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What followed this revolutionary change is still a subject of angry
dispute among doctors and former patients. Many things were wrong with
the old asylums, which could be brutal and uncaring, but they were also a
place of refuge for people who desperately needed one and had nowhere
else to go. Barbara Taylor, a historian who spent time as a patient in the
late 1980s in the Friern mental hospital in north-east London, formerly
known as Colney Hatch, recalls in an essay that “for me Friern was truly
an asylum. I entered it on my knees: I could no longer do ordinary life,
and giving up the struggle was an incalculable relief. My home in the
hospital was a locked acute ward with a deservedly violent reputation: a
Dickensian barrack of crumbled brickwork and peeling walls, reeking of
fag smoke and teeming with ghosts; but for me it was sanctuary.”
The end of the asylums came not just in Britain but across the world
and is still going on. In the United States the number of beds available for
psychiatric patients fell from 558,000 in 1955 to 53,000 in 2005.
Some of the slogans of the anti-asylum movement in Britain and the
US are chilling in their covert or unintentional cruelty. One of them was
“de-institutionalisation”, as if healthy people, and not just the mentally ill,
are not themselves dependent on institutions where they work, such as a
school or an office. The institutional needs of the mentally ill are often
very simple, described by one social worker as being “a place where you
can go and sit and chat and have a cuppa, and lunch”.
But even this is sometimes denied them on the grounds that it makes
them part of a “dependency culture”. A carer, lamenting the closure of a
day centre in Wales, says “often people are very withdrawn, lonely or low,
or in another world, others have lost most of their personality and are
referred to as being burnt out. These people don’t want or need anything
very demanding, just coming to the centre and getting out of the house is
enough, and a blessing for carers.”
The disastrous impact of “care in the community” was being
recognised in the 1990s and more sophisticated community care became
available such as the Early Intervention in Psychosis units that aim to help
young people suffering their first psychosis by detecting and treating it in
its early stages. But the closure of so many mental asylums in the past