Jamie is on the trail of derelict mental hospitals (not ‘asylums’, thanks all the same). I used to work at Cane Hill – well, I worked there for about six months in 1979, but it seemed a lot longer. Some of the pictures behind that link looked incredibly familiar, even with several years’ worth of dilapidation – looking at one of the corridor shots I was half expecting to see someone pushing a floor-buffer. As an unqualified Nursing Assistant I did shifts more or less wherever I was needed, so I saw just about everything: the psycho-geri wards (very quiet but quite a lot of dirty work); the short-term ward (for people who had only just come in and people who would soon be well enough to leave, although these weren’t always the same people); the locked ward (less scary than it sounds – largely because everyone was drugged up to the eyeballs – but not much less). I spent most of the time I was there on a long-term ward; it was about half-and-half schizophrenics and people who were just too institutionalised to function anywhere else, many of whom had originally been found on the streets.
It was a dreadful place, which institutionalised patients more or less as a matter of course, and in some cases confined them for decades; there was an old man on the ward who’d had a bit of a weird episode at the age of 16, in 1932, and been locked up ever since. It also put vulnerable people at the mercy of staff many of whom were both dedicated and competent, but not all of whom were either. The long-term ward was run on the basis of a flurry of activity in the morning (wash, shave, dress and feed 25 men), another at lunchtime and a third in the evening. Between those times, nothing happened – nothing at all. Once the morning rush was over, in particular, the charge nurse would take the opportunity to call for tea and biscuits, then tell me and the student nurses about his views on life at enormous length. One long-term patient died while I was there (although after I’d been moved away from that ward); apparently he fell on the steps up to the ward, hit his head and lay there all night undiscovered. He was an unusually florid schizophrenic – nothing they could give him would stop him having strange ideas and compulsions, which generally involved wandering around the hospital – and the door to the ward was often kept locked to stop him getting out, although this was officially an open ward. As I understand it was locked that night.
But I’m not totally convinced that hospitals like that were a bad thing. One of the drugs we used to administer to schizophrenics was fluphenazine, a.k.a. Modecate. It was a slow-release ‘depot’ injection, designed to keep the visions and compulsions damped down for a fortnight at a time, and as such was administered intra-muscularly; you’d draw a cross on one of the patient’s buttocks with an alcohol swab, take aim for the upper outer quadrant and away you went. (I never did this myself – being untrained, unqualified and terrified – although I was repeatedly urged to have a bash.) I asked one day what would happen if you were careless and jabbed them in the lower inner quadrant. You don’t want to do that, you could paralyse them, I was told. This all came back to me the other day, when I noticed packets of Modecate on the pharmacy shelves at our local Boots, presumably for people being cared for in the community to take away and self-administer. The idea of trusting schizophrenics to inject their own anti-psychotic medication, at just the time when the previous dose is wearing off, strikes me as a bit hopeful.
Tangentially, it’s things like this which make me wonder what on earth the Tories’ plans for public expenditure cuts are actually going to mean. The old institutions aren’t there to be cut any more: the erstwhile populations of Cane Hill – and the others – have already been tipped out into community care. Similarly, councils have already been forced to outsource what used to be in-house services, the profitable bits of the postal service have already been carved up by TNT and DHL, and Stagecoach have already eaten public transport. If (on top of all that) defence is going to be protected, it’s hard to see what’s left to cut. Perhaps in another thirty years we’ll be looking at slideshows of abandoned universities.