Atlas›Domain XVI · Historical, discredited & harmful›Guide 022
Guide XVI-022

Horn's rotatory machines and drenchings

Ernst Horn1806Berlin
A 30 · L 58 · M 1218 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the historical record of Ernst Horn's work as second physician at the Charité, Berlin (1806–1818), as given in the Allgemeine Deutsche Biographie (Bandorf 1881), Yamanaka (History of Psychiatry, 2003), Flüh (Deutsches Ärzteblatt, 2011) and Tromans (Tate Papers 13, 2010), set against current WHO and NICE positions on coercion and restrictive interventions. This guide covers the psychotherapist's own work: historical literacy, recognition, assessment, safeguarding, reporting, referral, advocacy and work with people affected by coercive care. It gives no instructions for any of the historical methods, which are listed here for history and safety and are not recommended.

What it was. Ernst Horn (1774–1848) ran the Charité's asylum wards in Berlin from 1806 until he left at his own request in 1818 [source: Bandorf 1881, ADB]. Among the physical therapies used under him were rotatory machines (devices that spun a confined patient), drenchings (heavy dousing with water) and a restraint known at the Charité as "the sack", in which a patient was bound tightly inside a sack and hung from a beam [source: Tromans 2010; Flüh 2011; Yamanaka 2003 reference list]. Horn belonged to a wider European fashion for "Cox's Swing" and similar rotation devices in the early nineteenth century [source: Dickson 2018].

Its idea of how change happened. Contemporary rationales held that a strong shock to body and senses could break a disordered state of mind. Tromans links this to the period's aesthetics of the sublime: physicians sought to give the patient a stronger dose of awe or terror to restore a sense of proportion, and Burke's physiology framed terror as exercise for the nerves [source: Tromans 2010]. Dickson ties the brief popularity of rotation to Enlightenment ideas, industrial technology, theories of irritability and the new practice of moral management [source: Dickson 2018]. Joseph Mason Cox, a principal British advocate, described the swing's calming action as a "mechanical anodyne" [source: Winter et al. 2013, citing Cox 1804].

Why it matters now. The 1811 death of a woman patient confined in the sack led to a criminal investigation of Horn that Flüh calls one of the first sensational medical-liability cases [source: Flüh 2011]. Today WHO states that coercive measures such as restraint and seclusion are not therapeutic, can cause severe injury and death, and damage trust in services [source: WHO 2025]. Clients meet this history through family archives, museums and art, training, and their own experiences of restraint or forced treatment.

2. Framework

Historical phases (outline only).

  • Theory (late 18th century). Shock, terror and the sublime are recast as correctives for madness; older bleeding and purging continue alongside [source: Tromans 2010].
  • Diffusion (from 1804). Cox's Practical Observations on Insanity (first published 1804) promotes the swinging chair; British, Irish, German and French physicians exchange case reports [source: Tromans 2010; Dickson 2018].
  • Horn at the Charité (1806–1818). Horn becomes second physician in 1806 and teaches clinical medicine. The ADB credits him with treating mental disorder as illness and securing equal treatment for mentally ill patients at the Charité, while noting that his methods "at times went too far" and drew sharp criticism (paraphrased from the German) [source: Bandorf 1881]. A patient dies in the sack on 1 September 1811; a Charité surgeon colleague blames Horn; a Kammergericht judge investigates; the charges are dropped on 20 April 1812 [source: Flüh 2011]. Yamanaka shows the scandal pressed Horn to publish internal hospital details, which ironically built his reputation as a pioneering clinical psychiatrist, and traces professional hostility among Reil, Langermann and Hufeland [source: Yamanaka 2003]. In 1818 Horn publishes his Öffentliche Rechenschaft on twelve years at the Charité and leaves; in 1819 he becomes professor of clinical medicine [source: Bandorf 1881; Flüh 2011]. The year 1818 is sometimes attached to the death; it is the year of Horn's published defence and report, while the death itself is dated 1 September 1811 [source: Flüh 2011].
  • Decline. Non-restraint and moral therapy later ridiculed the shock methods [source: Tromans 2010]; Cox's chair "lost favour" and lived on mainly in vertigo research [source: Swift 2014; Winter et al. 2013].
  • Today. WHO calls coercive measures failures of care and promotes their elimination through QualityRights [source: WHO 2025]; NICE NG10 covers restrictive interventions (restraint, rapid tranquillisation, seclusion) within a graded approach that starts with prevention and de-escalation [source: NICE NG10].

