bbc mental: a history of the madhouse

People get very carried away, thrilled and outraged by this sort of thing. Frissons are felt and so forth. The thing is though, that gasping at the appalling etc etc doesn’t actually make sense unless you look at the context. There was a hell of a lot of appalling in those days and you didn’t have to be physically or mentally ill to get some. All you had to do was be working class. And that was in the western, developed world. There are also hard questions to be asked about exactly what got improved.

Okay, here comes the sensationalist stuff. Also, total spoiler alert.

The documentary starts during the part of England’s history, still well within living memory, when ‘mad’ or not, people were shoved into asylums and frequently simply left there. It focuses largely on High Royds in Yorkshire, one of the ‘Great Asylums’.

Then came the NHS (1948), ECT, insulin coma therapy and still, the lobotomy. As we know, just one of those treatments is still in use. By 1957, patients were still being violently assaulted by staff, some even called it thump therapy.

In the mid 50s, with new ‘miracle’ psych drugs (beginning with Largactil, an antipsychotic), came the belief that asylums would eventually become completely redundant. Lithium resurfaced. High Royds became a globally known centre of drug research.

Psychiatry began to grow kinder, introducing patient activities and occupational therapy, “it is serious, scientific treatment.” Doors began to open – literally and figuratively.

In 1959, the mental illness act was passed and there was a call to end the stigma and treat mental patients with the same compassion as those with physical illnesses.

In 2015, we (the so called mentally ill) are still dreaming of that happening.

‘Mental hospitals’ began to be closed down by the government. Enoch Powell made plans for what has since been called ‘care in the community’.

By the 60s, it was clear that the drugs didn’t necessarily work and that conditions in asylums were frequently still barbaric. “They’ll tek ye away in a green van ta High Royds!” Hippies happened. R.D. Laing happened. “A normal response to a mad world is to be mad.”

The 70s happened and some more refined, but still frightening brain surgery. “I was like a zombie for four years … there was more violence inflicted on me than I inflicted on anybody … I’ll never forgive them for it.” Although no asylums had been shut down, wards began to be closed and care in the community became a thing.

By the 80s (ohai Maggie Thatcher), patients incapable of coping had been dumped on the streets. Long stay beds diminished and the community barely cared for anyone. The asylums began to close.

By 1990 100k patients had been discharged. Psychiatric hospitals were emptied fast, only leaving beds for ‘some’ acute cases. For some people, this was a very welcome emancipation. Patients began to be called users, as in service users. Institutionalised people had to make their way without much help. Some were abused verbally on the streets.

Panic grew as incidents of violence by ex psychiatric patients grew. “Both psychiatrists and police judge that overwhelming force is necessary.” The government stated that community care had failed.

High Royds was one of the last asylums to be closed, in 2003.

What the hell is the answer, really?

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