The Evolution and Closure of Asylums

[Music] for over a hundred years Britain's mentally ill were hidden from society in vast Victorian science those who are locked away have left their own testimony I remember getting the first glimpse of the Ospital it's big looming place to the Clocktower on that and I remember then thinking my goodness what am i letting myself in far in the last decades of the asylums psychiatrists tried to cure as well as care for patients some of their attempts were barbaric there was a disaster they made a hole in the skull that went is the brain and the right was a bit that was it this was a time when treatment was undergoing a revolution some patients felt science was being pushed too far it's richly Pro bond and burnt a puta madre now these institutions had to be shut down when it happened it was a moment of history that changed Britain this is the story of the closing of the asylums and the often troubled lives they left behind [Music] [Music] hi roids in Yorkshire was typical of the great asylums [Music] it was a village in its own right with its own forms of butcher a bakery even a railway station that ran right to the center of the asylum at its height it held over 2,500 patients it was just massive you could walk around all day and and never walk around all of it I was in the place with the longest corridors I've ever seen there were miles of corridor a lot of patients were socially inadequate not strictly speaking and mentally ill not disturbed with voices not suffering from delusions not showing any thought disorders at all simply inadequate and couldn't cope they weren't wanted those good burgers of bleedin Bradford who dentist patients in here would certainly have thought that they were doing the right thing by the patients although really they were doing the right thing by their towns I think that word dumped it's an awful word isn't it but you could think and I think rightly that a lot of patients were dumped here by their relatives by the community they weren't wanted and hi Rodge was a convenient place for them it was not just high Royds many of Britain's asylums contained patients who had been locked up for no clear psychiatric reason people got admitted on all sorts of dubious grounds that didn't really have anything directly to do with their mental states and their families had abandoned them and there was no one to support them outside the institutions even in the 1950s some patients ended up in the asylums for a very long time this patient used to be a skilled gardener he came here 35 years ago and here's an old soldier he fought in the 1418 wall many patients were admitted on genuine medical grounds some of them easily treatable outside Hospital nowadays Agra phobia panic turns Mester phobia uh-huh I knew if I went walking in the street anywhere I just clips [Music] after the war Joan Tugwell had left the army and was suffering genuine mental distress she was 25 and living with her foster parents panic attacks were making her life a misery I went to bed one night and I thought I couldn't breathe so I kept screaming handsome um I can't breathe I can't breathe Sir John's Hospital near Aylesbury was Joan's local Asylum for her family it seemed to offer some hope of refuge she was duly committed to care my mother asked if I go in but she knew I wasn't world that said they had two big doorman seas and each of them had a bed so she busy one door was he so the top of one bed was down this way the next bed up that way there next one down here and then the next one up there so that it won't breathe into one another because we're so close you're lucky we'll get into better mood I forgot my food mover bear it was to be the start of a third of a century inside mental hospitals for Joan in the early 50s the regime was harsh some of those she met were not what she would have thought of as mad you would wonder you said well from in there nothing wrong with some about me I was I think that's wrong with me the asylum life was empty and repetitive after months on her ward Joan asked the nurse if she could help with the beds it was a way of occupying herself for a part of the day I asked if alpha beta base Alfred Stanley and watch you're making 60 bed reactive no her hand so we both made all the bed alcohol offered an escape from her feelings of anxiety one evening in the asylum Joan got hold of some spirits and ended up drunk and in the wrong ward I supposed to times over the cake when Kenan said good evening to all the stuff and half past that was Old Stone when I came round I was in a padded cell they're frightening because you don't hear them and they can't hear you everything's wrong Webber and you have canvas night dresses as canvas blanket if you share that they look better here you despite the vast majority of patients having committed no offense life in the asylums was dominated by security the wards were not opened the doors weren't have to open the door was open to let the patient out and enclose after he'd gone there's a quasi prison atmosphere there the only crime you who commit if you're on the patient was to escape in many ways the large asylum still housed inmates rather than patients conditions inside had altered little in the last half-century the change was on its way [Music] this leaflet is coming through your letterbox one day soon read it carefully when the Labour government created the National Health Service in 1948 mental institutions were entirely separate from general hospitals before the NHS was created there was some debate as to whether or not the asylums in psychiatry would be included in the National Health Service and it was decided finally that it would be included and by including it I think it did help to to bring the system's together hospitals and specialist services medicines it was the parting of ways with the old pool or ideology notionally the mental patient was being embraced by the NHS ethos the whole idea of the quality of membership [Music] while medical science had advanced rapidly in the years before the creation of the NHS therapy for mental illness was still very limited but now psychiatrists began to experiment with new ideas and new treatments you get an increasing view that mental illness is really the same as other physical illnesses and can be treated using the same sort of means using physical interventions that work on the body one of these relatively new treatments was the controversial electro convulsive therapy or ECT it meant passing an electrical current through the brain to induce a seizure it seemed to ease the symptoms of severe depression in some patients those psychiatrists could not explain how it worked put a wire here and here and then we switch on in your hair into a fit have a productive fifth hole ECT units were set up so that patients could be treated in large numbers until the early 1950s the procedure was carried out largely without anaesthetic a member of staff would lean heavily on the needs another one at the ankles and one at each side holding the shoulders down and the consultant applied an electrical charge through the brain the patient of course jerked very very violently that's why we were holding him down because it had been known that this procedure could cause practice and had cord fractures despite appearances ect was regarded as a step forward it seemed to offer some patients a real hope of improvement yeah insulin doses are being prepared and checked another of these so called shock treatments was insulin therapy where doctors induced a coma by injecting large doses of insulin into the body insulin coma treatment to give it its full title offers the greatest likelihood of relief and cure for some patients whose illness is of a deep-seated nature as you said angel anemia but then wasn't very nice to her they used seven patients who go right into a coma they would scream all the time I mean I think it made him feel queer it would burn up all the sugar in their body and drop the blood sugar level very very low and they were going to coma and that was supposed to be beneficial in some way to the brain in this condition the mind has a chance to be completely relaxed and the functions of the brain have the opportunity of as it were setting out on a new path when consciousness returns physical treatments like this advance the image of psychiatry as a fast developing scientific branch of Medicine in reality insulin proved a harmful medical failure 44 people were killed from its effects during this period made me Bears let me give you a fit and that heck says away we can't give you anymore incident versus affection you've made you have a fit but one form of treatment was more drastic than all the others the lobotomy [Music] some psychiatrists believe that by removing sections of the brain itself certain serious mental disorders could be permanently treated at least 15,000 of these operations known as prefrontal leucotomy x' were performed in britain it was a disaster there was a blind operation they made a hole in the skull Oh which the so called probe went into the brain and it might with a bit that was it there was no until much much later and the attempt to refine the exactly where they cut was made there was lots of patients walking around with two holes and have either side of the forehead that you could see the actual dint where this skull had been a trap and away and an instrument had been put in what wonders it had been better had been left alone I had the misfortune to have recommend in all 16 of them 16 patients who had the operation and that was of no benefit whatsoever to any one of them and some of them had the tragedy of personality change towards the end of the 1950s this crude form of prefrontal leucotomy was phased out little was then known about the workings of the brain for most patients there was no alternative to long periods in an asylum they were vulnerable people and the public was not interested it could be a recipe for abuse Derek McCarthy began his career as a psychiatric nurse in 1957 at San Nicolas Hospital near Newcastle he was