Phases of the psychotherapist's work. Session number and length follow the client's needs and the setting; pace is set by the client [synthesis].

  1. Recognition and assessment. Goal: find out how this history reaches the client (curiosity, family archive, art, own experience of coercive care, work role). Move on when you know the client's relationship to the material and current safety.
  2. Safety and safeguarding. Goal: check for current coercion, abuse or risk, including suicide risk, and act on any safeguarding duty. Move on when immediate risks are managed and any referral is made.
  3. Processing and meaning-making. Goal: help the client place personal or family experience in context, process trauma with supported methods, and reduce shame. Move on when distress is manageable and the client has a usable account of what happened.
  4. Repair and advocacy. Goal: support complaints, records requests, commemoration or reform work the client chooses. Close when the client's own goals are met [synthesis].

3. Guiding principles

  • Never teach, provide, supervise or refer to the historical methods or any modern equivalent. In practice: describe effects and history only; route any interest in body-shock "cures" to medical assessment [synthesis].
  • Treat coercion as harm, not therapy. WHO holds that restraint and seclusion are not therapeutic and breach human rights instruments including the CRPD [source: WHO 2025]. In practice: do not frame a client's restraint experience as "for their own good" unless they do.
  • Hold historical complexity. Horn was both credited with reform (treating mental disorder as illness) and criticised for excess [source: Bandorf 1881]. In practice: avoid caricature; reformers and coercion often coexisted.
  • Never name patients. The woman who died in 1811 is described by role only [synthesis]. In practice: do the same in teaching, writing and supervision.
  • Power is the clinical lens. The case turned on whether a physician answered for a treatment's outcome [source: Flüh 2011]. In practice: notice where clients felt powerless with clinicians, including with you.
  • Trauma-informed pacing. Imagery of spinning, dousing and confinement can trigger people who were restrained [synthesis]. In practice: ask before showing or describing material; keep descriptions general.
  • Consent and the right to stop. Applies to any discussion, record reading or museum visit planned in therapy [synthesis]. In practice: agree a stop signal.
  • Collaborative planning beats control. WHO promotes advance plans made with service users, de-escalation and peer support [source: WHO 2025]. In practice: build crisis plans with the client, not for them.
  • Duty to act on current abuse. Historical interest never replaces present-day safeguarding [synthesis]. In practice: ask directly about current restraint, seclusion or forced treatment.
  • Stay in role. Never advise starting, stopping or changing a medicine; route medical questions to the prescriber [synthesis].
  • Avoid moralising. Facts carry the weight [synthesis]. In practice: state what sources say; let the client draw conclusions.
  • Multiple relationships. Where you also work in the service that restrained a client, consider APA Ethics Code Standard 3.05 (Multiple Relationships) [source: APA Ethics Code].

4. Intervention inventory

The interventions below are the psychotherapist's own work; steps not drawn from a cited source are marked [synthesis].

4.1 Building your own historical literacy

  • Purpose / when: before working with clients, students or families who raise early-asylum history; to speak accurately and without sensationalism.
  • Steps: (1) Learn the outline: Horn at the Charité 1806–1818, rotatory machines, drenchings and the sack, the 1811 death and the 1811–1812 investigation [source: Bandorf 1881; Flüh 2011]. (2) Learn the theory of the time: shock and the sublime, irritability, moral management [source: Tromans 2010; Dickson 2018]. (3) Learn the counter-record: Horn's reform credit and the criticism of excess [source: Bandorf 1881]. (4) Link it to current positions on coercion [source: WHO 2025; NICE NG10]. (5) Keep a short, neutral summary ready [synthesis].
  • Example language (illustrative): "In the early 1800s some doctors believed a strong physical shock could reset a disturbed mind. Those methods hurt people, and one patient at the Berlin Charité died in 1811."
  • Watch for: drifting into lurid detail, or into excusing it as "of its time". Working if you can answer questions accurately in a few sentences.

4.2 Recognising the history in client material

  • Purpose / when: a client mentions spinning chairs, cold dousing, sacks or "old asylum treatments", often with fear, humour or fascination.
  • Steps: (1) Note the reference without correcting or expanding it. (2) Ask where they met it (family story, documentary, museum, art, own care). (3) Ask what it means to them now. (4) Decide whether it is curiosity, distress, identification or a fear about present care [synthesis].
  • Example language (illustrative): "You mentioned the spinning chair. What brought that to mind today?"
  • Watch for: a client using history to talk at a safe distance about their own restraint. Working if the reference opens a conversation about the client's own experience.

