A document has been unearthed that reveals the high cost of mental health care in Edinburgh in the 1840s.
The eye-opening bill, an image of which appeared on Twitter last weekend, provides a fascinating insight into the state of mental health care as it was almost a century before the National Health Service was set up.
On Sunday, Colin (@LunaticAsylums) tweeted an image of a 174-year-old bill detailing the cost of board for two psychiatric patients at the Royal Edinburgh Asylum - now the Royal Edinburgh Hospital.
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Originally called the Edinburgh Lunatic Asylum, the psychiatric hospital was set up in Morningside in the early 1800s, initially for patients whose families could afford to pay.
Twitter user Colin is a collector of documents, photographs and other ephemera relating to UK mental health institutions from years gone by.
The bill, which Colin picked up on eBay, shows the annual charges incurred by two patients, Margaret Duncan and Margaret Lauder, at the Morningside hospital. The document is from the inspector of the poor in Carriden and dated September 24, 1849.
The cost for a three month stay of care for the two patients from July 1 to October 1 came to 12 pounds and 10 shillings - roughly £1,278 when adjusted for inflation. Annually, the price for two boards is given as £25, which is around £2,500 today.
In an age where we take free health care for granted, it's certainly food for thought.
Mental health care provision in the mid-19th century was a far cry from what it is today - particularly for those from the poorer classes.
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In those pre-NHS days, payment for mental health services was made according to the means of each patient, with those classed as paupers often forced to find some way to cough up the costs or seek charity.
Patients with mental illnesses would typically be described as lunatics, imbeciles, insane, idiots or cretins.
Scotland's capital, however, thankfully had better mental health care provision than most British cities in the 1800s.
Founding
The Royal Edinburgh Asylum, which was also often referred to as the Edinburgh Lunatic Asylum, opened in 1813 and grew to become one of the largest psychiatric hospitals in Britain.
It was set up in the wake of the death of legendary Edinburgh poet Robert Fergusson, who had succumbed to a brain injury and died in the city's Bedlam 'madhouse' in 1774.
The poet's doctor, Andrew Duncan was so appalled by Fergusson's treatment in his final days that he launched a state fundraising appeal to found a dedicated psychiatric hospital in the capital.
Unlike the majority of the UK's other asylums, the Edinburgh institution focused on providing a safe and humane environment for patients, with the use of restraints and physical punishment kept to an absolute minimum.
While many of the common treatment methods would now be considered barbaric by modern standards, the Royal Edinburgh Asylum made significant advancements in the fields of psychotherapy and occupational therapy.
Patients were also allowed a degree of freedom. They were encouraged to take frequent walks in the fresh air around the landscaped grounds and participate in sporting activities, such as lawn bowls.
The 19th century facility was eventually replaced by the Royal Edinburgh Hospital, which continues to provide a wide range of psychiatric and mental health services, including treatment for learning disabilities, eating disorders and dementia. In the 1960s, the Young People's Unit and Alcohol Problem Unit were also set up on the hospital campus.
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