Any doctor today who advised cutting a mentally ill patient until they bled then making their skin blister with arsenic would be struck off. Or they may even end up in jail.
But this was the ‘care package’ physicians drew up for King George in the late 1700s to ‘cure’ his manic episodes.
The descent of this much-loved monarch into insanity and his barbarous medical treatments are vividly portrayed in Alan Bennett’s award-winning work The Madness of George III.
A playwright’s genius lies in their ability to sum up the human condition. One of Britain’s finest dramatists, Bennett succeeds in shining a light on the desperation, loss of dignity and distress often experienced by those who suffer mental health issues.
In King George’s time, this plight was reinforced by inhumane attitudes. Muzzles and chains were among the ‘tools’ used to restrain patients, along with forcing them to sit naked for long periods. This was the case until well into the 1800s and beyond.
The widely held view was that ‘lunatics’ - so-called because of a mistaken belief that changes in the moon’s phases triggered instability - were unproductive therefore could not contribute to the economy. It was also felt that ‘madmen’ threatened society’s order and discipline. They needed to be confined and controlled, preferably behind locked doors.
Thankfully we have progressed. Much has changed for the better in how we manage mental illness since George III. Gone - or nearly - are the vast asylums first introduced by the Victorians to warehouse those with ‘untreatable’ disorders such as schizophrenia.
Instead, the focus is now largely upon treating people in the community where they have a say in how they are supported and how their condition is best addressed. Indeed, admission to a psychiatric institution is often a last resort.
However, in my opinion, there is still a way to go until mental health services enjoy parity of esteem with physical health services. Across the country, psychiatric hospitals and community mental health services are underfunded and overstretched.
Reading the latest figures on restraint, you could even be forgiven for believing that we are back in a previous century. The number of incidences this last resort measure has been used on those with learning disabilities has soared, according to figures obtained by the BBC and published last month.
Mental health support should be fit for a modern age and this approach not only helps patients - the NHS saves money too. It avoids expensive-to-run treatment beds being blocked by patients who should have been discharged but have nowhere suitable to go.
Mental illness does not discriminate. You can be affected if you are a monk or a monarch. What is needed to improve services is vision, commitment and resources to ensure we keep moving forward.
Not to regress to those dark days of ‘mad’ George III.