4.3 Assessing the client's relationship to coercive care

  • Purpose / when: whenever the history connects to a client's own psychiatric care.
  • Steps: (1) Ask, with permission, whether they have experienced restraint, seclusion, forced medication or detention. (2) Ask when, where and how often, without asking for graphic detail. (3) Screen for trauma symptoms tied to those events. (4) Ask how it affects their trust in services now; WHO notes coercion damages that trust [source: WHO 2025]. (5) Record what they say in their words [synthesis].
  • Example language (illustrative): "Some people who have been held down or shut in a room in hospital carry that with them. Has anything like that happened to you?"
  • Watch for: dissociation, sudden shutdown, anger at you as a representative of services. Working if the client can name the experience and stays within tolerance.

4.4 Safety and suicide-risk check

  • Purpose / when: when memories of coercive care, or of a relative's institutional death, surface with hopelessness.
  • Steps: (1) Ask directly about suicidal thoughts, plans and intent using your service's standard risk assessment. (2) Ask about protective factors. (3) Build a safety plan with the client. (4) Give crisis resources: 988 (US); Samaritans 116 123 (UK and Ireland). (5) Follow safe-messaging principles: no method detail [synthesis].
  • Example language (illustrative): "When you think about what happened on the ward, do you ever have thoughts of ending your life?"
  • Watch for: reluctance to disclose for fear of being detained again; name that fear openly. Working if the client co-owns the plan.

4.5 Collaborative crisis and advance planning

  • Purpose / when: for clients who fear future coercion or have been restrained before.
  • Steps: (1) Explain that WHO promotes plans made jointly by staff and service users setting out what to do and not do during distress [source: WHO 2025]. (2) Help the client list early warning signs, what helps, what harms, and who to contact. (3) Encourage sharing the plan with their care team. (4) Where a formal advance statement or directive exists locally, refer to the care team or an advocate for the legal form [synthesis; legal forms vary by jurisdiction, uncertain].
  • Example language (illustrative): "If things got very hard again, what would you want staff to know about what calms you and what makes it worse?"
  • Watch for: the plan becoming the therapist's plan. Working if the client feels more in control of future care.

4.6 Trauma-focused work with survivors of present-day coercive care

  • Purpose / when: a client has trauma symptoms linked to restraint, seclusion or forced treatment.
  • Steps: (1) Validate that WHO describes these experiences as traumatic and harmful to recovery [source: WHO 2025]. (2) Offer an evidence-based trauma-focused therapy you are trained in, following current national guidelines [synthesis; specific guideline uncertain: not verified]. (3) Stabilise first: grounding, sleep, support network. (4) Process memories at the client's pace with consent before and during. (5) Address shame and self-blame. (6) Coordinate with the care team where the client agrees [synthesis].
  • Example language (illustrative): "What happened to you was frightening, and the fear you still feel makes sense."
  • Watch for: re-traumatisation by the therapy setting itself (closed doors, power differences); offer choices about seating and exits. Working if intrusions and avoidance reduce.

4.7 Family-history work: an ancestor in an early asylum

  • Purpose / when: a client finds an ancestor in asylum records, or a family story about a relative "shut away".
  • Steps: (1) Ask what they know, what they fear and what they hope to find. (2) Prepare them for distressing records before they read. (3) Help them place the ancestor in the treatment ideas of the time, without assuming any specific method was used. (4) Explore inherited family silences, shame and fears of hereditary madness. (5) Support rituals of remembrance they choose [synthesis].
  • Example language (illustrative): "Before you open the file, let's think about what you might find and how you'll look after yourself afterwards."
  • Watch for: over-identification ("it will happen to me"); clarify how care and diagnosis have changed. Working if the client can hold the ancestor with compassion rather than dread.