shocked by the treatment routinely handed out to long-stay patients the first time was on the first day on the first ward that I worked on when the charge nurse that was showing me around smacked and or little old blind man across the back of the head so fiercely that he flew across the room and hit the wall I was very shocked because the charge nurse had been quite nice to me when I came on the ward and I was a bit lost for words and he said them don't you know if you live among [ __ ] you become [ __ ] this kind of brutality was considered almost inevitable for some of the categories of the mentally ill on the ward for difficult patients Derek's colleagues called this tough approach thump therapy the patient had been acting rather histrionic Lee sliding off his chair onto the floor and this was during the unofficial staff rest time at dinnertime eventually the charge nurse of the ward got sick of this disappeared into the toilet area he came out with a nano bucket full of cold water and threw it all over the patient in the dayroom want everyone to see and then run the bucket over the top of the patients head and within a few seconds the patient had slid back on the floor again so he called the staff nurse and they dragged him by his collar across the flow into the bathroom area they later shouted for me and I went in and they were holding him under the water in the bath bringing him up and then pushing them under redone when they stopped Derick had to dry the patient off I went at the charge nurse who was then in the office and said he's completely dried down and put new clothes on him can I have the key to get the socks in his shoes owed and he said to me what do you think this is Butlins send him out as he is there was no evidence of this kind of treatment at high roids but investigations in subsequent decades revealed persistent abuse at other asylums I'm convinced it was endemic and in fact inquiries later on proved that the same things were going on in other male sides of mental hospitals right right throughout the country by the mid 1950s almost half the new NHS's beds were given over to mental illness or mental disability and the cost was mounting hope came from the laboratories of scientists working on a new generation of drugs French psychiatrists started to use a drug called chlorpromazine which proved to be very effective in calming psychotic patients within a few years Logue active as it came to be called here had spread right across Europe and America [Music] it was the first in a new range of drugs now pouring out that were to revolutionize the way mental illness could be treated these drugs promised the end of the locked doors and iron bars and ultimately the end of the Asylum system itself it was quite exciting you know this was something new and we asked student nurses were allowed to get involved in it it was a turning point some psychiatrists felt that the new drugs had solved the riddle of mental illness trouble is with anything right that that gets into the press and this hailed as a miracle which it isn't but the air of optimism is quite important result just the carers where are cures the new spirit of optimism was felt keenly at high Royds doctors here became pioneers of the new drugs research much to the benefit of the asylums grim image it had a pretty formidable reputation you know in the sense that it was run in some respects like a prison and there was a king desire in the early 50s to change its image for the better dr. Roy Holland started his career as a biochemist he was invited to hi roids and given his own staff to research the effect of the drug lithium on the brain chemistry of patients I wanted to do biochemical work on patients on the manic-depressive patients on whom I got some useful results who the idea was to do a balance of what went into the patient and measure what came out dr. Holland's research proved a vital step in establishing lithium as one of the most prominent new drugs it is still widely used today as a treatment a range of new drugs are introduced during the 1950s and 60s but they're not just new there is a whole new idea about them and the new idea is that they are specific treatments for specific disorders so that rather than just being substances that drug people or contain people sedate people which was what was thought about the old drugs they are seen to be substances that somehow work on the underlying physical basis of mental disorder it may have looked and felt like an old Victorian Asylum but high roids was now at the forefront of the drugs revolution it was acknowledged as a research center for mental illness and its medical staff presented their findings all over the world [Music] the new Wonder drugs created hope for the future but even before they arrived some enlightened psychiatrists had started to develop a more humane approach to care on the wards the first thing we did apart from improving the clothing and the decorations of a place were also find occupation I worked on principle with them unemployment was evil alongside the advances in treatment some patients were now being given a new program of activity healing is the hallmark of the hospital these handcrafts are one form of it a piece of homemade cloth or a basket these are proof to these ladies that they can still do some things as well as anybody and even if the work is slow and clumsy it's better than brooding occupational therapy this is called it's serious scientific treatment but more fundamental reforms were taking place the first hospitals were now starting to experiment with an open-door policy something that would have once been anathema to the ethos of the asylum at one time the patient's had nothing to do except to walk around inside air in courts now one of the first things I did was to soar down the railings there is a move to open the doors of wards to let people come and go much more freely the asylums just physically was spruced up they were decorated and made more homely [Music] in the mid-1950s there were over a hundred and fifty thousand patients in mental hospitals more than at any time in their history politicians from all parties agreed that the asylum regime was very expensive its morality was now also being questioned in 1959 the Conservative government passed a radical new Act of Parliament that introduced a more compassionate approach to the treatment of the mentally ill perhaps one of our greatest reforms is in the new Mental Health Act which interprets in modern terms the new approach to mental sickness so that it is no long run illness with a stigma but one which should be treated with the same sympathy and understanding as any other physical disability the nation's conscience had been pricked Britain was coming face to face with its asylums which had quarantined the mentally ill from society for over a hundred years you had to justify not locking the doors but why you were locking the doors it was that I wasn't accepted that you simply locked them that's what had always done ye locking them why do these patients have to be locked in the 1959 act represented the final break with the Victorian period it was the turning point because it recognized for the first time that the mental hospital and in the future was not necessarily going to be the main locus of care for people with mental health problems the impetus for change was gaining strength but it took a maverick politician to grasp the vision of a nation without asylums Enoch Powell shared the sense that the old mental institutions were shameful relics of the past in a prophetic speech in 1961 he made a dramatic pledge to tear them down now look and see what are the implications of these bold words they imply nothing less than the elimination of by far the greater part of this country's mental hospitals as they exist today it was a call to arms and Powell was under no illusions about the strength of the likely opposition to his plans there they stand isolated majestic imperious brooded over by the gigantic water tower and chimney combined rising unmistakable and daunting out of the countryside the asylums which our forefathers built with such immense solidity to express the notions of their day do not for a moment underestimate their powers of resistance to our assault the water tower became the defining image of the speech Enoch Powell was determined to remove everything it stood for and replace it with a new model of care based in the units of General Hospital's and the community he foretold the end of the mental hospital regimes at that time there were a hundred or so in this country none had closed and none of them had any attention of of closing at that time so this was a visionary speech that with looking beyond the current regime to a completely different social landscape it was a national social conscience that was awakened and it was beginning of the end for places like this Enoch Powell had drawn up a bold new plan for mental health outside the asylums but as he predicted it had little immediate impact on the echoing wards and endless corridors of Britain's existing mental hospitals here altering the brains chemical balance remained the focus but the new drugs which had initially held out the promise of closing the asylums now seemed to be doing the opposite in the 1960s there was a growing recognition that drugs might not be ending the asylum culture but prolonging it a BBC documentary in 1969 found that conditions within mental hospitals were still disturbing for many patients the tranquilizing drugs were causing new problems they are basically sedative drugs but they produce a very special sort of sedation which is a bit like having Parkinson's disease so that not only do they sedate you but they make you physically rigid and they physically slow you up and they mentally slow you are to me well like the system came down on me so heavily straightaway it was just you know as if things like drugs and shock treatment was the answer to my unhappiness or whatever which it certainly wasn't it made things a lot worse [Music] Jeanne Davison was brought up in