For over 100 years, Britain's mentally ill were hidden
from society in vast Victorian asylums.
Those who were locked away have left their own testimony.
I remember getting the first glimpse of the hospital -
this big, looming place with a clock tower and that, and I remember
then thinking, "Oh, my goodness! What am I letting myself in for?"
In the last decades of the asylums, psychiatrists tried to cure as well
as care for patients. Some of their attempts were barbaric.
It was a disaster. They made a hole in the skull,
they went into the brain and they waggled it a bit and that was it.
This was a time when treatment was undergoing a revolution.
Some patients felt science was being pushed too far.
He switched the probe on and burnt a piece of my brain out.
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.
High Royds in Yorkshire was typical of the great asylums.
It was a village in its own right,
with its own farms, a butcher, a bakery, even a railway station
that ran right to the centre of the asylum.
At its height, it held over 2,500 patients.
It was just massive -
you could walk round all day and never walk round all of it.
I was in a place with the longest corridors I've ever seen.
There were miles of corridors.
A lot of patients were socially inadequate,
not, strictly speaking, 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 burghers of Leeds and Bradford
who'd sent 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 High Royds 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.
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 14-18 War.'
Many patients were admitted on genuine medical grounds,
some of them easily treatable outside hospital nowadays.
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.
St 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.
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.
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.
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.
Despite the vast majority of patients having committed
no offence, life in the asylums was dominated by security.
The wards were not opened, the doors weren't left open.
The doors were opened to let the patient out
and then closed after he'd gone.
There was a quasi prison atmosphere there,
and the only crime you could commit,
if you were a patient, was to escape.
In many ways, the large asylums still housed inmates
rather than patients. Conditions inside had altered little
in the last half century, but change was on its way.
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 and 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 bring the systems together.
'Hospitals and specialist services, medicines, drugs...'
It was the parting of ways with the old Poor Law ideology.
Nationally, the mental patient was being embraced by the NHS ethos,
the whole idea of equality of membership.
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
electroconvulsive 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,
though psychiatrists could not explain how it worked.
Whole 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 knees,
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 fractures and had caused fractures.
Despite appearances, ECT was regarded as a step forward.
It seemed to offer some patients a real hope of improvement.
Here, 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.
It would burn up all the sugar in their body and drop
their blood sugar level very, very low and they would go into 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 advanced 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.
But one form of treatment was more drastic than all the others -
the lobotomy.
Some psychiatrists believed
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 leucotomies,
were performed in Britain.
It was a disaster. It was a blind operation.
They made a hole in the skull in which the so-called probe
went into the brain and they waggled it a bit and that was it.
There was no, until much, much later,
any attempt to refine exactly where the cut was made.
There were lots of patients walking around with two holes on either side
of their forehead. You could see the actual dint where
the skull had been trepanned away and an instrument had been put in.
One wonders if they'd have been better if they'd been left alone.
I had the misfortune to recommend, in all, 16 of them.
16 patients who had the operation,
and it 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 St Nicholas 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 round
smacked a little old blind man across the back of the head
so fiercely that he flew across the room and hit the wall.
THUD!
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. He said, "Don't you know?
"If you live among shit you become shit."
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".
A patient had been
acting rather histrionically, sliding off his chair onto the floor,
and this was during the unofficial staff rest time at dinner time.
Eventually the charge nurse of the ward got sick of this
and disappeared into the toilet area.
He came out with an enamel bucket full of cold water...
..and threw it all over the patient in the day room for everyone
to see and then rammed the bucket over the top of the patient's head.
And within a few seconds, the patient had slid back on the floor again.
So he called a staff nurse and they dragged him by his collar
across the floor 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 him under again.
When they stopped, Derek had to dry the patient off.
I went to the charge nurse who was then in the office and said,
"He's completely dried down. I've put new clothes on him.
"Can I have the key to get the socks and the shoes out?"
And he said to me, "What do you think this is?! BLEEP Butlins?
"Send him out as he is."
There was no evidence of this kind of treatment at High Royds.
But investigations in subsequent decades revealed persistent abuse
at other asylums.
I'm convinced it was endemic, and in fact, enquiries later on proved
that the same things were going on in other male sides
of mental health hospitals 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, Largactil - as it came to be called here -
had spread right across Europe and America.
It was the first in a new range of drugs now pouring out
that were to revolutionise 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, as 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.
The trouble is with anything like that, it gets into the press
and it's hailed as a miracle,
which it isn't.
But the air of optimism was quite important -
we aren't just carers, we are curers.
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 asylum's 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 keen desire in the early '50s
to change this image for the better.
Dr Roy Hullin started his career as a biochemist.
He was invited to High Royds 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, from whom we got some useful results.
The idea was to
do a balance of what went into the patient and measure what came out.
Dr Hullin'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 Royds was now at the forefront of the drugs revolution.
It was acknowledged as a research centre for mental illness,
and its medical staff presented their findings all over the world.
