Bethlem Royal Hospital


Bethlem Royal Hospital, also known as St Mary Bethlehem or Bethlehem Hospital, is a psychiatric hospital in London (Monks Orchard Rd, Beckenham BR3 3BX). Bethlem is an unique institution and it has been continuously involved in the care of the mentally ill since at least the 1400s. As such it has a strong claim to be oldest foundation in Europe with an unbroken history of sheltering and treating the mentally disturbed.1 In the 15th century, english people usually referred to the Bethlem Royal Hospital as Bedlam, which became, by definition, a name associated to a place or situation of madness and chaos.2


Main entrance view.


The hospital 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. Bethlem was established by the Bishop-elect of Bethlehem, the Italian Goffredo de Prefetti, following a donation of personal property by the London alderman and former sheriff, Simon Fitzmary. The original location was in the parish of St Botolph, Bishopsgate's ward, just beyond London's wall and where the south-east corner of Liverpool Street now stands.3

Plan of the first Bethlem.4

Bethlem grew from very humble beginnings: by 1403 the hospital was catering for only six men. The building remained physically intact during the dissolution of monasteries, at the time of Henry VIII, who granted in 1547 its custody to the City of London. The hospital truly assumed its national and international notoriety in 1675-6, with its rebuilding at Moorfields.5 The architect chosen for the new hospital was the natural philosopher and polymath Robert Hooke.

In 1728, James Monro became Bethlem's chief physician, initiating a Monro family dynasty that lasted for four generations. The family name "Monro" became synonymous with the very word "mad-doctor", since patients were routinely beaten, starved, and dunked in ice cold baths.6


Bethlem Royal Hospital at Moorfields.7

By the end of the eighteenth century Bethlem was facing financial difficulties, and the building was experiencing physical deterioration8: a new rebuilding was made necessary. A fund-raising drive was initiated in 1804 and a national campaign to solicit donations from the public was launched in 1805. A competition was held to design the new hospital and even a noted Bethlem patient, James Tilly Matthews, the first fully documented case of paranoid schizophrenia, took part in it, although the task was not given to him. The new Bedlam, rebuilt in a neoclassical style, was completed in 1815 at St George's Fields.9

Bethlem Royal Hospital at St. George Fields.10


In 1931 Bethlem moved to its current home, a large campus in the London suburbs on the site of Monks Ochard House. Nowadays, patients live in small, separate, home-like buildings rather than a fortress-like structure, as it was in the previous buildings.
The hospital has now become a centre of research for mental diseases and holds a small museum, the Bethlem Museum of the Mind.

Map of the hospital.


Fitzmary house.


Larkbarrow house.


River house.

The hospital offers an extraordinary therapeutic environment for promoting recovery, housing facilities like a swimming pool, an art gallery, nature walks and an extensive occupational therapy programme. The Bethlem occupational therapy programme includes activities like art sessions, dramatherapy, therapeutic cooking and gardening.11

Entrance to the Occupational therapy Department.

  • Photos and main text by Leonardo FrascĂ  moc.liamg|acsarfodranoel#| and Francesco Auletta moc.liamg|99.atteluaecnarf#| (January 2019)

Related items


  • Daniel Hack Tuke. Chapters in the History of the Insane in the British Isles. London: Keegan Paul, Trench & Co.; 1882.
  • Jonathan Andrews, Asa Briggs, Roy Porter, Penny Tucker, Keir Waddington. The History of Bethlem. London & New York: Routledge; 1997.
  • Jonathan Andrews. Bedlam revisited: a history of Bethlem hospital (Ph.D.thesis). London: Queen Mary and Westfield College London University, 1991.


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