From Castle on the Hill, to Asylum in the ‘hood
Originally, Psychiatric Asylums were built in quiet, rural locations, set within acres of grounds. This was so as to provide an escape from the busyness and stress of city life, to promote relaxation and healing in the patients. This was known as a therapeutic landscape- places with health-promoting properties.
However, as time passed, towns and cities began to expand into the countryside, in a process known as urban sprawl. As such, they began to approach and eventually surround the psychiatric asylums which were once so out of the way. What had once been isolated institutions suddenly had neighbours and communities, rather than being unknown places of rumour and legend.
These sites have now been a part of these communities for decades and, as the local communities have become more familiar with them, they have reduced their ‘otherness’. It has been said that people will accept what they see as unfamiliar and ‘other’, but only if this does not impact upon them directly. So as long as the mental hospitals do not overly impact on the surrounding community, they will be accepted. This is perfectly interpreted in the following passage from Terry Pratchett’s Unseen Academicals: “’well, what I’m saying is’ started the man who had nothing against Dwarfs, ‘we don’t mind anyone, so long as they mind their own business and don’t do any funny stuff’”.
To relate this to former psychiatric asylums, these spaces, when they were isolated and separate, were unknown spaces to be feared. In the aftermath of urbanisation and in particular the urbanisation of the asylum, public access to psychiatric asylum sites creates a familiarity within the local community and acts to dispel the otherness of the psychiatric institution and detoxifies the space. This may act to reduce the level of stigma attached to these sites over time.
However, the decline of the asylum from the 1960s onwards, and the rise of the community care programs which aimed to replace them, presented a new challenge. Community care in this instance was the policy of transferring responsibility from state institutions, such as asylums, to their relatives and local welfare agencies. The familiarity with long-standing asylums may have acted to improve relations with the community, but community care was new, different, ‘other’. Dear and Wolch described this shift from institutional care to community care as ‘landscapes of despair’. This may seem dramatic at first glance, but the large-scale removal of patients from asylums to be treated in the community led to a whole host of issues. It led to a large increase in patients becoming homeless and/or criminalised. As a result, many went through a process of transinstitutionalisation, which is where they end up in other, non-specalised, institutional settings, such as prisons.
This was partly caused by a lack of planning, and the rushing through of reform. Supporters of the shift to community care saw it as a liberation, freeing people from custodial care in ‘brutal and dehumanising conditions’, and therefore it was vital to close the institutions as soon as was possible. There was also a sense that this move would ‘normalise’ mental ill-health and therefore destigmatise patients.
This reasoning can be seen as coming from a positive place; however, the issue was that policies of closure were enacted before a comprehensive plan was made for where residents in those institutions would go once they closed. Other reasons for asylum closure include that it would save money, as asylums were seen as a ‘waste of resources’; a rise in anti-psychiatry ideologists; and the management structures of the asylums and their NHS Trusts. Community care was eventually reformed on the back of a number of killings made by people with mental health issues (awful occurrences, but it would be irresponsible not to point out that this was not common, and not all patients released were ‘dangerous’, but a select few who required more care than was provided). The 1984 murder of a social worker, Isabel Schwarz, led to a government enquiry and eventual reform.
From being isolated institutions, separate from society, these asylums slowly became more urban as the footprints of towns expanded. The asylums became a part of local communities, and built up relationships, and a familiarisation with local communities. The rise of community care then led to a number of additional problems, including the criminalisation of mental health. The decline of the psychiatric asylum as the main method of mental health care is a tricky topic. Psychiatric asylums themselves were never intended to be the dark, ‘brutal and dehumanising’ institutions many believed them to be. They were set up with good intentions, and over time were let down by a lack of foresight, insufficient funding, and more patients than they were built to contain. The move to community care was seen by many as a liberation, but once again a lack of foresight and planning meant that this, at least initially, was as much of a disaster as the system they aimed to replace.
For histories and images from Urban Explorers see Behind Closed Doors.
For a mental health timeline, including shifts to community care see the Mental Health History Timeline.
And for an in-depth look at the themes discussed in this article, and other aspects of asylum history: Joshua J Green (2017). Towards a Conceptual Understanding of the Continuing Presence of the Psychiatric Asylum in Contemporary Urban Britain, see Josh’s PhD Thesis.
By Josh Green
Josh completed his PhD at the University of Southampton in 2017. His research focused on former psychiatric asylum sites and their continued presence in the UK, looking at themes such as memory, stigma, conservation, and governance. Josh’s haphazard career has led to his contribution to the Department of Health’s advisory document “Health and Wellbeing”, serving ice-cream, dolphin conservation work, teaching at universities and secondary schools, and working in museums. As well as the history of psychiatric asylums, Josh’s interests are wide ranging and include health policy, prison hulks, and quakers, amongst seemingly endless other things.