Claudia Hammond charts the development of mental health care in the UK from the 1950s until today, to ask where we are now, and where we’re going. Will the stigma of mental illness ever be entirely removed?
Community Care?
Wednesday 21 January 2009
Care in the Community became the byword in the 1980s. While it left some on the streets or in prison, others were empowered as consumerism enabled the service user movement to grow.
When Enoch Powell launched his 1962 Hospital Plan he believed all the asylums would be closed by 1975. In fact it wasn't until the 1980s that the closures really got under way, with thousands of former inmates beginning new lives in the community. For many this was a new beginning: with genuine care, life in the community was infinitely preferable to the total institutiions from which they had emerged. But for those who lacked support and could not cope, homelessness and even prison were the alternative to what had been, for some, genuine asylum.
At the Surrey History Centre, where Woking Mind work with the archivists to examine the history of the local asylums, Claudia Hammond meets a former patient of Brookwood for whom squatting in the derelict asylum was preferable to life in a community that didn't care. While in Reigate service users, frustrated by the lack of formal support, have set up their own in the shape of Stepping Stones drop-in centre.
In any one year in the UK, one in four of us will experience a mental health problem. How we are treated depends on the current understanding and attitude to mental illness. All those who were asked, including many Radio 4 listeners who contributed their experiences as mental health service users or providers over the last half century, conceded that it’s better to have a mental health problem now than at any other point in that time. Yet there were reservations: Although the huge Victorian asylums could be cruel and impersonal, they did afford a retreat from a world that can be difficult to navigate at a time of mental crisis. Today, with acute beds scarce, you are soon tipped back out to cope in the community as best you can when you suffer ‘an episode’.
On the other hand, drugs are much improved, with far fewer side effects, and the recognition that talking therapies can help (even if they’re hard to access) makes for an approach that’s more understanding.
In speaking to those who have experienced mental health care and those who have supplied it for over half a century, what struck the presenter, Claudia Hammond, time and again was that how we are helped depends on the current social and political emphasis as much as on the latest drug advances. Most importantly, whether we are understood or stigmatised will vary according to our culture and social framework.
Additional Information
Closing the Asylum: The Mental Patient in Modern Society by Peter Barham, Penguin Books Ltd; 2Rev Ed edition (30 Oct 1997) ISBN-10: 0140265805 ISBN-13: 978-0140265804
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