a working-class district of Bradford at the end of the 50s it was very much expected of me that I leave school and got to work in a factory are some kind of dead-end job and that was difficult because I found it boring in her teens she began to feel depressed and alienated I was dissatisfied with my lifestyle and I suppose that in a way was the start of it this sort of feeling that I got that life was empty and meaningless Jean felt that she needed someone to talk to she asked her GP for an appointment with a psychiatrist who recommended that she spend a week of rest and observation at high roads her local mental hospital right back from child or did sort of joked with other kids saying they'll take it away in a green van too high road you know it was the mental hospital that we all knew about what stands out in my mind was walking up the drive and getting the first glimpse of the hospital in the sort of fading light I think that made it look maybe more gothic or whatever this big looming place with a clock tower than that and I remember then thinking oh my goodness what am i letting myself in for Jean arrived on a ward when medical confidence in the positive effects of drugs was at its height the morning after she arrived she was given her first taste of log acting no wonder it knocked me out and made me drowsy because that's what lag Act L does it's a really stroll what the Carl antipsychotic drug while heavily drugged gene was persuaded to sign up to a course of electroconvulsive therapy ECT was routinely being carried out with anesthetic but the procedure was still terrifying for a teenager who had had no previous contact with psychiatry he can't have any breakfast that morning and small ambulance comes and picks up all the patients on the way and took me to another part of the building where the give ECT we're given an injection in a bomb that's to dry.you mouth apparently and stops you swallowing your tongue as one nurse says when you'd having a fit I was scared yet I mean I'm even scared of just having an unaesthetic film stop never mind the thought of electric shocks going into brain they came round with a hot water bottle and we'd to put it on the back of our hands to make the veins stand out for the anesthetic injection and I remember feeling really powerless laid on me back I mean this injection I panicked and wanted it all to stop then and try to certify them to stop them doing it then and then the next thing I remember is waking up being really confused feel really disorientated it's like everything's familiar but not quite right somehow and the worst thing though I found was I told that there might be temporary effects like that but I thought what if what if it's doing some permanent damage so my brain this this that was horrible [Music] what was initially supposed to be a week of observation for Jean became a stay of several months on an inpatient ward at high Royds this turned into five years as a day patient by the end jeanne felt that the hospital itself had become part of the problem not the solution I felt I've just got sucked into going along with their norms or whatever you know and it strange really it's like yeah a different world that you saw him start starts becoming a part of your world in a way gene felt that ECT and the drugs were actually contributing to her depression so she began secretly cutting back on her dosage against the advice of high roid staff it was an act of rebellion with positive effect as I gradually caught down I gradually got much much better all this drowsiness depression lack of interest the less drugs I were on the more that started lifting the change was amazing without the drugs I'd almost forgotten what it felt like to be awakened alive again that well that was lovely that was marvelous genes resistance to her psychiatrists was part of a wider phenomenon too many patients doctors now seemed over reliant on pills the new tools of their trade they saw drugs being used as blunt instruments in a way that was out of step with the spirit of the time Britain in the 60s was undergoing enormous social changes there was a new freedom to break down barriers and challenge orthodoxy the drive to close the asylums captured this rebellious movement mental hospitals were just another battleground in a power struggle with the establishment there are obviously a whole raft of civil libertarian movements that get going ideas about what mental illness really is and how it should be treated become ideas of broad social interest at the forefront of this radical new thinking was the controversial psychiatrist RD Laing his books and speeches outlined a new approach to treatment in which the patient not the doctor knew best I wouldn't war the gaff and shoot my mouth off on television and to the public at large and this is exactly what I think that any of us who have got dissent within a particular professor's ought to do his books and ideas caused a sensation the general thesis of the politics of experience is that we live in a mad world and that a normal response to a mad world is to be mad and that the the sanity that most of us manage to maintain is actually the more abnormal sort of response but many powerful mainstream psychiatrists working in the asylums closed ranks against the new ideas blanks thinking was treated as peripheral meanwhile some doctors were seeking progress along experimental lines particularly in surgery find your eyelids getting rather heavy you'll go to sleep okay psychiatrists at high roids were so confident about one pioneering form of brain operation that they gave permission for a documentary crew to film it being carried out on one of their patients the documentary focused on Maggie Chapman who had been admitted to high roid several times as a patient during the early 70s my job this one at dinnertime no matter where meditation table which was your agitation tab that big one yours have been reduced a bit we thought eyes Maggie was a 42 year old housewife with five children she was struggling to cope and was prone to violent outbursts Johnny tops anybody said out to me yeah did lash out in anybody's that upset me kids or I could just lash out it was just after training ever serene a ever so often I just used up conch or penny mark I just stopped so the chip we after the hospital hi Lloyd's Olympian milk that doesn't look farm during one of her stays at high roids Maggie was approached about a new operation which doctors convinced her could end her fits of violence it was telling me out how my temper would eventually I would end up doing life in prison for murder are in a mental hospital for the rest of my life right I was really doubt I was at low ebb I want to get off that smelly Ward right was disgusting and it was telling me how I'd benefit from this operation it was to burn this part of my brain that would stop me from getting angry and and I've been outbursts being violent now if we leave you as you are and don't do anything then you're not going to spend a month a year in a mental hospital which you are doing at the moment the only time spent in a mental hospital is gradually going to go creasing and you're going to end up there so we're forever balancing the risks of an operation against the risks to the patient of not doing the operation can you put your head it was terrifying surgery though the doctors regarded it as a huge leap forward Maggie was taken from the asylum to the local hospital there two nylon balls were fixed in her forehead to act as guides for electrodes which would pinpoint the crucial part of her brain the electrode is attached to the electricity supply and a current is switched on stimulating the area at the bottom of the electro how to do what why did you have to do that oh no didn't I look inside oh damn other hand shook inside yes right I'm looking shocked is the noise that that made must be still in me ed if a motorbike girls pass me Oh somebody's drilling in the road it's like oh god I just got stunned like everything shakes in my head keep looking out friends yeah keep looking I don't look out when he got the response of fear in my eyes the pupils were like taps eyes died later on that's when he knew that it connected to the part of my brain that reacts to fear a new electrode is put in the correct position and to this will be attached a much larger current which causes the tip of the electrode to heat up it's fritzy Pro bomb and burnt a piece of my brain out Maggie's doctors regarded the operation as a success it did at least get her out of high Royds but she insists the effects of the surgery were debilitating I was at a zombie for four years I couldn't communicate with people it were like miss peach had gone and the body my body was all wobbly Maggie is now a successful campaigner for local community causes she is adamant that she has pulled her life together in spite of the operation not because of it her experimental treatment is now a piece of surgical history Maggie still bitterly regrets what was done to her and how she was persuaded to consent to it I don't think I needed that treatment and and I located this way right that there was more violence inflicted on me then I have inflicted on anybody that was GBH what they did to my brain I'll never forgive him for it [Music] by the mid-70s Enoch Powell had hoped that many if not all the old mental institutions would have disappeared but not a single asylum had closed Britain had ended a recession bringing drastic cuts in health spending [Music] numbers in the asylums had to be reduced but many hospitals the cull happened gradually one ward at a time it started in the early seventies when a Ward would be shut down if a person died in that water a patient was discharged from this ward we physically removed the bed so that nobody could be admitted into it again if GPS wanted to refer a patient for possible admission for observation there wasn't a bad any longer people had to be nursed in the community they had to be cared for in the community throughout the 1970s almost every asylum in Britain remained open but as individual