian era.

 

Rather than resorting to punishment or deprivation, Dr. Clark emphasized the importance of a therapeutic environment. His treatment philosophy focused on providing patients with fresh air, clean and pleasant surroundings, nourishing food, and meaningful mental stimulation.

Above all, Dr. Clark believed in the power of kindness. He championed compassionate care, recognising the humanity and dignity of each patient. This humane approach helped lay the groundwork for more modern attitudes toward mental health treatment and challenged many of the harsh practices of the time.

The legacy of Hartwood Asylum is complex — a reflection of both the constraints and progress of its era. It stands as a reminder of the journey towards more enlightened and respectful care for those living with mental health challenges.

The Building

The hospital buildings at Hartwood were designed following a diversified plan that reflected the growing need for specialised care in psychiatric treatment during the late 19th and early 20th centuries. The original layout featured a central main building with prominent towers flanked by side wings, allowing for segregation of patients by condition, gender, and severity of illness. This design aimed to improve both patient management and staff oversight, while fostering a therapeutic environment.

As the industrialisation of the surrounding Lanarkshire area accelerated, the local population grew rapidly. This demographic change led to a corresponding rise in the hospital’s resident numbers, which reached approximately 960 by 1913. To accommodate this influx, additional facilities were required. James Lochhead, a local architect, was commissioned to design several new structures over the ensuing decades, including a sanatorium in 1904 to care for patients with tuberculosis and other chronic illnesses, a new reception block in 1916 to streamline admissions, and a male staff hostel in 1936 to house hospital workers.

One of the most significant additions was the Nurses’ Home, constructed from 1926 and officially opened in 1931. This building remains the largest and only surviving example of these expansions, offering dedicated accommodation that helped professionalise nursing staff at the hospital.

Many of the hospital’s buildings were connected by glazed, enclosed walkways. These covered corridors allowed controlled movement of patients across the expansive site, safeguarding both patient safety and privacy while ensuring efficient access to medical and recreational facilities.

By the mid-1950s, Hartwood Hospital had evolved into a self-contained “hospital village.” It featured a variety of amenities designed to support the needs and wellbeing of its residents and staff. These included a bowling green for recreation, a small arcade of shops for daily essentials, and a dance hall where social events and gatherings took place, helping to foster a sense of community within the hospital grounds.

Hartwood also had its own cemetery, where over 1,255 former patients were laid to rest, a somber reminder of the many lives intertwined with the institution’s history.

The “village” model of patient care at Hartwood reflected broader trends in psychiatric treatment inspired by European innovations such as the Alt-Scherbitz Hospital near Leipzig, Germany, established in the 1870s. This model encouraged care within a community-like setting rather than isolated institutionalisation, aiming to provide patients with a more normalised and supportive environment.

At its peak, Hartwood was the largest asylum in Europe, housing up to 2,500 residents. However, the introduction of the 1990 Community Care Act marked a major shift in mental health policy across the UK. The Act promoted care within local communities instead of large institutional settings, leading to the gradual closure and redundancy of Hartwood’s sprawling hospital buildings.

For most of its operational history, until the establishment of the National Health Service in 1948, Hartwood primarily served pauper patients. Their care was funded by local Parochial Boards, with costs varying depending on the level of accommodation and services provided. These fees started at a pauper rate of around £58 per year but could increase according to individual needs, reflecting the hospital’s role as a last refuge for many of society’s most vulnerable.

Self-sufficiency

Hartwood Hospital was a largely self-sufficient community, featuring its own library, medical surgery, dispensary, butchery, dairy, bakery, shop, and workshops. The hospital grounds also included agricultural land, where produce was grown to support the residents and staff. For recreation, there was a ballroom that hosted musical entertainment—today this space serves as a residents’ lounge. Additionally, the site contained underground vaults whose purpose added to the complex’s unique character.

Patients were accommodated separately in either the female or male wards and contributed to the hospital’s daily life by working on the farm or in essential services such as the kitchen and laundry. The hospital had its own spring-fed reservoir, ensuring a reliable and independent water supply.

Hartwood was once connected to the nearby Shotts railway line, providing convenient transport links to Glasgow via private sidings. However, these sidings were eventually closed a few years later as transportation needs evolved.

