Liverpool “lunatic asylum”: A forgotten chapter in the history of Australian health care

Background: Historical accounts of Australia's early colonial lunatic asylums often neglect to mention the asylum that operated in Liverpool, NSW between 1826 and 1839. Aim: To find and explore the earliest available evidence of the mental health care provided within Liverpool lunatic asylum. Methods: A literature search was followed by manual searches of primary sources held by the State Records Authority of New South Wales, the State Library of NSW, Liverpool Library and Liverpool Regional Museum. International records available through Ancestry.com were also accessed. Findings: Contrary to previous historical accounts, Liverpool lunatic asylum was located within the parsonage of St Luke's Church in Liverpool. This building was better suited to mental health care than the disused military barracks previously home to the patients of Australia's first asylum at Castle Hill. Discussion: Despite the substantial challenges of delivering mental health care in the early colony of NSW, the lunatic asylum at Liverpool retained long term staff who worked there throughout the 13 years of its operation. Payment of wages to a nurse within the Liverpool lunatic asylum indicates a shift in approach to nursing in colonial mental health care that makes an important contribution to the historical identity of nursing in Australia. Conclusion: Clarifying historical information using primary sources that illuminate care within Liverpool lunatic asylum is important because history has the potential to inform and contextualise modern approaches to health care.