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This article examines contradictory attitudes towards insanity in the navy and how mental disorder affected officers and seamen’s reputations and careers. It challenges assumptions that dangerous sea-service and the prioritization of ability meant that those who experienced disorder were considered inherently ‘unfit’, exposing the complexity of eighteenth-century ideas of merit and disability. Using medical and administrative records, it reconstructs treatment and service patterns which prove that insanity was not an irrevocable bar to employment. Medical ideas underpinned a policy of indifference towards derangement, fostering cultures of sympathy and tolerance in which personal connection and patronage operated predominantly as mechanisms of inclusion, rather than exclusion.

Patronage and insanity: tolerance, reputation and mental disorder in the British navy 1740–1820