Seeking asylum... in the community

It's 20 years since the National Health and Community Care Act (1990) became law. The Act signalled the end of the old County Asylums. John O'Donoghue was a patient in three of them, Claybury, Friern, and Banstead. With only around ten of the original 120 County Asylums still functioning, perhaps, he says, it's time to take stock

Community Care has its roots in Enoch Powell’s Hospital Plan of 1962. This called for mental health services to be moved to psychiatric units in District General Hospitals. The Hospital Plan informed policy in the sixties but was never implemented. In 1972 came the Whittingham Report following allegations of ill-treatment and the conviction of a male nurse on manslaughter charges in a large Lancashire asylum. The report concluded that the mental health system was divided into “well staffed ‘acute’ units and ‘long stay dumps’”.

More scandals followed.

1981 saw Care in the Community, a Green Paper proposing the shifting of resources from the NHS to local councils and voluntary associations. In 1984 the House of Commons investigated implementing Community Care.

By this time I had seen for myself what life was like in the asylums. Lush, extensive grounds contrasted with large Gothic Victorian buildings. Long stay patients in WRVS hand-me-downs wandered the corridors or did Industrial Therapy, whilst admission patients like me talked about our problems and painted in the Art Hut.

I was discharged from Banstead in 1984. It closed in 1986 as reports and legislation aimed at the closure of the asylums proliferated, until in
1990 Community Care became law.

By now my turn on the merry-go-round was coming to an end. Banstead was demolished in 1989 and Claybury and Friern started moving out patients soon after. I couldn’t go on being a revolving door client. I was lucky to get into the University of East Anglia, met my wife, and got my first proper job, working for a Community Care project in Haringey, north London. Some of the long stay patients I had known in Friern lived in the project. I could have been one of them.

The old asylums had a terrible reputation, a legacy of our Victorian grandfathers, like the workhouse and the gaol. And yet I think there’s something we’ve lost with their demise.

Asylum, a place of safety and refuge, is now at a premium. The model of care I experienced in Claybury, an open-ended programme that went at the patient’s pace, set in peaceful grounds – where do you go to find this now? And has Community Care actually been the answer to their closure?

Twenty years after the Community Care Act I fear these are questions that are still unanswered.

• John O’Donoghue is the author of Sectioned: A Life Interrupted (John Murray 2009), Mind Book of the Year 2010.

•• disabilitynow.org.uk/living/features/opening-up-the-asylum