4.8 Psychoeducation on the history, paced and non-graphic

  • Purpose / when: a client asks to understand what happened in early asylums.
  • Steps: (1) Ask how much detail they want. (2) Give the outline: the shock rationale, the devices in general terms, the harms [source: Tromans 2010; Winter et al. 2013]. (3) Name the later turn to moral treatment and non-restraint [source: Tromans 2010]. (4) Link to current standards [source: WHO 2025]. (5) Check how they feel afterwards [synthesis].
  • Example language (illustrative): "The idea was that a big jolt could break a mental illness. It didn't work that way, and doctors later turned to calmer, more humane care."
  • Watch for: requests for operating details; decline and explain why [synthesis]. Working if the client reports understanding rather than fear.

4.9 Working with a client drawn to "shock" cures

  • Purpose / when: a client believes they need to be "shocked out of" depression or anxiety, or is drawn to spinning, startle or dousing ideas promoted online or by a practitioner.
  • Steps: (1) Explore the appeal (speed, control, punishment, hope). (2) Share, in outline, that shock and rotation methods were abandoned and that common reported effects included vertigo, pallor, nausea and vomiting [source: Winter et al. 2013]. (3) Do not recommend any version; route any physical or vestibular intervention question to their physician [synthesis]. (4) Note that a 2013 turntable study in healthy volunteers is laboratory research and not a treatment [source: Winter et al. 2013]. (5) Offer supported psychological care for the underlying problem [synthesis].
  • Example language (illustrative): "It sounds like part of you wants something drastic to force the change. Can we look at what that part needs?"
  • Watch for: self-punishing motives and risk-taking; screen for self-harm. Working if the client turns towards supported care.

4.10 Safeguarding when coercion or abuse is happening now

  • Purpose / when: a client describes current restraint, confinement, cold-water dousing, forced spinning or other physical punishment in a care home, hospital, family or group setting.
  • Steps: (1) Listen, record verbatim, avoid leading questions. (2) Assess immediate danger. (3) Follow your service's adult or child safeguarding procedure and inform the safeguarding lead. (4) Where a client lacks capacity or is a child, act without delay under local law. (5) Tell the client what you will do and why, unless that would increase risk. (6) Follow up [synthesis].
  • Example language (illustrative): "What you've told me worries me for your safety. I need to share it with the safeguarding team, and I'll tell you what happens next."
  • Watch for: retraction under pressure. Working if a protective plan is in place.

4.11 Children and young people

  • Purpose / when: a minor, or a parent, describes punitive physical methods used on a child (confinement, dousing, spinning as punishment).
  • Steps: (1) Follow mandatory reporting and child-protection routes in your jurisdiction. (2) Seek assent from the young person and consent from those with parental responsibility for therapy, while recognising that safeguarding duties override confidentiality. (3) Never name the child in notes shared outside the record beyond what the referral requires. (4) Coordinate with child-protection services [synthesis].
  • Example language (illustrative): "It's my job to help keep young people safe, so I need to talk to people whose job is to protect children."
  • Watch for: a parent presenting harsh methods as "treatment". Working if the child is protected and the family engaged.

4.12 Duties when a colleague or institution uses abusive or non-indicated restrictive practices

  • Purpose / when: you learn that a colleague or service uses restraint, seclusion or physical "shock" methods outside lawful, guideline-based limits.
  • Steps: (1) Record what you observed or were told. (2) Raise it with the service's safeguarding lead and line management. (3) If unresolved, use your professional regulator or licensing board and the relevant inspectorate or patient-safety route. (4) Use whistleblowing protections where they exist. (5) Never take part in, supervise or refer to the practice [synthesis]. (6) NICE NG10 sets restrictive interventions inside a graded approach beginning with prevention and de-escalation; use it as a benchmark in England [source: NICE NG10].
  • Example language (illustrative, to a manager): "I'm raising a concern about how restraint was used on this ward yesterday, and I'd like it logged as a safeguarding matter."
  • Watch for: pressure to stay quiet; personal cost to you. Working if the concern is logged and investigated.

4.13 Supporting staff with moral distress after coercive practice

  • Purpose / when: a nurse, doctor or support worker client is troubled by restraint or seclusion they took part in.
  • Steps: (1) Normalise: WHO notes staff may feel coercive measures conflict with their own values [source: WHO 2025]. (2) Separate guilt about specific acts from systemic failure. (3) Explore what they want to change (training, raising concerns, Safewards-style approaches) [source: WHO 2025 names Safewards]. (4) Where they disclose possible abuse, apply 4.12 [synthesis].
  • Example language (illustrative): "It sounds like what you were asked to do clashed with why you came into care work."
  • Watch for: burnout; WHO notes individual efforts alone can lead to it [source: WHO 2025]. Working if the client finds a constructive route.

