As some of you know, I’ve been working on a bipolar memoir for a while now. It’s been particularly interesting to look back to my early childhood and consider the messages I may have internalised about mental health. It’s hard when someone is growing up for them to realise what is specific and odd about their family or community; it takes stepping away, experiencing new and different circumstances, to throw the strangeness into relief. I was well into adulthood before I was able to reflect on the peculiarities of my upbringing with regard to mental health.
Our village had two major employers, both of which drew an interesting and varied array of migrant workers, making the community a far cry from the 99% white British populations of its neighbouring villages. The first of these was a brickyard; the second was a large Victorian psychiatric hospital (although many villagers, such the residents of the older persons’ bungalows opposite my house, still referred to it as “the asylum”). The hospital was a major presence in the village, employing hundreds of our friends and neighbours in its wards, laundries and kitchens, yet for me it was a shadowy place, somewhere close at hand yet only ever visited for the annual Summer Fete. Sometimes I would be taken through the wrought iron gates and up the tree-lined driveway to feed the horse in the paddock or help my mum collect seasoned firewood, but we always stopped short of the hospital itself. The only glimpses I caught of the building were bits of the roofs protruding through the trees; they seemed exotic, pointy and turreted, more like churches or castles then the concrete tower block of a hospital I was taken to when I dislocated my thumb.
Although I didn’t get to see the hospital itself, I saw plenty of some of the patients. A little group was allowed out every day to wander round the village. These were people who had lived most of their lives at the asylum/hospital and were utterly and irredeemably institutionalised. As a child, I found these patients frightening – and although I was generally a highly anxious child and was frightened of almost (something I have since learned is often a precursor to childhood-onset bipolar), this was one fear I shared with my friends. The patients appeared old, with creased, whiskery faces (I understood some of them had been there since before the War, although I think now that many probably looked older than their years, after a life of incarceration). Many showed clear signs of what I now know to be tardive dyskinesia; some seemed unable to speak. It is impossible, thinking back, to identify whether each patient’s condition was caused by a genuine underlying problem, by decades of institutional life, or by over-use of old generation antipsychotics. Once in the village, there was nothing for them to do but walk around all day. When dusk fell, they would make their way back up the tree-lined drive, some lurching, some twitching, to return to the closest thing they had to home. We village children had no idea how to relate the patients. Most of us tried avoid them, but some of the boys would make fun of them.
My mum tried hard to get me not to be afraid of the patients, even though they looked scary. She reminded me that these were probably the people who had been at the hospital longest, that they had most likely been put there by their own families because they had a learning disability, or behaved strangely, or just had a baby out of wedlock. And so I did feel sorry for them – it was awful to contemplate being sent away by the people who are supposed to love you – but I could never quite quash my fear. Even my mum, in fact, was not entirely immune to their strangeness. I remember hearing her scream one evening, how I ran to the kitchen to see “Mad Old Lizzie” with her face pressed to the glass, staring in at my mother through the window. “I thought it was a witch,” my mum said, shakily. A funny thing, I thought, for a grown-up to say.
There was another category of patient at the “asylum”: those in locked wards. A bit of internet research shows that in the mid 80s there were 63 wards at the hospital, all of which were fully occupied (giving a total patient population above 2000). I have been able to find references to the hospital having a designated “secure unit”, although other sources suggest that around a quarter of the wards were locked at any one time (so a locked down population of around 500), including “M8 Ward” which held transfers to the mental health system from the local prison. My mum’s best friend Anna, a Greek woman who was recruited by the NHS and had never worked anywhere else in the UK, would sometimes tell us stories of the people she cared for on the locked wards and how they had ended up there. She certainly wasn’t supposed to be telling us in such detail, and I probably wasn’t supposed to be listening, but I soaked up every aspect of the violent crimes she described.
The only other connection between the locked wards and the village was the hospital siren. Like many other facilities with secure facilities (Broadmoor, for example), the hospital had something like a WWII air-raid siren which could be sounded in the event of an escape. I only ever seemed to hear the siren after dark, and would lie in my bed with the duvet over my head. Fretting there alone, with my mother and father downstairs and apparently oblivious, I would return to my belief that they didn’t know how to keep me safe. I often had an anxious sense that they didn’t know what they were doing as parents, and even posited that they had at some reason realised this and chosen therefore not to have another child). It would, I thought, be the easiest thing in the world for someone to climb onto the flat roof of the bathroom and in through my bedroom window. Why didn’t my parents think of that?
The hospital only completely closed in 1999, and it is now a housing development which retains the listed Victorian facade. I can’t help wonder if the people who have bought the luxury apartments have any concept of the human misery the building saw during its 130 years as an asylum/hospital. I know Care in the Community was disastrous for many long-term patients; when I was at university, I met a man who had been forced to leave this same hospital as, one by one, the wards were closed. He told me how he used to go back there and knock on the windows, begging to be let back in, how the staff had to keep refusing. The way the closures were carried out was unhelpful and did not appear to many service users to be in their interests. But these concealed, locked asylums were like parallel universes, semi self-sufficient and operating alongside communities, not within them. There is still resistance today to developing mental health services within the heart of communities (for example, this recent case in Sheffield). We need to firm in responding to these challenges. “Mental health” isn’t something that happens to them and not to us, and we need to be treated and supported not over there and hidden away, but in our own communities.