wards shut down many former patients were tipped onto the streets to cope with life outside in the early 1980s the BBC's brasstacks program found that it was left to charities like the Salvation Army to pick up the pieces [Applause] 65,000 beds in long-stay Ward's have been phased out in 20 years but the community cared was supposed to take their place as scarcely materialized the long-term mentally ill are still with us but now in many cases fending for themselves and I will comfort you today and every day I ended up being a vagrant and diagnosed as schizophrenic and I then became a revolving door patient [Music] heling lie Hospital in Sussex was home to Andrew voice at various points in 70s he had had a nervous breakdown when he was 23 and ended up being committed then discharged several times in a row I was never got right by the old Asylum regimes they would give me medication by injection I found that I got a side effect called akathisia and I would be extremely restless but sedation at the same time for a week day and night after that injection it was an unbearable experience 400 and he was as anxious to avoid the painful symptoms as the asylum was to move him on like many others he was a victim of a diminishing number of long-stay beds I would get paranoid I would be living rough I wouldn't be looking after myself I'd be neglecting myself and I would get returned to the asylum usually by the police and that was the nature of my revolving-door life and when I got back into the asylum again they would stop me on injections again and they did this about 12 times between about 1975 and about 1990 beyond the asylum walls many patients found there was little organized care and no hope of a secure life [Applause] [Music] but there was no going back in the 1980s the asylums finally began to close the revolution arrived swiftly with a momentum of its own by 1990 a hundred thousand patients had been discharged into wider society history is taking its revenge on the institution's the mental hospital is becoming extinct [Music] one after another the great Victorian buildings began a process of shifting their patience on mass into the community and shutting their gates forever instead of doing things piecemeal things were all done in one rush it was you know Wakefield have decided they're going to empty their psychiatric hospitals Otisfield have done the same Wolverhampton Birmingham all of them are going to do the same so we must keep up with them so everybody went out into the community this was the start of care in the community as we know it today the idea was that the majority of patients be placed out in the community with psychiatric support an ITV film documented the closure of one mental disability institution in Stockport under the new system there would still be feds for some acute cases but for most patients it was the start of a new life thank you very much everything you've done for me I don't know what Savage on about all these years thanks very much everybody I'll cut nice and eat next rehearsal the trickle of people who've been leaving hospital during the last decade is now a flood it's a revolution against institutional care the new rules mean that everyone has the right to a say in their own future freedom is government policy the asylums were closed down by mrs. Thatcher she's a strange person to thank for an act of social justice but we have her to thank for a run emancipating us former psychiatric patients by closing down the old asylums with the closure of the asylums came a new spirit among patients as they began to conform the realities of life outside they found a new self-confidence it was a chance to share in the individualism of the time once you actually stopped destroying people's lives by locking them up and destroying any kind of individuality you actually did open the floodgates for saying hang on there's a set of people who believe they're actually worth more than that amidst the wreckage of the asylums a grassroots movement sprang up in which patients challenged doctors preeminent role in decisions about treatment the user movement as it was called campaigns successfully for patients to be more than the passive recipients of psychiatry now we have a system where people expect to be and want to be knowledgeable about their problems and they want to be involved in the sorts of treatments that doctors prescribe [Music] Joan Tugwell who was first admitted into a mental hospital in 1953 because of her panic attacks was now released into the outside world she had been in one Asylum or another for a third of a century first thing were being free I mean after thirty three and a half years is a long term you got their hair to go about it when yet Nick really so you got do things for yourself Jones transition to the outside world was filmed by her local Health Service to show the challenges of care in the community long-term patients had to get used to a life in which decades-old daily routines were left behind the reality wasn't all Joan had hoped for when it put me in the community I had no bulbs so false oh no I had no help it I had nothing to cook that's the coupon I had nothing to put into fridge I had no money and I wasn't there and that's how the lap it was hardly anything get the milk out of French oh yeah like many other patients Joan had to cope the certain amount of stigma with a shelter of the asylum gone old prejudices came to the surface when I used to peer off the bus and I was walking to my flat they don't call their children indoors until I was at a size not nice for you was it was he I'm gonna heard there was something sometimes people will say to me why didn't you go back to Broadmoor so I used as ever thought was to kill you then I would go back but Joan has survived she has made a life for herself in the community with the help of her carer and continued medication in another era she might have remained on a long stay Ward in an asylum until she died like many others Joan has found a degree of freedom I felt were the optimism it's and there was a future in the community for people and that um we could set goals for ourselves and we could achieve things and we could begin to take a bit of control over our line [Music] but the euphoria was short-lived the political honeymoon for care in the community was over very quickly in December 1992 at Finsbury Park tube station in London a recently released psychiatric patient stabbed a passenger in the eye and killed him it was the most notorious of several disturbing incidents which jolted the public's ideas about the new form of care it sparked panic in many parts of society it's 11 a.m. in a North London police station officers are being briefed about a potential killer not by a colleague but by the man's psychiatrist and the problem over the last three weeks has been increasing threats of violence and specific threats of wanting to kill variously his probation officer his girlfriend and his mother in 1997 the bbc's panorama program followed the work of a consultant psychiatrist in North London it was a vision of psychiatric services that nobody involved in care in the community wanted to see straight over both psychiatrist and police judge overwhelming force is necessary releasing thousands of psychiatric patients into society raised a whole new set of problems what seems to happen in the 90s is that people suddenly start to get cold feet about it all and start to fear that actually what this might mean is that you've got loads and loads of of people with uncontrolled mental illness running about society causing mayhem the newly elected Labour government was clearly on the side of safety first the health secretary Frank Dobson openly declared that Community Care had failed the political response was ultimately restrictive legislation doctors were given powers to force patients in the community to take medication or risk losing their newfound freedom to many people it seemed like a step backwards [Music] hi roids was finally closed in 2003 it was one of the last relics of the asylum Network unlike many others was bought by developers to be turned into luxury flats I felt it was past its best buy it had done its duty hitted service cars but people like these are unfortunate they still need to be cared for this place did indeed provide refuge from the world for some patients asylum in the true sense some feel that this ideal of protection and rest has been lost that the community can never replace this kind of institution my feeling is that the whole concept of Community Care is a disaster I don't think that the community cares not on my patch there is the model there are even those who think that the failure of the asylums has been exaggerated but few people have time for nostalgia I get very angry when I see people glorifying them you know these lovely estates in beautiful Victorian buildings in the country they were awful places they were demeaning devaluing places I know of no one who would love to go back to a 40 bedded dormitory and their bed and their Locker and their Gideon's Bible and the shared clothes Britain's asylums are now closed forever these were once extraordinary places home to more than a hundred and fifty thousand people at their height but they had outlived the ideals of their Victorian architects and too often had become dust bins of humanity what they leave behind are the lives they transformed I do realize that although I was in the system five years which seems an awfully long time follow the patients five years can turn into 50 60 years or whatever in that sense I can see that I was one of the lucky ones I suppose I always feel angry about it but I just don't like getting my way a carrot come I got over my life I'm not if I started dwelling on feeling anger all the time I mean I thought we were living with it the Open University has produced a CD exploring creative responses to mental health for your free copy go to BBC co uk call a eight four five three six six eight oh one five [Music] [Music] [Music] [Applause] [Music] you