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,
was to find occupation.
I worked on the principle
that unemployment...was evil.
Alongside the advances in treatment, some patients were now being given
a new programme of activity.
Healing is the hallmark of the hospital.
These handcrafts are one form of it.
A piece of home-made 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 patients had nothing to do except
to walk around inside airing courts.
Now one of the first things I did was to saw 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 were spruced up, they were
decorated and made more homely.
In the mid-1950s, there were over a 150,000 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 longer an 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 100 years.
You had to justify not locking the doors
but WHY you were locking the doors.
It wasn't accepted that you simply locked them -
that's what you'd always done. WHY are you 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 recognised for the first time
that the mental hospital 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 hospitals and the community.
He foretold the end of the mental hospital regimes.
At that time there were 100 or so in this country and none had closed,
and none of them had any intention of closing at that time.
So this was a visionary speech that was looking beyond
the current regime to a completely different social landscape.
It was a national social conscience that was awakened
and it was the 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 brain's 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 tranquilising 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 up.
It was a heavy-handed approach
which sometimes left patients more like automatons than human beings.
It felt at odds with the liberated spirit of the '60s.
For me, it were like the system came down on me so heavily straightaway.
It was just, you know, as if things
like drugs and shock treatment were the answer to my unhappiness
or whatever. It certainly wasn't.
It made things a lot worse.
Jean Davison was brought up in a working class district
of Bradford at the end of the '50s.
It were very much expected of me that I leave school
and go to work in a factory or 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 Royds, her local mental hospital.
Right back from childhood you'd sort of joked with other kids
saying, "They'll take you away in a green van to High Royds."
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 and 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 Largactil.
No wonder it knocked me out and made me drowsy
because that's what Largactil does.
It's a really strong what they call antipsychotic drug.
While heavily drugged, Jean was persuaded to sign up to a course
of electroconvulsive therapy.
ECT was routinely being carried out with anaesthetic,
but the procedure was still terrifying for a teenager
who had had no previous contact with psychiatry.
You can't have any breakfast that morning and a small ambulance comes
and picks up other patients on the way, and it took me to another part
of the building where they give ECT.
We were given an injection in our arm
that's to dry your mouth, apparently,
and stops you swallowing your tongue
as one nurse says, "when you're having a fit".
I was scared, yeah.
I mean, I'm scared of just having an anaesthetic full stop,
never mind the thought of electric shocks going into your brain.
They came round with a hot water bottle
and we had to put it on the back of our hands to make the veins
stand out for the anaesthetic injection.
And I remember feeling really powerless
laid on my back having this injection.
I panicked and wanted it all to stop then and tried to sort of fight them
to stop them doing it then.
And then the next thing I remember is waking up being really confused.
You feel really disorientated.
It's like everything's familiar but not quite right somehow.
And the worst thing, though,
I found was that we were told there might be temporary effects like that
but I thought, "What if it's doing some permanent damage to my brain?"
That was horrible.
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, Jean felt that the hospital itself had become part
of the problem not the solution.
I felt I'd just got sucked in to going along with their norms
or whatever, you know. And it's strange really, it's like
a different world that soon starts
becoming a part of your world in a way.
Jean 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 Royds staff.
It was an act of rebellion with positive effects.
As I gradually cut 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 awake and alive again. That was lovely, that was marvellous.
Jean's resistance to her psychiatrists
was part of a wider phenomenon.
To 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 mood.
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.
They wish I wouldn't 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 our particular professions ought to do.
APPLAUSE
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 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.
Laing's thinking was treated as peripheral.
Meanwhile, some doctors were seeking progress along experimental lines,
particularly in surgery.
You'll find your eyelids getting rather heavy.
In a minute you'll go off to sleep, OK?
Psychiatrists at High Royds 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 Maggi Chapman
who had been admitted to High Royds several times as a patient
during the early '70s.
No more tablets, Margaret?
Oh, I didn't have this one at dinner time?
Where's my agitation tablet?
Which is your agitation tablet? That big white one.
Yours have been reduced a bit. All right.
Maggi was a 42-year-old housewife with five children.
She was struggling to cope and was prone to violent outbursts.
Jelly Tots!
Anybody said 'owt to me, yeah, I did lash out,
and anybody that upset my kids or... I'd just lash out.
It was just all so draining, and every so often,
I just couldn't cope any more, I just stopped.
So they'd ship me off to the hospital -
High Royds or Lynfield Mount.
That doesn't look far off.
During one of her stays at High Royds, Maggi was
approached about a new operation which doctors convinced her could
end her fits of violence.
Screw that in...
They were telling me how my temper would eventually...
I would end up doing life in prison for murder,
or in a mental hospital for the rest of my life, right?
I was really down, I was at a low ebb,
I wanted to get off that smelly ward, right?
It was disgusting, and he 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 having 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 time spent in a mental hospital is
gradually going to go on increasing 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.
It was terrifying surgery, though the doctors regarded it
as a huge leap forward.
