Vaimuhaigla patsientide kogemus I maailmasõja eelsel Liivimaal
Experience of hospitalisation of patients in mental hospitals in pre-World War I Livonia

Summary/Abstract: Exploring the experiences of patients in mental hospitals in the Baltic Provinces before the First World War allows for a deeper understanding of contemporary concepts of madness: who was considered insane and why, how mental hospitals were perceived and utilised, and which factors influenced patients’ admission and length of stay. The primary sources analysed in this article consist mainly of autobiographical narratives by hospitalised individuals and patient case records. Accounts of hospitalisation by the poet Juhan Liiv (1864–1913) and the craftsman’s wife Marie Sternfeldt (1865–1943) reveal nuances absent from institutional records. Both describe being taken to a mental hospital against their will – Liiv through deception and Sternfeldt through brutal physical force. In addition, their release from hospital came as a surprise to both, as discharge depended largely on their families’ financial ability to pay for continued care. However, not all patients experienced hospitalisation as an instrument of familial power. The case record of the priest Johannes Lenz (1855–1895) shows that he was voluntarily admitted and discharged himself on two separate occasions. Patient agency can also be observed in the case of thirteen-year-old Alexander Enno (1879–?). Although admitted by his mother due to misbehaviour at home, Alexander behaved well in the hospital. After his release, behavioural problems quickly resumed at home, leading to a second admission, during which his conduct again improved. His case record offers a possible explanation for this dissonance, noting that his father was described as a „violent alcoholic“. The hospital may therefore have functioned as a safer environment than the home, suggesting that Alexander’s second admission may have involved an element of his own agency. Patients’ experiences also varied significantly according to their families’ financial means. Correspondence between Count Friedrich Berg (1845–1938) and Rothenberg Asylum director Theodor Tiling (1842–1913) reveals the extensive interior modifications Berg requested for his wife’s future ward. In contrast, conditions in Alexandershöhe, an asylum for pauper lunatics, were described as abhorrent by psychiatrist Juhan Luiga (1873–1927) in his 1904 dissertation On the Care of the Mentally Ill in the Baltic Provinces. While Luiga criticised the poor living conditions endured by patients, it remains open to question to what extent these conditions differed from those of other paupers – indeed, the guaranteed provision of one daily meal may have exceeded what many impoverished individuals received outside the institution. Finally, the article examines patient experiences at the University of Tartu psychiatric hospital, where patients also served as objects of medical education and research. Both their physical presence and their case records contributed to the scientific study of mental illness, shaping patients’ experience in ways distinct from non-university asylums.

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