[Music] for over a hundred years Britain's mentally ill were hidden from society in vast Victorian science those who are locked away have left their own testimony I remember getting the first glimpse of the Ospital it's big looming place to the Clocktower on that and I remember then thinking my goodness what am i letting myself in far in the last decades of the asylums psychiatrists tried to cure as well as care for patients some of their attempts were barbaric there was a disaster they made a hole in the skull that went is the brain and the right was a bit that was it this was a time when treatment was undergoing a revolution some patients felt science was being pushed too far it's richly Pro bond and burnt a puta madre now these institutions had to be shut down when it happened it was a moment of history that changed Britain this is the story of the closing of the asylums and the often troubled lives they left behind [Music] [Music] hi roids in Yorkshire was typical of the great asylums [Music] it was a village in its own right with its own forms of butcher a bakery even a railway station that ran right to the center of the asylum at its height it held over 2,500 patients it was just massive you could walk around all day and and never walk around all of it I was in the place with the longest corridors I've ever seen there were miles of corridor a lot of patients were socially inadequate not strictly speaking and mentally ill not disturbed with voices not suffering from delusions not showing any thought disorders at all simply inadequate and couldn't cope they weren't wanted those good burgers of bleedin Bradford who dentist patients in here would certainly have thought that they were doing the right thing by the patients although really they were doing the right thing by their towns I think that word dumped it's an awful word isn't it but you could think and I think rightly that a lot of patients were dumped here by their relatives by the community they weren't wanted and hi Rodge was a convenient place for them it was not just high Royds many of Britain's asylums contained patients who had been locked up for no clear psychiatric reason people got admitted on all sorts of dubious grounds that didn't really have anything directly to do with their mental states and their families had abandoned them and there was no one to support them outside the institutions even in the 1950s some patients ended up in the asylums for a very long time this patient used to be a skilled gardener he came here 35 years ago and here's an old soldier he fought in the 1418 wall many patients were admitted on genuine medical grounds some of them easily treatable outside Hospital nowadays Agra phobia panic turns Mester phobia uh-huh I knew if I went walking in the street anywhere I just clips [Music] after the war Joan Tugwell had left the army and was suffering genuine mental distress she was 25 and living with her foster parents panic attacks were making her life a misery I went to bed one night and I thought I couldn't breathe so I kept screaming handsome um I can't breathe I can't breathe Sir John's Hospital near Aylesbury was Joan's local Asylum for her family it seemed to offer some hope of refuge she was duly committed to care my mother asked if I go in but she knew I wasn't world that said they had two big doorman seas and each of them had a bed so she busy one door was he so the top of one bed was down this way the next bed up that way there next one down here and then the next one up there so that it won't breathe into one another because we're so close you're lucky we'll get into better mood I forgot my food mover bear it was to be the start of a third of a century inside mental hospitals for Joan in the early 50s the regime was harsh some of those she met were not what she would have thought of as mad you would wonder you said well from in there nothing wrong with some about me I was I think that's wrong with me the asylum life was empty and repetitive after months on her ward Joan asked the nurse if she could help with the beds it was a way of occupying herself for a part of the day I asked if alpha beta base Alfred Stanley and watch you're making 60 bed reactive no her hand so we both made all the bed alcohol offered an escape from her feelings of anxiety one evening in the asylum Joan got hold of some spirits and ended up drunk and in the wrong ward I supposed to times over the cake when Kenan said good evening to all the stuff and half past that was Old Stone when I came round I was in a padded cell they're frightening because you don't hear them and they can't hear you everything's wrong Webber and you have canvas night dresses as canvas blanket if you share that they look better here you despite the vast majority of patients having committed no offense life in the asylums was dominated by security the wards were not opened the doors weren't have to open the door was open to let the patient out and enclose after he'd gone there's a quasi prison atmosphere there the only crime you who commit if you're on the patient was to escape in many ways the large asylum still housed inmates rather than patients conditions inside had altered little in the last half-century the change was on its way [Music] this leaflet is coming through your letterbox one day soon read it carefully when the Labour government created the National Health Service in 1948 mental institutions were entirely separate from general hospitals before the NHS was created there was some debate as to whether or not the asylums in psychiatry would be included in the National Health Service and it was decided finally that it would be included and by including it I think it did help to to bring the system's together hospitals and specialist services medicines it was the parting of ways with the old pool or ideology notionally the mental patient was being embraced by the NHS ethos the whole idea of the quality of membership [Music] while medical science had advanced rapidly in the years before the creation of the NHS therapy for mental illness was still very limited but now psychiatrists began to experiment with new ideas and new treatments you get an increasing view that mental illness is really the same as other physical illnesses and can be treated using the same sort of means using physical interventions that work on the body one of these relatively new treatments was the controversial electro convulsive therapy or ECT it meant passing an electrical current through the brain to induce a seizure it seemed to ease the symptoms of severe depression in some patients those psychiatrists could not explain how it worked put a wire here and here and then we switch on in your hair into a fit have a productive fifth hole ECT units were set up so that patients could be treated in large numbers until the early 1950s the procedure was carried out largely without anaesthetic a member of staff would lean heavily on the needs another one at the ankles and one at each side holding the shoulders down and the consultant applied an electrical charge through the brain the patient of course jerked very very violently that's why we were holding him down because it had been known that this procedure could cause practice and had cord fractures despite appearances ect was regarded as a step forward it seemed to offer some patients a real hope of improvement yeah insulin doses are being prepared and checked another of these so called shock treatments was insulin therapy where doctors induced a coma by injecting large doses of insulin into the body insulin coma treatment to give it its full title offers the greatest likelihood of relief and cure for some patients whose illness is of a deep-seated nature as you said angel anemia but then wasn't very nice to her they used seven patients who go right into a coma they would scream all the time I mean I think it made him feel queer it would burn up all the sugar in their body and drop the blood sugar level very very low and they were going to coma and that was supposed to be beneficial in some way to the brain in this condition the mind has a chance to be completely relaxed and the functions of the brain have the opportunity of as it were setting out on a new path when consciousness returns physical treatments like this advance the image of psychiatry as a fast developing scientific branch of Medicine in reality insulin proved a harmful medical failure 44 people were killed from its effects during this period made me Bears let me give you a fit and that heck says away we can't give you anymore incident versus affection you've made you have a fit but one form of treatment was more drastic than all the others the lobotomy [Music] some psychiatrists believe that by removing sections of the brain itself certain serious mental disorders could be permanently treated at least 15,000 of these operations known as prefrontal leucotomy x' were performed in britain it was a disaster there was a blind operation they made a hole in the skull Oh which the so called probe went into the brain and it might with a bit that was it there was no until much much later and the attempt to refine the exactly where they cut was made there was lots of patients walking around with two holes and have either side of the forehead that you could see the actual dint where this skull had been a trap and away and an instrument had been put in what wonders it had been better had been left alone I had the misfortune to have recommend in all 16 of them 16 patients who had the operation and that was of no benefit whatsoever to any one of them and some of them had the tragedy of personality change towards the end of the 1950s this crude form of prefrontal leucotomy was phased out little was then known about the workings of the brain for most patients there was no alternative to long periods in an asylum they were vulnerable people and the public was not interested it could be a recipe for abuse Derek McCarthy began his career as a psychiatric nurse in 1957 at San Nicolas Hospital near Newcastle he was shocked by the treatment routinely handed out to long-stay patients the first