By the mid 19thcentury attitudes were changing towards people with learning disabilities. A debate started in Scotland on the need for improved facilities such as a residential training school. The debate was further fuelled by the 1855 Royal Commission into the country’s mental health provision which led to the Lunacy (Scotland) Act 1857. One of the main results of the Act was the creation of a General Board of Commissioners in Lunacy. Although the Act made no provision for children, in the Board’s first annual report it highlighted the work of the so-called ‘Idiot Schools’ at Baldovan and Gayfield Square, Edinburgh and the efforts being made to raise funds for a model institution.
These efforts were concentrated in the Society for Education of Imbecile Youth in Scotland, established in 1859. Rather than raising funds by relying on a few large donations, the idea of a penny subscription was introduced. Enough funds soon accumulated to allow the board of directors to purchase land. As it was to be a national institution, the Stenhouse Estate near Larbert was chosen for its central location and excellent rail links. The Board commissioned Frederick Pilkington to design the school.
The first dormitory opened in May 1863 and Dr Brodie, who had run the school at Gayfield Square, became the first resident physician. The new establishment was called the Scottish National Institution for the Education of Imbecile Children and was intended for children aged between six and twelve, although older and younger children were soon taken.
Initially all the children were admitted on a fee-paying basis. For those whose families could only afford part of the fee, the Institution would award subsidies following the election of suitable applicants by donors to the Society.
Dr Brodie and the Board of Directors eventually diverged in their vision for the Institution and Brodie resigned in December 1867. He was succeeded by Dr Adam Addison, medical superintendent 1868-1870 then Dr William Ireland, superintendent 1870-1881. The number of children grew steadily from 43 in 1867 to 95 in 1870. More facilities were added as funds were available and those funds were augmented in 1869 with a royal donation of £100.
After Ireland’s resignation in 1881, Alexander Skene, the first non-medical superintendent was appointed. He oversaw a period of almost continuous growth: 25 staff and 120 children when he started; 70 staff and 350 children by the time he left in 1911. New buildings were erected including an infectious diseases hospital, covered playground and staff cottages; and additional land purchased. The continued rise in the number of children infringed the Institution’s licence and application had to be made to the Commissioners in Lunacy to accommodate more.
When Skene retired in 1911, Dr Durward Clarkson became the medical superintendent and it was his vision that saw the creation of a life-long community. This vision was aided by the passing of the Mental Deficiency and Lunacy (Scotland) Act 1913. For the first time a distinction was drawn between mental illness and mental handicap and provided for new institutions for those with mental disabilities. Existing establishments could become certified institutions if they met the requisite criteria and the Scottish National Institution was one of these. Numbers increased and to free up more space a nurses’ home was built. By the time it opened in 1917 resident numbers had risen to 500 and staff to over 100.
The First World War threatened to prevent the implementation of the all-life care that the Act provided but by the 1920s the Institution could look at purchasing land for an Industrial Colony. After the purchase of Larbert House and estate, plans were drawn up for an administration block, nurses’ home and five villas where 300 people would be able to work on the land and at various trades. In the meantime Larbert House itself became home to 36 private residents - the first admissions of those over the age of 21. The Colony opened in September 1935 and with his ambition realised Dr Clarkson retired to be succeeded by Dr Thomas Spence.
During the Second World War there were serious staffing issues, exacerbated by the transfer of 130 patients from Gogarburn Hospital in Edinburgh which took the total number of residents to over 900. After the war ended the Institution became part of the National Health Service (NHS) thereby ending the charitable status it had had since its foundation.
The slow post-war economic recovery meant little could be done initially to accommodate increased demand. This improved in the 1950s and a twelve year plan to increase accommodation to over 1300 at a cost of £1million was set up in 1956. This was substantially completed by 1967 by which time a shift had started towards taking in more severely handicapped patients. As a result the Institution adopted its final name of the Royal Scottish National Hospital (RSNH).
Into the 1980s the move from institutional to community care gained momentum. Health Boards in other areas were also encouraged to take their patients back in a continuing drive to reduce numbers. Upgrading of existing facilities continued, however, and was partly funded through concentration on the Colony site and selling off the original building and land. The Ochil Park development proved to be the last big project and was as innovatory as the original Institution buildings – 6 ten-bedded bungalows for highly dependent patients.
The hospital finally closed in 2002. The site was re-used for the new Forth Valley Royal Hospital which opened in 2010.
[Source: The Royal Scottish National Hospital – 140 Years by Guthrie Hutton]