Most people don’t realise ‘Bedlam’ is a real place — Bethlem Royal Hospital in London — the original psychiatric institution and a horror show. People once paid money to stare at patients. Abuse, restraints, punishment-as-treatment culture. And that culture didn’t die; it just rebranded. The movie One Flew Over the Cuckoo’s Nest, starring Jack Nicholson, wasn’t fiction; it was reportage. Canada inherited the same British model — so yes, you really can get dragged into a psych ward just for raising your voice in Montreal, Canada. That’s Bedlam’s legacy.

Here is a little history lesson about Bedlam, brought to you by Wikipedia.

Bethlem Royal Hospital, also known as St Mary Bethlehem, Bethlehem Hospital, is a psychiatric hospital in Bromley, London. Its famous history has inspired several horror books, films, and television series, most notably Bedlam, a 1946 film with Boris Karloff.

It was founded in 1247 as the Priory of the New Order of our Lady of Bethlehem in the city of London during the reign of Henry III. making it the oldest psychiatric institution in the Western world. The hospital was originally located just outside the city walls, in the Bishopsgate Without area of the City of London. It moved a short distance to Moorfields in 1676, and then to St George’s Fields in Southwark in 1815, before moving to its current location in Monks Orchard in 1930.

The word ‘bedlam’, meaning uproar and confusion, is derived from the hospital’s nickname. Although it became a modern psychiatric hospital, historically it was representative of the worst excesses of asylums in the era of lunacy reform.

It is unknown when Bethlem, or Bedlam, began to specialise in the care and control of the insane, but it has been frequently asserted that Bethlem was first used for the insane from 1377. This date is derived from the unsubstantiated conjecture of the Reverend Edward Geoffrey O’Donoghue, chaplain to the hospital, who published a monograph on its history in 1914.

While it is possible that Bethlem was receiving the insane during the late fourteenth century, the first definitive record of their presence in the hospital is in the details of a visitation of the Charity Commissioners in 1403. This recorded that amongst other patients there were six male inmates who were ‘mente capti’, a Latin term indicating insanity. The report of the visitation also noted the presence of four pairs of manacles, 11 chains, six locks and two pairs of stocks but it is not clear if any or all of these items were for the restraint of the inmates.

While mechanical restraint and solitary confinement are likely to have been used for those regarded as dangerous, little else is known of the actual treatment of the insane for much of the medieval period. The presence of a small number of insane patients in 1403 marks Bethlem’s gradual transition from a diminutive general hospital into a specialist institution for the confinement of the insane. This process was largely completed by 1460.

Bethlem Hospital became infamous in the 18th–19th centuries for exactly the kind of abuses people think are exaggerations:

• chaining patients

• beating them

• cold baths

• isolation

• zero consent

• zero diagnostics

• “treatment” as punishment

• It was literally a tourist attraction.

People once paid a penny to walk through and stare at patients like a freak show.

That’s where the expression “this place is Bedlam” comes from — meaning chaos, cruelty, disorder, and degradation. The word survives because the practices survived.

Everything people think is ‘Victorian,’ actually continued in different forms well into the 20th century — and the power structure behind it still exists today:

institution decides → labels you → takes your rights, → and the burden of proof is on you.

That’s why One Flew Over the Cuckoo’s Nest felt real.

It wasn’t exaggerated.

Those dynamics: intimidation, forced sedation, humiliation, power-games — came straight from Bedlam-era institutional culture.

The movie Gone Girl also nailed the weaponisation of psychiatry.

Not about institutions per se, but about how easy it still is to distort the system to trap someone or discredit them.

Canada inherited the British psychiatric model.

So yes — the British “stiff upper lip” is an expectation people and institutions have of victims of systemic abuse. Speaking out about these things is seen with disapproval. Shouting or actually raising one’s voice is treated as a criminal act because it is labeled as “disturbing the peace”. The threshold for calling someone ‘disturbed’ or ‘aggressive’ is absurdly low.

A raised voice can be recast as ‘danger,’ ‘instability,’ ‘agitation,’ or “loss of control.”

And once that label is invoked, the system closes around you.

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