Uncertain grounds

Laura Marcus on the huge asylums used for banishing people society would rather not think about

Very possibly you passed by one today. Or you may pass one tonight. But unless you know they are there, chances are you’re completely unaware of some fascinating history on your doorstep.

Dozens of former asylums and mental hospitals that now lie derelict, abandoned and – almost – forgotten. Some have been turned into executive housing but frequently the residents have no idea about the astonishing past held in the sturdy bricks and mortar of their homes.

Every town had its asylum – many had more than one

And yet it really wasn’t that long ago that every town had its asylum – many had more than one. Some were county asylums where the poor were sent. Others were private institutions for the better off – though these often took poorer inmates too when the county hospitals became full.

The Victorians built dozens of these asylums. This was partly because it was recognised that the massive industrialisation in 19th century Britain was very dislocating for many people. And partly of course it was to shut away from society those deemed to be insane – though this was then, as now, a fluid and forever changing concept. Towards the end of the Victorian era a greater element of care and treatment crept into the asylums, though they were still, for many, truly terrifying places to be sent. Now, for those who can afford it, many of these former asylums have become highly sought-after places to live. Which makes sense as so many were built in beautiful grounds, often on a hilltop as hills were deemed by our Victorian ancestors to be good for mental health.

They were entire communities and provided employment

As well as once providing respite or incarceration, many of these mental hospitals were like mini villages, with shops, bakers, farms, laundries, cinemas and theatres. One, High Royds, in Menston near Leeds, even had a railway line running up to it. They were entire communities and provided employment with decent career structures for those living nearby, especially once the NHS took them over in 1948. In the post-war period, 150,000 people were hidden away in 120 vast Victorian institutions throughout the country and half of all new NHS beds were for the mentally ill.

The medical establishment and the press oassociated Irish people with drink and insanity

In the North West one reason for the growth in asylums from the latter part of the 19th century is Irish migration. In the first half of 1847 an estimated 300,000 Irish migrants arrived into the port of Liverpool, and although the wave slowed after the Great Famine, it still continued, and many settled in the North West.

Both the medical establishment and the press of the time associated Irish people with drink and insanity – reflecting fears over migration – and Lancashire’s four major asylums, Lancaster Moor, Prestwich, Rainhill and Whittingham, absorbed a huge number of them.

A three-year, Wellcome Trust-funded project called Madness, Migration and the Irish in Lancashire 1850-1921 was set up in 2010 to examine this phenomenon. “The study opens up a new and distinct area of historical inquiry and has relevance for psychiatry today, which is the challenge of explaining high rates of mental illness among migrants and minority ethnic groups,” comments the study’s research assistant Dr Sarah York.

By the late 1850s half of all admissions to Liverpool’s Rainhill Asylum were Irish. Overcrowding led to major expansion of the asylums. In 1851, when Rainhill opened, it was intended for only 400 patients. By 1886 a new annexe had to be built to house an additional 1,000 patients. There were similar building projects at Prestwich and Whittingham.

 “A lot of patients were just socially inadequate and couldn’t cope.”

Another large hospital in this area was Winwick in Warrington. In 1894 Lancashire Asylums Board commissioned the new asylum on the 207-acre Winwick Rectory Estate. It opened in 1897 for 50 “idiot boys” but by the time of the First World War the hospital housed 2,160 patients. It closed its doors in 1997 and most of the buildings were demolished, replaced by a housing estate, although what was Winwick Hall still remains as the admin block of Hollins Park Hospital in the grounds.

High Royds featured in a BBC4 and Open University programme called Mental: A History of the Madness, available on YouTube. At its peak High Royds had 2,500 patients but former psychiatric nurse Tom Booth says in the film: “A lot of patients were just socially inadequate and couldn’t cope. The good burghers of Leeds thought they were doing the right thing by them. In fact they were just dumped there, unwanted.”

Peter Barham, author of the book Closing the Asylum, adds: “There was often no clear psychiatric reason for them to be there. They were admitted on dubious grounds that didn’t have anything to do with their mental state.”