time was on the first day on the first ward that I worked on when the charge nurse that was showing me around smacked and or little old blind man across the back of the head so fiercely that he flew across the room and hit the wall I was very shocked because the charge nurse had been quite nice to me when I came on the ward and I was a bit lost for words and he said them don't you know if you live among [ __ ] you become [ __ ] this kind of brutality was considered almost inevitable for some of the categories of the mentally ill on the ward for difficult patients Derek's colleagues called this tough approach thump therapy the patient had been acting rather histrionic Lee sliding off his chair onto the floor and this was during the unofficial staff rest time at dinnertime eventually the charge nurse of the ward got sick of this disappeared into the toilet area he came out with a nano bucket full of cold water and threw it all over the patient in the dayroom want everyone to see and then run the bucket over the top of the patients head and within a few seconds the patient had slid back on the floor again so he called the staff nurse and they dragged him by his collar across the flow into the bathroom area they later shouted for me and I went in and they were holding him under the water in the bath bringing him up and then pushing them under redone when they stopped Derick had to dry the patient off I went at the charge nurse who was then in the office and said he's completely dried down and put new clothes on him can I have the key to get the socks in his shoes owed and he said to me what do you think this is Butlins send him out as he is there was no evidence of this kind of treatment at high roids but investigations in subsequent decades revealed persistent abuse at other asylums I'm convinced it was endemic and in fact inquiries later on proved that the same things were going on in other male sides of mental hospitals right right throughout the country by the mid 1950s almost half the new NHS's beds were given over to mental illness or mental disability and the cost was mounting hope came from the laboratories of scientists working on a new generation of drugs French psychiatrists started to use a drug called chlorpromazine which proved to be very effective in calming psychotic patients within a few years Logue active as it came to be called here had spread right across Europe and America [Music] it was the first in a new range of drugs now pouring out that were to revolutionize the way mental illness could be treated these drugs promised the end of the locked doors and iron bars and ultimately the end of the Asylum system itself it was quite exciting you know this was something new and we asked student nurses were allowed to get involved in it it was a turning point some psychiatrists felt that the new drugs had solved the riddle of mental illness trouble is with anything right that that gets into the press and this hailed as a miracle which it isn't but the air of optimism is quite important result just the carers where are cures the new spirit of optimism was felt keenly at high Royds doctors here became pioneers of the new drugs research much to the benefit of the asylums grim image it had a pretty formidable reputation you know in the sense that it was run in some respects like a prison and there was a king desire in the early 50s to change its image for the better dr. Roy Holland started his career as a biochemist he was invited to hi roids and given his own staff to research the effect of the drug lithium on the brain chemistry of patients I wanted to do biochemical work on patients on the manic-depressive patients on whom I got some useful results who the idea was to do a balance of what went into the patient and measure what came out dr. Holland's research proved a vital step in establishing lithium as one of the most prominent new drugs it is still widely used today as a treatment a range of new drugs are introduced during the 1950s and 60s but they're not just new there is a whole new idea about them and the new idea is that they are specific treatments for specific disorders so that rather than just being substances that drug people or contain people sedate people which was what was thought about the old drugs they are seen to be substances that somehow work on the underlying physical basis of mental disorder it may have looked and felt like an old Victorian Asylum but high roids was now at the forefront of the drugs revolution it was acknowledged as a research center for mental illness and its medical staff presented their findings all over the world [Music] the new Wonder drugs created hope for the future but even before they arrived some enlightened psychiatrists had started to develop a more humane approach to care on the wards the first thing we did apart from improving the clothing and the decorations of a place were also find occupation I worked on principle with them unemployment was evil alongside the advances in treatment some patients were now being given a new program of activity healing is the hallmark of the hospital these handcrafts are one form of it a piece of homemade cloth or a basket these are proof to these ladies that they can still do some things as well as anybody and even if the work is slow and clumsy it's better than brooding occupational therapy this is called it's serious scientific treatment but more fundamental reforms were taking place the first hospitals were now starting to experiment with an open-door policy something that would have once been anathema to the ethos of the asylum at one time the patient's had nothing to do except to walk around inside air in courts now one of the first things I did was to soar down the railings there is a move to open the doors of wards to let people come and go much more freely the asylums just physically was spruced up they were decorated and made more homely [Music] in the mid-1950s there were over a hundred and fifty thousand patients in mental hospitals more than at any time in their history politicians from all parties agreed that the asylum regime was very expensive its morality was now also being questioned in 1959 the Conservative government passed a radical new Act of Parliament that introduced a more compassionate approach to the treatment of the mentally ill perhaps one of our greatest reforms is in the new Mental Health Act which interprets in modern terms the new approach to mental sickness so that it is no long run illness with a stigma but one which should be treated with the same sympathy and understanding as any other physical disability the nation's conscience had been pricked Britain was coming face to face with its asylums which had quarantined the mentally ill from society for over a hundred years you had to justify not locking the doors but why you were locking the doors it was that I wasn't accepted that you simply locked them that's what had always done ye locking them why do these patients have to be locked in the 1959 act represented the final break with the Victorian period it was the turning point because it recognized for the first time that the mental hospital and in the future was not necessarily going to be the main locus of care for people with mental health problems the impetus for change was gaining strength but it took a maverick politician to grasp the vision of a nation without asylums Enoch Powell shared the sense that the old mental institutions were shameful relics of the past in a prophetic speech in 1961 he made a dramatic pledge to tear them down now look and see what are the implications of these bold words they imply nothing less than the elimination of by far the greater part of this country's mental hospitals as they exist today it was a call to arms and Powell was under no illusions about the strength of the likely opposition to his plans there they stand isolated majestic imperious brooded over by the gigantic water tower and chimney combined rising unmistakable and daunting out of the countryside the asylums which our forefathers built with such immense solidity to express the notions of their day do not for a moment underestimate their powers of resistance to our assault the water tower became the defining image of the speech Enoch Powell was determined to remove everything it stood for and replace it with a new model of care based in the units of General Hospital's and the community he foretold the end of the mental hospital regimes at that time there were a hundred or so in this country none had closed and none of them had any attention of of closing at that time so this was a visionary speech that with looking beyond the current regime to a completely different social landscape it was a national social conscience that was awakened and it was beginning of the end for places like this Enoch Powell had drawn up a bold new plan for mental health outside the asylums but as he predicted it had little immediate impact on the echoing wards and endless corridors of Britain's existing mental hospitals here altering the brains chemical balance remained the focus but the new drugs which had initially held out the promise of closing the asylums now seemed to be doing the opposite in the 1960s there was a growing recognition that drugs might not be ending the asylum culture but prolonging it a BBC documentary in 1969 found that conditions within mental hospitals were still disturbing for many patients the tranquilizing drugs were causing new problems they are basically sedative drugs but they produce a very special sort of sedation which is a bit like having Parkinson's disease so that not only do they sedate you but they make you physically rigid and they physically slow you up and they mentally slow you are to me well like the system came down on me so heavily straightaway it was just you know as if things like drugs and shock treatment was the answer to my unhappiness or whatever which it certainly wasn't it made things a lot worse [Music] Jeanne Davison was brought up in a working-class district of Bradford at the end of the 50s it was very