‘The Undesirables’ by Sarah Wise review

In 1919 ‘Bessie B.’, aged 24, was committed to Abingdon Workhouse, known locally as ‘the Grubber’, under the Mental Deficiency Act (MDA) of 1913. She was unmarried, had given birth to four children each with a different father, had syphilis and appeared to be destitute even though she had earned her own living without needing to fall back on Poor Relief. While Bessie showed no signs of mental deficiency, she was certified as a ‘moral imbecile’. Doubts were cast on whether or not she should be detained simply because of her ‘bad character’, but the workhouse medical officer believed that it would be ‘in her own interest’ in order to treat her syphilis. She left the institution five years later, one of the ‘lucky’ few to have got out.

Bessie B. was among the tens of thousands of children and young adults who were labelled ‘idiots’, ‘imbeciles’, ‘feeble minded’ or ‘moral imbeciles’ and forcibly confined in institutions when the MDA came into force on 1 April 1914. The practice of sequestering away young women and men for social and moral infractions such as getting pregnant out of wedlock, petty thieving, vandalism, persistent drunkenness and vagrancy has always been known about, but historians have struggled to ascertain the full extent to which it took place mainly because many records were lost, destroyed or closed under a 100-year rule to protect patient confidentiality.

The social historian Sarah Wise faced these obstacles too. Yet in her work to expose the shocking consequences of the MDA, particularly as it was applied to those who were identified as ‘feeble-minded’ or ‘moral imbeciles’, she has dug deep into the archives to show how a single act of Parliament wrecked tens of thousands of lives in the first half of the 20th century. The Undesirables is as compelling as it is shocking, advancing our knowledge of this shameful episode in leaps and bounds. 

How could such an act have been passed in Parliament, let alone be enforced? It emerged from various late-19th-century theories in which it was believed that certain character traits – along with mental and physical disabilities – were biological in nature and passed from one generation to the next. Compounding this were anxieties around the falling birth rate, especially among the middle and ‘artisan’ classes. When large numbers of men wanting to enlist in the army during the Second Boer War were turned away because they were not fit enough to fight, concerns grew about Britain not being strong enough to maintain (let alone advance) its imperial power. And even though poor health was attributed to appalling living and working conditions, the notion of an inherited ‘taint’, particularly among the working and upper classes, continued to gain traction. Of paramount concern, Wise writes, was the notion of ‘the feeble-minded woman pumping out litters of equally feeble-minded offspring’.

In some parts of the world, including certain American states, authorities resorted to sterilisation, to which Wise devotes a long and rather distracting chapter. Thankfully Britain did not take that route, though it was heavily debated. Instead, tens of thousands of young people were confined either in purpose-built colonies or in overcrowded workhouses where they were exploited for their labour, socially isolated and kept apart from the opposite sex.

After five years Bessie B. was allowed to leave the Grubber. She moved to Hove in Sussex where she worked as a servant and was closely watched by the Brighton Guardianship Society to ensure that she stayed away from drink, drugs and men. The less fortunate spent the rest of their lives languishing in institutions, often asylums, from which they were finally discharged during the 1980s and 1990s.

That was what happened to Dulcie and Bertha, two women I met at the other end of their institutional journey when I was working on a psychogeriatric ward in the late 1970s. They had spent decades in institutions. Dulcie was initially admitted because she was blind and had nowhere to go. Bertha had worked as a farm servant in a remote outpost in the Cambridgeshire Fens and was admitted to an institution as a teenager having given birth to an illegitimate child. By the time I met her she was bedridden with Parkinson’s. At night she would recall her girlhood: milk sops before bed, up at dawn, driving a cart to market through the water-logged fenlands. She had no happy memories of living in an institution.

There had always been vociferous opposition to the 1913 Act, including from many doctors who refused to certify people on the basis of arbitrary evidence that lacked any scientific foundation. As time passed the justifications upon which so many people had been locked away under the MDA became increasingly untenable, especially in the light of Nazi atrocities perpetrated during the 1930s and 1940s. After the war, investigations by the National Council for Civil Liberties turned its attention to the injustices of the MDA and reported in 1951 that some 50,000 so-called ‘mentally defective’ young people, many of whom had no history of criminality and who fell within the educationally ‘normal’ category, were still languishing in institutions as a direct result of the Act. In 1957-58 almost 2,000 people were released from institutions. The Act was finally repealed in 1959. By then thousands of people, including Dulcie and Bertha, had been bleached out of the system and forgotten about.

It is impossible not to feel outraged by this history of wasted lives. Wise does not shy away from calling to account the authorities who enforced the MDA, from the criminal justice system to the medical establishment, politicians and local government, as well as the wider public, for allowing this grave social injustice to happen.

• The Undesirables: The Law that Locked Away a Generation
  Sarah Wise
  Oneworld, 352pp, £22
  Buy from bookshop.org (affiliate link)

Louise Hide is a Wellcome Trust Fellow in Medical Humanities and an Honorary Senior Research Fellow at Birkbeck, University of London.