The Demise of the Asylum in Late Twentieth-Century Britain: A Personal History

Abstract

Mental health care in Britain was revolutionised in the late twentieth century, as a public asylum system dating back to the 1850s was replaced by a community-based psychiatric service. This paper examines this transformation through the lens of an individual asylum closure. In the late 1980s, I spent several months in Friern mental hospital in north-east London. Friern was the former Colney Hatch Asylum, one of the largest and most notorious of the great Victorian ‘museums of the mad’. It closed in 1993. The paper gives a detailed account of the hospital's closure, in tandem with my personal memories of life in Friern during its twilight days. Friern's demise occurred in an ideological climate increasingly hostile to welfare dependency. The transfer of mental health care from institution to community was accompanied by a new ‘recovery model’ for the mentally ill which emphasised economic independence and personal autonomy. Drawing on the Friern experience, the paper concludes by raising questions about the validity of this model and its implications for mental healthcare provision in twenty-first century Britain.

Teaching ‘small and helpless’ women how to live: Dialectical Behaviour Therapy in Sweden, ca 1995–2005

“…To need other people on a day-to-day basis (unless you are very young, very old or very disabled) is seen as inherently pathological; independence is a sina qua non of mental health. (Taylor, 2011: 198)We can recall, here, that where the patients quoted in the SKIP study expressed a need or wish for ‘support’ from other human beings, the clinicians interpreting their responses translated these as patients ‘feeling powerless, small, and helpless.’ The meaning might, on the surface, appear the same, but the language is significantly different. In the most basic sense, this is a difference between viewing a person’s suffering as a social or as an individual problem.…”

“…However, in a post-Enlightenment world of dichotomies, the flipside of emphasising choice and independence as desirable is what inevitably becomes un desirable as a result; in this case, an individual’s need for reliable, permanent structures and social support. Taylor’s (2011) astute assessment of mental health care in neoliberal, post-institutional Britain is an apt description of what is at stake for those who do not possess the ‘correct’ (i.e. normative) kind of independence and self-sufficiency, and is fitting also for the Swedish context:Today the discourse of mental health ‘providers’ is all about autonomy and independence.…”

“…To need other people on a day-to-day basis (unless you are very young, very old or very disabled) is seen as inherently pathological; independence is a sina qua non of mental health. (Taylor, 2011: 198)…”

“…Moral treatment also saw patients engaging in various forms of physical and mental activities (such as manual work, sewing, painting, singing, and going to church) designed to occupy their minds (and, in some instances, provide free labour). Barbara Taylor (2011) draws a parallel between moral treatment and the new psychological treatments of the post-war period in her autobiographical narrative of decarceration in Britain, suggesting that the latter was a kind of resurrection of the former. However, these two movements were anchored in fundamentally different worldviews and approaches to the human condition.…”

Relocating from out‐of‐area treatments: service users' perspective

“…Alongside these developments, the anti‐psychiatry movement emerged in the 1950s and challenged some of their core principles. While psychoanalytic psychiatrists endorsed ‘moral treatment’ based on a ‘psycho‐relational paradigm’ (Taylor 2011), biological psychiatrists argued that this work was ‘unscientific, costly and ineffective’. Psychoanalytic psychiatrists counter criticized by objecting to their practice of compulsorily detaining patients, and ‘coercing’ them into taking medication and accepting invasive medical procedures (Rissmiller & Rissmiller 2006).…”