much expected of me that I leave school and got to work in a factory are some kind of dead-end job and that was difficult because I found it boring in her teens she began to feel depressed and alienated I was dissatisfied with my lifestyle and I suppose that in a way was the start of it this sort of feeling that I got that life was empty and meaningless Jean felt that she needed someone to talk to she asked her GP for an appointment with a psychiatrist who recommended that she spend a week of rest and observation at high roads her local mental hospital right back from child or did sort of joked with other kids saying they'll take it away in a green van too high road you know it was the mental hospital that we all knew about what stands out in my mind was walking up the drive and getting the first glimpse of the hospital in the sort of fading light I think that made it look maybe more gothic or whatever this big looming place with a clock tower than that and I remember then thinking oh my goodness what am i letting myself in for Jean arrived on a ward when medical confidence in the positive effects of drugs was at its height the morning after she arrived she was given her first taste of log acting no wonder it knocked me out and made me drowsy because that's what lag Act L does it's a really stroll what the Carl antipsychotic drug while heavily drugged gene was persuaded to sign up to a course of electroconvulsive therapy ECT was routinely being carried out with anesthetic but the procedure was still terrifying for a teenager who had had no previous contact with psychiatry he can't have any breakfast that morning and small ambulance comes and picks up all the patients on the way and took me to another part of the building where the give ECT we're given an injection in a bomb that's to dry.you mouth apparently and stops you swallowing your tongue as one nurse says when you'd having a fit I was scared yet I mean I'm even scared of just having an unaesthetic film stop never mind the thought of electric shocks going into brain they came round with a hot water bottle and we'd to put it on the back of our hands to make the veins stand out for the anesthetic injection and I remember feeling really powerless laid on me back I mean this injection I panicked and wanted it all to stop then and try to certify them to stop them doing it then and then the next thing I remember is waking up being really confused feel really disorientated it's like everything's familiar but not quite right somehow and the worst thing though I found was I told that there might be temporary effects like that but I thought what if what if it's doing some permanent damage so my brain this this that was horrible [Music] what was initially supposed to be a week of observation for Jean became a stay of several months on an inpatient ward at high Royds this turned into five years as a day patient by the end jeanne felt that the hospital itself had become part of the problem not the solution I felt I've just got sucked into going along with their norms or whatever you know and it strange really it's like yeah a different world that you saw him start starts becoming a part of your world in a way gene felt that ECT and the drugs were actually contributing to her depression so she began secretly cutting back on her dosage against the advice of high roid staff it was an act of rebellion with positive effect as I gradually caught down I gradually got much much better all this drowsiness depression lack of interest the less drugs I were on the more that started lifting the change was amazing without the drugs I'd almost forgotten what it felt like to be awakened alive again that well that was lovely that was marvelous genes resistance to her psychiatrists was part of a wider phenomenon too many patients doctors now seemed over reliant on pills the new tools of their trade they saw drugs being used as blunt instruments in a way that was out of step with the spirit of the time Britain in the 60s was undergoing enormous social changes there was a new freedom to break down barriers and challenge orthodoxy the drive to close the asylums captured this rebellious movement mental hospitals were just another battleground in a power struggle with the establishment there are obviously a whole raft of civil libertarian movements that get going ideas about what mental illness really is and how it should be treated become ideas of broad social interest at the forefront of this radical new thinking was the controversial psychiatrist RD Laing his books and speeches outlined a new approach to treatment in which the patient not the doctor knew best I wouldn't war the gaff and shoot my mouth off on television and to the public at large and this is exactly what I think that any of us who have got dissent within a particular professor's ought to do his books and ideas caused a sensation the general thesis of the politics of experience is that we live in a mad world and that a normal response to a mad world is to be mad and that the the sanity that most of us manage to maintain is actually the more abnormal sort of response but many powerful mainstream psychiatrists working in the asylums closed ranks against the new ideas blanks thinking was treated as peripheral meanwhile some doctors were seeking progress along experimental lines particularly in surgery find your eyelids getting rather heavy you'll go to sleep okay psychiatrists at high roids were so confident about one pioneering form of brain operation that they gave permission for a documentary crew to film it being carried out on one of their patients the documentary focused on Maggie Chapman who had been admitted to high roid several times as a patient during the early 70s my job this one at dinnertime no matter where meditation table which was your agitation tab that big one yours have been reduced a bit we thought eyes Maggie was a 42 year old housewife with five children she was struggling to cope and was prone to violent outbursts Johnny tops anybody said out to me yeah did lash out in anybody's that upset me kids or I could just lash out it was just after training ever serene a ever so often I just used up conch or penny mark I just stopped so the chip we after the hospital hi Lloyd's Olympian milk that doesn't look farm during one of her stays at high roids Maggie was approached about a new operation which doctors convinced her could end her fits of violence it was telling me out how my temper would eventually I would end up doing life in prison for murder are in a mental hospital for the rest of my life right I was really doubt I was at low ebb I want to get off that smelly Ward right was disgusting and it was telling me how I'd benefit from this operation it was to burn this part of my brain that would stop me from getting angry and and I've been outbursts being violent now if we leave you as you are and don't do anything then you're not going to spend a month a year in a mental hospital which you are doing at the moment the only time spent in a mental hospital is gradually going to go creasing and you're going to end up there so we're forever balancing the risks of an operation against the risks to the patient of not doing the operation can you put your head it was terrifying surgery though the doctors regarded it as a huge leap forward Maggie was taken from the asylum to the local hospital there two nylon balls were fixed in her forehead to act as guides for electrodes which would pinpoint the crucial part of her brain the electrode is attached to the electricity supply and a current is switched on stimulating the area at the bottom of the electro how to do what why did you have to do that oh no didn't I look inside oh damn other hand shook inside yes right I'm looking shocked is the noise that that made must be still in me ed if a motorbike girls pass me Oh somebody's drilling in the road it's like oh god I just got stunned like everything shakes in my head keep looking out friends yeah keep looking I don't look out when he got the response of fear in my eyes the pupils were like taps eyes died later on that's when he knew that it connected to the part of my brain that reacts to fear a new electrode is put in the correct position and to this will be attached a much larger current which causes the tip of the electrode to heat up it's fritzy Pro bomb and burnt a piece of my brain out Maggie's doctors regarded the operation as a success it did at least get her out of high Royds but she insists the effects of the surgery were debilitating I was at a zombie for four years I couldn't communicate with people it were like miss peach had gone and the body my body was all wobbly Maggie is now a successful campaigner for local community causes she is adamant that she has pulled her life together in spite of the operation not because of it her experimental treatment is now a piece of surgical history Maggie still bitterly regrets what was done to her and how she was persuaded to consent to it I don't think I needed that treatment and and I located this way right that there was more violence inflicted on me then I have inflicted on anybody that was GBH what they did to my brain I'll never forgive him for it [Music] by the mid-70s Enoch Powell had hoped that many if not all the old mental institutions would have disappeared but not a single asylum had closed Britain had ended a recession bringing drastic cuts in health spending [Music] numbers in the asylums had to be reduced but many hospitals the cull happened gradually one ward at a time it started in the early seventies when a Ward would be shut down if a person died in that water a patient was discharged from this ward we physically removed the bed so that nobody could be admitted into it again if GPS wanted to refer a patient for possible admission for observation there wasn't a bad any longer people had to be nursed in the community they had to be cared for in the community throughout the 1970s almost every asylum in Britain remained open but as individual wards shut down many former patients were tipped onto the streets to