Near the railway lies the hospital’s graveyard, where 1,255 pauper patients are buried—an enduring testament to those who lived and died within the hospital community.

Treatment

It is important to acknowledge that, throughout its history, Hartwood Hospital saw both compassionate care but deeply controversial treatments. In the asylum’s early years, when mental illness was poorly understood and often considered untreatable, patients—referred to as inmates—were frequently restrained and left isolated, sometimes until their deaths. One of the more troubling practices included the administration of shock therapy without anaesthetic, reflecting the limited medical knowledge and harsh realities of psychiatric care at the time.

Despite these difficult chapters, Hartwood also represented progress. The hospital evolved into a National Health Service (NHS) psychiatric hospital, embracing more modern approaches to mental health care. However, by the mid-1990s, the institution was no longer suitable for contemporary treatment needs. As a result, the hospital wards were closed, and care transitioned to what we now understand as “care in the community,” focusing on supporting patients in less institutional and more integrated environments.

Following its closure as a hospital, the building found new purpose as a teaching college, before finally closing its doors in 1998.

By openly acknowledging both the successes and failings of Hartwood’s past, we gain a clearer understanding of how far mental health care has progressed—and the importance of continuing to improve treatment with compassion and respect.

Terminology

We are gradually building a glossary of words and phrases found in historical records dating back to 1895 and earlier.

Many of these terms have long since fallen out of everyday use—thankfully so, as they are now recognised as outdated, inaccurate, and offensive. Yet they serve an important purpose: they help us understand how society once viewed poverty, disability, and mental illness. They also reveal the often-harsh realities of the treatment and conditions imposed on some of society’s most vulnerable people.

To truly move forward, we must first confront and understand our past.

One particularly disturbing ideology that shaped public policy and care practices in the late 19th and early 20th centuries was eugenics. Eugenicists promoted the belief that allowing people with disabilities, mental illness, or those labelled as “feckless” or “idle”—particularly from poorer backgrounds—to reproduce would lead to the so-called “racial deterioration” of society. This pseudoscientific theory underpinned many forms of social control, including the strict segregation of individuals in poorhouses and asylums. These measures were not simply born out of Victorian morality, but were deliberate efforts to prevent reproduction and “undesirable” traits being passed on.

By the mid-1920s, language began to shift in response to slowly evolving attitudes within mental health care. The term “hospital” began to replace “asylum”, “nurse” replaced “attendant”, and “patient” was adopted in place of “lunatic.”While the realities within institutions were often still harsh, these changes in language marked early steps toward a more medical and humane model of care.

Understanding these historical terms—and the attitudes they reflect—allows us to appreciate just how far mental health care has come, and how important it remains to challenge stigma, prejudice, and exclusion.

Today, the stark language of “lunatics” and “asylums” jars our modern sensibilities, serving as a painful reminder of a very different era. Yet it was only 90 years ago that the Mental Treatment Act (MTA) of 1930 amended the Lunacy Act of 1890, officially replacing the term “lunatic” with “patient” and renaming asylums as mental hospitals. The MTA was a landmark in mental health legislation and laid the groundwork for the more progressive Mental Health Act of 1959, which finally repealed both earlier Acts.

In the early 19th century, individuals with mental illness—then labelled as “lunatics”—were often confined to specific wards within the poorhouse, cut off from society and heavily stigmatised. Later, large asylums were constructed to contain such individuals en masse, physically removed from towns and cities. While medical treatments were extremely limited, the design of these Victorian asylums reflected a growing belief in the therapeutic benefits of nature, space, and structure. These institutions were often grand buildings set on the outskirts, surrounded by farmland, gardens, and outdoor facilities—features still evident in the design and setting of Hartwood.

Personally, I find the language of the past deeply unsettling, and difficult to reconcile with today’s aspirations for mental health care—founded on dignity, empowerment, and recovery. Words like “asylum,” “madhouse,” and “lunatic” now carry heavy and harmful connotations. Yet it is important to acknowledge that this language reflected the limited understanding of the time. In earlier centuries, a person described as “mad” or a “lunatic” could have been experiencing anything from psychosis to what we now identify as depression, anxiety, or epilepsy.

