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Mental health in Singapore has its roots in the West. The first medical personnel in the field were mostly from Britain. Medical education in the early years was almost exclusively for the British, until the establishment of King Edward VII College of Medicine on the island in 1907. Hence, many influential ideas flowed over from the West through the years. == The Colonial years (1819–1942) == When Sir Stamford Raffles set foot on the island on 28 January 1819,〔(Lee 1978, p. 194)〕 he had with him troops of the Bengal Native Infantry and Sub-Assistant Surgeon Thomas Prendergast, who was in medical charge of the whole expedition.〔(Lee 1978, p. 194)〕 In May, Assistant Surgeon William Montgomerie, a more senior officer, came to join Prendergast.〔(Lee 1978, p. 194)〕 Their duties were of military and civil nature, and they served in Singapore until 1823 and 1827 respectively before returning to Bengal.〔(Lee 1978, p. 194)〕 In June 1827, the medical duties were shared between Surgeon B. C. Henderson and Assistant Surgeon Warrand, who came with a detachment of troops to relieve Montgomerie.〔(Lee 1978, p. 194)〕 Henderson was responsible for the General and Pauper Hospitals while Warrand was responsible for the convicts and troops.〔(Lee 1978, p. 194)〕 No institution for the mentally ill was available then. Prior to 1819 the population of the island was estimated to be 150.〔(Ng 2001a, p. 7)〕 Since then, the population started to grow at a rapid pace, due to the people, mainly from the Southeast Asian region, China and India,〔(Ng 2001a, p. 7)〕 who came to Singapore to take advantage of the employment opportunities generated by a growing entrepôt trade.〔(Institute of Mental Health 2003, p. 15)〕 As a result of this large influx of penniless people, overcrowding, bad living conditions and a habit of opium smoking led to a high rate of physical and mental illness.〔(Ng 2001a, p.7; Institute of Mental Health 2003, p. 15)〕 However, the medical needs of the natives were not top priority.〔(Institute of Mental Health 2003, p. 16)〕 Provision of health and medical facilities and services was limited because the government felt that the population was made up of immigrants who were not planning to make Singapore their home.〔(Ng 2001a, p. 7)〕 The mentally ill were referred to as "insane",〔(Ng 2001a, p. 8)〕 and unless they were deemed dangerous, they were ignored and left on the streets.〔(Ng 2001a, p. 8)〕 This meant almost complete neglect of the mentally ill.〔(Ng 2001a, p. 8)〕 The first sign of a need for care for the mentally ill was a request to send John Hanson, a Dane who had lived in Singapore for about five years, "to Calcutta or any other place where a Lunatic Asylum may be established" by the Superintendent of Police S. G. Bonham to the Secretary to Government on 27 May 1828.〔(Lee 1978, p. 194)〕 A similar item had been reported by acting Senior Surgeon W. E. E. Conwell, who had come in February 1828 on an inspection tour of the hospitals.〔(Lee 1978, p. 194)〕 In Conwell's report, it was noted that Hanson was being treated at the Singapore Infirmary and otherwise being confined in a jail since there was no suitable place for people like him.〔(Lee 1978, p. 194)〕 However, even after Singapore became the capital of the Straits Settlements in 1832〔(Lee 1978, p. 194)〕 and the headquarters of the Medical Department in 1835,〔(Lee 1978, p. 194; Ng 2001a, p. xix)〕 there was still no institution for the mentally ill. The jail was called the Convict Gaol, and lunatics were taken care of by the inmates.〔(Ng 2001a, p. 8)〕 Conditions in the jail were far from ideal.〔(Ng 2001a, p. 8)〕 Overcrowding was still the biggest problem.〔(Ng 2001a, p. 8)〕 In 1835, Senior Surgeon William Montgomerie, who had been promoted and had returned to Singapore in 1832, received orders for himself and Assistant Surgeon Thomas Oxley to continue visiting the lunatics and convicts in the jail in their capacity as Medical Officers.〔(Lee 1978, p. 194)〕 Instead of improvements in mental health care, by 1837 the practice of putting lunatics in jail became more ingrained.〔(Lee 1978, p. 194)〕 Special allowances were given to the Sheriff's Department, instead of the Medical Department, for care of lunatics: “Gaoler 25 Rupees; Overseer 15 Rupees; Two Convicts 10 Rupees”.〔(Lee 1978, p. 194)〕 Public outcry regarding mental health care started in 1838.〔(Ng 2001a, p. 8; Lee 1978, p. 195)〕 In the Singapore Free Press forum on 21 February 1838, it was argued that "it has been proved that in recent cases of insanity under judicious treatment, as large a proportion of recoveries will take place as from any other acute disease of equal severity"〔(Lee 1978, p. 195)〕 and the Editor added his comments highlighting the fact that "there is space enough in the hospital yard to construct a suitable building for their reception, and we hope that the absolute necessity there exists for providing something in the nature of a Lunatic Asylum will not be overlooked."〔(Lee 1978, p. 195; Ng 2001a, p. 8)〕 Despite that, little was done to improve the situation. The wakeup call came in October 1840, when one of the lunatics was killed by another in the jail.〔(Ng 2001a, p. 8; Institute of Mental Health 2003, p. 16; Lee 1978, p. 195)〕 Bonham, who had become Governor by then, immediately requested that Montgomerie write "a report on the number and state of the lunatics under treatment, and also suggestions for their better management".〔(Ng 2001a, p. 8; Lee 1978, p. 195)〕 Montgomerie reported on 16 November 1840 that there were 22 insane patients and he expected that the yearly average of seventeen patients would increase with growth of the settlement.〔(Lee 1978, p. 195)〕 In the report, he also suggested the Lunatic Asylum be built for 24 patients and should any more room be needed, buildings would be added on.〔(Lee 1978, p. 195)〕 In addition, floors "should be laid with bricks on edge, embedded in good mortar so as to admit of being washed, and prevent the patients lifting the floors, which constructed with tiles as in the Jail, they have been enabled to do so;"〔(Lee 1978, p. 195)〕 and "wood for the walls and bed places in consequence of very bad effects having arisen from patients in the Jail having destroyed the bed places and by squatting on the floor and leaning against cold walls, have in several instances cramped their limbs and stiffened their joints so as to cause lameness".〔(Lee 1978, p. 195)〕 Montgomerie also submitted a plan and estimate for $775.16.〔(Lee 1978, p. 195)〕 He did not suggest sending lunatics to India because he felt that they would feel more comfortable "among their countrymen than among strangers".〔(Lee 1978, p. 195, Ng 2001a, p. 9)〕 On 28 November 1840, Governor Bonham presented the case to the Government of Bengal.〔(Lee 1978, p. 196)〕 The Governor of Bengal accepted the plan on the recommendation of the Military and Medical Boards.〔(Lee 1978, p. 196)〕 The Asylum was to be built for "'the custody of the patients' and the same number of staff attended them as when they were in the Jail".〔(Lee 1978, p. 196)〕 The resolution, dated 12 May 1841, had stated that the "gross expense () not to exceed $775.10".〔(Ng 2001a, p. 9)〕 The eventual amount spent was slightly higher than that.〔(Ng 2001a, p. 9)〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Mental health in Singapore during the colonial period」の詳細全文を読む スポンサード リンク
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