cope with life outside in the early 1980s the BBC's brasstacks program found that it was left to charities like the Salvation Army to pick up the pieces [Applause] 65,000 beds in long-stay Ward's have been phased out in 20 years but the community cared was supposed to take their place as scarcely materialized the long-term mentally ill are still with us but now in many cases fending for themselves and I will comfort you today and every day I ended up being a vagrant and diagnosed as schizophrenic and I then became a revolving door patient [Music] heling lie Hospital in Sussex was home to Andrew voice at various points in 70s he had had a nervous breakdown when he was 23 and ended up being committed then discharged several times in a row I was never got right by the old Asylum regimes they would give me medication by injection I found that I got a side effect called akathisia and I would be extremely restless but sedation at the same time for a week day and night after that injection it was an unbearable experience 400 and he was as anxious to avoid the painful symptoms as the asylum was to move him on like many others he was a victim of a diminishing number of long-stay beds I would get paranoid I would be living rough I wouldn't be looking after myself I'd be neglecting myself and I would get returned to the asylum usually by the police and that was the nature of my revolving-door life and when I got back into the asylum again they would stop me on injections again and they did this about 12 times between about 1975 and about 1990 beyond the asylum walls many patients found there was little organized care and no hope of a secure life [Applause] [Music] but there was no going back in the 1980s the asylums finally began to close the revolution arrived swiftly with a momentum of its own by 1990 a hundred thousand patients had been discharged into wider society history is taking its revenge on the institution's the mental hospital is becoming extinct [Music] one after another the great Victorian buildings began a process of shifting their patience on mass into the community and shutting their gates forever instead of doing things piecemeal things were all done in one rush it was you know Wakefield have decided they're going to empty their psychiatric hospitals Otisfield have done the same Wolverhampton Birmingham all of them are going to do the same so we must keep up with them so everybody went out into the community this was the start of care in the community as we know it today the idea was that the majority of patients be placed out in the community with psychiatric support an ITV film documented the closure of one mental disability institution in Stockport under the new system there would still be feds for some acute cases but for most patients it was the start of a new life thank you very much everything you've done for me I don't know what Savage on about all these years thanks very much everybody I'll cut nice and eat next rehearsal the trickle of people who've been leaving hospital during the last decade is now a flood it's a revolution against institutional care the new rules mean that everyone has the right to a say in their own future freedom is government policy the asylums were closed down by mrs. Thatcher she's a strange person to thank for an act of social justice but we have her to thank for a run emancipating us former psychiatric patients by closing down the old asylums with the closure of the asylums came a new spirit among patients as they began to conform the realities of life outside they found a new self-confidence it was a chance to share in the individualism of the time once you actually stopped destroying people's lives by locking them up and destroying any kind of individuality you actually did open the floodgates for saying hang on there's a set of people who believe they're actually worth more than that amidst the wreckage of the asylums a grassroots movement sprang up in which patients challenged doctors preeminent role in decisions about treatment the user movement as it was called campaigns successfully for patients to be more than the passive recipients of psychiatry now we have a system where people expect to be and want to be knowledgeable about their problems and they want to be involved in the sorts of treatments that doctors prescribe [Music] Joan Tugwell who was first admitted into a mental hospital in 1953 because of her panic attacks was now released into the outside world she had been in one Asylum or another for a third of a century first thing were being free I mean after thirty three and a half years is a long term you got their hair to go about it when yet Nick really so you got do things for yourself Jones transition to the outside world was filmed by her local Health Service to show the challenges of care in the community long-term patients had to get used to a life in which decades-old daily routines were left behind the reality wasn't all Joan had hoped for when it put me in the community I had no bulbs so false oh no I had no help it I had nothing to cook that's the coupon I had nothing to put into fridge I had no money and I wasn't there and that's how the lap it was hardly anything get the milk out of French oh yeah like many other patients Joan had to cope the certain amount of stigma with a shelter of the asylum gone old prejudices came to the surface when I used to peer off the bus and I was walking to my flat they don't call their children indoors until I was at a size not nice for you was it was he I'm gonna heard there was something sometimes people will say to me why didn't you go back to Broadmoor so I used as ever thought was to kill you then I would go back but Joan has survived she has made a life for herself in the community with the help of her carer and continued medication in another era she might have remained on a long stay Ward in an asylum until she died like many others Joan has found a degree of freedom I felt were the optimism it's and there was a future in the community for people and that um we could set goals for ourselves and we could achieve things and we could begin to take a bit of control over our line [Music] but the euphoria was short-lived the political honeymoon for care in the community was over very quickly in December 1992 at Finsbury Park tube station in London a recently released psychiatric patient stabbed a passenger in the eye and killed him it was the most notorious of several disturbing incidents which jolted the public's ideas about the new form of care it sparked panic in many parts of society it's 11 a.m. in a North London police station officers are being briefed about a potential killer not by a colleague but by the man's psychiatrist and the problem over the last three weeks has been increasing threats of violence and specific threats of wanting to kill variously his probation officer his girlfriend and his mother in 1997 the bbc's panorama program followed the work of a consultant psychiatrist in North London it was a vision of psychiatric services that nobody involved in care in the community wanted to see straight over both psychiatrist and police judge overwhelming force is necessary releasing thousands of psychiatric patients into society raised a whole new set of problems what seems to happen in the 90s is that people suddenly start to get cold feet about it all and start to fear that actually what this might mean is that you've got loads and loads of of people with uncontrolled mental illness running about society causing mayhem the newly elected Labour government was clearly on the side of safety first the health secretary Frank Dobson openly declared that Community Care had failed the political response was ultimately restrictive legislation doctors were given powers to force patients in the community to take medication or risk losing their newfound freedom to many people it seemed like a step backwards [Music] hi roids was finally closed in 2003 it was one of the last relics of the asylum Network unlike many others was bought by developers to be turned into luxury flats I felt it was past its best buy it had done its duty hitted service cars but people like these are unfortunate they still need to be cared for this place did indeed provide refuge from the world for some patients asylum in the true sense some feel that this ideal of protection and rest has been lost that the community can never replace this kind of institution my feeling is that the whole concept of Community Care is a disaster I don't think that the community cares not on my patch there is the model there are even those who think that the failure of the asylums has been exaggerated but few people have time for nostalgia I get very angry when I see people glorifying them you know these lovely estates in beautiful Victorian buildings in the country they were awful places they were demeaning devaluing places I know of no one who would love to go back to a 40 bedded dormitory and their bed and their Locker and their Gideon's Bible and the shared clothes Britain's asylums are now closed forever these were once extraordinary places home to more than a hundred and fifty thousand people at their height but they had outlived the ideals of their Victorian architects and too often had become dust bins of humanity what they leave behind are the lives they transformed I do realize that although I was in the system five years which seems an awfully long time follow the patients five years can turn into 50 60 years or whatever in that sense I can see that I was one of the lucky ones I suppose I always feel angry about it but I just don't like getting my way a carrot come I got over my life I'm not if I started dwelling on feeling anger all the time I mean I thought we were living with it the Open University has produced a CD exploring creative responses to mental health for your free copy go to BBC co uk call a eight four five three six six eight oh one five [Music] [Music] [Music] [Applause] [Music] you

Transcript for:The Evolution and Closure of Asylums

Transcript for:
The Evolution and Closure of Asylums