With its landmark Gothic clock tower and endless corridors, High Royds was the archetypal Victorian asylum

They were inmates rather than patients. To be fair, there weren’t the treatments available for mental health problems then that there are now. The film shows how treatment of mental illness was often extreme and scarily experimental. There may have been the best intentions but it’s hard to see how anyone ever thought an insulin-induced coma could have helped those suffering from schizophrenia, yet it continued into the 1950s and 44 people died at High Royds after receiving insulin therapy. There were also 15,000 pre-frontal leucotomies, which one psychiatrist calls a disaster. “Patients were walking around with holes in the side of their heads.”

With its landmark Gothic clock tower and endless corridors, High Royds was the archetypal Victorian asylum, built to keep out of sight those deemed to be out of their minds. While many former patients can never forgive places like High Royds for robbing them of their liberty and in some case their personalities, institutions like this did offer genuine asylum from the complexity of a world they found difficult to cope with. And despite the horrors of insulin therapy, High Royds wrote itself into the medical history books when its doctors helped pioneer lithium as a treatment for bipolar disorder – then called manic depression. It’s a treatment still widely used today.

Tom Heller, an Open University academic who worked on Mental: A History of the Madness, says: “Although asylums were a familiar sight on the outskirt of every major town, the public seemed only too willing to shut their minds to what was going on behind the walls. But important lessons can still be learnt from the experiences of people associated with that phase in history – a phase of dealing with people who were rejected largely because they didn’t easily fit in to mainstream society.”

Now we have care in the community and mental health services are shrinking with public sector cuts. And the prison population continues to rise. Coincidence? The mental hospitals were shut at least in part to save money and make money – they stood on valuable land. But many of our mentally sick now have nowhere to go and often end up homeless or in prison. Which costs the country considerably more. And now only the richest can afford to live in an asylum.

Nursing ambitions

Dave Pointon, 60, is a former psychiatric nurse, manager and trainer. He began his career, as many psychiatric nurses did, straight out of school aged 16 when he became a mental nurse cadet at St Edward’s in Cheddleton, Leek – near where he lived. He also worked at Parkside Hospital in Macclesfield. Both are now luxury housing estates.

“I was acting as a research assistant for a friend doing his PhD about mental illness in prisons when it dawned on me – prisons are the new asylums now.

There were many people there who should never have seen the gates of a mental hospital

“Many prison officers told us they felt more like mental health nurses than prison wardens. They’d seen the change as mental hospitals closed and prisons filled up with people who would’ve once been sent to a mental hospital. It’s reckoned about 60 per cent of prisoners have a mental health problem.

“It was folly to lose the psychiatric hospitals even though when I started in 1968 it was obvious there were many people there who should never have seen the gates of a mental hospital. But to close them down en masse was wrong. It was done to save money but it costs much more to keep people in prison.

“I hadn’t a clue what to do after school. My grandfather worked as a bricklayer at the local mental hospital and he got me an interview. When I arrived I asked what the person interviewing me did and was told he was the principal nursing officer. ‘Oh, so I’m going to be a nurse then!’

“I really enjoyed the job. It was challenging and different. You never knew what to expect and we were given training in every speciality.

“We had 900 patients, up to 400 nursing staff and every trade you could think of – our own plumbers, engineers, upholsterers, bricklayers and gardeners. And within these departments patients were gainfully employed – and paid.

“The patients also had their own shop and cinema and a patients’ football and cricket team. There was also a hall and stage where regular concerts and dances were held. A village in its own right. People felt safe and valued.

“There was a great social life for staff – I met my first wife there and many other couples got together too. Having left school at 16 with one O level I ended up with a degree and a masters and teaching at a university – the kind of journey no longer open to school leavers.

“I now run a pub. It’s no different really – full of lunatics and I give medication out.”

Photo of High Royds Asylum: Mark Mozaz Wallis

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