In most cases, treatment amounted to little more than confinement. The prevailing approach was one of control: physical restraint, isolation, and institutionalisation. Mental illness was poorly understood, and that lack of knowledge bred fear—fear that justified the removal of people from their homes, families, and communities.

As our understanding of mental health continues to evolve, we must reflect on this history—not to judge it by today’s standards, but to learn from it. To ensure we never return to a time when people were locked away and forgotten simply for being unwell. Language shapes how we see others—and ourselves. By changing the words we use, we help reshape the attitudes and expectations that define our society.

The designation of a person as a “pauper” was also deeply significant. Under the Poor Law, Boards of Guardians were responsible for covering the costs of asylum care for individuals from their locality, even if the individual contributed means-tested payments towards their own treatment. With the legal reforms of the early 20th century, an “insane pauper lunatic treated in an asylum” became, in official terms, “a rate-aided patient of unsound mind treated in a hospital.”

This shift in terminology—away from language rooted in moral judgement and social shame—brought mental illness closer in line with physical illness. It was an early step toward what we now refer to as “parity of esteem”—the principle that mental health should be valued equally with physical health.

By recognising the power of words, we honour the lives affected by this system and reinforce our ongoing commitment to progress, compassion, and inclusion.

 

Diagnoses and Therapy

In its early years, Hartwood Hospital primarily admitted patients from the local area, with funding provided by the parochial county boards. Patients arrived with a variety of diagnoses—including psychosis, depression, and anxiety disorders—terms which were still evolving within clinical language at the time. Like many institutions of the era, Hartwood also cared for individuals with long-term learning disabilities and elderly patients living with dementia.

Fresh air therapy was one of several holistic treatments employed, reflecting the optimism and progressive medical thinking of the period. From its inception, the hospital farm played a central role, offering patients open-air activity as part of their recovery, while also supplying fresh produce to the hospital kitchens. Occupational therapies such as arts and crafts were actively encouraged, and many local homes today still cherish the small woven stools crafted by former patients—lasting reminders of the healing power of creativity and meaningful work.

Facilities

The modernisation of mental hospitals brought significant changes—not only in medical treatment but also in emphasising occupation and entertainment as vital components of recovery. By the mid-1930s, mental hospitals across Scotland featured cinemas, hosted dances, and organized sports clubs, reflecting a growing recognition that engagement and social activities were essential for rehabilitation. Hartwood Hospital embraced this approach wholeheartedly.

At the heart of Hartwood stood a grand hall on the first floor—an ornate and formal space capable of accommodating up to 1,200 people for musical performances and dances. This hall was central to the hospital’s social life, offering patients a chance to gather, enjoy entertainment, and participate in community events.

Today, mental hospitals like Hartwood often appear as ghostly, derelict relics, scarred by years of neglect and a legacy of negative publicity. However, beneath these images lies a rich history of daily efforts to make institutional life more humane and liveable. In its early years, every ward at Hartwood was brightened by fresh flowers and a rotating collection of books updated fortnightly. It was common for such hospitals to maintain sports teams, run education programs, and offer art and music classes, all designed to enrich patients’ lives.

With mental health awareness at an all-time high, Hartwood’s history of compassionate care and community-focused rehabilitation offers valuable lessons. It reminds us that beyond medical treatment, fostering social connection and creative engagement plays a crucial role in healing—and can help guide the future of mental health care.

Removing The Stigma

Simply looking at the bricks and mortar of these institutions tells us little about what life was truly like for the individuals who lived within their walls. Each person’s story and experience were unique—shaped by their circumstances, treatment, and the attitudes of the time.

The stigma surrounding mental health today is, in many ways, a legacy of how people were historically treated. For centuries, those with mental health issues were often chained in prison-like conditions or confined to isolated, out-of-town asylums—places deliberately hidden from public view, embodying the phrase "out of sight, out of mind." Tragically, many were buried in unmarked, remote graves, such as the 1,255 paupers laid to rest in our own cemetery, their lives and struggles largely forgotten.

Acknowledging this painful past is essential—not only to honor the memory of those who endured such hardships but also to challenge ongoing stigma. By remembering them, raising awareness, and fostering open conversations about mental health, we can work together to create a society where wellbeing is prioritized, compassion is central, and no one feels invisible or forgotten.