4.14 Teaching and supervision using the Horn case

  • Purpose / when: training clinicians on power, accountability and the history of coercion.
  • Steps: (1) Present the case in outline: the 1811 death, the colleague's accusation, the court investigation, the 1812 dropped charges [source: Flüh 2011]. (2) Add Yamanaka's point that professional rivalry shaped the scandal and that disclosure built Horn's reputation [source: Yamanaka 2003]. (3) Ask trainees where today's equivalents of "therapeutic" coercion lie. (4) Never name the patient; never show operating detail. (5) Offer a debrief [synthesis].
  • Example language (illustrative): "Horn was seen as a reformer and was also investigated after a patient died. What does that tell us about how good intentions and harm coexist?"
  • Watch for: trainees with lived experience of restraint; give opt-outs. Working if discussion turns to current practice.

4.15 Museum, art and media encounters

  • Purpose / when: a client is distressed after seeing asylum devices or imagery (exhibitions, documentaries, the art discussed by Tromans) [source: Tromans 2010].
  • Steps: (1) Ask what they saw and what it stirred. (2) Ground if needed. (3) Link to the client's own history only if they do. (4) Plan future visits with exits and support [synthesis].
  • Example language (illustrative): "Seeing that chair seems to have taken you somewhere. Where did it take you?"
  • Watch for: flashbacks. Working if the client can choose future exposure freely.

4.16 Referral and coordination with medical and psychiatric care

  • Purpose / when: physical symptoms (e.g. vertigo, injury) or medication questions arise.
  • Steps: (1) Route physical symptoms to a physician. (2) Route medication questions to the prescriber; never advise starting, stopping or changing a medicine. (3) With consent, share relevant trauma history so care can avoid re-traumatising practices [synthesis].
  • Example language (illustrative): "That dizziness needs a doctor's look. Would it help if I wrote a note about what we've discussed?"
  • Watch for: avoidance of all services after coercion; support graded re-engagement. Working if the client attends.

4.17 Advocacy and rights-based reform

  • Purpose / when: a client or clinician wants to change practice.
  • Steps: (1) Point to WHO QualityRights as a framework for de-escalation training and reducing coercion [source: WHO 2025]. (2) Support the client's choice of route: complaint, peer advocacy, service-user involvement, writing. (3) Connect to peer support; WHO describes peer workers' role [source: WHO 2025]. (4) Respect a client's choice not to advocate [synthesis].
  • Example language (illustrative): "Some people find meaning in helping change how services work. Others want to put it behind them. Either is fine."
  • Watch for: advocacy as avoidance of personal grief. Working if it adds meaning without overwhelm.

4.18 Repair after harm in care, including your own service

  • Purpose / when: a client was harmed by a service, or felt coerced in your own work.
  • Steps: (1) Acknowledge what happened without defensiveness. (2) Explain complaint and records-access routes. (3) If the harm involved your service, inform your supervisor and follow duty-of-candour rules where they apply. (4) Repair the rupture in therapy before moving on [synthesis].
  • Example language (illustrative): "I can see that the way I pushed that topic felt like being pinned down. I'm sorry. Let's slow down and you set the pace."
  • Watch for: appeasement without change. Working if trust returns.

5. Handling problems

The problems below are the psychotherapist's own synthesis [synthesis]; a source tag marks any point drawn from a cited source.

  • Client stuck in rumination about the historical cruelty. Name the pattern; ask what the history stands for in their own life; move from "what they did then" to "what I need now".
  • Resistance rooted in distrust of all clinicians. WHO notes coercion damages trust in services [source: WHO 2025]. Respond by making power explicit: what you can and cannot do, confidentiality limits, the client's right to stop. Do not argue for the system.
  • Overwhelm or flashbacks when devices or confinement are mentioned. Stop, ground, use the agreed stop signal; return only with consent; describe material only in general terms.
  • Non-adherence to a crisis plan or medical follow-up. Explore whether the plan or the service feels coercive; revise the plan with the client; never advise on medicines.
  • Rupture: the client experiences you as controlling. Acknowledge, apologise for your part, offer choices (pace, topic, seating, door); see 4.18.
  • Client insists on hearing exact methods. Explain that you describe history and effects, not how devices were used; offer reputable histories in outline (see Sources).
  • Client wants to try a "shock" or spinning self-treatment. Do not endorse or teach; route to a physician; assess for self-harm and suicide risk; give 988 (US) or Samaritans 116 123 (UK and Ireland) where risk is present.
  • Fear of disclosure because of past detention. Explain the specific threshold at which you would share information; involve the client in any necessary step.
  • Family conflict over an ancestor's story. Hold multiple accounts; help the client decide what to share and with whom.
  • Your own reaction (anger, shame for the profession). Take it to supervision; avoid moralising in session.
  • You work in a service that uses restrictive practices. Clarify roles under APA Ethics Code Standard 3.05 where a multiple relationship arises [source: APA Ethics Code]; use 4.12 for concerns; keep the therapy space separate where possible.
  • Uncertain facts. Where accounts differ (for example the year of the death, or Horn's birth year in some catalogues), tell the client which source you follow and why.

