Rachel Ditchfield

Image: IWM (Q 82924)

A copy of a 19th century print showing the exterior of the Bethlem Royal Hospital at Lambeth Road, London.

Rachel Ditchfield began her AHRC Collaborative Doctoral Partnership ‘The Bethlem Royal Hospital During the First World War’ in January 2024.

A joint project between IWM and the University of Liverpool, it aims to explore the previous life of IWM’s building as the world’s oldest psychiatric hospital, Bethlem Royal Hospital, at a time when civilians endured the unique psychological pressures of ‘total war’.

Using a range of hospital documentation, from patients records to board minutes to personal writings and photographs, Rachel hopes to present fresh insights into what life was like for the patients and staff who lived and worked at Bethlem during the war.

She will particularly focus on how they experienced the building, in the hopes of providing visitors to IWM with a window into the museum’s own history.

In addition, she plans to use medical records from Bethlem to contribute to the wider understanding of civilian mental health during the First World War, an under-researched area.

War and the Mind

IWM

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Transcript

Rachel Ditchfield, researcher: “We are standing in the Imperial War Museum right now, and this building actually used to be a psychiatric hospital called the Bethlem Royal Hospital about 100 years ago.

It moved from this building in 1930 and then the building became the Imperial War Museum, as it is today. And the hospital itself moved out to Beckenham, where it is now, and it's still a functioning hospital to this very day. In this project, I'm looking to research for the first time, a period in Bethlem’s history that no one's looked at before and that's what happened during the First World War. I'm going to be using, medical case note, the asylum board minutes and all of the records that they've created, as well as the hospital magazine and photographs, any sources that relate to the history of this place. I'm going to piece those together to find out what it is that happened here and document the patients’ lives as well as the staffs’ lives.

One of my main focuses in the project is about the building itself. I'm currently in one of the atrium galleries, and if you look towards the front of those galleries, you can see this would have been the external wall of the building. And where I'm standing right now would have been the airing courts, where patients could go for exercise.

Mental health care now is very different to what it was 100 years ago. One of the main roles of the asylum was to take you out of the situation that had led to, or the circumstances that were contributing to your mental illness and give you a bit of respite. So, people who were coming here would have been quite profoundly ill. And the kinds of things that would bring people to the hospital were work stress, grief, loss of the family but also, kind of, delusions and paranoia, that were caused by, by these illnesses.

And during the war, we can see in some of those certificates the war being included as a potential cause of that illness. The experience of being a civilian living through a war will have profound effects on your psychological state. And I'm hoping that through this project, I can give some concrete examples from real people who lived through that time and were affected by it and a really personal story of how their lives and their mental state was affected by the experience of living through a total war.

And it would be things like financial stress due to the war or worry about, a loved one who's gone off to fight or fear of the Zeppelin raids, air raids that were happening in London at the time. And Bethlem was, was caught up in that as well. The patients who were here would have experienced air rage during their stay in the hospital. When you read some of the case notes about some of the patients who stayed here, you can get a real sense of, of the struggles that they're going through. And it can be really emotionally impacting reading those stories, because not all of them end very well.

But there are also signs of recovery and, signs of relationships within the hospital that kind of made that stay a bit brighter for them. Gives a bit of hope when you're reading it as well.”

IWM's War and the Mind exhibition ran from 27 September 2024 - 27 April 2025.

The exhibition explored the many psychological dimensions of war and featured groundbreaking research projects funded by UK Research and Innovation, in particular the Arts and Humanities Research Council (AHRC).

A film featuring Rachel's project was part of the Ending Wars section of the exhibition. In this video, Rachel talks about the reasons people might have been admitted to the 'Bethlem' Royal hospital during the First World War and how they were cared for.