Maggi was taken from the asylum to the local hospital.
There, two nylon bores were fixed in her forehead to act as guides
for electrodes which would pinpoint the crucial part of her brain.
TV NARRATION: 'The electrode is attached to the electricity supply
'and a current is switched on, stimulating the area
'at the bottom of the electrode.'
Talk to me, Margaret. I'm sorry I had to do that.
Why did you have to do that?
I went all funny and my head all shook inside.
Oh, dear. My head shook inside.
Yes, all right.
Everything shook - the eyes, everything, my teeth.
The noise that that made must be still in my head.
If a motorbike goes past me
or somebody's drilling in the road
it's like,
"Oh, God!" I just can't stand. It's like everything shakes in my head.
Keep looking up.
I'm frightened. Yes, keep looking up. Look up.
'When he got the response of fear in my eyes, the pupils were like
'cat's eyes, dilated.
'That's when he knew that he'd connected to the part of my brain'
that reacts to fear.
TV NARRATION: '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.'
ELECTRICITY CRACKLES
He switched the probe on and burnt a piece of my brain out.
Maggi'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 like a zombie for four years.
I couldn't communicate with people - it were like my speech had gone,
and my body, my body was all wobbly.
Maggi 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.
Maggi 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 I look at it this way, right,
that there was more violence inflicted on me
than I ever inflicted on anybody.
That was GBH, what they did to my brain.
I'll never forgive them for it.
BELL PEALS
CROWS CAW
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.
Numbers in the asylums had to be reduced.
At many hospitals the cull happened gradually, one ward at a time.
It started in the early '70s when a ward would be shut down.
If a person died in that ward or a person 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 bed 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 Brass Tacks programme found that it was
left to charities like the Salvation Army to pick up the pieces.
# The Salvation banner of love
# We'll fight beneath its colours till we die
# Then go to our home above. #
65,000 beds in long-stay wards
have been phased out in 20 years. But the community care that was
supposed to take their place has scarcely materialised.
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, amen.
I ended up being a vagrant and diagnosed as schizophrenic,
and I then became a revolving-door patient.
Hellingly Hospital in Sussex was home to Andrew Voyce
at various points in the '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'd got a side effect called akathisia
and I would be extremely restless
but sedated at the same time
for a week, day and night, after that injection.
It was an unbearable experience for Andrew 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.
When I got back into the asylum again
they would start 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 organised care and no hope of a secure life.
But there was no going back.
In the 1980s, the asylums finally began to close.
That door will open a bit further...
The revolution arrived swiftly with a momentum of its own.
By 1990, 100,000 patients had been discharged into wider society.
History is taking its revenge on the institutions.
The mental hospital is becoming extinct.
One after another, the great Victorian buildings began a process
of shifting their patients en masse 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,
Huddersfield have done the same, Wolverhampton, Birmingham,
all of them are doing 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 beds for some acute cases,
but for most patients it was the start of a new life.
Thank you very much for everything you've done for us.
I don't know what I'd have done without you all these years.
Thanks very much, everybody.
That's nice and neat. THEY LAUGH
'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 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 confront 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 worth more than that."
Amidst the wreckage of the asylums, a grassroots movement sprang up
in which patients challenged doctors' pre-eminent role
in decisions about treatment.
The User Movement, as it was called, campaigned 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 treatments that doctors prescribe.
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.
Joan's 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.
Do you want to get the milk out of the fridge, Joan? Yeah.
Like many other patients, Joan had to cope
with a certain amount of stigma.
With the shelter of the asylum gone, old prejudices came to the surface.
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 optimism that there was a future in the community
for people and that
we could set goals for ourselves and we could achieve things
and we could begin to take a bit of control over our lives.
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 11am in a North London police station.
Officers are being briefed about a potential killer, not by a colleague
but by the man's psychiatrist.
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 programme
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.
'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 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 new-found freedom.
To many people, it seemed like a step backwards.
High Royds was finally closed in 2003.
It was one of the last relics of the asylum network,
and like many others,
was bought by developers to be turned into luxury flats.
I felt it was past its best-by.
It had done its duty, it had served its cause,
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" is the motto.
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 and 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 Gideons Bible and the shared clothes.
Britain's asylums are now closed forever.
These were once extraordinary places, home to more than
150,000 people at their height.
But they had outlived the ideals of their Victorian architects
and too often had become dustbins of humanity.
What they leave behind are the lives they transformed.
I do realise that although I was
in the system five years, which seems an awfully long time,
for other patients five years can turn into 50, 60 years or whatever,
and 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 let
it get in my way. I can't, can I?
Got to get on with my life, haven't I?
If I started dwelling on feeling anger all the time
my life wouldn't be worth living, would it?
The Open University has produced a CD exploring
creative responses to mental health. For your free copy go to -
Subtitles for the deaf and hard of hearing by Red Bee Media Ltd
E-mail subtitling@bbc.co.uk