Harm account

What was actually done

Under Ernst Horn, second physician at the Charité in Berlin from 1806 to 1818, patients on the asylum wards were subjected to physical "shock" and restraint methods. Tromans records that Horn "drenched his patients in epic quantities of water" and favoured rotatory machines [source: Tromans 2010]. Rotation was used first on a bed and later on a chair [source: Snopes; uncertain: secondary]. A restraint known as "the sack" was used on the wards and described at the time as a treatment: the patient was bound tightly inside a sack and hung from a beam, which was supposed to calm her [source: Flüh 2011; the device is also listed in Yamanaka 2003]. On 1 September 1811 a woman patient who had been screaming all day was put into the sack and hung up in this way to quiet her, and died during it; the post-mortem could not settle whether suffocation had internal or external causes [source: Flüh 2011]. A Charité surgeon colleague blamed Horn, a judge of the Prussian Kammergericht investigated from September 1811, and the charges were dropped on 20 April 1812; public dispute continued until 1818 [source: Flüh 2011]. Rotation devices of this family were in use across Britain, Ireland, Germany and France in the early nineteenth century [source: Dickson 2018].

How it caused harm

  • Physical: reported effects of rotation included vertigo with pallor, nausea and vomiting, and sometimes loss of bladder control [source: Winter et al. 2013]. Confinement in the sack was followed by a patient's death [source: Flüh 2011].
  • Psychological: the methods were designed to frighten or overwhelm the senses [source: Tromans 2010]; later accounts describe abusive use of rotation to force behaviour change [source: Winter et al. 2013].
  • Accountability: the case exposed how hard it was to hold a physician responsible for a treatment's outcome [source: Flüh 2011], and professional rivalry shaped how it was handled [source: Yamanaka 2003].
  • Continuing pattern: WHO states that restraint and seclusion today can cause severe physical injury and death, are experienced as traumatic and harm recovery and trust [source: WHO 2025].

Recognising it today

  • The historical devices are no longer used in psychiatry; rotation survives in vestibular testing and laboratory research, not as mental-health treatment [source: Swift 2014; Winter et al. 2013].
  • The logic of "shocking" a person out of distress persists in some coercive settings and unregulated offerings. Signs: physical punishment presented as therapy; confinement, dousing or forced disorientation; claims that fear or discomfort is curative; no consent or right to stop [synthesis].
  • In services, the modern heirs are restraint and seclusion used outside lawful and guideline limits; WHO found unwarranted coercion in many long-term institutions in its 2018 European assessment [source: WHO 2025].

What to do instead and how to help those harmed

  • Supported care: WHO calls for ending coercive measures through rights-based care, de-escalation, jointly made advance plans, peer support and approaches such as Safewards, with QualityRights training for staff [source: WHO 2025]. In England, NICE NG10 places restrictive interventions within a graded approach starting with prevention and de-escalation [source: NICE NG10].
  • Survivors: offer trauma-informed, evidence-based psychological therapy, crisis and advance planning, and links to peer support (see 4.3–4.6) [synthesis].
  • Families: support relatives researching ancestors in asylums or bereaved by institutional deaths (see 4.7) [synthesis].
  • Reporting and legal routes: current abuse goes to safeguarding leads, child-protection services, regulators and inspectorates; clients may also use complaint procedures, independent advocates and, where appropriate, legal advice (see 4.10–4.12) [synthesis].
  • Crisis resources: 988 (US); Samaritans 116 123 (UK and Ireland).

Sources

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